Credentials

Nursing Home Administrator License: Requirements, Exam and Education

How Do You Get a Nursing Home Administrator License?

A nursing home administrator license comes from your state board, not a national body, and every state requires one. Most states combine a degree requirement, an administrator-in-training (AIT) internship and the national NAB exams, then add their own state exam or coursework. New York, for example, requires a 12-month AIT, and Florida's internship runs 650 to 2,000 hours depending on your degree. Twelve master's programs on this site include a long-term care track, and some, like Texas State's Master of Long-Term Care Administration, build the AIT into the degree.

Researched and edited by Taylor Rupe · Updated September 28, 2026

A staff member leans in to talk with older residents seated around an activity table in a care home — Photo: Jsme MILA / Pexels

Who Needs a Nursing Home Administrator License

A nursing home administrator license is required in every state. The BLS says so directly: all states license nursing home administrators, and the requirements vary by state. New York puts the stakes plainly in its own rules. No nursing home in the state may operate unless an administrator with a valid license and registration supervises it.

The job itself is broad. The BLS describes nursing home administrators as managing every part of a facility, from admissions and building maintenance to the care of residents. New York’s Department of Health goes further and calls them, in effect, the chief executive officers of health care organizations.

So if long-term care is your goal, the license is the credential that matters most. A master’s degree helps you qualify and compete, but it doesn’t replace the license. Here’s how the pieces fit.

States Set the Rules, Not NAB

This is the most important thing to understand. The National Association of Long Term Care Administrator Boards (NAB) writes the national exams, but NAB states outright that it doesn’t set requirements or issue licenses. Each state has its own process, including its own education rules and its own AIT hours.

The order matters too. You apply to your state board first. Only after the board approves your application can you register for the NAB exam, and NAB can’t approve an exam application on its own. So the first step is always the same: read your state board’s requirements before you choose a degree program or an internship site.

The NAB Exams

Nursing home administrator candidates take two NAB exams: the CORE exam, which covers what every long-term care administrator needs, and the NHA line of service exam for nursing homes.

Exam	Questions	Seat time
CORE	125 total (100 scored, 25 pretest)	150 minutes
NHA line of service	75 total (60 scored, 15 pretest)	90 minutes

Since February 1, 2026, the combined CORE plus NHA application costs $480. Get the combination right before you pay: if you apply for the wrong exam and withdraw, NAB keeps a 40% processing fee.

Retakes are now limited. Starting January 1, 2026, you get up to 4 attempts per exam in each cycle, which runs July 1 to June 30. The count resets each July 1. You schedule the exam through Pearson VUE once you’re approved.

Many states add their own exam on top. Florida, for instance, requires its Nursing Home Administrator Laws and Rules Examination as well as the NAB exam.

The AIT Internship

The administrator-in-training internship is where most of your time goes. It’s a supervised placement in a nursing home under a licensed administrator, called a preceptor, and it’s the practical half of the license. Some states now call it an Administrator Residency. Ohio, for one, runs an Administrator Residency program as its pathway to practical training.

Hours vary widely. In New York, the AIT is a 12-month full-time internship in a qualifying nursing home, and it must be approved by the board in writing before you start. An internship that begins without approval won’t count. In Florida, the length depends on your education, as the next section shows.

The practical point for you: an AIT is a job-sized commitment. If your degree program builds one in, you finish school and the internship at the same time. If it doesn’t, you’ll add months after graduation.

Finding an AIT Site and Preceptor

States don’t just count hours. They also set rules about where the internship happens and who supervises it.

Florida requires the 650-hour internship to be affiliated with your college or university, supervised by a board-approved preceptor, and completed in a skilled nursing facility with at least 60 beds. A small facility won’t qualify, however good the experience.

New York is stricter on timing. The AIT must happen in a qualifying nursing home under a qualified preceptor, within the last 10 years, and all hours must be finished within two years. Part-time internships may be considered. Before you can even ask for approval, you need an active application on file and three of the five required courses done: nursing home administration, health care financial management and legal issues in health care.

When Experience Replaces the Internship

Both states give experienced managers another route. New York accepts two years of full-time work in a qualifying nursing home, in an administrative position above department head, within the last five years, in place of the AIT. Florida accepts a year of management experience directing departments such as resident care, dietary and bookkeeping, and adds a 1,000-hour AIT if that experience wasn’t in a skilled nursing facility.

How Three States Compare

The same license looks very different from state to state. Here’s what Florida and New York ask for, from their boards’ own sites, followed by how Ohio frames it:

State	Education	Internship or experience	Exams
Florida	Bachelor’s in health care or health services administration (or 60 prescribed semester hours), or any bachelor’s	650-hour internship with a relevant degree; 1,000-hour AIT as an option; 2,000-hour AIT with an unrelated bachelor’s	NAB NHA exam plus Florida Laws and Rules exam
New York	Bachelor’s plus 15 credit hours in five subjects	12-month full-time AIT, or two years of qualifying field experience	Licensing examination

Florida

Florida gives you four routes. With a bachelor’s in health care administration or a similar major, you need a university-affiliated internship of at least 650 hours with a board-approved preceptor in a skilled nursing facility of at least 60 beds, or a 1,000-hour AIT. With any other bachelor’s, the AIT grows to 2,000 hours. A fourth route counts a year of qualifying management experience. Every applicant also completes electronic fingerprinting.

