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South Carolina Nursing Home Administrator — Requirements & Free Practice

US-SC · License preparation

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Nursing Home Administrator

Licensure as a nursing home administrator under the South Carolina Board of Long Term Health Care Administrators.

Licensing authority: South Carolina Board of Long Term Health Care Administrators · Application information

Licensure by endorsement from another jurisdiction
Background
Current credit report and fingerprint review
Equivalence
Board finds other jurisdiction's standards substantially equivalent
Existing License
Current nursing home administrator license from another jurisdiction
Scores
Passed national and South Carolina portions; transferred national scores may be submitted
Placement in inactive status
No examination is required for this applicant pathway.
Employment
Must affirm no employment as an administrator in a covered facility
Filing
Application and fee by license expiration

Official no-examination sources

Effective from 2026-09-22.

Initial licensure by examination
Age
At least 21 years
Application
Complete application, references, transcripts, fees, and Board approval before exam registration
Background
State and federal fingerprint review, character evaluation, and current credit report
Education Experience
One of the statutory education and experience combinations or Board-approved HSE qualification
Provisional licensure during unexpected vacancy
Consultant
Consultant administrator may be required after exam failure or on extension
Duration
Expires after 90 days or issue of initial license unless Board extends it
Pre Examination
May receive provisional license before passing examinations; examinations remain required for permanent licensure and continuation
Vacancy
Facility has unexpected administrator vacancy; owner or board officer supplies required letter
Reactivation from inactive status
No examination is required for this applicant pathway.
Filing
Application, fee and annual continuing education for every inactive year

Official no-examination sources

Effective from 2026-09-22.

Reactivation from retired status under five years
No examination is required for this applicant pathway.
Filing
Application, fee, six hours of recent continuing education and 14 more within 90 days

Official no-examination sources

Effective from 2026-09-22.

Reinstatement after more than one year of lapse
Continuing Education
Board rule allows accumulated continuing education or retaking national and state examinations; statute requires current initial qualifications
Lapse
Initial application and current licensure qualifications required after more than one year
Reinstatement within one year of lapse
No examination is required for this applicant pathway.
Filing
Renewal application, fees, continuing education proof, and affidavit of no practice during lapse
Lapse
License lapsed within one year and was neither revoked nor suspended

Official no-examination sources

Effective from 2026-09-22.

License renewal
No examination is required for this applicant pathway.
Continuing Education
20 hours, including five in patient care; application and fee

Official no-examination sources

Effective from 2026-09-22.

Placement in retired status
No examination is required for this applicant pathway.
Eligibility
Age 65 or at least 20 years licensed; no covered administrator employment
Filing
Application and fee by license expiration

Official no-examination sources

Effective from 2026-09-22.

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

South Carolina Nursing Home Administrator State Examination

Examination outline
  • Standards for Licensing Nursing Homes
Examination sources