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How to Become a Licensed Nursing Home Administrator

Do you want to be a nursing home administrator? If YES, here are the educational requirements you must meet to become a licensed nursing home administrator.

A nursing home administrator is one who supervises plans, develops, monitors and maintains appropriate standards of care throughout all departments in the nursing home. To function effectively, the nursing home administrator must have effective communication, leadership, and business skills.

The nursing home administrator position is expected to take a bit of a twist as time goes on as nursing homes across board are seeing more intakes of patients and residents with more health conditions and issues. Because of this, nursing homes are starting to get described as small scale hospitals.

Long gone are the days that nursing home administrators are solely responsible for management duties. In this modern world, they are now in charge of a whole new set of operations relating to marketing, communication, and leadership.

These are the reasons why potential nursing home administration must be properly qualified before they are awarded licenses to manage nursing homes. Outlined below is the step by step route one can follow to qualify as a nursing home administrator.

6 Requirements to Become a Licensed Nursing Home Administrator

  1. Age

To ensure that you are suitable to apply to become a nursing home administrator, you must be at least 21 years of age. You will be required to submit one of the following to establish your age: driver license, ID card for non-drivers, passport or birth certificate. Other acceptable forms of identification can be considered on a case-by-case basis.

  1. Character and Suitability

Another area that is usually judged for applicants is their character. The Board of Examiners of Nursing Home Administrators must determine that there is nothing in your background that may affect your ability to carry out the responsibilities of a nursing home administrator in a professional, competent and ethical manner.

Your character and suitability will be assessed based on a review of your responses (and related documentation) to the questions contained in the “Character and Suitability” section of the Nursing Home Administrator Licensure Application.

  1. Education

This is one of the toughest areas in the application. You must document that you hold a Bachelor’s (or higher level) Degree from an accredited educational institution. Your degree must have included (or be supplemented by) successful completion of 15 credit hours of course work at an accredited educational institution in the following five areas:

  • Nursing Home Administration
  • Health Care Financial Management
  • Legal Issues in Health Care
  • Gerontology
  • Personnel Management

An accredited educational institution is one that is listed in the U.S. Department of Education’s Database of Accredited Postsecondary Institutions and Programs as having its degree program accredited by a regional or nationally recognized accrediting agency.

Each course must be at least three credit hours. Courses will be considered for 10 years from the date of successful completion, with the exception of Nursing Home Administration, which will be considered for five years from the date of successful completion.

The following may be substituted to satisfy the 15 credit hour education requirement:

  • Two or more years of service as the full-time Administrator-of-Record of an out-of-state nursing facility within the last five years. An Administrator-of-Record is a licensed and currently registered nursing home administrator who is charged with the general administration of a nursing home.
  • Being a nursing home administrator requires a minimum of a bachelor’s degree in healthcare administration. However, most nursing home administrators have master’s degrees in long-term care administration, health services administration, public health or business administration. Professional degrees in healthcare management are accredited by the Commission on Accreditation of Healthcare Management Education (CAHME). The organization’s website lists qualifying programs by state.
  • A typical program may result in a Master of Science in Health Administration degree. Courses may focus on business skills, such as leadership, marketing, operations management, organizational behavior and financial affairs as they relate to healthcare. Students also learn about health law, healthcare information systems and medical statistics.

In all states and in the District of Columbia, nursing home administrators must complete an accredited, state-approved training program and internship. They must also pass a state licensing exam. For license renewal, continuing professional education is also required.

  1. Field Experience

To satisfy this criteria, you must document successful completion of a 12-month Administrator-In-Training Program (Internship) or two years of qualifying field experience.

Note: You must complete either an internship or qualifying field experience, but not both.

