Healthcare Administration Degrees

Credentials in healthcare administration

The Nursing Home Administrator License (NHA)

Edited by Taylor Rupe, B.A. Psychology, University of Washington Seattle · B.S. Computer Science, Oregon State University

Last updated

Everything else on this part of the site is optional. The nursing home administrator license is not: it is a permission to practice, issued by a state, and running a nursing home without one is unlawful everywhere in the country.

Key facts for the NHA credential
What it is License, legally required
Awarded by NAB and your state licensing board
Open to Candidates approved by their own state board
Headline fee $480 for a combined CORE and NHA application, effective 1 February 2026
Keeping it Continuing education on your state board's cycle

A License Is Not a Certification, and the Difference Is Legal

The other credentials covered on this site are voluntary. FACHE, CMPE, CPHQ and CHFP are professional certifications: bodies award them, employers may value them, and nothing in law requires any of them. You can build an entire career in healthcare management without one.

A license is different in kind. It is a state's permission to practice, granted on conditions the state sets, and it can be suspended or revoked. Without it you may not hold the post at all, regardless of how qualified you are or how willing the employer is. That is why this page exists separately from the nursing home administrator career page: the career page is about whether the job suits you, and this one is about a legal requirement that does not care.

It also explains why the timelines are longer here than for anything else in the field. A certification body can decide you are eligible in a fortnight. A state board has a statutory process, a training requirement and a queue.

The State Board Comes First, Not NAB

The commonest mistake is to treat the national examination as the starting line. NAB states plainly that it is unable to approve NHA exam applications: the state licensing board approves the candidate, and the candidate then applies through NAB to sit.

So the first action is to find your state's board of long term care administrators and read their requirements, because everything else follows from them. They decide what degree qualifies, how long the supervised administrator-in-training period runs, what coursework counts, and whether experience can substitute for part of it. Those answers differ enough between states that a national figure would be wrong for most readers, which is why this page does not offer one.

How the Two NAB Examinations Are Structured

NAB CORE and NHA line of service examination structure
Paper Scored Pretest Total questions Seat time
CORE 100 25 125 150 minutes
NHA line of service 60 15 75 90 minutes

Pretest questions are unscored items being trialled for future papers, so the number you are marked on is smaller than the number you answer. Seat time includes reading the welcome materials, the non-disclosure agreement and post-test questions.

Beyond Nursing Homes: The Other Lines of Service

NAB's CORE paper is common to every candidate, and the second paper depends on the setting. Nursing homes take the NHA line. Resident care and assisted living take RCAL, and home and community based services take HCBS.

This matters if long-term care is a career rather than a job. Someone who expects to run a campus spanning several care types will eventually need more than one line, and NAB's Health Services Executive qualification requires both the RCAL and HCBS papers. Worth knowing at the start, when the CORE paper is fresh, rather than at the point of promotion several years later.

Questions About the Nursing Home Administrator License

Is the nursing home administrator license required in every state?
Yes. All 50 states and the District of Columbia require a licensed administrator to run a nursing home, and the requirement originates in the federal Omnibus Budget Reconciliation Act of 1987 rather than in state preference. There is no jurisdiction you can relocate to in order to avoid it.
How much does the NAB exam cost?
A combined CORE and NHA application is $480, a figure NAB states as effective 1 February 2026. That is the examination cost alone. Your state board charges separately for the license itself, and those fees are set state by state.
Can NAB approve my exam application?
No, and NAB says so directly: it is unable to approve NHA exam applications. Your state licensing board approves you as a candidate first, and only afterwards do you apply through NAB to sit. People who contact NAB first are routinely sent back to their board, so start there.
What is on the NAB exams?
Two papers. The CORE examination has 100 scored questions plus 25 pretest questions, 125 in total, with 150 minutes of seat time. The NHA line of service examination has 60 scored plus 15 pretest, 75 in total, in 90 minutes. Seat time includes the welcome materials and the non-disclosure agreement, so it exceeds the testing itself.
Is the NHA license the same as a certification?
No, and the difference is legal rather than semantic. A certification is voluntary: no law requires it and an employer may ignore it. A license is a permission to practice, granted by a state, without which holding the job is unlawful, and which a regulator can suspend or revoke. NHA is the only credential in healthcare management that works the second way.

Sources for This Nursing Home Administrator License Data