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Arkansas Nursing Home Administrator — Requirements & Free Practice

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Licenses, application pathways and examination requirements

Each license and applicant pathway has its own requirements and exemptions. Choosing practice questions does not determine your eligibility.

Inactive Nursing Home Administrator License

A licensed administrator not administering or managing a nursing home may keep their license current by completing the renewal application's inactive administrators section and submitting the required inactive license fee.

Licensing authority: Department of Human Services

Change active licence to inactive status
No examination is required for this applicant pathway.
Renewal
Pay inactive fee and verify continuing education compliance.

Official no-examination sources

Effective from 2025-01-01.

Annual inactive licence renewal
No examination is required for this applicant pathway.
Renewal
Pay inactive fee; inactive status can last at most three consecutive years.

Official no-examination sources

Effective from 2025-01-01.

Nursing Home Administrator License

Licence required to administer, manage, supervise, or be in general administrative charge of a nursing home.

Licensing authority: office of long-term care · Application information

Initial licensure by examination
Age
At least 21 years old.
Application
Sworn application, fee, State Police background check, approved administrator-in-training proof.
Character And Health
Ethics compliance and ability to perform full-time administrator duties.
Education And Experience
Qualifying education and nursing-home experience or internship, or approved administrator-in-training program.
Other Exam
The DHS implementation page permits either NHA LOS or RCAL/HCBS as the second NAB component; this is an alternative, not two mandatory LOS examinations.
Time Limit
18 months from approval to become licensed.
Military reciprocity for service members, veterans and spouses — granted without further training or testing
No examination is required for this applicant pathway.
Applicability
This route applies only when DHS grants reciprocity without further training or testing; the waiver is not automatic. If DHS does not grant the waiver, obtain the individual examination requirements; this route does not specify them.
Documents
Application, DD214, DMS-7790, Social Security card, photo ID and joint service transcript.
Eligibility
Qualifying service member, veteran or spouse, with similar-scope NHA licence in good standing and qualifying training and competency program.
Waiver
Military reciprocity may be granted without further training or testing.

Official no-examination sources

Effective from 2025-04-16.

Automatic occupational licensure for out of state individuals — DHS does not require an additional examination
No examination is required for this applicant pathway.
Applicability
This route applies only when DHS does not exercise its authority to require an examination. If DHS requires an examination, obtain the individual requirements; the general discretionary clause does not establish a mandatory CORE/NHA/state combination.
Background
No disqualifying offence or pending complaint, allegation or investigation.
Discretion
DHS may require an examination under 20 CAR § 402-305(c).
Other Requirements
Meet all other Arkansas requirements, including background check and continuing education.
Prior Practice
Similar-scope US licence in good standing for one year, or three years of work in a jurisdiction that does not license this occupation.

Official no-examination sources

Effective from 2025-04-16.

Reactivation of inactive licence
No examination is required for this applicant pathway.
Reactivation
Notify the division and complete required continuing education hours; individualized guidance is available from the Office.

Official no-examination sources

Effective from 2025-01-01.

Annual active licence renewal
No examination is required for this applicant pathway.
Renewal
Submit application, fee and continuing education verification by July 1.

Official no-examination sources

Effective from 2025-01-01.

temporary or provisional certified nha licensure

Temporary or provisional NHA license granted to a uniformed service member, uniformed service veteran, or their spouse while full licensure is expedited.

Licensing authority: Office of Long-Term Care, Division of Provider Services and Quality Assurance, Department of Human Services

Temporary or provisional military NHA licence
No examination is required for this applicant pathway.
Eligibility
Qualifying service member, veteran or spouse while full licensure is expedited.

Official no-examination sources

Effective from 2025-01-01.

Arkansas Nursing Home Administrator State Licensure Exam

Format
In-person written examination
Passing score
70
Examination outline
  • 20 CAR Part 400. Rules for Nursing Homes
  • 20 CAR Part 402. Rules for Licensing of Nursing Home Administrators in Arkansas
Examination sources

NAB National Core Knowledge Exam for Long-Term Care Administrators (CORE)

