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, the role of an LNHA is one of the most crucial at these facilities. LNHAs are in charge of managing staff, patients, admissions, budgets, records, equipment maintenance and upgrades, and compliance with federal regulations.

In a typical day, nursing home administrators manage the daily duties of employees, 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 make sure patients are safe and healthy, LNHAs must ensure local and federal regulations are being met, doing all that they can to maintain compliance in all areas. As such, it can be a very demanding and stressful job, often requiring off-hours work during the evenings, on weekends, and on holidays. Moreover, because they often deal with challenging situations, they must excel at stress management and communication.

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, as well as 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 reports that medical and health service managers (including LNHAs) have a median annual salary of $100,980. reported a median annual salary of $117,533 for nursing home administrators, with a typical range of between $104,535 and $130,819.

Furthermore, the BLS projected that openings for medical and health service managers will swell 32 percent nationwide between 2019 and 2029, much faster than the four percent average expected among all U.S. occupations in that same decade.

This growth is in large part 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 the need for 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 diploma. 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 their search on universities and colleges that offer bachelor’s degrees in nursing home administration or closely related fields. Many choose to 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 subjects that are most important 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, which can provide them with similar education but with a heavier clinical focus. Below are a few well-known online programs that aspiring LNHAs can consider:

  • Utica College offers an online MHA in healthcare administration with a focus on three specializations: acute care (financial management and development of IT systems at acute care facilities), service organizations (organizational development and leadership), and long-term care (effective management practices in planning and quality improvement). Graduates can expect to develop a thorough understanding of designing, developing, and evaluating administrative strategies.
  • Maryville University designed an online master of health administration with concentrations available in data management, senior services, healthcare strategies, or population management. No healthcare experience is required with this 100 percent online program.
  • USC Leonard Davis offers an online master of arts in gerontology that can be completed in as little as 18 months. Courses focus on the spectrum of the aging process, from sociology and biology to social policy and psychology, and can prepare students for careers that feature distinct leadership roles in business, administration, medicine, law, and advocacy for the elderly.

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:

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

The NAB website has details about state-specific requirements as well as exam fees, which range from $175 to $425 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 administrator in training (AIT) hours, but not all states require a state exam.

Note that 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
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 Yes 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, biennial
New Mexico BA Yes 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 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 to know 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 largest association of long-term and post-acute care providers in the country, advocating for quality care for elderly and disabled people. The AHCA has state affiliates that may prove helpful for students.
Rachel Drummond
Rachel Drummond

Rachel Drummond is a freelance writer, educator, and yogini from Oregon. She’s taught English to international university students in the United States and Japan for more than a decade and has a master’s degree in education from the University of Oregon. A dedicated Ashtanga yoga practitioner, Rachel is interested in exploring the nuanced philosophical aspects of contemplative physical practices and how they apply in daily life. She writes about this topic among others on her blog (Instagram: @racheldrummondyoga).