Table Of ContentNURSING HOME ADMINISTRATION
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Eighth Edition E
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Michael Mileski, DC, MPH, MHA, MSHEd, LNFA, FACHCA K MICHAEL MILESKI
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Rebecca McClay, DNP, MS, ACNPC-AG, CCRN-CMC-CSC, TCRN, NPD-BC
• REBECCA Mc CLAY
Now in its eighth edition, Nursing Home Administration remains the authoritative M
textbook detailing the nursing facility administrator role, including what they do, how c
they think, and how they lead. By breaking down the art of administration into its basic, C
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need-to-know tasks—forecasting, planning, organizing, staffing, directing, controlling A
quality, innovating, and marketing—this text provides the essential context for managing Y
and leading nursing homes and skilled nursing facilities. Thoroughly updated to include
the four domains of practice as put forth by the National Association of Long Term Care
Administrator Boards (NAB) for the 2022 licensure examination and beyond, this textbook
is complete with essential context for the domains and associated competencies to better
prepare students for the required NAB examination. N NURSING
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With revised sections addressing new federal regulations and laws affecting the field, best
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practices in residential care, and refreshed examples and cases, this text continues to set
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students up for success in working as a nursing facility administrator. Updated sections
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address changes within the residential care continuum, provide further information on N
patient-driven payment models and value-based care, and inform current practices for G
marketing and controlling quality within the long-term care facility. Chapter boxes reflect H HOME
common pitfalls in practice while real-life case studies and critical-thinking exercises,
including a “What Would You Do?” section that concludes all chapters, encourage students O
to consider challenges they may experience in the field. In addition to the updated domains M
of practice—care, services, and supports; operations; environment and quality; and
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leadership and strategy—the book describes how core components fit together.
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New to the Eighth Edition: ADMINISTRATION
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n Includes the updated 2022 domains of practice as they relate to the licensing examination standards of the
National Association of Long Term Care Administrator Boards (NAB) I
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n Replete with information on new federal laws, requirements, and regulations including links to important
resources such as the Minimum Data Set (MDS) 3.0 I
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n Provides insight into the impact the COVID-19 pandemic has and will have on managing a long-term
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care facility
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n Introduces “Common Pitfalls in Practice” sections and “What Would You Do?” boxes in each chapter,
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designed to spark critical thinking and discussion
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n Updated figures, tables, and references throughout
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Key Features:
n Provides an in-depth discussion of nursing facility administration EIGHTH EDITION
n Utilizes current data from the field of long-term care
n Case studies throughout the textbook address real-world situations and experiences for administrators and
managers in nursing facility administration and skilled nursing care
Eighth
n Qualified instructors can gain access to the book’s accompanying Instructor’s Manual
Edition
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Nursing Home Administration
Michael Mileski, DC, MPH, MHA, MSHEd, LNFA, FACHCA, is currently continu-
ing his work in long-term care and acute care environments as a field consultant.
He also shares his extensive and diverse experience with upcoming administrators
through his associate professorship at Texas State University, where he is program
director of the Long-Term Care Administration Program in the School of Health
Administration. Dr. Mileski received his doctor of chiropractic degree at Texas
Chiropractic College and his master of public health, master of health administra-
tion, and master of higher education from Purdue University Global. He has been a
licensed nursing facility administrator for more than 20 years and is a Fellow of the
American College of Health Care Administrators. Dr. Mileski’s active research focus,
with many peer-reviewed publications, is long-term care efficacy and effectiveness in
addition to his work on patient experience improvement and efficiency. When pos-
sible, he enjoys traveling and exploring exotic historic and artisanal beverages and
cultures.
Rebecca McClay, DNP, MS, ACNPC-AG, CCRN-CMC-CSC, TCRN, NPD-BC, is
currently working in intensive care as part of a hospitalist team. Her strong clinical
background and high level of clinical and administrative acumen have allowed her
to become the quality improvement champion for the group. Dr. McClay received
her DNP in adult/gerontology acute care from the University of Arizona and has
remained active in research and project development, with several peer-reviewed
publications. Her research focus is on improving the bedside experience through
supporting and implementing healthy work environment standards. In her spare
time, she loves to take road trips around the country searching for wonderful,
locally influenced artisan chocolates.
