How to Become a Licensed Nursing Home Administrator (LNHA)

Licensed nursing home administrators (LNHAs) supervise nursing homes. They maintain and manage these facilities, which provide medical care and housing for elderly and disabled individuals. LNHAs coordinate all clinical and administrative affairs, ensuring these homes function smoothly. Because of the large staff of nurses, aides, and other medical personnel providing round-the-clock care at nursing homes, an LNHA is one of the most crucial at these facilities. LNHAs manage staff, patients, admissions, budgets, records, equipment maintenance and upgrades, and compliance with federal regulations.

On a typical day, nursing home administrators manage employees’ daily duties, admit new patients, oversee operations, provide tours for prospective patients and their families, and research new technology and equipment that can benefit the home.

To ensure patients are safe and healthy, LNHAs must ensure local and federal regulations are being met, doing all they can to maintain compliance in all areas. As such, it can be very demanding and stressful, often requiring off-hours work during the evenings, on weekends, and on holidays. Moreover, they must excel at stress management and communication because they often deal with challenging situations.

Nursing home administrators may work in nursing homes, assisted living facilities, or retirement communities. No matter the setting, they must provide the necessary leadership that ensures a safe and efficient environment for staff and patients. Their typical duties include managing all staff and personnel, financial issues, medical care, supplies, and facilities. To become an LNHA, students must first obtain a bachelor’s or master’s degree in healthcare administration, followed by state and national licensing.

Because of the high demand, significant responsibilities, and education requirements, LNHAs can expect to make almost six figures a year. In fact, the U.S. Bureau of Labor Statistics (2024) reports that medical and health service managers (including LNHAs) have a median annual salary of $110,680. By comparison, (2024) reported a median annual salary of $129,800 for nursing home administrators, with a typical range of between $115,400 and $144,400.

Furthermore, the BLS (2024) projected that openings for medical and health service managers will swell 28 percent nationwide between 2022 and 2032, much faster than the 3 percent average expected for all U.S. occupations in that same decade.

This growth is largely due to aging Baby Boomers who are just beginning to enter retirement age and will continue to do so over the next ten years. With more facilities, there will be an increased need for experienced, qualified nursing home administrators who can lead them.

Read on to discover how to join this rewarding and lucrative career.

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A Step-by-Step Guide to Becoming a Licensed Nursing Home Administrator

Aspiring licensed nursing home administrators must follow a particular path to fulfill their passion and obtain a career in nursing home management. While there are several different options for students, the guide below explores one possible route to becoming an LNHA.

Step 1: Graduate from high school (four years)

To move on to further levels of study, students must obtain their high school diplomas. Preparation for a career in nursing home administration can and should start with excelling in courses at the high school level, such as chemistry, biology, math, finance, and writing. These courses will form a firm basis for when the student is ready to attend college and pursue a four-year bachelor’s degree.

Step 2: Obtain a bachelor’s degree in nursing, health administration, or another field (four years)

Students should focus on universities and colleges offering bachelor’s degrees in nursing home administration or closely related fields. Many become registered nurses (RNs) to gain some clinical experience, while others focus more squarely on administrative capacities in their education and work experience.

Undergraduate programs in nursing administration specifically provide the tools students will need to manage daily operations, handle patient requirements, and assist with budgeting. Students should take courses on long-term care administration, public health administration, health services administration, and business administration.

Step 3: Earn a master of healthcare administration or a related degree (two years)

A master of health administration (MHA), long-term care, nursing home administration, or gerontology is the typical path to becoming an LNHA as it allows students to deepen their knowledge in critical areas and specialize in the most important subjects to them.

A master’s degree can also set one apart during the interview process. However, students can also enroll in a master’s of science in gerontology, providing similar education but with a heavier clinical focus. Below are a few well-known online programs that aspiring LNHAs can consider:

Utica University

Utica University offers an online master of healthcare administration (MHA) program that prepares students for administrative roles in settings across the healthcare continuum. The program provides students with the skills and knowledge to pursue exciting and new advancement opportunities in several healthcare organizations. Graduates can expect to develop a thorough understanding of designing, developing, and evaluating administrative strategies.

