What it takes to become a licensed nursing home administrator in Iowa: the routes to a license, the Administrator-in-Training (AIT) option and its preceptor, the NAB exams, fees, continuing education, renewal, provisional licenses and moving here.
| Who licenses | The Iowa Board of Nursing Home Administrators, in the Iowa Department of Inspections, Appeals, and Licensing (DIAL) |
|---|---|
| Eligibility | A bachelor’s degree, the NAB exams and one of three training options, or NAB Health Services Executive (HSE) certification (Rule 481-980.2) |
| AIT requirement | No hour minimum in the current rules. The AIT is one of three options: an AIT under a preceptor, an accredited college practicum, or 2,080 hours of experience in a nursing home (Rule 481-980.2(3)(c)). See the routes below |
| National exams | NAB Core of Knowledge + NHA Line of Service, both required: the rule asks for “all required national NAB examinations” (Rule 481-980.2(3)(b)); $480 for the two, paid to NAB |
| State exam | None, and no jurisprudence exam. Rule 481-980.2 names only the national NAB examinations, and NAB’s Iowa page shows “State: No” |
| Continuing education | 40 hours every two years, up to 20 of them carried over from the last period; none for your first renewal (Rule 481-981.2); mandatory reporter training every 3 years if you examine, attend, counsel or treat children or dependent adults |
| License renewal | Every two years; licenses expire 31 December of odd-numbered years, next on 31 December 2027 (Rule 481-980.1); $60, with a 30-day grace period and a $60 late fee |
| Board fees | $120 for the license (Rule 481-507.10); NAB’s exam fee is separate |
| Official sources | dial.iowa.gov (the Board) · IAC 481, Chapters 980 to 983 · Iowa Code ch. 155 · nabweb.org (national exams) |
Verified against the sources above, September 2026. Requirements change; the current rules, as the Board applies them, govern, so confirm with the Board before you apply.
The Iowa Board of Nursing Home Administrators licenses nursing home administrators. Since 1 July 2023 it has sat within the Iowa Department of Inspections, Appeals, and Licensing (DIAL): the state government realignment in SF 514 moved the licensing of health professions, this one included, to DIAL. The Board has nine members, four of them licensed nursing home administrators (one from a nonproprietary home) and two representing the public (Iowa Code § 147.14(1)(r)).
The Board’s rules are Iowa Administrative Code (IAC) 481, Chapters 980 to 983: licensure in 980, continuing education in 981, discipline in 982, and the adoption of uniform and model rules in 983. Until 18 September 2024 the licensure rules were numbered 645 Chapter 141, the citation you will still find on older pages and forms.
| Website | DIAL’s nursing home administrator page · The Board’s page |
|---|---|
| Applications | Submitted online (Rule 481-980.2(1)), for new licenses |
| Address | 6200 Park Avenue, Suite 100, Des Moines, IA 50321. NAB’s Iowa page still shows an older address |
| Phone | 515-281-0254 |
The statute, Iowa Code § 155.3, asks that you be “of sound mental health and physically able to perform the duties”, have “sufficient education, training, or experience to administer, supervise, and manage” a nursing home, and pass the exam the Board prescribes. Rule 481-980.2 turns that into two paths:
Two more checks. DIAL verifies U.S. citizenship or lawful presence through SAVE. If your degree is from outside the United States, you need an equivalency evaluation “by International Educational Research Foundation, Inc.” (980.3).
Find the row that fits you:
| Route | What you need | Rule |
|---|---|---|
| NAB HSE | Verification of your Health Services Executive (HSE) certification through NAB | 980.2(2) |
| Degree + AIT | Bachelor’s degree or higher, the NAB exams, and an “Administrator training program supervised by a preceptor”. The rule sets no hours | 980.2(3)(c) |
| Degree + practicum | Bachelor’s degree or higher, the NAB exams, and a “Practicum in long-term health care completed through an accredited college or university” | 980.2(3)(c) |
| Degree + experience | Bachelor’s degree or higher, the NAB exams, and 2,080 hours of long-term health care administration or health-care-related experience in a nursing home, which “may be approved by board staff” | 980.2(3)(c) |
The three standard routes share the degree and the exams; only the training differs. HSE certification is a separate route on its own.
