DelawareNursing Home Administrator License Requirements

Nursing home administrator education requirements vary by state. Most states require at least a bachelor's degree from an accredited institution, with some states requiring a master's degree. The Administrator-in-Training (AIT) program provides supervised practical experience in a licensed nursing facility under a licensed preceptor. AIT programs range from 480 to 2,000 hours depending on the state. Many states require or prefer degrees in healthcare administration, public health, business administration, or a related field.

The NAB (National Association of Long Term Care Administrator Boards) is the primary national examination body for nursing home administrators. Approximately 45 states require the NAB examination as a condition of licensure. The NAB exam covers five domains: resident care management, human resources, financial management, governance and management, and environmental management. Some states additionally require a state-specific examination covering local regulations and laws. All states require completion of an Administrator-in-Training (AIT) program as a prerequisite.

The NAB examination is a comprehensive test covering five core domains of nursing home administration: resident care management, human resources management, financial management, governance and management, and environmental management. The exam uses a scaled scoring system with 113 as the passing threshold. Some states additionally require a state-specific jurisprudence or supplemental examination covering local laws, regulations, and facility standards. Candidates must complete all education and AIT requirements before sitting for examinations.

Additional Notes

Delaware requires one of the longest AIT programs at 2,080 hours (one full year full-time).

All 50 states and the District of Columbia require licensure for nursing home administrators under the federal Omnibus Budget Reconciliation Act of 1987 (OBRA '87). Each state establishes its own licensing board and requirements, though the NAB (National Association of Long Term Care Administrator Boards) provides a national examination used by most states. Administrators must complete an Administrator-in-Training (AIT) program and meet education requirements before licensure.

Licensed nursing home administrators are responsible for the overall management and operation of nursing facilities, including skilled nursing facilities, intermediate care facilities, and long-term care homes. They oversee resident care, staff management, financial operations, regulatory compliance, and facility maintenance. All Medicare and Medicaid-certified nursing facilities must have a licensed administrator. Some states permit dual licensure allowing administrators to oversee multiple facilities, while others require a dedicated administrator for each facility.

CE Details

48 CE hours required per 2 years renewal cycle. Topics typically include long-term care regulations, patient care management, financial management, and human resources.

Regulatory Board

Nursing home administrator licenses must be renewed on schedule with the state licensing board. Most states require biennial renewal with 20-50 continuing education hours per cycle. CE requirements typically cover long-term care regulations, patient care management, financial management, human resources, infection control, ethics, and emergency preparedness. Many states require specific topics such as abuse prevention, resident rights, and dementia care training as part of the CE requirement.

Reciprocity Requirements

• •Hold a current, active NHA license in another state
• •Provide verification of licensure from the original state
• •Pass a criminal background check
• •Pay the application and endorsement fees
• •Have passed the NAB examination

Most states offer reciprocity or endorsement for nursing home administrators licensed in other states. Requirements typically include verification of current licensure, passing the NAB examination, completion of an AIT program, and background check clearance. States that use the NAB examination generally offer smoother reciprocity for administrators who have already passed it. Some states may require a state-specific jurisprudence examination. Reciprocity agreements vary and should be verified with the specific state licensing board.