The 36-credit program includes courses such as healthcare accounting processes, human resources management, healthcare financial management, perspectives in gerontology, healthcare administrator leadership, data analysis for healthcare leaders, and marketing and strategic planning in the service sector.

Admission requirements include a bachelor’s degree with a grade point average of 3.0 or higher, a completed application, official transcripts, two letters of recommendation, a personal statement, and a current resume.

Graduates of the program will be able to take up roles such as ancillary services directors, clinical project managers, nursing home administrators, direct care coordinators, informatics directors, compliance officers, facilities managers, and marketing directors.

  • Location: Utica, NY
  • Accreditation: Accreditation Council for Business Schools and Programs (ACBSP); Middle States Commission on Higher Education (MSCHE)
  • Expected Time to Completion: 24 months

Maryville University

Maryville University designed an online master of health administration with concentrations in health informatics and analytics; healthcare leadership; population health management; and senior services. No healthcare experience is required with this 100 percent online program.

Graduates of the program will be prepared for senior-level positions in various healthcare settings such as state, local, and private hospitals, government agencies, nursing and residential care facilities, home healthcare services, and physicians’ offices. They can take up roles such as hospital administrators, nursing home administrators, healthcare marketing directors, and recruiters.

To get accepted into the program, applicants must have a bachelor’s degree from a regionally accredited institution with a cumulative GPA of 3.0 (GPAs below 3.0 may be considered for conditional admission), a personal letter explaining qualifications for graduate work, and an understanding of basic statistics. Letters of recommendation and GMAT scores are not required for admission.

As part of the program, students will delve into healthcare operations; the healthcare industry and its impact on healthcare management; healthcare quality and performance improvement; health policy & economics; healthcare informatics; introduction to gerontology; and managerial epidemiology.

  • Location: St. Louis, MO
  • Accreditation: Higher Learning Commission (HLC)
  • Expected Time to Completion: 24 months

USC Leonard Davis

USC Leonard Davis offers an online master of science in gerontology that can be completed in as little as 18 months. The program positions students at the forefront of research and policy and helps them build analytical skills while studying the mysteries and mechanics of aging, population health, and longevity.

Students in this program will explore gerontology through a sophisticated and multidisciplinary approach. The program also offers several optional tracks that students can take to add value to their resumes. These specializations include psychology, care management, nutrition, entrepreneurship, end-of-life, geriatric care, and health science.

Comprising 44 credits, the program includes courses such as the physiology of development and aging; life span developmental psychology; life span developmental sociology; social policy and aging; integrating gerontology: a multidisciplinary approach; and research methods.

USC Leonard Davis also offers a 28-credit master of arts in gerontology program, a 28.5-credit master of arts in long-term care administration program, a 32-credit master of arts in aging services management program, a 33-credit master of arts in medical gerontology program, and several more such programs.

  • Location: Los Angeles, CA
  • Accreditation: Western Association of Schools and Colleges, the Senior College and University Commission (WSCUC); Accreditation for Gerontology Education Council
  • Expected Time to Completion: Full-time (18 months); part-time (18 to 36 months)

Step 4: Get licensed (less than one year)

The last step is becoming a licensed nursing home administrator. Licensing requirements vary by state; however, national licensing is overseen by the National Association of Long-Term Care Administrator Boards (NAB). There are also several different licenses students can complete:

  • Home and Community-Based Services (HCBS)
  • Nursing Home Assistance (NHA)
  • Residential Care and Assisted Living (RCAL)

The NAB website details state-specific requirements and exam fees, ranging from $185 to $440, depending on the license.