Provider
Pearson VUE
Format
Objective multiple-choice items with four response options, one correct; delivered by Pearson VUE
Exam questions
125 (100 scored, 25 non-scored pretest)
Time limit
150 minutes seat time; 2 hours 10 minutes to answer questions
Passing score
Scaled score of 113 on a 50-150 scale
Exam fee
CORE only $320; CORE and NHA combo $480 (effective 2/1/2026)
Examination outline
  • Care, Services, and Supports (39%)
    • Quality of Care: Medical and Nursing Care Practices
    • Quality of Care: Medication Management and Administration
    • Quality of Care: Disease Management (e.g., acute vs. chronic conditions)
    • Quality of Care: Nutrition and Hydration (e.g., specialized diets)
    • Quality of Care: Activities of Daily Living (ADLs) and Independent Activities of Daily Living (IADLs)
    • Quality of Care: Rehabilitation and Restorative Programs
    • Quality of Care: Care Recipient Assessment and Interdisciplinary Care Planning
    • Quality of Care: Clinical and Medical Records and Documentation Requirements (e.g., storage, retention, destruction)
    • Quality of Care: Medical Director
    • Quality of Care: Emergency Medical Services (e.g., CPR, first aid, Heimlich maneuver, AED)
    • Quality of Care: Transition of Care (e.g., admission, move-in, transfer, discharge, and move-out)
    • Quality of Care: Basic Healthcare Terminology
    • Quality of Life: Psychosocial Needs (e.g., social, spiritual, community, cultural)
    • Quality of Life: Person-Centered Care and Comprehensive Care Planning
    • Quality of Life: Care Recipient Bill of Rights and Responsibilities
    • Quality of Life: Care Recipient Safety (e.g., fall prevention, elopement prevention, adverse events)
    • Quality of Life: Care Recipient (and Representative) Grievance, Conflict, and Dispute Resolution
    • Quality of Life: Care Recipient Advocacy (e.g., Ombudsman, resident and family council)
    • Quality of Life: Care Recipient Decision-Making (e.g., capacity, power of attorney, guardianship, conservatorship, code status, advance directives, ethical decision-making)
    • Quality of Life: Care Recipient (and Representative) Satisfaction
    • Quality of Life: Recognition of Maltreatment (e.g., abuse, neglect, exploitation)
    • Quality of Life: Mental and Behavioral Health (e.g., cognitive impairment, depression, social support systems)
    • Quality of Life: Trauma-Informed Care (e.g., PTSD)
    • Quality of Life: Pain Management
    • Quality of Life: Death, Dying, and Grief
    • Quality of Life: Restraint Usage and Reduction
    • Quality of Life: Foodservice (e.g., choice and menu planning, dietary management, food storage and handling, dining services)
    • Quality of Life: Social Services Programs
    • Quality of Life: Therapeutic Recreation and Activity Programs
    • Quality of Life: Community Resources, Programs, and Agencies (e.g., meals on wheels, housing vouchers, Area Agencies on Aging, Veterans Affairs)
    • Ancillary Services: Hospice and Palliative Care
    • Ancillary Services: Specialized Medical Equipment (e.g., oxygen, durable medical equipment)
    • Ancillary Services: Transportation for Care Recipients
    • Ancillary Services: Telemedicine (e.g., e-health)
    • Ancillary Services: Diagnostic Services (e.g., radiology, lab services)
    • Ancillary Services: Dental and Oral Care Services
    • Ancillary Services: Healthcare Partners and Clinical Providers (e.g., MD/DO, Nurse Practitioner, Psychiatrist, Podiatrist, Dentist)
    • Ancillary Services: Volunteer Programs
  • Operations (37%)
    • Financial Management: Budgeting and Forecasting
    • Financial Management: Financial Analysis (e.g., ratios, profitability, debt, revenue mix, depreciation, operating margin, cash flow)
    • Financial Management: Revenue Cycle Management (e.g., billing, accounts receivable, accounts payable, collections)
    • Financial Management: Financial Statements (e.g., income/revenue statement, balance sheet, statement of cash flows, cost reporting)
    • Financial Management: Revenue and Reimbursement (e.g., PDPM, PDGM, ACOs, HMOs, Medicaid, private payors)
    • Financial Management: Financial Reporting Requirements (e.g., requirements for not-for-profit, for-profit, and governmental providers)
    • Financial Management: Integration of Clinical and Financial Systems (e.g., EMR/HER, MDS)
    • Financial Management: Internal Financial Management Controls (e.g., segregation of duties, access)
    • Financial Management: Supply-Chain Management (e.g., inventory control)
    • Financial Management: Resident Trust Accounts for Personal Funds
