A nursing home administrator is the head of operations at a nursing home, acting like the chief executive officer for the facility. Nursing home administrators usually hold at least a master's degree, and they must be licensed to practice in the states where they work. Individual states have different requirements for licensure, but generally people must have proof of education and experience, preferably under the guidance of a preceptor, and they must be able to pass an examination which covers basic topics nursing home administrators are expected to be familiar with.

Skilled nursing facilities, as they are more properly known, are very diverse. Some include relatively healthy older adults who simply need some assistance with their daily lives, while others house very ill patients who may require complex and specialized nursing. For example, a facility which is designed specifically for Alzheimer's patients is highly specialized, with nurses who have been trained to handle Alzheimer's and dementia. A nursing home administrator is responsible for ensuring that every aspect of the facility's operations runs smoothly.

In large facilities, the administrator is usually assisted by people who may take on some of the duties which would be performed by the nursing home administrator alone in a smaller facility. The responsibilities of the administrator typically include: managing personnel, processing admissions into the facility, managing finances, and overseeing day to day operations at the home. The nursing home administrator sets and enforces policies, resolves disputes, oversees the dietary program at the facility, and ensures that personnel are properly trained.

Overseeing the well being of the residents is also important. Skilled nursing facilities do not just provide medical care: they must also provide residents with a high quality of life. Nursing homes usually have social programs which are overseen by the administrator, and they may have amenities such as hair salons, movie screening rooms, and other facilities which are designed to make residents feel comfortable and to prevent residents from feeling bored.

This kind of work requires a great deal of organizational skills and the ability to multitask. At any given time, a nursing home administrator can be addressing several issues at once, some of which may be critically important. Nursing home administrators also need to keep up with changes in the law regarding nursing homes, and to address the concerns of family members who are worried about their loved ones and elder advocacy organizations who want to confirm that the residents are being treated with compassion and respect.