What it takes to become a licensed nursing home administrator in Alabama: the Administrator-in-Training (AIT) hours your degree sets, the NAB exams, who takes the Alabama State Written Exam, fees, continuing education, renewal and finding a preceptor. Figures come from the Board’s rules, its 2024 FAQ, the Code of Alabama and NAB, with section numbers.
| Who licenses | The Alabama Board of Examiners of Nursing Home Administrators (ALBOENHA), an independent board of seven members appointed by the Governor (Code of Ala. § 34-20-4). Its rules are Ala. Admin. Code chapter 620-X |
|---|---|
| Basic requirements | At least 19, of good moral character, and a college degree (620-X-5-.02(1); Board FAQ) |
| AIT requirement | Set by your degree: 2,000, 1,000, 500 or 200 hours; an approved internship can replace the 500 or 200; none after a NAB-approved academic program (620-X-5-.02(1)(e)) |
| National exams | NAB Core of Knowledge (CORE) and NHA Line of Service, for anyone not applying by reciprocity: a scaled score of at least 113 on each (620-X-5-.06(1)); $480 for the two, paid to NAB |
| State exam | For reciprocity (endorsement) and reinstatement applicants only (620-X-5-.06(1); 620-X-7-.01; Board FAQ): 50 questions (Board FAQ), 75 percent to pass (620-X-5-.06(1)), $350 (620-X-A-.22). First-time candidates take the NAB exams; NAB’s summary lists “State: Yes” and does not say whether first-time candidates take it. Details ↓ |
| Continuing education | 24 hours a year, no more than 10 in one day, from Board-approved or NAB/NCERS-approved courses (620-X-6-.01; Board FAQ) |
| Renewal | Every year, due the last day of the month your license expires; late renewal within 90 days, with a $400 fee (620-X-7-.01; 620-X-A-.22) |
| Board fees | $150 application, $150 original license, $125 renewal; check or money order only (620-X-A-.22; Board FAQ) |
| Official sources | alboenha.alabama.gov (the Board) · Ala. Admin. Code 620-X · nabweb.org (national exams) |
Verified against the sources above, September 2026. Rule numbers such as 620-X-5-.02 are sections of the Alabama Administrative Code. Requirements change; the current rules, as the Board applies them, govern, so confirm with the Board before you apply.
The Alabama Board of Examiners of Nursing Home Administrators, which shortens its name to ALBOENHA, licenses administrators under Act 1969-986, now Code of Alabama §§ 34-20-1 to 34-20-16. It is an independent state board, not part of the Alabama Department of Public Health (ADPH). ADPH licenses the nursing homes themselves, under its own rules in chapter 420-5-10.
The Governor appoints the Board’s seven members: three licensed nursing home administrators nominated by the Alabama Nursing Home Association (ANHA), a physician, a hospital administrator, a registered nurse and a consumer member (§ 34-20-4). The office is at 4156 Carmichael Road, Montgomery, AL 36106, phone (334) 271-2342.
Rule 620-X-5-.02(1) and Code § 34-20-9 set the basics. You must be:
With the application go three letters of reference from people “engaged in either business, or professional work” and a photo taken within the last three months (620-X-5-.03(2), (7)). Once the Board approves you, you have one year from approval to test (620-X-5-.03(9)).
Your degree sets your Administrator-in-Training (AIT) hours. The tiers are in rule 620-X-5-.02(1)(e), and the Board’s 2024 FAQ gives the same list:
| Your education | AIT | Rule |
|---|---|---|
| Associate degree, plus at least four years of supervisory experience in a licensed nursing home | 2,000 hours | (e)1 |
| Bachelor’s degree in any subject, from an accredited college or university | 1,000 hours | (e)2 |
| Bachelor’s degree with a major in health care administration | 500 hours, or a Board-approved internship affiliated with a university or college | (e)3 |
| Master’s degree with a major in health care or hospital administration | 200 hours, or a Board-approved internship affiliated with a university or college | (e)4 |
| A completed NAB Academic University Approved Program | No AIT | (e)6 |
The rule lists one more route, (e)5, for applicants who have met the requirements of the federal final rules under the Omnibus Budget Reconciliation Act of 1987 (OBRA ’87). If you think it fits you, ask the Board. The tiers have stood since the rule was last amended, effective 20 February 2001.