    • Risk Management: OSHA Rules and Regulations
    • Risk Management: Workers’ Compensation
    • Risk Management: Ethical Conduct and Standards of Practice
    • Risk Management: Compliance Programs
    • Risk Management: Risk Management Process and Programs
    • Risk Management: Quality Improvement Processes (e.g., root cause analysis, PDCA/PDSA)
    • Risk Management: Scope of Practice and Legal Liability
    • Risk Management: Internal Investigation Protocols and Techniques (e.g., incidents, adverse events)
    • Risk Management: Mandatory Reporting Requirements (e.g., incidents, adverse events, abuse, neglect, financial exploitation, fraud)
    • Risk Management: Insurance Coverage (e.g., liability, property)
    • Risk Management: Healthcare Record Requirements (e.g., confidentiality, disclosure, safeguarding, HIPAA, HITECH)
    • Risk Management: Security (e.g., cameras, monitoring systems, locks, staff location reporting)
    • Risk Management: Contracted Services (e.g., roles, responsibilities, oversight, background checks)
    • Human Resources: Federal Human Resources Laws, Rules, and Regulations (e.g., ADA, FMLA, Wage and Hour, FLSA)
    • Human Resources: Selection and Hiring Practices (e.g., EEOC, interviewing, adverse impact, protected classes, occupational qualifications)
    • Human Resources: Compensation and Benefits Programs (e.g., time off, healthcare insurance, employee pay and payroll)
    • Human Resources: Organizational Staffing Requirements and Reporting (e.g., PBJ)
    • Human Resources: Staff Certification and Licensure Requirements
    • Human Resources: Professional Development (e.g., maintenance of credentials, continuing education)
    • Human Resources: Employee Training and Orientation
    • Human Resources: Performance Evaluation
    • Human Resources: Human Resource Policies (e.g., drug-free workplace, discipline, job classification, photography and video, social media usage, mobile phone usage)
    • Human Resources: Employee Record-Keeping Requirements
    • Human Resources: Employee Grievance, Conflict, and Dispute Resolution
    • Human Resources: Employee Satisfaction, Engagement, and Retention
    • Human Resources: Cultural Competence and Diversity Awareness
    • Human Resources: Labor Relations (e.g., union, collective bargaining [CBA], contract/pool staff)
  • Environment and Quality (13%)
    • Care Setting: Federal Codes and Regulations for Building, Equipment, Maintenance, and Grounds
    • Care Setting: Person-Centered Environment (e.g., home-like environment)
    • Care Setting: Safety and Accessibility (e.g., ADA, safety data sheets)
    • Care Setting: Facility Management and Environmental Services
    • Care Setting: Information Systems Infrastructure (e.g., configurations, data security, technical controls)
    • Care Setting: Preventative and Routine Maintenance Programs (e.g., pest control, equipment, mechanical systems)
    • Care Setting: Infection Control and Sanitation (e.g., linens, kitchen, hand washing, healthcare-acquired infections, hazardous materials)
    • Care Setting: Disaster and Emergency Planning, Preparedness, Response, and Recovery (e.g., Appendix Z)
    • Regulatory Compliance: Federal Healthcare Laws, Rules, and Regulations
    • Regulatory Compliance: Government Programs and Entities (e.g., Medicare, Medicaid, waivers)
    • Regulatory Compliance: Certification and Licensure Requirements for the Organization
  • Leadership and Strategy (11%)
    • Leadership: Organizational Structures (e.g., departments, functions, systemic processes)
    • Leadership: Organizational Change Management
    • Leadership: Organizational Behavior (e.g., organizational culture, team building, group dynamics)
    • Leadership: Leadership Principles (e.g., communication, styles, mentoring, coaching, personal professional development)
    • Leadership: Governance (e.g., board of directors, governing bodies, corporate entities, advisory boards)
    • Leadership: Professional Advocacy and Governmental Relations
    • Organizational Strategy: Mission, Vision, and Value Statements
    • Organizational Strategy: Strategic Business Planning (e.g., new lines of service, succession management, staffing pipeline)
    • Organizational Strategy: Business Analytics (e.g., evidence-based practice, data analytics)
    • Organizational Strategy: Business Development (e.g., sales, marketing, partnerships, ACOs, contracts and agreements, negotiations)
    • Organizational Strategy: Public Relations and External Stakeholders (e.g., hospitals, referrals sources, local community, donors)
Examination sources

