When a loved one moves into a skilled nursing facility the flurry of new faces can be confusing for seniors and their family members.

Who on the staff should you get to know? Who's responsible for which aspects of your loved one's care?

Robin Maibach, Admissions and Social Services Director at Lourdes-Noreen McKeen, a retirement community in West Palm, FL, highlights the staff members that residents of skilled nursing facilities and their family members are most likely to interact with:

Charge Nurse

  • Other names: head nurse, staff nurse, director of nursing (DON), chief nursing executive or officer (CNE, CNO)
  • What they do: The charge nurse in a skilled nursing setting is there to oversee the nursing staff that helps senior residents with various health issues that may come up. These health care professionals generally work in eight-hour shifts to ensure that a senior has round-the-clock access to medical care. This means that, in any given 24-hour period, there may be three different people who take turns performing the role. Maibach advises caregivers to try and become familiar with the nurses assigned to the daytime shifts (generally 7:00 am-3:00 pm and 3:00 pm-11:00 pm)
  • When to go to them: An elderly resident should contact the charge nurse when they have a health concern that they wish to seek treatment for. A senior who is not feeling well, or who has a cut, blister, or pain that needs treatment and they don't know what to do, should seek out the charge nurse on duty or contact an available CNA (see below for description).

Social Worker

  • Other names: case manager, geriatric social worker
  • What they do: Skilled nursing facilities generally have one social worker assigned to each individual unit. These staff members exist to handle the non-nursing related issues that can crop up.
  • When to go to them: If a senior is experiencing problems with unmet needs, or financial concerns, they should seek the help of their social worker to resolve the problem. Maibach says that a social worker can help an elderly resident with everything from getting broken hearing aid fixed, to helping a depressed resident gain access to a mental health professional. They also are trained to help residents navigate the complex processes underlying billing and financial aid.

Activities Director

  • Other names: recreation director, lifestyle coordinator, social director, life enrichment director, activity program coordinator
  • What they do: An activities director is usually a full-time employee who is responsible for developing and implementing plans for various engagement activities and outings for senior residents.
  • When to go to them: A senior (or family member) who has questions regarding a particular activity or program offered by the facility—or an idea for one—should consult the activities director.

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Medical Director

  • Other names: N/A
  • What they do: The medical director is responsible for reviewing the care that a resident is currently receiving from their personal doctor and make sure that their medical needs are being met by the medical professionals in the assisted living community. They are constantly in contact with the community's nursing staff as well as an individual resident's primary care physician.
  • When to go to them: According to Maibach, medical directors don't often interact directly with seniors and their caregivers. Questions regarding an elder's health are generally fielded by either the community's nursing staff or their personal doctor, not the medical director.

Certified Nursing Assistant (CNA)

  • Other names: nursing aide, care manager, licensed practical nurse
  • What they do: According to Maibach, CNAs provide the bulk of hands-on care for seniors in skilled nursing facilities. They can assist an elder in performing activities of daily living, including: bathing, grooming, eating, toileting, etc.
  • When to go to them: A senior should seek the services of a CNA if they require help with tasks relating to personal hygiene, eating or incontinence.

Dietary Coordinator

  • Other names: dietary assistant, food service coordinator, clinical nutrition manager
  • What they do: Depending on the facility, a dietary professional may or may not be involved in the day-to-day preparation and serving of food to senior residents. Sometimes they will act in a strictly advisory capacity, helping design menus and meals to fit a senior resident's specific requirements.
  • When to go to them: Typically, the family members of seniors living in skilled nursing facilities will play a significant role in helping a senior communicate their menu preferences to the dietary coordinator. If a senior has particular dietary restrictions or questions regarding the preparation or serving of food, they should solicit the help of the dietary coordinator or an available CNA.


  • Other names: custodial service, maintenance staff
  • What they do: Senior residents in a skilled nursing facility are not responsible for cleaning their own rooms or doing their own laundry. Room cleaning and linen changes are the daily responsibility of the housekeeping staff.
  • When to go to them: A senior who has an accident or needs something in their room cleaned should contact the housekeeping staff for assistance.