From Therapist to Executive Director: The Why and the How

By Chad Long, Therapy Resource

Post-acute health care is making a massive shift this October with Medicare’s change to the Patient Driven Payment Model (PDPM), where patient clinical characteristics drive the reimbursement and functional outcomes determine success.

Along with the payment model changing, we are in the midst of a significant population shift (often referred to as the Silver Tsunami) in which we have a growing number of older people, many of whom need a greater number of health care services.

“The Silver Tsunami is already rolling in and projections from the U.S. Census Bureau point to 2030 as a milestone year in which older people will actually outnumber children for the first time in history.” Tom Sullivan, March 15, 2019

“As the number of senior people rises in many economies of the world, the need for long-term care and aging-in-place services will increase.” Reenita Das, Aug 11, 2015

So who will help champion the changes in health care delivery and ensure clinical and operational success in Post-Acute? Why not Therapy Professionals?! As licensed therapists and therapy assistants, we have a unique opportunity to move into Skilled Nursing Operations (Nursing Home Administrators, Executive Directors, CEOs, etc.) and work in a new capacity within the Interdisciplinary Team.

Within the Ensign Affiliated Facilities, we are seeing a growing number of Directors of Rehab moving into Operations and having great success. So why would therapy professionals be good candidates for Administrators in Training and, eventually, Executive Directors? At a recent Service Center meeting, led by Spencer Burton, a few reasons were discussed:

Why DOR to ED:

  • Clinical backgrounds
  • Mini-business leader (HR, Compliance, Billing, Maintenance, etc.)
  • Balance of clinical and financial
  • Multipliers
  • Vision -> Path: Perspective — Push to goals
  • Teaching, coaching, developing people
  • Creative
  • Likeable
  • Challengers
  • Communication skills
  • Well-versed in Ensign culture

Guess who is a Therapist and Facility Operator?

  • Salma Moore: Arroyo Vista
  • Ryan Goldbarg: Victoria Ventura
  • Matt Scott: Mission Hills
  • Brian Rupert: Villas at Sunny Acres
  • Doug Haney: Bella Vita
  • Amy Guiterrez: La Hacienda
  • Ediel Barrera: McAllen Transitional
  • Marissa Parker: Legacy
  • Kyle Martin: Kirkwood
  • Kumar Pradeep: South San Antonio
  • Amber Thompson: New Braunfels
  • Travis Jones: Cornerstone

So what are the requirements to become a Licensed Nursing Home Administrator? Well, that depends on the state in which you live. However, there are a few common requirements. Typically, you must be 19 to 21 years of age, have a bachelor’s degree, complete an Administrator in Training Program (or have a master’s degree in a health-care-related field) and successfully pass the National and State Nursing Home Administrator Exam. Below is a list of basic requirements, per state, and a link to the National Association of Long Term Care Administrators Boards.

If you are interested in growing in a different career path from therapy to more facility operations, please contact Jamie Funk at, or talk with your facility administrator. Let’s be the change we want to see in our organizations and in health care!