  • Administrator-In-Training Program (Internship) runs for 12 months, and must be completed in a qualifying nursing facility under the supervision of a qualified preceptor within the last 10 years. Part-time internships may be considered. All internship hours must be completed within two years.
  • Participation in an internship requires the advance written approval of the Board. To be approved, the internship must be structured in accordance with the Administrator-In-Training Program (Internship) Guidelines. Internships started prior to receiving the Board’s written approval will not be accepted.
  • Prior to requesting approval to participate in an internship, you must have an active application on file with the Board and satisfied the first and second criteria, as well as the Nursing Home Administration, Health Care Financial Management and Legal Issues in Health Care course work as required by the state.
  • Field Experience — The applicant must have two years of full-time service as a staff of a qualifying healthcare facility in an administrative position above the department-head level, but not above the Administrator-of-Record, requiring active participation in the administration, direction and operation of the facility, within the last five years.

The position must have included daily participation in management decisions that affect two or more major departments or service areas within the facility and directly impact the provision of care and services to the residents/patients in the facility:

(e.g., Food Services, Nursing, Rehabilitation [including all of Physical Therapy, Occupational Therapy, Recreation and Speech/Audio] and Social Services). The position must be compensated at a salary commensurate with the level of responsibility.

  1. Course of Study

To satisfy this criteria, you must document successful completion of three credit hours of education at an accredited educational institution in the area of Nursing Home Administration. The course will be considered for five years from the date of successful completion.

If you substituted two or more years of service as the full-time Administrator-of-Record of an out-of-state nursing facility within the last five years, the substitution also applies here. The following may also be substituted to satisfy the three credit hour course of study requirement:

  • a current Nursing Home Administrator certification issued by the American College of Health Care Administrators (ACHCA).
  • Consideration will be given to out-of-state certificate programs only for Administrators-of-Record in out-of-state nursing facilities.
  1. Examination

The Nursing Home Administration Examination is intended to assess the knowledge and understanding of information and tasks, essential for entry-level licensure as a nursing home administrator. You must receive a passing score on the Nursing Home Administrator Licensing Examination.

To be eligible to sit for the examination, you must satisfy the required course work. If you hold a nursing home administrator license issued by another state, the examination requirement in New York State may be waived.

In order to be granted a waiver, the issuing state must verify that you took and passed the Nursing Home Administrator Licensing Examination developed by the National Association of Long Term Care Administrator Boards (Professional Examination Service examination prior to October 1982).

The verification must be in the form of a letter on official letterhead (affixed with a state seal), including the following: your name, license number, date license was issued, examination taken, examination date, examination score (raw score and scale score), registration status, expiration date and disciplinary action (if any).

How to Get a Nursing Home Administrators License

There are several steps to be taken before one can be licensed as a nursing home administrator. They include;

1. Download, print and complete license application forms

These forms include: the Application for Nursing Home Administrator License; Request for Reciprocity Verification of Out-of-State Licensure Status; Application for Approval of Administrative Intern Program; Quarterly Progress Report for Nursing Home Administrative Intern Program; Certification of Program Completion for Nursing Home Administrative Intern Program.

2. Payment

Pay the non-refundable application fee of $100 through the online payment system. Print the payment confirmation page or the confirmation email as proof of payment. Applications that arrive without proof of payment will not be processed.

3. Put it together

Create an application packet which includes:

The completed forms as outlined above

Proof of payment of the $100 application fee

An official college transcript

Three letters of reference (other than from your administrator)

4. Submit

Send the complete application packet to the Home Administrators Licensing Board and wait for a response.


Administrators must keep up with constant regulation changes and changes in industry standards. Because of this, nursing home administrators will need experience working within a nursing home facility before they will be considered for an open position, even when they have earned their license.

Typically, individuals are hired as administrators only after they have worked in lower level or entry-level administration positions.

Some relevant work experience that will look favorably upon a candidate for an administration position in an assisted living facility include: management positions in healthcare settings, employment at a nursing home, residential care facility marketing positions and volunteer work within a nursing home. Positions within hospitals and doctor offices are also preferred.