Nursing Home Administrator

The population in the United States over 65 is slated to double by 2050, increasing demands for long-term care facilities. Roughly 69 percent of the country will be in long-term care at some point in their lives (Administration of Aging, LongTermCare.gov). Not surprisingly, the demand for nursing home administrators is growing as they are the ones who ensure that the business side of these nursing homes is running smoothly. They are responsible for a range of duties, including budgeting, staffing, facilities management, patient satisfaction, and compliance. 

Professionals in the field have generally completed a bachelor’s degree in healthcare management, although more and more students are pursuing a master’s in health management to be more competitive in the job market. 

Licensing for nursing home administrators is done at the state level but is overseen by the National Association of Long Term Care Administrator Board (NAB), which administers the national test. Some states require administrator-in-training hours to be completed for licensure. 

Continue reading to learn more about what it takes to become a nursing home administrator, job prospects in the field, education requirements, and steps to obtain a license.

Nursing home administrators have typically earned either a bachelor’s or master’s degree at an accredited college or university. Undergraduate majors for this career include healthcare management, health administration, and administration in health systems, among others. 

Various graduate-level degrees are available, including a master’s of business administration (MBA) with an emphasis in healthcare administration or a master of health administration (MHA). 

Specializations within this field include community health, long-term health administration, health informatics, and gerontology. 

Admission requirements for nursing home administrator programs vary from institution to institution. Most undergraduate programs require first-time college students to have completed high school or a GED. Students are also typically required to take specific high school courses to be eligible for admission, such as foreign language and advanced math. SAT or ACT scores are required for most schools as well. 

Master’s degree students may be required to submit GRE or GMAT scores, depending on the type of degree they are pursuing. Many programs require work experience prior to applying for an MBA or MHA degree so students will need to supply their resume. Depending on the program, letters of recommendation and personal statements may be required. 

The National Association of Long Term Care Administrator Board (NAB) helps license, credential, and regulate administrators of long term care facilities. They have accredited programs in 14 schools across the country in nursing home administration (NHA), residential care/assisted living (RCAL), or health services executive qualification (HSE). These programs are both graduate and undergraduate degrees. 

The Commission on Accreditation of Healthcare Management Education (CAHME) overseas individual program accreditation for master’s degrees in healthcare management. This governing agency promotes, improves, and evaluates graduate healthcare management degrees in the United States and Canada.

Overall, prospective students should ensure that their programs of interest are accredited by an organization with approval from the Council on Higher Education Accreditation (CHEA), a national standard for academic quality.

Kent State University- School of Lifespan Development and Educational Services

Kent State offers a bachelor of science in human development and family studies with a concentration in nursing home administration. Students in this concentration take courses in accounting, management, and human resources, in addition to courses on gerontology, biology of aging, and death and dying. Overall, students are required to complete 36 core credits, six elective credits, and at least six general science credits to complete this degree. 

Graduates will be qualified to work as administrators in long-term care facilities and will be eligible to sit for the national and state exams required to become a licensed nursing home administrator (LNHA).

• Location: Kent, OH
• Duration: Four years
• Accreditation: National Association of Long Term Care Administrator Board (NAB) 

University of Washington – School of Public Health

The master’s in health administration (MHA) at the University of Washington’s School of Public Health prepares students to become the healthcare leaders of tomorrow. Ranked nationally by US News & World Report, this program is designed for early-career professionals seeking employment as health administrators. Students are required to complete 25 courses for a total of 76 credits, including a capstone project. Internships between the first and second years of study are required. 

• Location: Seattle, Washington
• Duration: Two years
• Accreditation: Commission on Accreditation of Healthcare Management Education (CAHME)

University of Minnesota – School of Public Health

The University of Minnesota offers a Master of Healthcare Administration (MHA) program through its School of Public Health. This program prepares students for leadership roles in various healthcare settings, including long-term care facilities. The curriculum encompasses courses in healthcare finance, organizational management, health policy, and ethics. Students also engage in a summer residency between the first and second years, providing practical experience in a healthcare organization. Graduates are well-equipped to pursue licensure as nursing home administrators, subject to state-specific requirements.

• Location: Minneapolis, MN
• Duration: Two years
• Accreditation: Commission on Accreditation of Healthcare Management Education (CAHME)

​Del Mar College – Department of Allied Health

Del Mar College offers an Advanced Technical Certificate in Long Term Care Nursing Home Administration, designed for individuals holding a bachelor’s degree in any field who aspire to become licensed nursing home administrators in Texas. The program encompasses coursework aligned with the National Association of Long Term Care Administrator Boards (NAB) domains, including resident care and quality of life, human resources, finance, physical environment, and leadership and management. Students must complete a minimum of 15 semester credit hours in these areas. 

