Domains of Practice for Nursing Home Administrators - Required Skills and Knowledge

SKILLS (applicable to ALL Domains)

• Creating and communicating a vision
• Communicating effectively
• Cultivating effective relationships
• Inspiring and motivating
• Demonstrating empathy
• Group facilitation, consensus building and team building
• Delegating, leading and empowering
• Coaching, teaching, counseling and mentoring
• Negotiating, collaborating and resolving disputes
• Problem solving
• Analyzing and interpreting information/data
• Informed decision-making/critical thinking
• Recognizing and ensuring care recipient holistic needs are being met
• Assessing and recognizing safety concerns and needs
• Allocating and optimizing resources and programs
• Writing and evaluating policies and procedures
• Developing and evaluating systems
• Protecting and promoting financial viability
• Managing regulatory and accreditation surveys, inspections and audits
• Prioritizing and managing time
• Utilizing technology
• Utilizing social media

Customer Care, Supports and Services

Knowledge of:

• Applicable Federal and State laws, rules and regulations
• Government programs and entities
• Ethical decision-making
• Interpersonal relationships, dispute resolution and group dynamics
• Psychosocial aspects of aging
• Physiological aspects of aging
• Basic principles and concepts of nursing
• Basic medical terminology
• Basic pharmaceutical terminology
• Basic principles and regulations for medication management/administration
• Basic principles and concepts of restorative/wellness programs
• Basic principles of rehabilitation
• Basic principles of acute and chronic diseases
• Basic principles of infection control
• Basic principles of pain management
• Basic principles of fall prevention
• Basic principles of elopement prevention
• Basic principles of creating a safe environment for care recipients
• Basic understanding of mental health issues
• Basic understanding of cognitive impairments
• Basic principles of behavior management
• Basic principles of restraint usage and reduction
• Basic elements of a social services program
• Basic elements of a therapeutic recreation/activity program
• Basic principles of nutrition including specialized diets
• Basic principles of dietary sanitation, food storage, handling, preparation and presentation
• Basic principles of hospice and palliative care
• Grieving process
• Death and dying
• Person-centered care concepts
• Diversity of care recipients
• Care recipients' support network interests, needs, and values
• Care recipient Bill of Rights
• Resident Assessment Instrument (RAI) and interdisciplinary care plan requirements and process
• Care recipient assessment instruments (OASIS) and interdisciplinary care plan requirements and process
• Care recipient assessments and care plans other than RAI and OASIS
• Admission/move-in, transfer and discharge/move-out requirements
• Bed-hold requirements
• Roles, responsibilities, regulation and oversight of contracted providers and services
• Services and resources available across the continuum of care (such as community, social, financial, spiritual)
• Care recipient specific legal matters (such as power of attorney, guardianship, conservatorship, code status, Advance Directives)
• Activities of Daily Living (ADLs) and Independent Activities of Daily Living (IADLs)
• Role of Medical Director
• Role of health care partners and clinical providers
• Medical services, specialties and equipment (such as oxygen, durable medical equipment, podiatry)
• Emergency medical services and techniques (such as CPR, first aid, Heimlich Maneuver, AED)
• Centers for Medicare and Medicaid Services (CMS) quality indicators and measures
• Quality assurance and performance improvement processes as related to care and services
• Techniques for auditing care recipient services and outcomes
• Signs and symptoms of abuse, neglect and exploitation
• Mandatory reporting requirements for incidents and adverse events
• Medical record content, format and documentation requirements
• Confidentiality, disclosure and safeguarding medical record information requirements
• Transportation options for care recipients
• Environmental services (such as housekeeping and laundry)
• Hospitality services
• Basic technological advances in health care

Human Resources

Knowledge of:

