One of the most common points of confusion for new candidates, settled up front: yes, nursing home administrator licensure requires passing both NAB exams. Here is what each one is, how they differ, how they are scored, and how to prepare for the pair without doing the work twice.
| Core of Knowledge (CORE) | NHA Line of Service | |
|---|---|---|
| What it is | The foundation exam, required of all long-term care administrator candidates across every line of service | The nursing home specific exam for NHA licensure |
| Questions | 125 total (100 scored + 25 unscored pretest) | 75 total (60 scored + 15 unscored pretest) |
| Time | 150 minutes | 90 minutes |
| Pace | 72 seconds per question | 72 seconds per question |
| Content | All 4 NAB domains, weighted toward Care & Services and Operations | Same 4 domains, weighted toward nursing-home-specific care and regulatory scenarios |
| Passing score | 113 scaled (50-150 scale) | 113 scaled (50-150 scale) |
| Delivery | Computer-based, multiple choice with four options, at Pearson VUE testing centers | |
Figures reflect NAB's published materials as of July 2026; the current NAB Candidate Handbook is the final word.
NAB licenses administrators across several lines of long-term care service: nursing homes (NHA), residential care and assisted living (RCAL), and home and community based services (HCBS). Rather than build fully separate exams that repeat the shared material, NAB splits the job in two. The Core of Knowledge exam covers what every long-term care administrator must know, regardless of setting: financial management, human resources, regulatory fundamentals, quality, leadership. Your Line of Service exam then tests the setting-specific layer; for nursing home administrators that means the NHA exam, with its emphasis on skilled nursing regulation and clinical care scenarios.
The practical consequence: the two exams draw on the same 4-domain outline, which means preparation genuinely transfers between them. The full domain map, including how each exam weights the domains differently and the restructure coming July 1, 2027, is in The Core Domains Explained.
Application is commonly combined (NAB's published fee schedule lists a combined Core + NHA application, $480 effective February 1, 2026), and scheduling runs through your Authorization to Test and Pearson VUE. Whether you sit both on one day or split them is a scheduling decision governed by your ATT windows and seat availability; the handbook and your state board describe the current mechanics. Candidates who split them usually take the Core first, since it is the broader exam and the NHA builds on the same domains.
Scoring is independent. Pass one and fail the other, and you retake only the failed exam, unless your state board says otherwise. How retakes work, including the four-attempts-per-cycle cap, is covered in NAB Exam Pass Rates and Retakes.
NAB publishes no comparative statistics, so every answer you will read is opinion. What can be said structurally: the Core is longer and wider, and it is where candidates from clinical backgrounds meet the finance and HR material that is furthest from their experience. The NHA is shorter but denser in nursing-home-specific care and survey scenarios, which is where business-background candidates feel the stretch. In other words, the harder exam is usually the one furthest from your day job. An honest breakdown of the overall difficulty question, including what NAB does and does not publish, is in How Hard Is the NAB Exam?
Because both exams share the domain outline, the efficient preparation is one program that covers every domain and adds nursing-home-specific depth, not two separate cram cycles. A structure that works: daily mixed practice across all 4 domains so nothing decays, targeted drilling on your weakest domain, all 15 calculation types until they are automatic (they appear on both exams; free walkthrough in The 15 NAB Math Calculations), and timed full-length rehearsal before test day. Also check whether your state adds its own exam on top of the pair: your state's page in our state-by-state requirements guide covers that, along with AIT hours and CE rules.
Question counts, timing, fees, and scoring above reflect NAB's published materials as of July 2026 and change between handbook editions. Some states also require additional state-specific exams or licensing steps. The current handbook and your state board are the final word.
Yes. NHA licensure requires passing both the Core of Knowledge exam and the NHA Line of Service exam. Some states add a state exam on top of the two.
The Core (125 questions, 150 minutes) tests foundational knowledge across all lines of long-term care. The NHA (75 questions, 90 minutes) tests the same 4 domains with nursing-home-specific weighting and scenarios.
NAB publishes no comparative data, so any ranking is opinion. The Core is longer and broader; the NHA is shorter and more setting-specific. Which feels harder usually tracks your professional background.
A scaled score of 113 on each exam, on a 50-to-150 scale, scored independently. Fail one and you retake only that one, unless your state board says otherwise.
100 NAB-style questions a day across all 4 Core domains plus the NHA Line of Service, automatic weak-spot training, and a weekly timed Checkpoint. Try 5 free questions first.
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