Nursing home org chart example

How a nursing home is usually structured

A nursing home is run by a licensed administrator, and the license is the reason the chart starts where it does: state law and the federal conditions of participation make one named person accountable for everything in the building, and the corporate regional director that a chain gives the administrator belongs on the company's chart, not this one. The medical director is a physician the facility must have and rarely employs, drawn as a contractor under the administrator: he sets medical policy and oversees the attending physicians, and he is not the director of nursing's manager, which is the mistake half the charts in the sector make. The administrator in training is a real position, a licensure candidate serving the supervised months the state requires, and the chart marks her as an intern so nobody reads her as a deputy.

Nursing is the largest department and the chart gives it the largest column: a director of nursing, who must be a full-time registered nurse, an assistant director, a unit manager for each unit, rehabilitation, long-term care and memory care, with the memory care position open because it is the hardest one to keep filled, and beneath them the nurses who work for the whole building rather than a unit. The infection preventionist is a required, named role since 2019 and gets a card, not a side duty. The MDS coordinator completes the assessments that set each resident's care plan and the facility's reimbursement, which is why she is a nurse in the nursing column with a dotted line to the business office: the assessment is clinical, the money it produces is not. The charge nurses, the medication aides and the nursing assistants belong on each unit's own chart, which the unit manager keeps.

The rest of the building is department heads. The business office manager carries billing for Medicare, Medicaid and managed care, HR and payroll, medical records and admissions, which is the census and therefore the revenue. Social services reports to the administrator directly, because resident rights and discharge planning should not sit under nursing or the office. In a facility this size an assistant administrator carries the support departments, dietary with a cook supervisor and the consultant dietitian the regulations require, environmental services with housekeeping and maintenance, and activities; in a smaller building every department head reports to the administrator and the chart is one row. The therapy company that provides physical, occupational and speech therapy is a contractor under the administrator with a dotted line to the director of nursing, and the consultant pharmacist who reviews every resident's drug regimen each month is a contractor in the nursing column. All of them are on the chart because the surveyor will ask for them.