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Illinois Nursing Home Administrator — Requirements & Free Practice

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Nursing Home Administrator

Ordinary nursing home administrator license.

Licensing authority: Department of Financial and Professional Regulation · Application information

Licensure by endorsement
Illinois Nursing Home Administrator Supplemental Examination
Board Review
The Department may request additional information or a Board interview.
Education
Provide high school or GED certification and qualifying education or experience.
Equivalence
The other jurisdiction requirements or applicant qualifications at original licensure must have been substantially equivalent to Illinois requirements at that time.
Existing License
Hold a nursing home administrator license from another U.S. jurisdiction.
Records
Provide original jurisdiction certification, examination scores, health statement, work history, and fee.
Initial licensure by examination
Age
At least 21.
Application
Apply to IDFPR, pay the fee, and provide required work history and records.
Education
High school or GED plus an accepted degree, approved course, or qualifying nursing/college education with experience.
Health
Statement of sound physical and mental health dated within one year of application.
Religious Accommodation
Applicants from qualifying religious denominations receive an examination without medical-technique proficiency.
Score Timing
Complete both portions within three years of application; apply for the license within one year after successful examination notice.
License renewal
No examination is required for this applicant pathway.
Fee CE
Pay renewal fee and certify required continuing education; first renewal is exempt from continuing education.
Timing
Renew during the month before November 30 of an odd-numbered year.

Official no-examination sources

Effective from 2026-09-22.

Restoration after five years or less: expired
No examination is required for this applicant pathway.
Continuing Education
Provide 36 hours of continuing education or three semester hours of college coursework completed in the prior two years.
Fees
Pay the applicable restoration or renewal fees.
Status
Expired license for five years or less.

Official no-examination sources

Effective from 2026-09-22.

Restoration after five years or less: inactive
No examination is required for this applicant pathway.
Continuing Education
Provide 36 hours of continuing education or three semester hours of college coursework completed in the prior two years.
Fees
Pay the applicable restoration or renewal fees.
Status
Inactive license for five years or less.

Official no-examination sources

Effective from 2026-09-22.

Restoration after more than five years
Alternative Fitness
In addition to continuing education, submit qualifying active out-of-state practice, military-service affidavit, another 36 hours of continuing education, or pass both portions of the licensure examination.
Continuing Education
Provide 36 hours of continuing education or three semester hours of college coursework in the prior two years.
Fee
Pay the applicable restoration fee.
Status
License expired or inactive for more than five years.

Limited Nursing Home Administrator License

Restricted to qualifying religious institution.

Licensing authority: Department of Financial and Professional Regulation · Application information

Limited initial licensure for qualifying religious institution
Education Health
Satisfy the education, experience, and applicable health documentation in 68 Ill. Adm. Code 1310.30.
Medical Techniques
The examination may not require medical-technique proficiency.
Practice Limit
May administer only an institution of the certifying church or denomination.
Religious Certification
Certification by a recognized church or denomination relying on spiritual healing, approving administration of its care institution.
License renewal
No examination is required for this applicant pathway.
Fee CE
Pay renewal fee and certify required continuing education; first renewal is exempt from continuing education.
Timing
Renew during the month before November 30 of an odd-numbered year.

Official no-examination sources

Effective from 2026-09-22.

Limited Temporary Nursing Home Administrator License

Temporary restricted religious-institution license.

Licensing authority: Department of Financial and Professional Regulation · Application information

Temporary license extension
Extension
Request extension pending successful completion of the next available licensure examination; a missed or failed examination voids the temporary license.
Fee
Pay the extension processing fee when applicable.
Special Circumstances
A 12-month extension may also be requested for qualifying military service, incapacitating illness, or unanticipated relocation, subject to Board recommendation and Department approval.
Initial limited temporary licensure for qualifying religious institution
After Issue Exam
Take the licensure examination during the temporary period.
Appointment
Accepted or appointed as full-time administrator.
Education Health
Submit the temporary-license education, experience, health, and work-history documentation.
Practice Limit
Limited to an institution of that church or denomination and the named facility.
Religious Certification
Certifying church or denomination approves the applicant to administer its care institution.

Temporary Nursing Home Administrator License

Facility-specific temporary license.

Licensing authority: Illinois Department of Financial and Professional Regulation · Application information

Temporary license extension
Extension
Request extension pending successful completion of the next available licensure examination; a missed or failed examination voids the temporary license.
Fee
Pay the extension processing fee when applicable.
Special Circumstances
A 12-month extension may also be requested for qualifying military service, incapacitating illness, or unanticipated relocation, subject to Board recommendation and Department approval.
Initial temporary licensure
After Issue Exam
Take the next scheduled licensure examination before the temporary license expires.
Appointment
Accepted or appointed as a full-time administrator at a named Illinois licensed nursing-care facility.
Duration
Temporary license is facility-specific and generally valid for one year.
Education Health
Submit health statement, high school or GED, accepted education or qualifying experience, and work history.
Fee
Submit application and fee; practice authority can begin for up to 60 days while pending.

Illinois Nursing Home Administrator Supplemental Examination

Provider
Continental Testing Services
Format
Multiple-choice
Time limit
90 minutes
Passing score
75
Examination outline
  • General Provisions and Administration (17%)
    • Subpart A General Provisions — Sections 300.110 through 300.340
    • Subpart B Administration — Section 300.510
    • Subpart C Medical Staffing — Section 300.1230
    • Subpart K Maintenance, Housekeeping and Laundry — Sections 300.2210 through 300.2230
    • Subpart L Furnishings, Equipment and Supplies — Sections 300.2410 through 300.2430
    • Subpart M Water Supply/Sewage Disposal — Sections 300.2610 through 300.2640
    • Subparts N/O Design/Construction Standards — Sections 300.2810 through 300.3140
    • Subpart R Daycare Programs — Section 300.3710
  • Policy and Personnel (15%)
    • Subpart C Policies — Sections 300.610 through 300.690
    • Subpart D Personnel — Sections 300.810 through 300.840
  • Medical Services (35%)
    • Subpart E Medical/Dental Care — Sections 300.1010 through 300.1050
    • Subpart F Nursing/Personal Care — Sections 300.1210 through 300.1240
    • Subpart H Medications — Sections 300.1610 through 300.1650
  • Resident Services (33%)
    • Subpart G Resident Care Services — Sections 300.1410 through 300.1430
    • Subpart I Records — Sections 300.1810 through 300.1880
    • Subpart J Food Service — Sections 300.2010 through 300.2110
    • Food Service Sanitation Rules/Regulations — Sections 750.100 through 750.1700
    • Subpart P Residents' Rights — Sections 300.3210 through 300.3330
    • Subpart S Persons with Serious Mental Illness — Sections 300.4000 through 300.4090
    • Subpart U Alzheimer’s Special Care Units — Sections 300.7000 through 300.7080
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