The below chart outlines the NHA licensure requirements by state, according to NAB. Please note that the minimum age for licensing varies from 18 to 21. All states require students to sit for the national exam, and most require at least 400 administrators in training (AIT) hours, but not all states require a state exam.

While national NHA licensing and many states require a minimum of a bachelor’s degree in healthcare administration, many NHAs have master’s degrees in public health, long-term care administration, health services administration, or business administration.

State of Licensure Degree Required State Exam? Continuing Education (CE) Hours Required
Alabama AA Yes 24, annual
Alaska BA No N/A
Arizona BA Yes 50, biennial
Arkansas AA Yes 20, annual
California BA Yes 40, biennial
Colorado HS Yes N/A, annual
Connecticut BA No 40, biennial
Delaware N/A No 48, biennial
District of Columbia BA Yes 40, biennial
Florida BA Yes 40, biennial
Georgia HS No 40, biennial
Hawaii BA No N/A
Idaho BA Yes 20, annual
Illinois BA Yes 36, biennial
Indiana N/A Yes 40, biennial
Iowa BA No 40, biennial
Kansas BA Yes 50, biennial
Kentucky BA No 30, biennial
Louisiana BA Yes 18, annual
Maine BA No 24, annual
Maryland BA Yes 40, biennial
Massachusetts BA No 40, biennial
Michigan BA No 36, biennial
Minnesota BA Yes 20, annual
Mississippi AA Yes 40, biennial
Missouri HS Yes 40, biennial
Montana HS Yes 20, annual
Nebraska AA No 50, biennial
Nevada BA No 30, biennial
New Hampshire BA Yes 40, biennial
New Jersey BA No 60, Triennial
New Mexico BA No 24, annual
New York N/A N/A N/A
North Carolina AA Yes 30, biennial
North Dakota BA Yes 20, annual
Ohio BA Yes 20, annual
Oklahoma BA or AA Yes 24, annual
Oregon BA Yes 20, annual
Pennsylvania HS Yes 48, biennial
Rhode Island BA No 40, biennial
South Carolina AA Yes 20, annual
South Dakota AA Yes 40, biennial
Tennessee AA Yes 18, annual
Texas BA Yes 40, biennial
Utah HS No 40, biennial
Vermont BA Yes 40, biennial
Virginia BA No 20, annual
Washington BA No 36, biennial
West Virginia BA Yes 20, annual
Wisconsin N/A Yes 24, biennial
Wyoming BA No 25, annual

Helpful Resources for Aspiring Nursing Home Administrators

There is a broad spectrum of resources for students pursuing a career as an LNHA. The following list of professional organizations can assist students and professionals as they pursue a career in this rewarding field.

  • National Association of Long-Term Care Administrator Boards: NAB is the leading national authority on licensing professionals within the long-term care industry. Students will find everything they need about licensure, from exam information and state boards to academic accreditation and continuing education.
  • State Websites: Students can also find state-level websites, such as ones for Missouri and Massachusetts. Each state may also have its own internship requirements and programs, such as New York.
  • American Healthcare Association: The AHCA is the country’s largest long-term and post-acute care provider association, advocating for quality care for elderly and disabled people. The AHCA has state affiliates that may prove helpful for students.
Rachel Drummond, MEd
Rachel Drummond, MEd

As a contributor on MHAOnline, Rachel Drummond has brought her expertise in education and mindfulness to the healthcare management field since 2019. She writes about integrating innovation into healthcare administration, emphasizing the importance of mental and physical well-being for effective leadership and decision-making in the fast-paced world of healthcare management.

Rachel is a writer, educator, and coach from Oregon. She has a master’s degree in education (MEd) and has over 15 years of experience teaching English, public speaking, and mindfulness to international audiences in the United States, Japan, and Spain. She writes about the mind-body benefits of contemplative movement practices like yoga on her blog, inviting people to prioritize their unique version of well-being and empowering everyone to live healthier and more balanced lives.