NAB National Nursing Home Administrators Line of Service Exam (NHA)

Provider
Pearson VUE
Format
Objective multiple-choice items with four response options, one correct; delivered by Pearson VUE
Exam questions
75 (60 scored, 15 non-scored pretest)
Time limit
90 minutes seat time; 1 hour and 10 minutes to answer questions
Passing score
Scaled score of 113 on a 50-150 scale
Exam fee
NHA only $190; CORE and NHA combo $480 (effective 2/1/2026)
Examination outline
  • Care, Services, and Supports (45%)
    • Quality of Care: Medical and Nursing Care Practices
    • Quality of Care: Medication Management and Administration
    • Quality of Care: Nutrition and Hydration (e.g., specialized diets)
    • Quality of Care: Rehabilitation and Restorative Programs
    • Quality of Care: Care Recipient Assessment and Interdisciplinary Care Planning
    • Quality of Care: Clinical and Medical Records and Documentation Requirements (e.g., storage, retention, destruction)
    • Quality of Care: Medical Director
    • Quality of Care: Emergency Medical Services (e.g., CPR, first aid, Heimlich maneuver, AED)
    • Quality of Care: Transition of Care (e.g., admission, move-in, transfer, discharge, and move-out)
    • Quality of Life: Psychosocial Needs (e.g., social, spiritual, community, cultural)
    • Quality of Life: Person-Centered Care and Comprehensive Care Planning
    • Quality of Life: Care Recipient Bill of Rights and Responsibilities
    • Quality of Life: Care Recipient Safety (e.g., fall prevention, elopement prevention, adverse events)
    • Quality of Life: Care Recipient (and Representative) Grievance, Conflict, and Dispute Resolution
    • Quality of Life: Care Recipient Advocacy (e.g., Ombudsman, resident and family council)
    • Quality of Life: Care Recipient Decision-Making (e.g., capacity, power of attorney, guardianship, conservatorship, code status, advance directives, ethical decision-making)
    • Quality of Life: Recognition of Maltreatment (e.g., abuse, neglect, exploitation)
    • Quality of Life: Mental and Behavioral Health (e.g., cognitive impairment, depression, social support systems)
    • Quality of Life: Trauma-Informed Care (e.g., PTSD)
    • Quality of Life: Pain Management
    • Quality of Life: Death, Dying, and Grief
    • Quality of Life: Restraint Usage and Reduction
    • Quality of Life: Foodservice (e.g., choice and menu planning, dietary management, food storage and handling, dining services)
    • Quality of Life: Social Services Programs
    • Quality of Life: Therapeutic Recreation and Activity Programs
    • Ancillary Services: Hospice and Palliative Care
    • Ancillary Services: Transportation for Care Recipients
    • Ancillary Services: Diagnostic Services (e.g., radiology, lab services)
    • Ancillary Services: Dental and Oral Care Services
    • Ancillary Services: Healthcare Partners and Clinical Providers (e.g., MD/DO, Nurse Practitioner, Psychiatrist, Podiatrist, Dentist)
    • Ancillary Services: Volunteer Programs
  • Operations (28%)
    • Financial Management: Revenue and Reimbursement (e.g., PDPM, PDGM, ACOs, HMOs, Medicaid, private payors)
    • Financial Management: Financial Reporting Requirements (e.g., requirements for not-for-profit, for-profit, and governmental providers)
    • Financial Management: Integration of Clinical and Financial Systems (e.g., EMR/EHR, MDS)
    • Financial Management: Resident Trust Accounts for Personal Funds
    • Risk Management: OSHA Rules and Regulations
    • Risk Management: Compliance Programs
    • Risk Management: Scope of Practice and Legal Liability
    • Risk Management: Internal Investigation Protocols and Techniques (e.g., incidents, adverse events)
    • Risk Management: Mandatory Reporting Requirements (e.g., incidents, adverse events, abuse, neglect, financial exploitation, fraud)
    • Risk Management: Healthcare Record Requirements (e.g., confidentiality, disclosure, safeguarding, HIPAA, HITECH)
    • Risk Management: Security (e.g., cameras, monitoring systems, locks, staff location reporting)
    • Risk Management: Contracted Services (e.g., roles, responsibilities, oversight, background checks)
    • Human Resources: Organizational Staffing Requirements and Reporting (e.g., PBJ)
    • Human Resources: Staff Certification and Licensure Requirements
    • Human Resources: Professional Development (e.g., maintenance of credentials, continuing education)
    • Human Resources: Employee Training and Orientation
    • Human Resources: Performance Evaluation
    • Human Resources: Employee Record-Keeping Requirements
    • Human Resources: Cultural Competence and Diversity Awareness
  • Environment and Quality (27%)
    • Care Setting: Federal Codes and Regulations for Building, Equipment, Maintenance, and Grounds
    • Care Setting: Person-Centered Environment (e.g., home-like environment)
    • Care Setting: Safety and Accessibility (e.g., ADA, safety data sheets)
    • Care Setting: Facility Management and Environmental Services
    • Care Setting: Preventative and Routine Maintenance Programs (e.g., pest control, equipment, mechanical systems)
    • Care Setting: Infection Control and Sanitation (e.g., linens, kitchen, hand washing, healthcare-acquired infections, hazardous materials)
    • Care Setting: Disaster and Emergency Planning, Preparedness, Response, and Recovery (e.g., Appendix Z)
    • Regulatory Compliance: Federal Healthcare Laws, Rules, and Regulations
    • Regulatory Compliance: Government Programs and Entities (e.g., Medicare, Medicaid, waivers)
    • Regulatory Compliance: Certification and Licensure Requirements for the Organization
    • Regulatory Compliance: Regulatory Survey and Inspection Process
    • Regulatory Compliance: Procedures for Informal Dispute Resolution (IDR)
    • Regulatory Compliance: Centers for Medicare and Medicaid Services (CMS) Quality Measures
    • Regulatory Compliance: Quality Assurance and Performance Improvement (QAPI)
    • Regulatory Compliance: Bed-Hold Requirements
    • Regulatory Compliance: Pre-Admission Screening Annual Review (PASRR)
    • Regulatory Compliance: Facility Assessment
Examination sources