• Applicable Federal and State laws, rules, and regulations
• Licensure requirements and scopes of practice
• Service provider staffing requirements
• Employee position qualifications, job analysis, job descriptions
• Employee recruitment, selection, interviewing, reference and background checks
• Employee orientation, training and continuing education requirements and resources
• Compensation and benefit programs (such as employee assistance programs, insurance, salary, retirement)
• Human resource policies and procedures (such as employee grievance, workplace rules, discipline, absenteeism, turnover, classification, exemption status
• Diversity training
• Performance evaluation procedures
• Safety and injury prevention training
• Occupational Safety and Health Administration (OSHA) rules and regulations
• Workers compensation rules, regulations, and procedures
• Drug-free workplace programs
• Methods for assessing, monitoring and enhancing employee satisfaction
• Employee recognition, appreciation and retention programs
• Leadership development
• Types and methods of communication
• Conflict resolution and team dynamics
• Information technology safeguards related to such issues as data security, social media, e-mail, voicemail, computer software, cell phones, photography, video, texting
• Union/management and labor relations
• Employee record-keeping requirements and procedures
• Mandatory reporting requirements

Finance

Knowledge of:

• Applicable Federal and State laws, rules, and regulations
• Operational and capital budgeting and forecasting methods
• Financial statements and reporting requirements for not-for-profit and for profit service providers
• Service-related sources of revenue/reimbursement
• Reimbursement methods across the continuum of care
• Alternative sources of revenue
• Integration of clinical and financial services
• Billing, accounts receivable and collections
• Accounts payable procedures and management
• Revenue cycle management
• Internal controls
• Contracts and agreements
• Financial analysis (such as ratios, profitability, debt covenants, revenue mix, depreciation, forecasting)
• Financial statements (such as income statement, balance sheet, statement of cash flows)
• Financial measures (such as operating margin, day's cash on hand, staffing, expense analysis) Risk Management
• Insurance coverage (such as property, liability)
• Inventory control and management
• Payroll procedures and documentation
• Purchasing process and supply chain management (such as request for proposals, pricing, ordering, receiving, group purchasing organization)
• Resident trust accounts for personal funds

Environment

Knowledge of:

• Federal, State and local standards, codes and regulations for building, equipment, maintenance and grounds
• Environmental principles that promote care recipient rights
• Health Insurance Portability and Accountability Act (HIPAA) compliance
• Community resources, programs and agencies available to meet the care recipients' home needs
• Design principles that create a safe, secure and home-like atmosphere based on the needs of the individual served
• Safety and security procedures
• Physical plant security principles
• Preventative and routine maintenance programs for buildings, grounds and equipment
• Contracted services for mechanical, electrical, plumbing, laundry systems, information technology
• Compliance matters related to provision of contracted services
• Infection control and sanitation regulations/standards of practice
• Pest control programs
• Handling and disposal of potentially hazardous materials
• Disaster and emergency planning, preparedness, and recovery
• Community resources available in the event of emergency or disaster
• The use, storage and inspection of required emergency equipment
• Policies and procedures for housekeeping, maintenance and laundry services
• Technology infrastructure

Management and Leadership

Knowledge of:

• Applicable Federal and State laws, rules, and regulations, agencies and programs
• Code of ethics and standards of practice
• Components and purpose of mission, vision and value statements
• Stakeholders' roles, responsibilities and limitations
• Roles and responsibilities of owners and governing bodies
• Services available in the health care continuum
• Provider's role in the health care continuum
• Methods for assessing, monitoring and enhancing care recipient satisfaction
• Provider's certifications and licensing requirements
• Regulatory survey and inspection processes, including the plan of correction process
• Grievance procedures
• Procedures for Informal Dispute Resolution (IDR)
• Compliance programs
• Reportable outcome measurements
• Risk management principles and processes
• Providers' legal and criminal scope of liability
• Internal investigation protocols and techniques
• Strategic business planning
• Management information systems
• Technology to support operations
• Sales and marketing techniques
• Public relations including media relations
• Volunteer programs
• Elements of contracts and agreements
• Care recipient rights and responsibilities
• Role of care recipient advocates and advocacy groups
• Mandatory reporting requirements
• Quality assurance and performance improvement techniques and models
• Organizational change management
• Organizational structures
• Leadership and management principles and philosophies (such as planning, organizing, directing, delegating, motivating, evaluating)
• Personality and leadership styles
• Diversity awareness (such as culture, ethnicity, race, sexual orientation, gender, religion, language)
• Workforce planning and education
• Human Resources management theory and principles
• Governmental relations and advocacy
• Functions of all departments and services