Nursing Home Executive Director

Position Summary

The Executive Director is responsible for the overall leadership, operations, financial performance, regulatory compliance, resident experience, and staff development of the assisted living community.

This position provides hands-on leadership to ensure the community operates safely, efficiently, and in accordance with all applicable state and federal regulations. The Executive Director will lead a strong resident-centered culture while maintaining accountability for census, occupancy, financial performance, staffing, quality, and customer satisfaction.

The ideal candidate is an experienced senior living leader who is equally comfortable managing people, finances, regulatory requirements, resident and family concerns, and day-to-day operational challenges.

Essential Responsibilities

Community Operations

• Provide overall leadership and direction for the community and its departments.
• Oversee daily operations to ensure a safe, comfortable, and welcoming environment for residents.
• Establish operational priorities and hold department leaders accountable for performance.
• Develop and implement policies, procedures, and quality improvement initiatives.
• Ensure the community is appropriately staffed and operational needs are consistently met.

Resident Care \& Experience

• Promote a resident-centered culture focused on dignity, independence, safety, and quality of life.
• Monitor resident satisfaction and promptly address concerns from residents and families.
• Oversee the admissions, move-in, retention, and discharge processes.
• Maintain strong relationships with residents, families, physicians, healthcare providers, and community partners.
• Ensure resident services and care plans are appropriately implemented.

Financial Management

• Maintain accountability for the community's budget, revenue, expenses, and overall financial performance.
• Monitor operating results and develop corrective action plans when necessary.
• Partner with ownership/regional leadership on annual budgeting and long-term financial planning.
• Control labor, supply, and operating expenses while maintaining quality of care.
• Monitor key performance indicators, occupancy, revenue, and profitability.

Occupancy, Sales \& Marketing

• Partner with sales and marketing leadership to achieve occupancy and revenue goals.
• Participate in tours, referral development, community outreach, and relationship building.
• Develop relationships with hospitals, physicians, rehabilitation centers, home health agencies, senior organizations, and other referral sources.
• Monitor competitive market conditions and identify opportunities for census growth.
• Create a culture where every team member contributes to resident retention and community growth.

Staff Leadership

• Recruit, hire, train, develop, and retain qualified team members.
• Provide leadership, coaching, performance management, and accountability to department heads.
• Conduct regular leadership meetings and performance reviews.
• Promote teamwork, professionalism, communication, and employee engagement.
• Address staffing, performance, and employee-relations issues promptly and appropriately.

Regulatory Compliance \& Quality

• Maintain compliance with all applicable Missouri assisted living regulations and federal requirements.
• Ensure required licenses, certifications, inspections, records, and documentation are maintained.
• Prepare the community for state surveys, audits, inspections, and other regulatory reviews.
• Develop and implement corrective action plans when deficiencies are identified.
• Maintain high standards related to resident rights, safety, infection prevention, emergency preparedness, and quality assurance.

Community \& Leadership Presence

• Serve as the primary leadership presence within the community.
• Maintain visibility and accessibility to residents, families, and employees.
• Represent the community professionally within the local healthcare and senior living market.
• Participate in resident events, staff meetings, community programs, and leadership activities.
• Respond appropriately to emergencies and urgent operational matters, including occasional after-hours availability.

Qualifications

• Bachelor's degree in Healthcare Administration, Business Administration, Hospitality, or a related field preferred.
• Minimum of 3–5 years of leadership experience in assisted living, senior living, long-term care, healthcare, or a related environment.
• Previous Executive Director, Administrator, or senior operational leadership experience strongly preferred.
• Demonstrated experience managing budgets, staffing, operations, and financial performance.
• Strong knowledge of assisted living regulations and compliance requirements.
• Proven ability to recruit, develop, and retain employees.
• Experience with census growth, sales, marketing, and referral development preferred.
• Strong communication, organizational, problem-solving, and conflict-resolution skills.
• Ability to lead in a fast-paced environment and make sound decisions independently.
• Must demonstrate genuine compassion and respect for older adults and their families.
• Missouri Assisted Living Administrator/Director licensure or eligibility, as required by applicable regulations.

Key Performance Expectations

The successful Executive Director will be accountable for:

• Occupancy and census growth
• Resident and family satisfaction
• Regulatory compliance
• Staff retention and engagement
• Labor management
• Budget and expense management
• Revenue and profitability
• Quality assurance
• Referral development
• Overall community culture and reputation