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Test Name : Nursing Home Administrator (NAB)
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Required Activity Areas:
The AIT Program should be based on the five domains of practice, which are covered in the various departments found in a long term care facility. The tool presents
the departments as modules and rotations; it is through these departments/modules that the program should be designed, so that the individual AIT can meet an appropriate and tailored amount of time in each of the domains as appropriate. These modules include:
• Administration
• Human Resources
• Nursing
• Business Office/Financial Management
• Diet
• Rehabilitation
• Medical Records
• Activities
• Social Services/Admissions
• Housekeeping/Laundry
• Environmental Management/ Maintenance

A. Quality of Care/Nursing
1. Develop a rounding sheet with the administrator and director of nursing that is resident- centered; initiate implementation.
2. Observe nurse peer review on administration of medications.
3. With director of nursing, ensure medications are not expired.
4. Develop resident satisfaction surveys and make recommendations for implementation as necessary. B. Rehabilitation
1. Organize and implement a follow-up program for discharged residents to the community.
2. Develop audit for equipment inventory and complete audit; report.
C. Medical/Resident Records
1. Conduct admission audit of current in-house resident population, analyze data and report. Assist with recommendations, as needed.
2. Conduct audit of flu vaccination response variables, analyze data and report. Assist with recommendations, as needed.
3. Conduct audit of admission and annual required vaccines, analyze data and report. Assist with recommendations, as needed.
4. Conduct medical records audit with appropriate staff.
D. Activities
1. Develop and implement a volunteer program
2. Develop/enhance Life Enrichment/Person Centered Care program
a.Interview residents and families and analyze information to ensure that desired activities are planned and implemented as necessary
b.Working with Directors of Activities and other personnel as needed, help develop in-service for Life Enrichment/Person Centered Care; assist appropriate staff with delivering in-services.
E. Social Services/Admission
1. Conduct an audit of admissions documents (per regulations and organization policy), analyze and report.
2. Complete an audit of resident preferences, such as time to eat, rise and retire, bath/showers, time of therapy, etc. Make recommendations as necessary
3. Develop and implement an outreach program that communicates regularly with residents and/or families post discharge.
F. Dietary
1. Develop a questionnaire for residents related to dietary satisfaction including variables such as taste, temperature, timeliness, presentation, etc; implement, analyze and report; make recommendations.
2. Meet with the dietician and dietary manager to learn how menus are developed, followed, and implemented; conduct an audit to confirm residents are receiving correct foods, drinks and adaptive devices.
3. Understand nutritionally compromised concerns and how weights are monitored.
4. Audit purchasing and storage of dietary supplies and food; report to dietary manager and administrator.
5. Audit to ensure foods are served and maintained at proper temperatures and in accordance with the Food Code.
G. Housekeeping/Laundry
1. Conduct weekly audits, evaluating such variables as dust, floors, toilet, showers of designated public areas; track, trend and report accordingly.
2. Audit resident rooms for housekeeping variables;track, trend and report accordingly.
3. Audit residents to determine if laundry is clean and received promptly.
4. Audit infection control, safety and cross contamination procedures and make recommendations as necessary.
5. Follow the linen distribution system from soiled to clean and report accordingly.
6. Observe resident clothing management

II. Possible Activities/Assignments related to Domain 20: Human Resources
A. Conduct an employee file audit per regulations and organizational policy.
B. Collect annual turnover rates for last few years, and develop a strategic plan with activities, timeframes, etc. for identified changes.
C. Develop an employee satisfaction questionnaire, administer it and analyze data;develop a subsequent plan.
D. Develop, organize and implement several employee activities.
E. Track absentee information, such as shift, day of week, reason, frequency;
analyze and report the findings.
F. Audit external health care providers (e.g., physicians, dentists, podiatrists) to determine current licenses, liability insurance, etc.; analyze and report the findings.
G. Study and analyze recruiting plans/staffing patterns and offer ideas to improve current processes to ensure that the needs of the residents cared for are met.
H. Review and understand the facilitys employee handbook to ensure accuracy and that all federal/state guidelines are followed and make recommendations as necessary.
I. Review and evaluate payroll plans, compensation plans, and benefit packages
J. Participate in a complete employee hiring and orientation process ( interview, background check, etc.).
K. Conduct a staff meeting and an in-service training program.
L. Participate in a disciplinary/grievance procedure and an employee counseling session.
M. Understand and have knowledge of National Labor Relations Board (NRLB) as it relates to the facility.
N. Review and evaluate the unemployment compensation record of the facility and attend an unemployment compensation hearing as necessary.
O. Review and report on ways to encourage and support professional development of team members.