Additionally, the program requires a minimum of 1,000 hours of internship training in a licensed nursing facility, with at least 500 hours completed during traditional business hours. This comprehensive approach ensures that graduates meet the educational and practical experience requirements set by the Texas Department of Aging and Disability Services (DADS) for licensure.

• Location: Corpus Christi, TX
• Duration: One to one and a half years 
• Accreditation: Southern Association of Colleges and Schools Commission on Colleges (SACSCOC)​

University of Wisconsin-Eau Claire – College of Business

The University of Wisconsin-Eau Claire offers a Bachelor of Business Administration (BBA) in Health Care Administration (HCAD), preparing students for leadership roles in long-term and post-acute care settings. The program is accredited as a Health Service Executive (HSE™) program by the National Association of Long Term Care Administrator Boards (NAB). A distinctive feature of this program is the 12-month paid Administrative Residency, providing students with hands-on experience in a real healthcare environment. This residency bridges academic knowledge with practical application, enhancing leadership and management skills. Graduates are eligible to sit for the Nursing Home Administrator licensure exam in Wisconsin, Minnesota, and many other states. 

• Location: Eau Claire, WI
• Duration: Four years
• Accreditation: National Association of Long Term Care Administrator Boards (NAB)

Western Michigan University

​Western Michigan University’s online bachelor of science in healthcare services and sciences (BS-HSS) program equips students with a comprehensive understanding of the healthcare system, preparing them for diverse roles in health services or further graduate studies. The curriculum encompasses essential topics such as health policy, medical terminology, ethics, health literacy, patient communication, and service delivery. Students also engage in a capstone project or internship to gain practical experience. 

Students can pursue the 15-credit minor in long-term care administration to specialize further. This minor imparts the skills and knowledge necessary to manage operations in nursing facilities, adult day care centers, home care organizations, or assisted living facilities. The coursework covers federal regulations applicable to all U.S. nursing facilities and provides guidelines for effective management across various long-term care services. Completing this minor meets the educational requirements for licensure as a nursing home administrator in the State of Michigan. 

• Location: Kalamazoo, MI
• Duration: Four years
• Accreditation: Higher Learning Commission (HLC)

Southeast Community College

​Southeast Community College’s long-term care administration program is designed for individuals aspiring to leadership roles in assisted living or nursing home settings. Offered entirely online, the program provides flexible learning options tailored to meet the educational requirements for licensure as a nursing home administrator and exceeds the standards for assisted living administrator approval in Nebraska. Students can choose between an associate of applied science degree and a certificate option, depending on their prior educational background. The curriculum covers essential topics such as financial management, ethics, marketing, and regulatory standards, preparing graduates to oversee the operations of long-term care communities. While the program equips students with the necessary education, completion of an administrator-in-training program and passing relevant licensure exams are required to practice, with specific requirements varying by state. ​

• Location: Lincoln, NE
• Duration: Two years for the associate’s
• Accreditation: Higher Learning Commission (HLC)

Rasmussen College – School of Business

Graduates of an associate degree program can attend Rasmussen College’s fully online bachelor’s completion program and earn a bachelor of science (BS) in health management in 18 months. The course comprises 23 courses for a total of 90 credits. Students take courses in healthcare policy, healthcare law and ethics, and operations management. 

The hands-on courses and simulation exercises that are integral to the course prepare students to step into leadership roles with patient-first practices. This program features competency-based education allowing students to demonstrate what they know and receive credit for it, rather than simply completing courses on a schedule.  

• Location: Bloomington, MN
• Duration: 18 months
• Accreditation: Higher Learning Commission (HLC)

Suffolk University Boston – Sawyer Business School 

Business-minded students with a passion for healthcare can find the online master’s of health administration (MHA) at Suffolk University Boston to be a great fit. This program is designed for professionals already in the field seeking advancement and those wishing to pursue a new career in health management. 

Students can complete this fully online program in 28 months. Through the course of their studies, students gain hands-on experience in the field, master analyzing data-driven business decisions, and learn from healthcare industry leaders excelling in the field. 

• Location: Boston, MA
• Duration: 28 months
• Accreditation: Commission on Accreditation of Healthcare Management Education (CAHME)

Western Governors University (WGU) 

Western Governors University offers a bachelor’s of science in healthcare administration, designed to prepare students for administrative and managerial roles within the healthcare sector. The program integrates general business competencies with specialized skills in healthcare administration, covering areas such as healthcare policy, regulatory guidelines, emergency planning, and evidence-based practices. 