The current licensure rules in Chapter 980 set no hour count and no required structure for the Administrator-in-Training (AIT) program. DIAL’s AIT verification form (rev. 11/2025) has no hour count either: your preceptor attests that you have “completed an administrator in training program” and fills in “The curriculum completed was through ____”. So the content and length of your AIT are something to settle with your preceptor at the start.
You may see “720 hours” for Iowa on older sites, and NAB’s Iowa page still lists “Minimum: 720”. That was the old rule. Rule 645-141.4, in its 2009 version, required “720 clock hours of long-term health care practicum”, in “nine areas of practicum requiring 80 clock hours each”, with up to 320 hours that could be waived. The 720-hour practicum had already been dropped before the Board readopted the licensure chapter in 2024 (ARC 7971C), and today’s Chapter 980 has no AIT hour figure.
A preceptor is a licensed administrator “approved by the department to supervise a person in a mentoring or administrator training program” (980.1). Under Rule 481-980.4, as amended by ARC 9469C (in effect since 19 November 2025, after the Administrative Rules Review Committee delayed its 10 September 2025 date by 70 days), your preceptor must have:
Other states: AIT Hours by State.
The free AIT Planner turns your AIT into a plan across facility departments. The departments and the way time is split among them are our planning aid, not an Iowa rule: Iowa sets no AIT hours or areas, so agree on the plan with your preceptor. No account needed.
Open the free AIT PlannerOn the standard path you pass the exams from NAB, the National Association of Long Term Care Administrator Boards. Rule 481-980.2(3)(b) asks for a “Passing score on all required national NAB examinations”, and NAB’s Iowa page lists the Core and NHA exams.
| Core of Knowledge | 125 questions (100 scored, 25 pretest); 130 minutes to answer, within 150 minutes of seat time, per NAB’s candidate handbook |
|---|---|
| NHA Line of Service | 75 questions (60 scored, 15 pretest); 70 minutes to answer, within 90 minutes of seat time, per NAB’s candidate handbook |
| Delivery | Pearson VUE |
| Fee | $480 for the Core and NHA together, paid to NAB, from 1 February 2026 |
| Attempts | Up to 4 attempts at each exam per cycle (1 July to 30 June) from 1 January 2026; the count resets each 1 July. A state may allow fewer (NAB) |
More in NAB Exam Format and The Core Domains Explained.
Iowa has no state exam and no jurisprudence exam. Rule 481-980.2 names only the national NAB examinations, DIAL’s application page lists only the NAB passing score, and NAB’s Iowa page shows “State: No”.
The NAB exams are national exams, not Iowa exams. Once you run an Iowa nursing facility, you answer to Iowa’s nursing facility rules (IAC 481-Chapter 58), and to 42 CFR Part 483 if the home is certified for Medicare or Medicaid. Four differences you will meet on the job, each with the Iowa section:
| Topic | Federal rule (42 CFR 483) | Iowa rule | Section |
|---|---|---|---|
| How many facilities one administrator runs | An administrator “Licensed by the State, where licensing is required” (483.70(d)(2)); the rule sets no limit on the number of facilities, the distance between them or the time spent in each | Not more than two nursing facilities, “no greater than 75 miles” apart, with “no more than 150 beds in total” and “the equivalent of three full eight-hour days per week in each facility” | 58.8(2) |
| Assistant administrator | No assistant administrator requirement; 483.70(d)(2) addresses only the administrator | An administrator in charge of two facilities must “employ an individual designated as a full-time assistant administrator for each facility” | 58.8(6) |
| Administrator hours | No hours set for the administrator (483.70(d)(2)) | The administrator of only one facility “shall be considered as a full-time employee”, and “Full-time employment is defined as 40 hours per week.” | 58.8(7) |
| Provisional administrator | State licensure “where licensing is required” is the only administrator qualification (483.70(d)(2)). Part 483 has no provisional-administrator rule, but the federal rules for state licensing programs allow one provisional license “for a single period not to exceed 6 months” to fill an unexpected vacancy (42 CFR 431.710) | Board approval; a facility may not have one “for more than 12 consecutive months” and must “notify the department in writing within 14 days” of the appointment | 58.8(4) |
Iowa: IAC 481-Chapter 58 (current through the 5 August 2026 supplement). Federal: 42 CFR Part 483 and 42 CFR 431.710 in the eCFR.
