License GuideSOC 11-9111

Nursing Home Administrator
License.

A health services manager oversees the daily operations of hospitals, clinics, and health agencies. They plan budgets, hire and supervise staff, and ensure facilities comply with regulations. They coordinate between departments to improve patient care and efficiency. Managers handle scheduling, purchasing medical supplies, and managing patient records systems. They also work with insurance companies and government agencies on billing and funding. Their goal is to keep the organization running smoothly while controlling costs and maintaining quality care.

At a Glance

Everything a Nursing Home Administrator needs to know.

The Work
What you actually do

Licensed nursing home administrators are regulated at the state level. Every state sets its own education, exam, and experience requirements.

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A health services manager oversees the daily operations of hospitals, clinics, and health agencies. They plan budgets, hire and supervise staff, and ensure facilities comply with regulations. They coordinate between departments to improve patient care and efficiency. Managers handle scheduling, purchasing medical supplies, and managing patient records systems. They also work with insurance companies and government agencies on billing and funding. Their goal is to keep the organization running smoothly while controlling costs and maintaining quality care.

The Exam
Two-part proctored test

Most states require a national or state-administered exam covering nursing home administrator knowledge, ethics, and state law.

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You'll face a two-part exam. The national section covers core nursing home administration topics that apply everywhere. Then comes your state's specific laws and regulations. Most states contract with testing companies like PSI, Pearson VUE, or Prometric to administer both portions. You schedule your test through their system, show up with valid ID, and take the exam at their testing center. The national portion typically runs 120 questions. You need to pass both sections to get licensed. Each state sets its own passing score, so check your state's requirements before test day.

Renewal
Keeping it active

Continuing education is required between renewals in almost every state. Hours and topics vary by board.

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Nursing home administrator licenses require continuing education to renew. Your state board sets the hour requirement and mandates specific topics, often including ethics and state regulations. Check your state's board website for exact CE hours needed and approved course options.

Is This For You
Who fits this career

Strong candidates for the nursing home administrator role combine the technical knowledge tested on the exam with judgment and communication skills you build through supervised experience.

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You need technical know-how to pass the licensing exam, but that's just the foundation. The real work happens when you're managing staff, addressing resident complaints, and making decisions about care quality under time pressure. You'll spend less time on theory and more time talking to families, reviewing budgets, and solving problems that don't have clean answers. Strong judgment matters more than perfect knowledge. You succeed by staying calm when things go wrong, asking clarifying questions before acting, and explaining your decisions clearly to people who disagree with you.

Unlicensed Risk
Practicing without a license

Practicing as a nursing home administrator without an active license is illegal in every state. Typical penalties include civil fines, forfeited income, and in some states criminal charges on repeat offenses.

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Practicing as a nursing home administrator without an active license violates state law across the country. Individuals who operate unlicensed face civil fines and must forfeit any income earned while unlicensed. States also impose criminal penalties for repeat violations, which can include jail time. The specific fines and criminal consequences vary by state and the number of prior offenses.

Career Outlook
+20.5% projected

Employment change 2024 to 2034. Flagged as a bright-outlook occupation.

The Path

How to Get a Nursing Home Administrator License.

You'll follow a consistent path across most states. Start with accredited education in your field. Next comes a national or state exam to demonstrate competency. You'll need supervised experience (the hours vary by state). A background check is standard. Finally, you'll complete continuing education between license renewals to stay current. Each state sets its own minimums for hours, degrees, and experience length, so check your specific state's requirements before applying.

1
Meet state minimums
Each state publishes minimum age, residency, and education requirements. Review the requirements of the state where you plan to practice.
2
Complete required education
Most states require formal education or training specific to the nursing home administrator role, completed through accredited programs.
3
Pass the required exam
Most states use a state or national exam for nursing home administrators. Some states also require a jurisprudence or state-law portion.
4
Submit fingerprints and background check
Most boards collect electronic fingerprints through IdentoGO, Fieldprint, or a similar vendor and run a state and federal background check.
5
Apply for the license
Submit the state application with transcripts, exam scores, experience verification, and fees. Processing runs a few days to several months depending on state and board.
6
Pay fees and activate
Once approved, you pay the initial license fee, post any required bond or insurance, and the state issues your license number.
7
Track renewals and continuing education
Most licenses renew every one to three years with a set amount of continuing education. Missing CE or renewal deadlines risks license inactivation.
Timeline

How long it takes.

Background check and exam scheduling
2 to 6 weeks
License issuance after passing
Few days to several weeks
State processing times vary widely.
Cost Breakdown

What it costs out of pocket.

Application and license fee
Paid to the state board at submission. Varies widely by state.
$50 to $500
Fingerprint and background check
Flat vendor fee set by the state.
$40 to $120
Exam fee
Paid to the testing vendor when you schedule.
$50 to $400
Professional liability insurance
Annual policy. Required or strongly recommended in most states.
$300 to $2,500
Compensation

What Nursing Home Administrators Earn.

National annual wage by percentile.

Bottom 10%
$70k
25th percentile
$89k
Median
$118k
75th percentile
$162k
Top 10%
$219k
Resources

Where to train, certify, and connect.

Optional next steps once your Nursing Home Administrator license is active.

Advanced
Certified Health Service Administrator
American Correctional Association
Specialty
Healthcare Information Security and Privacy Practitioner
International Information Systems Security Certification Consortium, Inc.
Advanced
Certified Correctional Health Professional - Physician
National Commission on Correctional Health Care
Advanced
Certified Surgical Services Manager
Competency and Credentialing Institute
Advanced
Certified Medical Manager
Professional Association of Healthcare Office Management
Advanced
Core Certification Healthcare Interpreter
Certification Commission for Healthcare Interpreters
Core
Certified Patient Safety Officer
International Board for Certification of Safety Managers
Advanced
Certified Revenue Cycle Representative
Healthcare Financial Management Association
Specialty
Certified Revenue Integrity Professional
American Association of Healthcare Administrative Management
Specialty
High Complexity Clinical Laboratory Director
American Association of Bioanalysts
Core
Certified Healthcare Facility Manager
American Hospital Association
Specialty
Healthcare Research Compliance Certification
Health Care Compliance Association
State vs State

Compare any two states.

Pre-license hours and fees vary widely. Pick two states to see the gap.

Left
Right
Varies
Pre-license hours
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Exam fee
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License fee
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Nursing Home Administrator Program
Issuing board
Texas Health and Human Services Commission
Frequently Asked

Questions people ask.

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