Rule 620-X-5-.07 sets the conditions:
Since 17 March 2022 the Board’s AIT outline forms (620-X-A-.10, .11, .18 and .20) follow NAB’s domains and set minimum hours in each:
| Program | Care, Supports and Services | Operations | Environment and Quality |
|---|---|---|---|
| 200 hours | 88 | 54 | 52 |
| 500 hours | 220 | 135 | 130 |
| 1,000 hours | 440 | 270 | 260 |
| 2,000 hours | 880 | 540 | 520 |
Your preceptor needs the Board’s approval before the program starts. Under 620-X-5-.07, Preceptor (1) to (6), a preceptor:
Approval is “effective for a period of three years”, after which the preceptor reapplies for recertification (Form 620-X-A-.16). University and college internships, the alternative on the 500- and 200-hour routes, are approved under 620-X-5-.08: the program sends the Board the student’s name, the facility and the preceptor before the internship starts.
Other states: AIT Hours by State.
The free AIT Planner turns your AIT hours into a plan across facility departments. The department split is our planning aid, not an Alabama rule: the Board approves your preceptor’s program, and its forms set minimum hours by NAB domain. No account needed.
Open the free AIT PlannerFor candidates who are not applying by reciprocity, rule 620-X-5-.06(1) requires “a score of at least 113 scale score on both” NAB exams: the Core of Knowledge (CORE) and the Nursing Home Administrator (NHA) Line of Service. The Board’s FAQ calls them a “two-part National Examination”, taken once your application is approved. NAB is the National Association of Long Term Care Administrator Boards, and you schedule its exams with Pearson VUE. From NAB’s exam information page:
| Core of Knowledge | 125 questions (100 scored, 25 unscored pretest), 150 minutes of seat time (130 to answer questions) |
|---|---|
| NHA Line of Service | 75 questions (60 scored, 15 pretest), 90 minutes of seat time (70 to answer questions) |
| Both together | $480 for CORE and NHA together, from 1 February 2026 |
| Passing score in Alabama | A scaled score of at least 113 on each, NAB’s standard on a 50 to 150 scale (620-X-5-.06(1), effective 13 April 2020) |
| Attempts | Since 1 January 2026, up to 4 per exam cycle (1 July to 30 June) |
| Scheduling | Pearson VUE, (800) 834-1426 |
More in NAB Exam Format and The Core Domains Explained.
The Board calls it the Alabama State Written Exam; its fee schedule calls it the “State (Reciprocity) Written Exam” (620-X-A-.22). The state gives it, not NAB: NAB’s Alabama page lists “State Exam Administration: State”.
Rule 620-X-5-.06(1) gives the NAB exams to “all applicants not applying through reciprocity” and the State written examination to “All applicants who apply through reciprocity”. The Board’s 2024 FAQ agrees: “Every Reciprocity/Endorsement applicant MUST take and pass” it, and so must “Every expired license applicant” who is reinstating (also 620-X-12-.01; 620-X-7-.01). For a first-time candidate on the degree and AIT route, the FAQ describes the two-part National Examination and does not list the state exam.
NAB’s summary of Alabama’s requirements lists “State: Yes”, and under HSE recognition says “The state regulatory exam is still required”; it does not say whether first-time candidates on the AIT route take it. NAB summarizes each state’s rules; the Board sets them. If you are applying for the first time and anything you receive from the Board mentions the state exam, ask the Board.
| Format | 50 multiple-choice questions (Board FAQ) |
|---|---|
| Passing score | 75 percent: “at least 75% on the State examination” (620-X-5-.06(1)) |
| Fee | $350 on the Board’s fee schedule (620-X-A-.22). Rule 620-X-13-.01, amended effective 14 September 2023, sets a maximum of $700; the fee schedule and the Board’s 2024 FAQ show amounts charged below the maximums, so confirm the current fee with the Board |
| When | Given as needed, “usually about 30 days after the Board approves a reciprocity application” (Board FAQ) |
| Preparation | “There is no practice test or pre-licensure course” (Board FAQ). The Board posts a bibliography on its website and sends it to approved applicants |
By law, the licensing examinations must include a test of the applicant’s “proficiency in the rules and regulations of health and safety” (Code § 34-20-10(a); 620-X-5-.01(1)); neither says which exam covers it. The Board’s FAQ says “The bibliography for the state examination is on our website”, so study from that list. The health and safety rules an Alabama nursing home runs under include ADPH’s nursing facility rules, Ala. Admin. Code chapter 420-5-10. The comparison and figures below come from that chapter, as background for the job.