What the federal rule adds in a certified home. Nurse staffing, unless waived: sufficient licensed nurses on a 24-hour basis and a licensed nurse as charge nurse on each tour of duty (483.35(a)), and a registered nurse “for at least 8 consecutive hours a day, 7 days a week” and a full-time RN director of nursing (483.35(b)). CMS’s 2024 minimums (3.48 hours per resident day and a 24/7 RN), which were never enforced, were repealed by an interim final rule with comment period published 3 December 2025 and effective 2 February 2026 (90 FR 55687). Abuse reporting: alleged abuse, neglect, exploitation or mistreatment, including injuries of unknown source and misappropriation of resident property, goes to the administrator and to officials including the State Survey Agency “immediately, but not later than 2 hours” if it involves abuse or serious bodily injury, and within 24 hours otherwise (483.12(c)(1)); and the facility must have policies ensuring that each covered individual reports any reasonable suspicion of a crime against a resident to the State Survey Agency and local law enforcement, as section 1150B of the Social Security Act requires (483.12(b)(5)).
Other Iowa facility rules to know. When the administrator is away, a “responsible person” is named in writing to the department, and the administrator may not be absent “for more than 3 months without approval of the department” (58.8(5)). The facility tells the department “Within two weeks of any change in administrator” (58.5(5)). Criminal record, child abuse and dependent adult abuse checks run under Iowa Code § 135C.33 (58.11(3)). Before the medication aide course, a candidate must complete an approved nurse aide course, nurse aide training and testing program or nurse aide competency examination, work at least 480 hours for the facility that employs them, and have that facility’s “letter of recommendation for admission to the medication aide course” (58.21(6)(c)).
From Rule 481-507.10:
| License (application) | $120 |
|---|---|
| Provisional license | $120 |
| License renewal, every two years | $60 |
| Late renewal, within the 30-day grace period | $60 |
| Reactivation | $120 |
| Duplicate or reissued license certificate | $20 |
| Verification of license | $20 |
“All application fees are nonrefundable,” DIAL notes. On the standard path a first license comes to $120 to DIAL and $480 to NAB for the two exams.
Each licensee must “complete a minimum of 40 hours of continuing education” per CE period, which runs from 1 January of an even-numbered year to 31 December of the next odd-numbered year (Rule 481-981.2).
Mandatory reporter training. Separate from the 40 hours, a licensee who “examines, attends, counsels, or treats children, dependent adults, or both” must complete training in the “identification and reporting of child abuse, dependent adult abuse, or both” to renew (Rules 481-980.7(3) and 980.7(8)). Under Iowa Code §§ 232.69 and 235B.16 the training comes within six months of starting employment and again every three years, and the Board must require it “as a condition of licensure”. Under 980.7(8), keep your documentation for three years; the training is not required while you are on active military duty or if you hold a hardship waiver.
Licenses expire on “December 31 of odd-numbered years” (Rule 481-980.1), so the next expiration is 31 December 2027. You can renew online up to 60 days before, and DIAL sends reminders at 60, 50, 40 and 30 days. The fee is $60. If you were first licensed within 6 months of a renewal date, you renew at the one after it, two years later (980.7).
Once licensed, display the license “in a conspicuous public place at the primary site of practice” (980.7).
If a facility’s administrator is unable to serve, dies or otherwise leaves the home without a licensed administrator, the Board can issue a provisional license to someone who steps in (Rule 481-980.5). It is Iowa’s temporary license for this job.
