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Nursing home administrator self-assessed preparedness

Siegel, Elena O.; Leo, Michael C.; Young, Heather M.; Castle, Nicholas G.

doi: 10.1097/HMR.0b013e318294e5ce

Background: Nursing home administrators (NHAs) are in key positions to improve nursing home quality. NHAs require state-level licensure, which involves passing a national NHA licensure examination and fulfilling state-level licensure requirements that vary widely across states. With multiple pathways to NHA licensure, little is known about NHAs’ preparation and training to meet the complex demands of this position.

Purpose: The aim of this study was to explore NHAs’ self-assessed person-job fit based on NHAs’ self-rated preparedness and the importance of the activities that supported their preparation.

Methodology/Approach: A descriptive cross-sectional design was used to collect data from NHAs (N = 175) randomly recruited from nursing homes in five states, with a mailed self-administered questionnaire. Data analysis included descriptive statistics, correlations, and t tests/ANOVA.

Findings: Thirty percent of respondents reported they were well prepared, overall, for their first NHA position. The findings suggest NHA preferences for more formalized ways to develop their entry-level competencies, with lower preference for On-the-job training, Previous job experience, and Self-study and higher preference for Administrator-in-training, Bachelor’s degree programs, and Mentoring.

Practice Implications: There is an urgent need for NHAs who are well prepared to effectively address our nation’s mandates for nursing home quality improvement. With multiple pathways to NHA licensure, this exploratory study provides initial insights about NHAs’ self-assessed preparation and training. The findings suggest that NHAs prefer more formalized ways to prepare for the NHA position. Research is needed to identify specific teaching/learning practices and on-the-job training that maximize the NHAs’ preparation to meet their job demands.

Elena O. Siegel, PhD, RN, is Assistant Professor, Robert Wood Johnson Foundation Nurse Faculty Scholar, 2007–2009 JAHF/Atlantic Philanthropies Claire M. Fagin Fellow, Betty Irene Moore School of Nursing at UC Davis, Sacramento, California. E-mail:

Michael C. Leo, PhD, is Biostatistics Investigator, Kaiser Permanente Center for Health Research, Portland, Oregon. E-mail:

Heather M. Young, PhD, RN, FAAN, is AssociateViceChancellor for Nursing,UCDavis, Dean and Professor, Betty IreneMoore School of Nursing at UC Davis, Sacramento, California. E-mail:

Nicholas G. Castle, MHA, PhD, is Professor, Department of Health Policy and Management, University of Pittsburgh, Pennsylvania. E-mail:

Presentation of Findings

(1) Gerontological Society of America 64th Annual Scientific Meeting – Boston, MA, November 21, 2011.

The authors have disclosed that they have no significant relationship with, or financial interest in, any commercial companies pertaining to this article.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins