How to Become a Nursing Home Administrator

As the Baby Boomer generation ages, the healthcare industry as a whole has and will continue to see increased demand for good-quality nursing home care. This, in turn, has lead to a greater need for nursing home administrators who organize and manage patient care, staffing, finances and community relations. The U.S. Bureau of Labor Statistics estimates that by 2024, nursing home administrator jobs will grow by 17 percent. Perhaps more than ever now is the perfect time to learn how to become a nursing home administrator. Here are four steps to entering into this field.

1. Earn a Bachelor’s Degree
The minimum educational requirement for employment as a nursing home administrator is a bachelor’s degree in a business or healthcare field from an accredited college or university. Many majors exist for prospective nursing home administrators, including health services, public health, long-term care, and gerontology. In addition to a degree, graduates must complete 100 hours in a course of study in healthcare administration approved by the National Association of Long Term Care Administrator Boards (NAB). This requirement may be waived if the degree is in healthcare administration.

2. Complete a State-Approved Training Program
In addition to formal education, prospective nursing home administrators must complete a state-approved Administrator-In-Training (AIT) program consisting of supervised practice of nursing home administration in a nursing facility. Trainee administrators are assigned to a preceptor, a licensed nursing home administrator who ensures that training goals are met. Preceptors attend to trainees’ learning needs and provide periodic progress reports to the Board throughout the training period. The length of an AIT program depends on a trainee’s education. On average, trainees must complete a minimum of 1,000 hours of training. Completion of an AIT program enables prospective nursing home administrators to sit for licensure examinations.

3. Obtain a License
All states require a license to become a nursing home administrator. Although requirements for licensure vary by state, most states require prospective nursing home administrators to pass both NAB and state examinations. The NAB examination assesses candidates’ entry-level knowledge of nursing home administration. It comprises 150 questions covering five topics: resident-centered care and quality of life, leadership and management, human resources, finance, and environment. As a result, candidates must be well versed in all areas of nursing home administration. Because state exams vary, candidates are advised to consult the Board for the state in which they plan to take the examination for specific information on the examination’s format and content. Licensure is granted after achieving a passing grade of at least 75 percent on both the NAB and state examinations and is contingent upon final approval from the Board.

4. Consider Certification
Although not required, certification can help nursing home administrators gain a competitive advantage over other licensed administrators. Requirements for the American College of Health Care Administration’s Certified Nursing Home Administration (CNHA) designation include a current nursing home administrator (NHA) license held for at least two years, a minimum of two years’ experience as a nursing home administrator, a baccalaureate degree if licensed after January 1, 1996 and at least 40 hours of continuing education.

Training as a nursing home administrator takes time and effort, and only those who meet the high standards will obtain a license to practice in this challenging but rewarding field.


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