Students also take courses focusing on leadership, strategic thinking, and innovation. The curriculum culminates in a capstone project, allowing students to apply their learning in a practical context. WGU’s competency-based approach allows students to progress through the program at their own pace, potentially accelerating their educational journey based on prior knowledge and experience. Graduates are prepared for entry-level positions in various healthcare settings, including skilled nursing facilities, hospitals, insurance companies, and community health organizations. 

• Location: Fully Online
• Duration: Approximately 2.5 years 
• Accreditation: Northwest Commission on Colleges and Universities (NWCCU)

Depending on the level of education pursued, a person can expect to become a nursing home administrator in three to six years. The length of time depends largely on state licensing requirements and the number of administrator-in-training hours required. 

Step 1: Graduate from High School (Four Years)

Since a secondary degree is required for a career in nursing home administration, students will need to complete high school. Business, science, and math classes in high school help prepare students for their continuing education.

Step 2: Earn a Degree in Health Administration (Two to Six Years)

Some states only require students to have earned an associate degree to be credentialed as a licensed nursing home administrator (LNHA), but the majority require at least a four-year degree. However, with the job market becoming increasingly competitive, many students pursue a master’s degree in business administration (MBA) or health administration (MHA) to gain more skills and a competitive advantage. 

Step 3: Get Licensed (Timelines Vary)

Requirements for becoming an LNHA vary by state. Requirements for each state can be found on the National Association of Long Term Care Administrator Board (NAB) website. Eligibility to take the nursing home administration (NHA), resident care/assisted living (RCAL), and home- and community-based services (HCBS) exams is determined by each state.

National exam fees range from $175 to $425, whereas state exam fees can be up to $500 or more. In addition to the national exams, states sometimes require their own exams as well. Many states also require administrator in training hours which can vary from as few as 200 to as many as 2000.

Nursing home administrators are the backbone of the business side of long-term care facilities.  They must:

• Maintain and manage facilities
• Hire, train, evaluate, and schedule staff
• Oversee and manage facilities
• Supervise finances, including payroll, billing, and budgets
• Set and enforce policies
• Work with diverse populations, both in patients and staff
• Ensure disease control and prevention
• Control pharmaceuticals
• Manage family, patient, and staff grievances
• Oversee marketing 
• Make sure federal, state, and local regulations are adhered to
• Protect patients rights
• Research and implement new technologies to benefit patients

Licensing to become a licensed nursing home administrator is done by individual states. The National Association of Long Term Care Administrator Board (NAB) oversees national level testing and administers the exams for the nursing home administration (NHA), resident care/assisted living (RCAL), and home and community-based services (HCBS) certifications.

Nursing home administrators fall under medical and health services managers according to the Bureau of Labor Statistics (May 2024). There are over 400,000  professionals in this field, and they earn $137,730 per year on average, with these percentiles:

• 10th percentile: $69,680
• 25th percentile: $88,560
• 50th percentile (median): $117,960
• 75th percentile: $162,420
• 90th percentile: $219,080

Here are some alternatives to a career as a nursing home administrator. 

Become a Correctional Health Administrator

A correctional health administrator oversees the delivery of medical, mental health, and dental care within correctional facilities, ensuring compliance with healthcare regulations and standards. They manage clinical staff, coordinate care services, develop policies, and handle budgeting and administrative tasks to support inmate health and facility operations.

• Typical Education: Bachelor’s degree
• Licensing or Certifying Organization: National Commission on Correctional Health Care (NCCHC)

Become a Health Information Manager 

Health information managers oversee the collection, storage, and protection of patient health records, ensuring accuracy, confidentiality, and compliance with healthcare regulations. They use technology and data management systems to support clinical decision-making, billing, and overall healthcare operations.

• Typical Education: Bachelor’s degree
• Licensing or Certifying Organization: American Health Information Management Association (AHIMA)

Become a Healthcare Risk Manager

A healthcare risk manager identifies, assesses, and mitigates potential risks that could harm patients, staff, or the organization within a healthcare setting. They develop policies, oversee incident reporting, and ensure compliance with legal and regulatory standards to enhance patient safety and reduce liability.

• Typical Education: Bachelor’s degree
• Licensing or Certifying Organization: American Hospital Association (AHA)

Kimmy Gustafson

Writer

At HealthcareDegree.com, Kimmy Gustafson has delivered in-depth and insightful articles since 2019, aiding prospective students to navigate the complexities of choosing the right healthcare degree. Her recent work includes topics such as the ethics of gene editing and physician assistant’s fight for autonomy.

Kimmy has been a freelance writer for more than a decade, writing hundreds of articles on a wide variety of topics such as startups, nonprofits, healthcare, kiteboarding, the outdoors, and higher education. She is passionate about seeing the world and has traveled to over 27 countries. She holds a bachelor’s degree in journalism from the University of Oregon. When not working, she can be found outdoors, parenting, kiteboarding, or cooking.