Two points where the sources differ. On age, the adopted text of 980.5 says 20, while the notice that proposed the change (ARC 9273C) described it as a change “to increase the age of provisional administrators to 21” to comply with the nursing facility rules in Chapter 58, though the notice’s own proposed text also said 20. Chapter 58’s 21-year minimum (58.8(5)) applies to the “responsible person” who covers an administrator’s absence. If you are 20, confirm with the Board. On time, the Board’s 24 months is a limit on you, across your career. Rule 481-58.8(4) separately bars a facility from having a provisional administrator “for more than 12 consecutive months”. Both limits apply.
Endorsement. Under Rule 481-980.6 you need “an active license as a nursing home administrator for at least two years just prior to application”, and you must also meet the requirements of rule 481-980.2, so ask the Board how they apply to you. Verification of your license, from the jurisdiction of your most recent licensure, must be “sent directly from the jurisdiction to the board office” (980.2(4)). The statute also lets the Board license “without examination” where “reciprocal agreements are entered into” (Iowa Code § 155.11).
Licensure by verification. DIAL’s application page points out-of-state applicants to IAC 481-Chapter 501, Iowa’s universal recognition rule under Iowa Code ch. 272C. It covers anyone “licensed in at least one other jurisdiction that has a scope of practice substantially similar”, and there is a work-experience path for those with “at least three years of work experience”.
Military. DIAL’s military rules (IAC 481-Chapter 7) provide credit for “verified military education, training, or service”, no fee with a military service application, expedited reciprocity for veterans and military spouses, and a possible temporary license while you complete requirements. Chapter 7 applies to DIAL licensing authorities “unless that licensing authority has separate rulemaking authority and has adopted governing rules”, so ask the Board how it applies to you. Active-duty licensees are exempt from CE (981.4) and from mandatory reporter training (980.7(8)).
The main task is finding the right administrator. Look for an Iowa-licensed nursing home administrator with at least two years in the role, a clean license for the past year, and no family tie to you, who has taken NAB’s preceptor course or another board-approved course, or will before you start. Then call DIAL at 515-281-0254 to have board staff approve the preceptor before your first day.
NAB resources. The AIT Program Manual, the preceptor training modules, and, if you prefer the practicum route, NAB’s academic accreditation listings.
Associations. The Iowa Health Care Association and LeadingAge Iowa are good networking contacts for meeting administrators. IHCA’s certification programs page lists courses such as mandatory reporter training; it lists no AIT program.
For approaching facilities and preceptors step by step, see How to Find an AIT Preceptor and an Approved Program.
The legal sources for nursing home administrator licensure in Iowa, and the facility rules cited above. Iowa has no state exam, but these are the rules you train and work under.
Citations verified against official sources, September 2026. Provided for reference, not legal advice; the current official text governs.
The current rules set no AIT hour minimum. The AIT, supervised by a board-approved preceptor, is one of three options alongside an accredited college practicum or 2,080 hours of experience in a nursing home, each on top of a bachelor’s degree and the NAB exams (Rule 481-980.2(3)). NAB HSE certification is a separate route. The 720 hours you may see elsewhere, including on NAB’s Iowa page, was the old practicum rule.
No. Iowa requires the NAB exams, Core of Knowledge and NHA Line of Service, and no state or jurisprudence exam. Rule 481-980.2 names only the national NAB examinations.
40 hours every two years, with up to 20 hours carried over from the last period and at most 8 hours of self-study (Rules 481-981.2, 981.3). None is required for your first renewal. If you examine, attend, counsel or treat children or dependent adults, mandatory reporter training every three years is a separate renewal condition. Licenses expire 31 December of odd-numbered years.
Find an Iowa-licensed administrator with at least two years in the role, no discipline in the past year and no family tie to you, who has taken NAB’s or another board-approved preceptor course. Board staff must approve the preceptor before you start (Rule 481-980.4). The Iowa Health Care Association and LeadingAge Iowa are good networking contacts.
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