NAB National Residential Care/Assisted Living Administrators Line of Service Exam (RC/AL)

Provider
National Association of Long Term Care Administrator Boards (NAB); delivered at Pearson VUE test centers
Format
Objective multiple-choice items with four answer choices, one correct; line of service exam taken after or together with the separately scored CORE exam
Exam questions
75 (60 scored, 15 non-scored pretest)
Time limit
1 hour 30 minutes seat time; 1 hour and 10 minutes to answer questions
Passing score
Scaled score of 113 on a 50-150 scale
Exam fee
RC/AL only $190; CORE and RC/AL combo $480 (effective 2/1/2026)
Examination outline
  • Domain 1: Care, Services, and Supports (75% of the RC/AL exam) (75%)
    • 1A1 Quality of Care: Medical and Nursing Care Practices
    • 1A2 Quality of Care: Medication Management and Administration
    • 1A4 Quality of Care: Nutrition and Hydration (e.g., specialized diets)
    • 1A6 Quality of Care: Rehabilitation and Restorative Programs
    • 1A7 Quality of Care: Care Recipient Assessment and Interdisciplinary Care Planning
    • 1A8 Quality of Care: Clinical and Medical Records and Documentation Requirements (e.g., storage, retention, destruction)
    • 1A11 Quality of Care: Transition of Care (e.g., admission, move-in, transfer, discharge, and move-out)
    • 1B1 Quality of Life: Psychosocial Needs (e.g., social, spiritual, community, cultural)
    • 1B2 Quality of Life: Person-Centered Care and Comprehensive Care Planning
    • 1B3 Quality of Life: Care Recipient Bill of Rights and Responsibilities
    • 1B4 Quality of Life: Care Recipient Safety (e.g., fall prevention, elopement prevention, adverse events)
    • 1B5 Quality of Life: Care Recipient (and Representative) Grievance, Conflict, and Dispute Resolution
    • 1B6 Quality of Life: Care Recipient Advocacy (e.g., Ombudsman, resident and family council)
    • 1B7 Quality of Life: Care Recipient Decision-Making (e.g., capacity, power of attorney, guardianship, conservatorship, code status, advance directives, ethical decision-making)
    • 1B8 Quality of Life: Care Recipient (and Representative) Satisfaction
    • 1B14 Quality of Life: Restraint Usage and Reduction
    • 1B15 Quality of Life: Foodservice (e.g., choice and menu planning, dietary management, food storage and handling, dining services)
    • 1B16 Quality of Life: Social Services Programs
    • 1B17 Quality of Life: Therapeutic Recreation and Activity Programs
    • 1C3 Ancillary Services: Transportation for Care Recipients
    • 1C8 Ancillary Services: Volunteer Programs
  • Domain 2: Operations (12% of the RC/AL exam) (12%)
    • 2A5 Financial Management: Revenue and Reimbursement (e.g., PDPM, PDGM, ACOs, HMOs, Medicaid, private payors)
    • 2B7 Risk Management: Scope of Practice and Legal Liability
  • Domain 3: Environment and Quality (13% of the RC/AL exam) (13%)
    • 3A2 Care Setting: Person-Centered Environment (e.g., home-like environment)
    • 3B3 Regulatory Compliance: Certification and Licensure Requirements for the Organization
    • 3B4 Regulatory Compliance: Regulatory Survey and Inspection Process
Examination sources