What you need to become a nursing home administrator

To become a nursing home administrator, you need a bachelor's degree, a state license, and work experience in healthcare. Most states require you to pass the Nursing Home Administrator (NHA) exam, which tests your knowledge of regulations, resident care, and facility operations. The exact path varies by state — some require a specific degree in health administration, while others accept degrees in related fields like business or nursing, paired with relevant work experience.

The timeline typically takes four to six years from high school: a four-year bachelor's degree, then one to two years of supervised work experience in a nursing home or related healthcare setting, followed by exam preparation and testing. Some people speed this up by working in a nursing home while completing their degree part-time, so their work hours count toward the experience requirement.

Key Takeaways

  • You must hold a bachelor's degree and pass your state's Nursing Home Administrator exam; the specific degree field varies by state.
  • Most states require one to two years of supervised work experience in a nursing home, hospital, or long-term care setting before you can sit for the exam.
  • The National Association of Long Term Care Administrator Boards (NAB) administers the NHA exam in most states, and passing scores are recognized across state lines if you move.
  • Your state's health department or licensing board publishes the exact requirements for your location, and these requirements can change.
  • Some employers offer tuition support or will hire you as a department manager first, letting you build experience while you complete your degree.

Education requirements: degree and coursework

A bachelor's degree is mandatory in every state. The field of study matters less than you might think — some states specify a degree in health administration, business administration, or long-term care management, while others accept any bachelor's degree as long as you have the required work experience. A few states allow an associate's degree paired with additional work experience, but this is becoming less common.

Your coursework should cover healthcare management, finance, human resources, regulatory compliance, and resident care principles. If your degree is not in a healthcare field, you may need to take additional courses in gerontology (the study of aging) or long-term care administration before you sit for the state exam. Some community colleges and universities offer certificates in nursing home administration that can be completed alongside or after your bachelor's degree.

Work experience in long-term care settings

Most states require one to two years of full-time supervised work experience in a nursing home, assisted living facility, hospital, or other long-term care environment. This experience must be documented and verified by your employer. The supervisor who signs off on your hours must hold a current NHA license in most states, which is why you cannot straightforward work in any healthcare job — your direct supervisor matters.

Common entry-level positions that count toward this requirement include nursing home department manager, assistant administrator, director of nursing, or activities director. Some people start as licensed practical nurses (LPNs) or registered nurses (RNs) in a nursing home, which counts as supervised experience. Working in a hospital does count, but your supervisor must be someone with healthcare management credentials, not just any nurse or administrator.

You can often begin this work while finishing your degree, so your timeline does not have to be strictly sequential. Many nursing homes hire people in supervisory roles specifically because they are pursuing their NHA license, and the employer benefits from having someone committed to the field.

The Nursing Home Administrator exam and licensing

The National Association of Long Term Care Administrator Boards (NAB) administers the NHA exam in most states. The exam covers federal and state regulations, resident rights, infection control, financial management, human resources, and quality assurance. It is a multiple-choice test lasting about three hours, and you typically have one or two attempts per year to pass it, depending on your state.

Passing scores vary slightly by state but generally fall between 75 and 80 percent. You can prepare using study guides published by NAB, practice exams, and review courses offered by universities and online providers. Many people spend two to four months studying after they complete their work experience requirement.

Once you pass the exam, your state health department or licensing board issues your NHA license. This license is valid for a set period — usually two to four years — and you must renew it by completing continuing education hours. If you move to another state, you typically do not have to retake the exam; most states recognize NAB-issued licenses through reciprocity agreements, though you may need to register with the new state's licensing board and meet any additional state-specific requirements.

State-by-state variation in requirements

Requirements differ enough between states that you should check your specific state's health department or licensing board website before you commit to a program. Some states require a degree in a healthcare field specifically; others do not. Some require two years of work experience; others require only one. A few states have different pathways for people who are already licensed nurses.

Your state's licensing board publishes the official requirements, the list of approved degree programs, and the current exam schedule. They also maintain a registry of licensed administrators, so you can see who holds a license in your area and sometimes find contact information if you want to ask someone about the actual work.

Finding programs and getting started

If you do not yet have a bachelor's degree, start by looking for programs in health administration, business administration, or long-term care management at universities and colleges in your state. Many offer evening or online options if you need to work while you study. Your state's licensing board website often lists approved programs, though you are not required to attend an approved program — you just need a bachelor's degree and the required work experience.

If you already have a bachelor's degree in another field, you can move directly to the work experience phase. Look for entry-level management positions in nursing homes, assisted living facilities, or hospitals. Many nursing homes have formal training programs for people pursuing their NHA license and will hire you knowing that is your goal. Contact the human resources department and mention that you are working toward your NHA license — employers often see this as a sign of commitment and may offer tuition support or flexible scheduling to help you prepare for the exam.

Once you have completed your degree and your required work experience, you can register to sit for the NHA exam through your state's licensing board or directly through NAB, depending on your state's process. The exam registration fee typically ranges from $300 to $500, and you will need to submit proof of your degree and your supervised work hours.

Continuing education and license renewal

After you pass the exam and receive your license, you are required to complete continuing education (CE) hours to renew your license. Most states require between 20 and 40 hours of CE every two to four years. These hours can come from workshops, online courses, conferences, or university classes related to healthcare management, resident care, regulations, or leadership.

Many nursing home associations, universities, and online providers offer CE courses specifically designed for NHA renewal. Your state's licensing board publishes a list of approved CE providers, so you know which courses will count toward your renewal. Planning ahead — taking a few courses each year rather than cramming them all before your renewal date — makes the process less stressful and keeps your knowledge current.

Frequently Asked Questions

Can I become a nursing home administrator without a bachelor's degree?

Most states now require a bachelor's degree, but a few still allow an associate's degree paired with additional work experience or a nursing license. Check your state's specific requirements with your health department or licensing board, as these rules change and vary significantly by location.

How long does it take to become a nursing home administrator?

Typically four to six years from high school: four years for a bachelor's degree, one to two years of work experience, and a few months of exam preparation. If you already have a degree, you can move through the work experience and exam phases in two to three years total.

Do I need to be a nurse to become a nursing home administrator?

No. A nursing background is helpful but not required. You need a bachelor's degree and work experience in a long-term care setting, which can come from many roles — nursing, management, administration, or other healthcare positions. Many successful administrators come from business or healthcare management backgrounds.

Will my NHA license work if I move to another state?

Most states recognize NHA licenses through reciprocity agreements, so you typically do not have to retake the exam. You will need to register with your new state's licensing board and may need to meet additional state-specific requirements or take a state-specific law exam, but the full exam is usually not required.

What does a nursing home administrator actually do day-to-day?

Administrators oversee all facility operations: staffing, budgets, resident care quality, regulatory compliance, and community relations. You manage department heads, may support the home meets state and federal regulations, handle resident and family concerns, and work with your board or ownership on long-term planning. The role is part manager, part advocate, and part problem-solver.