The current chapter 420-5-10 was adopted in 1996 and amended since, and many sections repeat wording from 42 CFR Part 483 as it stood before 2016. Three places where it differs:
| Topic | Federal rule (42 CFR 483) | Alabama rule | Ala. Admin. Code |
|---|---|---|---|
| Fires and unusual occurrences | No fire-reporting deadline; 483.90(a) requires the Life Safety Code (NFPA 101). The 2-hour and 24-hour clocks cover alleged abuse, neglect and related events (483.12(c)(1)) and reasonable suspicion of a crime (483.12(b)(5); Social Security Act § 1150B) | Catastrophes and unusual occurrences “documented within 24 hours” and the record kept at least 2 years; “Fires shall be reported within 24 hours” to ADPH’s Technical Services Unit | 420-5-10-.03(7)(j), (k) |
| Hot water for residents | No water temperature limit; the physical environment rules in 483.90 set none | Hot water used by residents “shall not exceed 110 degrees Fahrenheit” | 420-5-10-.18(4)(g)2 |
| Special Focus Facility sign | No signage requirement in Part 483. CMS runs the Special Focus Facility program (Social Security Act §§ 1819(f)(8), 1919(f)(10)) and flags designated facilities on Medicare.gov Care Compare | A facility designated a Special Focus Facility posts “This nursing home has been designated as a Special Focus Facility”, in bold, with a set explanation, on its main entrance door, in type of at least 24 points on paper at least 8.5 by 11 inches | 420-5-10-.03(46), (46)(a) to (c) |
Alabama: Ala. Admin. Code chapter 420-5-10 (ADPH). Federal: eCFR, September 2026.
State NHA Exams Explained covers how state exams work in general.
We build practice sets for state exams one state at a time: questions drawn from the state’s own rules, each cited to its section, the way our Illinois supplement is built. Alabama is not built yet. Leave your email and we will tell you if we build it.
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Finding a preceptor is up to you. The Board’s FAQ says “It is the applicant’s responsibility to find their own preceptor”, and the Board does not place AITs. The FAQ also says “A list of approved preceptors is on our website” (alboenha.alabama.gov). Ask administrators you know, your college if you are on an internship route, and the Board, at (334) 271-2342, to confirm that a particular administrator’s approval is current.
State associations: the Alabama Nursing Home Association (ANHA), which nominates three of the Board’s members (§ 34-20-4), and LeadingAge Southeast.
For the full step-by-step on approaching facilities and preceptors, see How to Find an AIT Preceptor and an Approved Program.
The amounts charged are those on the Board’s fee schedule (620-X-A-.22) and in its 2024 FAQ. Rule 620-X-13-.01, amended effective 14 September 2023, sets maximums (“not to exceed”) of two to five times these amounts, so confirm before you pay. The Board takes checks and money orders only: it “does not accept credit or debit cards”.
| Fee | Charged | Maximum (620-X-13-.01) |
|---|---|---|
| Application | $150 | $300 |
| Original license | $150 | $300 |
| Annual renewal | $125 | $300 |
| Late renewal | $400 | $800 |
| State written exam | $350 | $700 |
| Reciprocity questionnaire | $75 | $150 |
| Emergency permit | $750 | $1,500 |
| AIT application | $100 (200 to 1,000 hours); $150 (2,000 hours) | $400 (200 or 500); $500 (1,000); $700 (2,000) |
| Preceptor certification or recertification | $100 | $300 |
| Reactivating an inactive license | $400 | $1,000 |
| NAB CORE and NHA exams, paid to NAB | $480 for the two | Set by NAB |
Our estimate for a first-time candidate on an AIT route: $150 application + $150 license + $480 NAB exams, plus $100 or $150 for the AIT application, comes to $880 or $930. The $350 state exam fee is for reciprocity and reinstatement applicants. The Board may waive the initial licensing fee for eligible military families (620-X-13-.01).
