How to become a licensed nursing home administrator in Arizona: the routes in, the Administrator-in-Training (AIT) program, the NAB exams and the Board’s own state exam, fees, continuing education and renewal, with section numbers.
| Who licenses | The Board of Examiners of Nursing Care Institution Administrators and Assisted Living Facility Managers, the “NCIA Board” (A.R.S. 36-446.02) |
|---|---|
| Education | A bachelor’s degree; a master’s in a health-related field or business administration; or an associate degree in nursing plus Arizona RN licensure and experience (R4-33-201(1)) |
| AIT requirement | At least 1,000 hours, full time, finished in 6 to 12 months, for the bachelor’s and nursing routes only; no AIT on the master’s route or by reciprocity (R4-33-201, R4-33-202, R4-33-302) |
| National exams | NAB Core of Knowledge (CORE) and NHA Line of Service, or NAB Health Services Executive (HSE) qualification (R4-33-201(2)(a)); $480 for CORE and NHA applied for together, paid to NAB |
| State exam | Required: 50 multiple-choice questions in one hour, 80 percent to pass, given in person by the Board in Phoenix; $610 (R4-33-201(2)(b); Board exam page and fee schedule) Details ↓ |
| Continuing education | 50 hours every two years, with no carryover (R4-33-501) |
| Renewal | Every two years: the license expires 30 days after your birthday in each even-numbered year; $488 (R4-33-206; Board fee schedule) |
| Official sources | nciaboard.az.gov (the Board) · A.R.S. 36-446 et seq. · A.A.C. R4-33 (mirror) · nabweb.org (national exams) |
Verified September 2026. A.R.S. is the Arizona Revised Statutes. In the Arizona Administrative Code (A.A.C.), R4-33 numbers are Board rules and R9-10 numbers are Department of Health Services facility rules. Confirm with the Board before you apply.
The license comes from the Board of Examiners of Nursing Care Institution Administrators and Assisted Living Facility Managers (A.R.S. 36-446.02), which calls itself the NCIA Board. The Arizona State Library’s agency history lists it among self-supporting regulatory agencies; the Arizona Department of Health Services (ADHS) licenses the facilities themselves. SB1254, signed on 16 April 2024, continued the Board to 1 July 2032.
Arizona’s word for a nursing home is a nursing care institution, so the license is a nursing care institution administrator license (R4-33-201). The law is A.R.S. 36-446 to 36-446.16, and the Board’s rules are A.A.C. Title 4, Chapter 33.
R4-33-201 sets three routes to a license by examination; R4-33-202 adds reciprocity:
| Route | What you need | AIT | Rule |
|---|---|---|---|
| Bachelor’s | A baccalaureate degree from an accredited college or university | Yes: 1,000 hours | R4-33-201(1)(a) |
| Master’s | A master’s degree “in either a health-related field or business administration” | No | R4-33-201(1)(b) |
| Nursing | An associate degree in nursing, a current Arizona registered nurse license (A.R.S. 32-1632), and work as a registered nurse for five of the last seven years | Yes: 1,000 hours | R4-33-201(1)(c) |
| Reciprocity | A bachelor’s degree or ACHCA certification; a current license from another state, gained by passing the NAB exam and held for at least two years, or NAB Health Services Executive (HSE) qualification; and no prior restrictions on an administrator license | No | R4-33-202 |
On every route you pass the NAB exams, or qualify with NAB as a Health Services Executive (R4-33-201(2)(a)), and score “at least 80 percent on the Arizona examination” (201(2)(b)). The application under R4-33-204 includes official transcripts, character certifications and a fingerprint clearance card or proof you applied.
The Administrator-in-Training (AIT) program applies to the bachelor’s and nursing routes. With a master’s in a health-related field or business administration, or by reciprocity, you skip it. The standards are in R4-33-302:
The Board’s AIT FAQ says: “The NCIA and the Arizona Chapter of the American College of Health Care Administrators (AzACHCA) administer the AIT program.”
Your preceptor must be “licensed by the Board for at least two years”, “appointed full-time as a nursing care institution administrator”, in good standing with no discipline in the last three years, and must complete a course on the preceptor’s role (R4-33-302(4)). The FAQ names that course, “a six-hour Preceptor Certification Training Program”, and says the preceptor must be “certified to be an AIT Preceptor by AzACHCA”.
Other states: AIT Hours by State.
On the bachelor’s or nursing route, the free AIT Planner helps you spread your 1,000 hours across facility departments. That split is our planning aid, not an Arizona rule: agree on the plan with your preceptor and your program. No account needed.