New York

New York’s Board of Examiners of Nursing Home Administrators requires you to be at least 21 and to hold a bachelor’s degree with 15 credit hours in nursing home administration, health care financial management, legal issues in health care, gerontology and personnel management. Each course must be at least three credit hours. Then comes the 12-month AIT, or two years in a qualifying administrative role, and the licensing exam.

Ohio

Ohio licenses administrators through its Board of Executives of Long-Term Services and Supports (BELTSS). Its practical-training route is the Administrator Residency program, and it has a separate track for students in approved nursing home administrator programs. Beyond the standard license, Ohio also recognizes the Health Services Executive, which it describes as an aspirational and voluntary license. NAB’s HSE route requires both its RCAL and HCBS line of service exams in addition to CORE.

Master’s Programs With a Long-Term Care Track

Florida and New York set the license’s education floor at a bachelor’s, so a master’s isn’t the entry ticket. What the right one does is prepare you for the job and, in some programs, fold the internship into the degree. If a program’s courses match subjects your state names, like New York’s five, check with the board whether they count. This site tracks 12 long-term care programs at 9 schools, with estimated tuition (published per-credit rate times credits, before fees) from $16,566 to $87,648 and a median of $54,600.

Program	Long-term care focus	Estimated tuition
Texas State University Master of Long-Term Care Administration	Administrator-in-Training internship built in (LTCA 5681 taken twice, 12 credit hours)	$16,566
University of Southern Indiana MHA	Aging Services concentration	$16,740
Maryville University online MHA	Senior Services concentration	$28,800
Long Island University MHA (LIU Post)	Gerontology concentration	$51,660
University of Utah Traditional MHA	Long-Term Care concentration; CAHME	$62,400
Hofstra University MHA (in-person)	Long-Term Care Administration concentration; about 300-hour internship; CAHME	$87,648

Texas State stands out because its degree includes the AIT itself, the one requirement that otherwise adds months after school. Hofstra’s online MHA carries the same Long-Term Care Administration concentration and lets you complete its roughly 300-hour internship where you live (Hofstra online MHA). Other options include the Long Term Care emphasis at Minnesota State University Moorhead, the Long-Term Care Administration certificate option at the University of Michigan-Flint, and the long-term care administration track at Youngstown State University.

Check one thing before you enroll: whether the program’s internship meets your state’s AIT rules. A 300-hour internship won’t cover New York’s 12 months, and New York requires board approval before any AIT begins.

How to Get Your License, Start to Finish

The order here matters, because each step depends on the one before it:

Read your state board’s requirements, including education, AIT hours and exams.
Finish the degree and any specific coursework the state names.
Get board approval for your AIT if your state requires it, then complete the internship under a qualified preceptor.
Apply to your state board for licensure.
After board approval, register for the NAB CORE and NHA exams and any state exam.
Pass the exams and complete background checks such as Florida’s fingerprinting.

If you’re a nurse moving into administration, you’re in good company: the BLS notes that nursing home administrators may have years of registered nurse experience. For the wider picture of healthcare management jobs, see the careers guide. Compare costs in the MHA cost calculator, or see whether an MHA is worth it before you commit. The MHA requirements guide covers admissions.

Frequently Asked Questions

Is There a National Nursing Home Administrator License?

No. NAB writes the national exams, but it doesn't set requirements or issue licenses. Each state licenses its own administrators and decides the education, AIT hours and exams you need.

How Long Is the AIT Internship?

It depends on the state and your background. New York requires a 12-month full-time AIT or two years of qualifying field experience. Florida ranges from a 650-hour internship with a relevant degree to a 2,000-hour AIT with an unrelated bachelor's.

How Much Is the NAB Exam?

Since February 1, 2026, NAB charges $480 for the combined CORE plus NHA exam application. If you withdraw an application for the wrong exam, NAB keeps a 40% processing fee.

How Many Times Can You Take the NAB Exam?

Starting January 1, 2026, NAB allows up to 4 attempts per exam cycle for the CORE and NHA exams. The cycle runs July 1 to June 30 and the count resets each July 1.

Can You Become a Nursing Home Administrator Without a Degree in Health Administration?

In some states, yes, with a longer internship. Florida accepts any bachelor's degree if you complete a 2,000-hour administrator-in-training program. New York accepts any bachelor's plus 15 credit hours of specific coursework.

How Do You Look Up a Nursing Home Administrator License?

Through the state board that issued it. Ohio's Board of Executives of Long-Term Services and Supports runs a license lookup, and New York's Department of Health publishes a list of licensed nursing home administrators.