Licenses run for one year. Renewal is due “on the last day of the month in which the license expires” (620-X-7-.01), so check the date on your license. The FAQ says the renewal must be “POSTMARKED and sent to the Board offices by the expiration date”, with the $125 fee.
24 hours a year of continuing education (620-X-6-.01(1)(a)):
Neither the rule nor the FAQ provides for carrying hours over to the next year. The current rule sets no limit on distance learning.
Late renewal. For 90 days after the due date you may still renew, with a $400 late fee. After that the license “shall be deemed expired” (620-X-7-.01; § 34-20-13). To reinstate an expired license you file a new application, show 24 hours of current CE and pass the written state exam (620-X-7-.01; Board FAQ). Separately, the Board may, “for good cause shown”, reissue a license that has been revoked (620-X-7-.04).
Inactive status. You may hold a license inactive for up to five years, with no fee while inactive. To reactivate, you show 24 hours of CE completed within the past year and pay $400 (620-X-7-.01; § 34-20-13; 620-X-A-.22; Board FAQ).
Reciprocity (endorsement). Alabama licenses an administrator from a state whose standards are “substantially equivalent to those required in this state” and which gives Alabama licensees similar recognition (620-X-12-.01; Code § 34-20-12). You need a current active license in the state you are coming from, the Reciprocity Questionnaire (Form 620-X-A-.05), completed by each state where you currently hold or have ever held a license, the $75 questionnaire fee (620-X-A-.22), and at least 75 percent on the Alabama State Written Exam (620-X-5-.06(1); Board FAQ).
No temporary license. The Board issues an emergency permit instead (620-X-10-.01). When an administrator dies, resigns unexpectedly, becomes incapacitated or has the license revoked, the facility must “immediately notify the Board and the agency issuing the nursing home license” (620-X-10-.01; § 34-20-2), and it, not an individual, may request a permit for someone who is enrolled in an AIT and “eligible to sit for the licensure examination within 5 months”, is eligible for reciprocity, or has at least three years in a supervisory role in an Alabama nursing facility.
The permit is “not to exceed 180 days”, covers one facility, cannot be extended and costs $750; the FAQ adds that it “does NOT in any way enable an applicant to qualify for full licensure”. NAB’s summary says Alabama offers a temporary or provisional license; the Board’s FAQ describes only the emergency permit.
The statute and rules for administrator licensure in Alabama, the facility rules behind the figures above, and the other sources cited on this page.
Citations verified September 2026. The Code of Alabama is linked through the Board’s copy and a labeled mirror. Provided for reference, not legal advice; the current official text governs.
It depends on your degree: 2,000 hours with an associate degree and four years of supervisory experience in a licensed nursing home, 1,000 with any bachelor’s, 500 with a bachelor’s in health care administration, and 200 with a master’s in health care or hospital administration. A NAB-approved academic program needs no AIT (620-X-5-.02(1)(e)).
First-time candidates take the NAB Core of Knowledge and NHA Line of Service exams, with a scaled score of at least 113 on each (620-X-5-.06(1)). The 50-question Alabama State Written Exam is for reciprocity (endorsement) applicants under the same rule, and for anyone reinstating an expired license (620-X-7-.01; Board FAQ). NAB’s summary lists a state exam for Alabama and does not say whether first-time candidates take it.
It is for reciprocity and reinstatement applicants: 50 multiple-choice questions, 75 percent to pass (620-X-5-.06(1)), $350 on the Board’s fee schedule. By law, Alabama’s licensing examinations must include health and safety rules (Code § 34-20-10(a)); the Board posts a bibliography for the state exam on its website.
24 hours a year, no more than 10 in one day, from Board-approved or NAB/NCERS-approved courses, completed by your renewal date. Licenses renew every year (620-X-6-.01; 620-X-7-.01).
Yes, by reciprocity, if your state’s standards are substantially equivalent, with a current active license and at least 75 percent on the Alabama State Written Exam (620-X-12-.01; 620-X-5-.06(1)). There is no temporary license, only an emergency permit of up to 180 days, which a facility requests (620-X-10-.01).
The Board does not place AITs; its FAQ says finding a preceptor is the applicant’s responsibility and that “A list of approved preceptors is on our website”. A preceptor needs three years of Alabama licensure, or two elsewhere plus one in Alabama, and a Board-approved seminar (620-X-5-.07).
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