Types of Nursing Home Employees

Nursing Home EmployeesOn a typical day, nursing home residents will encounter a number of different employees within the facility. Additionally, there are several employees who are less seen on a day-to-day basis. These employees are responsible for the internal functioning of the nursing home.

As a nursing home resident or family member of a resident, it is important to be familiar with the types of nursing home employees and how they interact with residents. If nursing home abuse or neglect is suspected, employee knowledge can play a key role. Learn more about nursing home understaffing here.

Direct Care Nursing Home Employees

Direct care nursing home employees include:

  • Registered Nurses (RNs)
  • Licensed Vocational Nurses (LVNs) or Licensed Practical Nurses (LPNs)
  • Certified Nursing Assistants (CNAs)
  • Physical Therapists (PTs)


Registered Nurses (RNs) are required by law to assess the needs of nursing home residents. Once assessed, the RNs work with the Licensed Vocational Nurses (LVNs) and Licensed Practical Nurses (LPNs) to plan and implement the residents’ care and treatment.

They also evaluate outcomes of the facility’s residents. These nursing home employees are all required to be licensed in the state in which they work. RNs are typically required to have between two and six years of education. LPNs and LVNs typically have a year of training.

Nursing Assistants

Certified Nursing Assistants (CNAs) work under licensed nurses. CNAs typically assist with maintaining health and wellbeing in terms of daily activities. They help residents with tasks such as eating, hygiene, grooming, dressing, and using the bathroom.

Full time CNAs are required to complete nurse assistant training or a competency evaluation program within four months of becoming permanently employed. CNAs must also undergo continuing education every year.

Nursing Home Dietician

Federal nursing home laws require every nursing home to have a qualified dietician who works for the facility full-time, part-time, or as a consultant. The dietician receives federal qualification in two ways. The first is registration by the American Dietetic Association’s Commission on Dietetic Registration. The other is through training, education, or experience in the identification of dietary planning, needs, and implementation of dietary programs.

If the dietician is not a full-time employee, the nursing home is required to designate a director of food service. The director of food service is required to receive frequent consultation from the dietician.

Administration and Support Employees

Administration and maintenance employees do not play a large role in the daily activities of nursing home residents. The size of a nursing home’s administration team depends on the size of the nursing home. In some cases, the administration team consists of a few employees. In larger nursing homes, the staff may consist of dozens of employees in separate departments such as human resources, accounting, and the like.

Support employees include those such as maintenance employees, custodians, and groundskeepers. These types of nursing home employees are responsible for maintaining the functioning and appearance of the nursing home. Support employees may also include activities directors or coordinators. These nursing home employees may plan events and social activities within the nursing home.

Nursing Home Staffing Requirements

Federal law states certain staffing requirements for all nursing homes. The main requirement is that the nursing home has sufficient staff members to ensure proper care for all residents. However, there is no specific required number of staff members present during different times of the day.

One registered nurse (RN) is required to be on duty for a minimum of eight hours a day, seven days a week. Additionally, either an RN or licensed practical or vocational nurse (LPN/LVN) should be on duty 24 hours a day. Some states have additional requirements for nursing home staffing. Information on staffing requirements for each state can be obtained through the state’s health department.

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DeParle, Nancy-Ann. “Testimony on Nursing Home Staffing.” Assistant Secretary for Legislation. Department of Health and Human Services, 27 Jul 2000. Web. 29 May 2013. http://www.hhs.gov/asl/testify/t000727a.html

“PART 483—REQUIREMENTS FOR STATES AND LONG TERM CARE FACILITIES.” U.S. Government Printing Office. U.S. Government Printing Office, 29 May 2013. Web. 31 May 2013. http://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&sid=e3979b25f8d8b29c78b1b3f6c66dbdaa&rgn=div5&view=text&node=42:

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“What Information Can I Get About Staffing?.”Medicare.gov. N.p.. Web. 29 May 2013. http://www.medicare.gov/NursingHomeCompare/About/StaffingInfo/Staffing-Info.asp&xgt