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Types of Nursing Home Employees

A well-staffed nursing home has many different types of employees. Many of these employees have undergone specialized training for their roles and responsibilities. While there are some employees such as personal care attendants and registered nurses who are often seen in the hallways and walking into rooms, there are also specialized support staff that are not often seen by residents or their families. These staff members help with accounting and other important internal tasks, but don’t directly care for the elderly.

Although most elder abuse is inflicted by the people who come into regular contact with the elderly person, that is not always the case. Elder abuse can be committed by anyone who works at a nursing home, including the support staff that is rarely seen by families. In order to prevent abuse and report abuse that is occurring, elderly people and their families should know the different types of employees and nursing homes and understand what their specific roles are. This knowledge of the staff can be very important when reporting abuse. You can learn more about nursing home understaffing here.

Direct Care Employees

Direct care employees are the staff members who provide personal care and attention to the residents of the nursing home. As opposed to other employees, these staff members interact and are in contact with residents on a daily basis. Direct care employees include: registered nurses, licensed vocational nurses, licensed practical nurses, physical therapists, and certified nursing assistants.


Registered nurses, also called RNs, provide a lot of the medical care in nursing homes.  It is their responsibility to assess needs of the residents and create personal care plans for each person. Registered nurses may work with licensed vocational nurses and licensed practical nurses when planning and implementing personalized care.

Registered nurses will also be in charge of daily monitoring of the health and care of residents. If a resident is undergoing a new plan for care and treatment, the nurse should be assessing how that plan is addressing the patient’s needs. All nurses who work in nursing homes must be licensed with the state. RNs have nursing degrees and usually between two and six years of nursing education. Licensed vocational nurses and licensed practical nurses usually only have one or two years of nursing education.

Nursing Assistants

Certified nursing assistants work under the supervision of the licensed nurses. Though they are certified they do not have the same medical training or knowledge as licensed nurses. In general, nursing assistants provide assistance to residents with daily tasks such as eating, hygiene, dressing, and using the bathroom.

In order to work full time as a certified nursing assistant, a person must complete training and an evaluation program to become certified. Certified nursing assistants have to participate in continuing education courses every year in order to stay certified.

Qualified Dietician

According to federal regulations regarding nursing homes, each nursing home must have a qualified dietician. The dietician can work full time, part time, or as a consultant. In order to recognized as qualified by the government, a dietician must register with the American Dietetic Association’s Commission on Dietetic Registration. The dietician must also complete training, so that they can properly identify dietary needs, plan dietary programs, and implement those programs.

If a nursing home does not employ a dietician full time, they must ensure that their director of food services regularly consults with their dietician.

Admin and Support

Administration, support, and maintenance employees do not directly care for patients, but they still play an important role in nursing homes. They provide services such as human resources, accounting, marketing, and custodial services.


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:

“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

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