ALF administrator

The responsibilities of an ALF administrator are all-encompassing. Your day can start out by working on the financials, paying the bills of course. Next thing you know the dietary team is short a server and you must go in the dining room to wait tables. After lunch, you might even get to unclog a toilet!  The opportunities are limitless. While the role can be exhausting and forever changing it is one of the most rewarding experiences possible to lead a team that is responsible for the care of our seniors in a community. The state of Virginia has outlined the responsibilities of the administrator in the following regulation provided by DOSS:

22VAC40-73-150. Administrator provisions and responsibilities.

  1. Each facility shall have an administrator of record.
  2. If an administrator dies, resigns, is discharged, or becomes unable to perform his duties, the facility shall immediately employ a new administrator or appoint a qualified acting administrator so that no lapse in administrator coverage occurs.
  3. The facility shall notify the department’s regional licensing office in writing within 14 days of a change in a facility’s administrator, including the resignation of an administrator, appointment of an acting administrator, and appointment of a new administrator, except that the time period for notification may differ as specified in subdivision 2 of this subsection.
  4. For a facility licensed for both residential and assisted living care, the facility shall immediately notify the Virginia Board of Long-Term Care Administrators and the department’s regional licensing office that the licensed administrator died, resigned, was discharged, or became unable to perform his duties and that a newly licensed administrator has been employed or that the facility is operating without an administrator licensed by the Virginia Board of Long-Term Administrators, whichever is the case, and provide the last date of employment of the previously licensed administrator.
  5. For a facility licensed for both residential and assisted living care, when an acting administrator is named, he shall notify the department’s regional licensing office of his employment, and if he is intending to assume the position permanently, submit a completed application for an approved administrator-in-training program to the Virginia Board of Long-Term Care Administrators within 10 days of employment.
  6. For a facility licensed for both residential and assisted living care, the acting administrator shall be qualified by education for an approved administrator-in-training program and have a minimum of one year of administrative or supervisory experience in a health care or long-term care facility or have completed such a program and be awaiting licensure.
  7. A facility licensed only for residential living care may be operated by an acting administrator for no more than 90 days from the last date of employment of the administrator.
  8. A facility licensed for both residential and assisted living care may be operated by an acting administrator for no more than 150 days, or not more than 90 days if the acting administrator has not applied for licensure, from the last date of employment of the licensed administrator.
  9. An acting administrator may be granted one extension of up to 30 days in addition to the 150 days, as specified in subdivision 6 of this subsection, upon written request to the department’s regional licensing office. An extension may only be granted if the acting administrator (i) has applied for licensure as a long-term care administrator pursuant to Chapter 31 (§ 54.1-3100 et seq.) of Title 54.1 of the Code of Virginia, (ii) has completed the administrator-in-training program, and (iii) is awaiting the results of the national examination. If a 30-day extension is granted, the acting administrator shall immediately submit written notice of such to the Virginia Board of Long-Term Care Administrators.
  10. A person may not become an acting administrator at an assisted living facility if the Virginia Board of Long-Term Care Administrators has refused to issue or renew, suspended, or revoked his assisted living facility or nursing home administrator license.
  11. No assisted living facility shall operate under the supervision of an acting administrator pursuant to §§ 54.1-3103.1 and 63.2-1803 of the Code of Virginia more than two times during any two-year period unless authorized to do so by the department.
  12. The administrator shall be responsible for the general administration and management of the facility and shall oversee the day-to-day operation of the facility. This shall include responsibility for:
  13. Ensuring that care is provided to residents in a manner that protects their health, safety, and well-being;
  14. Maintaining compliance with applicable laws and regulations;
  15. Developing and implementing all policies, procedures, and services as required by this chapter;
  16. Ensuring staff and volunteers comply with residents’ rights;
  17. Maintaining buildings and grounds;
  18. Recruiting, hiring, training, and supervising staff; and
  19. Ensuring the development, implementation, and monitoring of an individualized service plan for each resident, except that a plan is not required for a resident with independent living status.
  20. The administrator shall report to the Director of the Department of Health Professions information required by and in accordance with § 54.1-2400.6 of the Code of Virginia regarding any person (i) licensed, certified, or registered by a health regulatory board or (ii) holding a multistate licensure privilege to practice nursing or an applicant for licensure, certification, or registration. Information required to be reported, under specified circumstances includes substance abuse and unethical or fraudulent conduct.
  21. For a facility licensed only for residential living care, either the administrator or a designated assistant who meets the qualifications of the administrator shall be awake and on duty on the premises at least 40 hours per week with no fewer than 24 of those hours being during the day shift on weekdays unless at least one of the following applies:
  22. 22VAC40-73-170 allows a shared administrator for smaller facilities.
  23. If the administrator is licensed as an assisted living facility administrator or nursing home administrator by the Virginia Board of Long-Term Care Administrators, the provisions regarding the administrator in subsection F of this section apply. When such is the case, there is no requirement for a designated assistant.
  24. For a facility licensed for both residential and assisted living care, the administrator shall serve on a full-time basis as the on-site agent of the licensee and shall be responsible for the day-to-day administration and management of the facility, except as provided in 22VAC40-73-170.
  25. The administrator, acting administrator, or as allowed in subsection E of this section, designated assistant administrator, shall not be a resident of the facility.

Top Takeaways:

  • The administrator shall be responsible for the general administration and management of the facility and shall oversee the day-to-day operation of the facility. This shall include responsibility for:
  1. Ensuring that care is provided to residents in a manner that protects their health, safety, and well-being;
  2. Maintaining compliance with applicable laws and regulations;
  3. Developing and implementing all policies, procedures, and services as required by this chapter;
  4. Ensuring staff and volunteers comply with residents’ rights;
  5. Maintaining buildings and grounds;
  6. Recruiting, hiring, training, and supervising staff; and
  7. Ensuring the development, implementation, and monitoring of an individualized service plan for each resident, except that a plan is not required for a resident with independent living status.

While this subsection is a tad long in the tooth it shows how the administrator is solely responsible for the entire operation of the ALF. When the survey team completes your inspection, they will come to them with any issues and expect them to lead the charge in righting the ship.