Open the free AIT PlannerR4-33-201(2)(a) requires “scaled passing scores on both the NAB core of knowledge and line of service examinations”, or NAB Health Services Executive (HSE) qualification. NAB is the National Association of Long Term Care Administrator Boards, and “An applicant shall make arrangements directly with NAB” (R4-33-205). You schedule at Pearson VUE once the state approves you. Times are from NAB’s Candidate Handbook (September 2026):
| Core of Knowledge | 125 questions (100 scored, 25 pretest), 150 minutes in all, 130 of them for answering questions |
|---|---|
| NHA Line of Service | 75 questions (60 scored, 15 pretest), 90 minutes in all, 70 of them for answering questions |
| Fee | $480 for CORE and NHA applied for together, paid to NAB. The same handbook lists $320 for CORE or $190 for NHA taken alone |
| Attempts | Since 1 January 2026, up to 4 attempts at each exam per cycle (1 July to 30 June) |
| If you fail one | A candidate who fails one of the required exams retakes only that one (R4-33-205) |
Only the NAB exams are at Pearson VUE; the Board gives the Arizona exam itself. More in NAB Exam Format and The Core Domains Explained.
The rules call it simply “the Arizona examination” (R4-33-201(2)(b)); the Board’s exam page calls it the Nursing Care Institution Administrator Exam. It is given by the Board, not NAB or Pearson VUE.
| Format | “50 multiple-choice questions, with one hour to complete” (Board exam page) |
|---|---|
| Passing score | You need “a score of at least 80 percent on the Arizona examination” (R4-33-201(2)(b)) |
| Where | In person, in Board Meeting Room C, 1740 W. Adams, Phoenix, AZ 85007 |
| How you get a seat | “Exams are by invitation only.” The Board reviews applications within 30 days and sets a test date only once every deficiency in your application is resolved. The rule requires exams “at least twice each year” (R4-33-205); the Board posts its exam dates on its exam schedule and invites approved applicants |
| Fee | $610, and $183 to retake (Board fee schedule, effective 6 May 2024) |
| Results | “The Board shall provide written notice” of your result. After passing, pay the license issuance fee within six months, or the Board closes your file (R4-33-205) |
| Not published | The Board’s pages list no content outline, waiting period between attempts or limit on attempts; ask the Board |
Instead of an outline, the Board publishes a study resources list with four items:
Four places where the Arizona facility rules set a different number, or add a requirement, compared with 42 CFR Part 483:
| Topic | Federal rule (42 CFR 483) | Arizona rule | A.A.C. |
|---|---|---|---|
| Nurse staffing | Sufficient nursing staff, 24 hours a day, to meet residents’ needs (483.35(a)); no hours-per-resident-day minimum. CMS repealed the 2024 minimum staffing standards, which were never enforced, by interim final rule (90 FR 55687, published 3 December 2025, effective 2 February 2026). A registered nurse “for at least 8 consecutive hours a day, 7 days a week”, unless waived (483.35(b)(1)), and a registered nurse as full-time director of nursing (483.35(b)(2)) | At least one nurse present on the premises and responsible for providing direct care to “not more than 64 residents”, and daily nursing staff records kept for at least 12 months | R9-10-412(B)(3) to (5) |
| Rooms | No more than 4 residents a room, or 2 in facilities whose construction plans were approved, or that were newly certified, after 28 November 2016 (483.90(e)(1)(i)) | “No more than two individuals reside in a resident room”. The only exception is a room in a facility operating before 31 October 1982 that has not undergone a modification, as defined in A.R.S. 36-401 | R9-10-426(A)(5) |
| Temperature | Facilities initially certified after 1 October 1990 keep a range of 71 to 81 °F (483.10(i)(6)) | Keep “a temperature between 70° F and 84° F” | R9-10-425(A)(6) |
| Quality grade | No letter grade in Part 483. CMS’s Five-Star rating is a separate program, not part of Part 483 | Based on the results of a compliance inspection, ADHS “shall issue a quality rating to each licensed nursing care institution”: A (Excellent) for 90 to 100 points, B for 80 to 89, C for 70 to 79, D for 69 or fewer, scored on nursing services, resident rights, administration, environment and infection control, and food services | R9-10-427 |
The federal nursing home rules (42 CFR Part 483, Subpart B) apply only to facilities certified for Medicare or Medicaid, so a certified Arizona home must meet both sets of rules. Arizona: A.A.C. R9-10 Article 4 (Cornell LII and Justia mirrors). Federal: eCFR, September 2026.
More on preparing in State NHA Exams Explained.
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First, check whether you need one. With a master’s degree in a health-related field or business administration, or a license by reciprocity, there is no AIT (R4-33-201(1)(b), R4-33-202).
AzACHCA. The Arizona Chapter of the American College of Health Care Administrators administers the AIT program with the Board and certifies AIT preceptors (Board AIT FAQ). Ask it about programs and certified preceptors.
The Board. Its page on starting an application lists a contact for AIT questions.
Other sources. ACHCA nationally publishes AIT and preceptor resources. The Arizona Health Care Association (AzHCA) runs professional development programs, according to its own site, and Arizona LeadingAge is another state association where you can meet administrators.
For the full step-by-step on approaching facilities and preceptors, see How to Find an AIT Preceptor and an Approved Program.