Nursing Home Administration
Eighth Edition
Michael Mileski, DC, MPH, MHA, MSHEd,
LNFA, FACHCA
Rebecca McClay, DNP, MS, ACNPC-AG,
CCRN-CMC-CSC, TCRN, NPD-BC
Copyright © 2023 Springer Publishing Company, LLC
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SUPPLEMENTS:
Instructor Materials:
Qualified instructors may request supplements by emailing [email protected]
Instructor’s Manual ISBN: 978-0-8261-4848-3
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Printed in the United States of America.
Gone are the days of yesterday’s nursing facility.
COVID-19 has changed our lives forever.
Today our halls are filled with heroes.
This book is dedicated to all those we have loved and lost.
Contents
Preface ix
List of Figures xiii
List of Tables xv
Instructor Resources xvii
PART 1: LEARNING HOW TO MANAGE THE HEALTHCARE ORGANIZATION
1.1 Management Functions 2
1.2 Forecasting 12
1.3 Planning 14
1.4 Organizing 20
1.5 Staffing 33
1.6 Directing 34
1.7 Comparing and Controlling Quality 78
1.8 Innovating 93
1.9 Marketing the Long-Term Care Facility 98
PART 2: UNDERSTANDING THE DEPARTMENTS AND MANAGING
HUMAN RESOURCES
2.1 Organization of the Nursing Facility and Its Staff 120
2.2 Identifying Human Resources Functions 165
2.3 Planning Employment Needs: Writing Job Descriptions 167
2.4 Forecasting Future Employment Needs 169
2.5 Recruiting Employees 172
2.6 Hiring Staff 179
2.7 Training Staff 193
2.8 Retaining Employees 200
2.9 Evaluating Employees 219
2.10 Paying Employees 225
2.11 Disciplining Employees 229
PART 3: LEARNING TO MANAGE THE ORGANIZATION’S FINANCES
3.1 The Administrator’s Role as Financial Manager 240
3.2 Generally Accepted Accounting Principles 244
3.3 Two Approaches to Accounting: Cash Accounting and Accrual
Accounting 246
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viii CONTENTS
3.4 The Two Main Steps in the Accounting Process: Recording Transactions and
Preparing Financial Statements 248
3.5 Putting Financial Statements to Work: Working Capital, Ratio Analysis, and
Vertical Analysis 263
3.6 Additional Accounting Procedures That Help the Administrator Maintain
Control Over the Facility 270
3.7 The Concept of Depreciation 291
3.8 Using “Costs” in Managerial Decisions 295
3.9 Budgets and Budgeting 303
3.10 Finance: The Broader Context 311
PART 4: LEARNING THE CONTINUUM OF LONG-TERM CARE
4.1 Origins, Overview, and Current Profile of the Nursing Facility
Industry 352
4.2 The Social Security Act: Medicare and Medicaid 381
4.3 Older Americans Act 392
4.4 Labor and Management: Laws and Regulations 395
4.5 Workplace Safety: The Occupational Safety and Health Act 418
4.6 Fire Safety: The Life Safety Code 424
4.7 Americans With Disabilities Act Accessibility Guidelines for Facilities 426
4.8 Voluntary Operating Standards: The Joint Commission 426
4.9 The Affordable Care Act 427
4.10 The Elder Justice Act 428
4.11 Patient Driven Payment Model 429
4.12 Value-Based Care and Pay for Performance 430
PART 5: BUILDING YOUR RESIDENT CARE SKILLS
5.1 Aging Process 436
5.2 Medical and Related Terms 443
5.3 The Aging Process as It Relates to Diseases Common to the Nursing Facility
Population 466
PART 6: PUTTING THE SYSTEMS TOGETHER
6.1 Setting Policies for the Facility 556
6.2 Developing a Person-Centered Care Plan 617
6.3 The Quality Indicators Survey: The Regulatory Survey and Inspection
Process and Plan of Correction 622
6.4 The Report Card 626
6.5 Getting Reimbursed for Care Given 627
6.6 A Glance at the Horizon 632
6.7 Summary Observations From a Career of Nursing Facility
Administration 633
Web Resources 641
Index of NAB Domains 643
Index 647