III.Possible Activities/Assignments related to Domain 30: Finance
A. Assist the administrator with all budget (capital, cash, operating, etc.) development and submission.
B. Understand and assist with accounts payable processing.
C. Analyze and understand how aged accounts work.
D. Understand the facilitys bad debt and write-off policy; determine avenues for improvement.
E. Understand triple-check systems for private pay and all third party payors.
F. Describe and review regularly produced financial reports to determine if fiscal issues have arisen and make recommendations as necessary
G. Review and describe the chart of accounts, bookkeeping procedures, income and expense statements and balance sheets; make recommendations as necessary.
H. Understand the financial audit process utilized by third party payors to ensure billings are in accordance with services provided.
I. Analyze and understand third party payor cost reporting systems.

IV. Possible Activities/Assignments related to Domain 40: Environment
A. Audit preventative maintenance logs per regulations and company policy;track and trend such variables as time of day, season, staff member, etc.
B. Audit resident rooms, utilizing audit tools to evaluate such items as electrical outlet plates, call bells, water temperatures and beds; track, trend and report accordingly.
C. Review emergency generator and life safety regulatory requirements according to state, local, and federal laws specific to your building(s) and prepare a compliance report.Conduct audit of past year of the log; develop/revise preventative
maintenance log with maintenance supervisor.
D. Conduct an audit of the past years log; develop and/or revise preventative maintenance logs with the maintenance supervisor.
E. Assist the administrator and maintenance supervisor with developing and implementing an emergency plan.
F. Develop a rounding sheet with the administrator and maintenance supervisor that is environmental and safety centered; initiate its implementation.
G. Audit Log Out/Tag Out procedures to ensure compliance.

V. Possible Activities/Assignments related to Domain 50: Management & Leadership
A. Review policy and procedure manuals to determine if they are appropriate and timely, per regulations and organization policy and make recommendations for change as necessary.
B. Develop and assist the administrator with an annual strategic planning meeting.
C. Review current internal and external contracts and agreements for accuracy, efficiency and timeliness; organize and make recommendations as necessary.
D. Review and become comfortable with federal regulations and state specific regulations; assist with educating department leaders, if needed.
E. Assist with writing a Plan of Correction and/or identified regulatory violations.
F. Review and update the facilitys organizational chart and job descriptions.
G. Review short-term and long-term goals of the organization for appropriateness.
H. Study the bylaws/mission statement/vision of the governing body and how decisions and policies are made within the organization. Analyze the authority throughout the facility.
I. Plan and attend internal and external meetings and prepare reports for the organization, as necessary.
J. Review the facility marketing plan and make recommendations for change as necessary based upon facility dynamics and community needs.
K. Review and understand the facilitys media publicity efforts, including (but not limited to) writing news releases, facility publications, newsletters, etc.
L. Organize and write a report to include competitive information, such as description of services and amenities, survey history, CMS 5-Star rating and community involvement.
M. Review the facilitys corporate compliance program to ensure all appropriate rules and regulations are followed.
N. Review and describe how the facilitys risk management program minimizes legal liability.
O. Review and analyze facilitys information management system, including technology, to ensure safeguards are in place to provide resident confidentiality, data security, social media, cell phones, etc.
P. Review and analyze the facilitys quality improvement programs.
Q. Review the facilitys customer satisfaction program, including resident relations initiatives, reception/concierge duties and resident/family surveys.
R. Transitional Care: understanding the various regional lines of service and how they relate, as well as initiatives to ensure continuous delivery of safe and quality care as consumers transition between the different lines of service.



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