Roles of Nursing Home Staff

When your loved one is living in a nursing home, staff members can become a key part of their world.Roles of Nursing Home Staff

Here’s a quick primer on the different type of staff and their roles at skilled nursing facilities.

Roles of Nursing Home Staff

Certified Nursing Assistants

CNAs often spend the most time interacting with residents. They help residents with self-care tasks like using the bathroom, bathing, dressing, eating and grooming. They also transfer residents between beds and wheelchairs and report any health concerns to nurses. Additionally, the job includes making beds, tidying up and other light housekeeping.

Direct Care Staff

The people who provide direct care — certified nursing assistants, licensed practical nurses and registered nurses — work to keep residents as pain-free and comfortable as possible.

Licensed Practical Nurses

The duties of an LPN (sometimes known as a licensed vocational nurse) often include:

  • Administering injections
  • Caring for ostomies
  • Discussing and recording health concerns
  • Giving feedings through a tube
  • Preparing patient charts
  • Performing tests

Occupational Therapists

Occupational therapists help short-term nursing home residents regain the skills they need to return home by teaching them how to simplify tasks and how to use adaptive equipment. They may also evaluate a resident’s home for safety after discharge.

When it comes to long-term residents, OTs work on basic life skills like bathing, dressing or feeding, sometimes modifying the environment to make activities easier. If a resident has dementia, an occupational therapist will focus on adapting activities throughout the stages of the illness.

Physical Therapists

Licensed physical therapists diagnose and treat residents recovering from injury or illness or living with a chronic condition which restricts their ability to function. A PT may perform joint and soft tissue mobilization to increase range of motion and prescribe exercise programs to strengthen muscles or to improve coordination and endurance. For instance, physical therapists can provide training in gait stability, mobility and posture to residents who are at risk of falling.

Registered Nurses

RNs typically care for around 12-16 residents at a time, assessing their needs, evaluating their outcomes, and implementing their care and treatment. Their tasks typically include:

  • Administering medications
  • Changing bandages and performing wound care
  • Changing tube feedings
  • Cleaning medication ports and tubes
  • Communicating with the doctor
  • Starting intravenous lines (IVs)
  • Supervising other direct care staff
  • Taking vital signs like blood pressure

Rehabilitative Staff

Nursing homes may also employ rehabilitation professionals to help improve patients’ level of functioning and decrease discomfort and pain.

Speech and Language Therapists

In a skilled nursing facility, speech and language therapists (SLPS) most commonly treat residents for swallowing disorders. These professionals perform tests to find out what is happening when a resident swallows, then recommend exercises and other strategies to make swallowing easier. In addition, SLPs help residents whose speech has been affected by diseases like Parkinson’s, speak clearer, louder and slower. These therapists can also provide residents techniques to help them remember information or compensate for impaired memory.

Other Roles:

Activities Directors

Because emotional and social health is just as important as physical health, nursing home administrators hire activities directors to add some spark. These professionals find out what interests residents, then they create stimulating and engaging recreational and social activities. Gentle arts and crafts programs, concerts, exercise classes and holiday celebrations are typical activities and events.


Federal nursing home laws require every nursing home to either hire or consult with a qualified dietitian, who is charged with developing a basic menu for the skilled nursing facility. Part of the role also involves assessing new residents to determine their nutrition risk and recommending a plan of care. Dieticians monitor the nutritional needs for at-risk residents (e.g., those who are receiving dialysis or are losing weight) on an ongoing basis and create special menus for those with health conditions like diabetes. If a resident is eating poorly, a dietitian may recommend an appetite stimulant or other supplement. They also may recommend therapeutic diets including texture-modified and food allergy diets. Another part of their job is managing kitchen staff and evaluating food handling, sanitation, and preparation.

Are there any important roles of nursing home staff that we’ve missed? Share your suggestions with us in the comments below.

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