Board fees come from the Board’s fee schedule, effective 6 May 2024, which cites R4-33-104 and A.R.S. 36-446.12(A). The rule text of R4-33-104 as published still shows the older, lower amounts (for example $500 for the Arizona exam); the Board’s schedule is the current one, so confirm any fee with the Board.
| Initial application | $183 |
|---|---|
| Arizona exam | $610 |
| Arizona exam retake | $183 |
| License issuance | $488, or $20.33 for each month left in the two-year period, whichever is less |
| NAB CORE and NHA exams | $480 for the two applied for together, paid to NAB; $320 for CORE or $190 for NHA taken alone (NAB Candidate Handbook, September 2026) |
| Renewal, every two years | $488 active, or $244 inactive |
| Late renewal | $122 |
The online payment portal adds a $3.00 convenience fee. Our estimate on the usual route: $183 + $610 + $480 + $488 = $1,761 in Board and NAB fees for a first attempt at each exam and your first license, or less if the prorated issuance fee is lower, plus the fingerprint clearance card and any AIT program costs.
You need 50 hours of Board-approved continuing education in each two-year period (R4-33-501; A.R.S. 36-446.07(E) says “at least fifty hours of continuing education every two years”).
Renewal. Your license “expires at midnight 30 days after the administrator’s birthday in each even-numbered year” (R4-33-206; A.R.S. 36-446.04), so 2026 is a renewal year. You renew with a CE affirmation, a copy of your fingerprint clearance card, disclosure of criminal and license actions from the last 24 months, proof of citizenship or work authorization unless already on file and non-expiring, and $488. A late renewal adds $122, and you affirm that you have not practiced since the license expired and that it was not surrendered, suspended or revoked. If you do not qualify for late renewal, you apply again as a new applicant under R4-33-201 or 202. After a revocation, you wait “at least 12 months” before applying (R4-33-210).
Two CE dates in the rules. R4-33-503 says an audited administrator’s license expires if CE documentation is not submitted “on or before June 30”. The Board’s licensee page takes CE extension requests no sooner than 30 April, for an end date no later than 31 October, with proof of CE registration. The license itself expires 30 days after your birthday in even-numbered years (R4-33-206). Confirm your CE deadline, and any extension, with the Board.
Inactive status ($244 every two years) needs no CE while inactive. To return to active status you need “twenty-five hours” of CE “within six months” (R4-33-207; A.R.S. 36-446.07(H)).
Reciprocity (R4-33-202). The conditions are in the routes table above. There is no AIT, but the rule still requires 80 percent on the Arizona exam. The statute lets the Board license “without examination or with partial examination” where standards are substantially equivalent (A.R.S. 36-446.05); ask the Board how it applies that to you.
Universal recognition (A.R.S. 32-4302). This covers people who establish residence in Arizona after being “licensed or certified by another state for at least one year” at the same practice level, in good standing, with any exam that state required passed and no disciplinary history or pending complaints. A board that tests on state law “may require an applicant to take and pass an examination specific to the laws of this state”, so the Arizona exam may apply. For spouses of active-duty members on a permanent change of station to Arizona, the statute provides licensure “without an examination”; ask the Board whether that waives the Arizona exam for you.
Temporary license (R4-33-203; A.R.S. 36-446.06). It is for applicants who meet every requirement except the exams, and the facility owner submits a notarized “Letter of Intent to Appoint”. You must not have held an Arizona temporary license “within the past three years” or have “failed the Arizona or NAB examination before applying”. It is “valid for 150 days and is not renewable”, costs $366, and is revoked automatically if you fail an exam during it.
Military. Once the Board is notified, an Arizona National Guard or Reserve member’s license “shall not expire while the member is serving on federal active duty” and is extended 180 days after return, and other active-duty members get 180 days past expiry; a similar extension follows a service-connected injury (A.R.S. 36-446.07(R), (S)).
The laws, rules and other sources cited on this page.
Citations verified September 2026. Rule text is linked on Cornell LII and Justia, labeled as mirrors of the official Arizona text. For reference, not legal advice; the current official text governs.
At least 1,000 hours of full-time training, finished in 6 to 12 months, on the bachelor’s route and the nursing route (associate degree in nursing plus an Arizona RN license) (R4-33-201, R4-33-302). The master’s route and reciprocity need no AIT.
The NAB Core of Knowledge and NHA Line of Service exams, or NAB Health Services Executive qualification, and the Arizona examination, with at least 80 percent to pass (R4-33-201(2)). NAB’s exams cost $480 for the two applied for together; the Board gives the Arizona exam in Phoenix for $610.
It has 50 multiple-choice questions in one hour. The Board’s study resources list names A.R.S. 36-446 et seq., the Board’s rules in A.A.C. Title 4, Chapter 33, A.R.S. 36-401 through 36-434, and ADHS rules in A.A.C. R9-10 Articles 1 and 4.
50 hours of Board-approved CE every two years, with no carryover (R4-33-501). The license expires 30 days after your birthday in even-numbered years; confirm your CE deadline with the Board.
Start with AzACHCA, the Arizona Chapter of the American College of Health Care Administrators, which administers the AIT with the Board and certifies AIT preceptors (Board AIT FAQ). With a master’s in a health-related field or business administration, you need no AIT.
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