What it takes to become a licensed nursing home administrator in Kentucky, where the legal title is long-term care administrator. Kentucky has no Administrator-in-Training (AIT) requirement and no state exam. This page covers what it asks for instead: a degree, one of three experience routes and the NAB exams, then the 2026 fee and continuing education rules, renewal, endorsement, temporary permits, and the Kentucky facility rules you will work under. Figures below are taken from the official sources listed on this page.
| License title | Long-term care administrator (LTCA); the license covers nursing homes and other long-term care facilities (KRS 216A.010) |
|---|---|
| Who licenses | Kentucky Board of Licensure for Long-Term Care Administrators (KRS 216A.040), placed in the Public Protection Cabinet and administered by its Department of Professional Licensing |
| Education | A bachelor’s degree from a college or university accredited by an agency recognized by the U.S. Department of Education (201 KAR 6:020 §2(1)) |
| AIT requirement | None. Instead, one of three experience routes: a NAB-accredited degree awarded within 2 years, a 1,000-hour internship that is part of a degree, or 6 months of long-term care management experience (§2(3)). A current NAB HSE covers it all (§3) |
| National exams | NAB Core of Knowledge + NHA Line of Service, with scores dated from 2 years before to 1 year after your application (§2(2)) |
| State exam | None, and no jurisprudence exam: the NAB exam is the board-approved exam (201 KAR 6:020 §1) |
| Continuing education | 30 hours every two years, no more than 15 in one day (201 KAR 6:071, effective 16 June 2026) |
| License renewal | Every two years from your issue or last renewal date, $125 (KRS 216A.090; 201 KAR 6:040; 201 KAR 6:061 §4) |
| Board fees | $250 for a first license, $400 by endorsement (201 KAR 6:061); the NAB exams are $480 more, paid to NAB |
| Official sources | ltca.ky.gov (the board) · KRS 216A · 201 KAR Chapter 6 · nabweb.org (national exams) |
Verified against the sources above, September 2026. Requirements change; the board's current published rule is always the final word.
Kentucky does not use the title “nursing home administrator.” The statute, the regulations and the board all say long-term care administrator, or LTCA. The license covers the administrator of any long-term care facility as KRS 216A.010 defines one, which includes nursing facilities, nursing homes, skilled nursing facilities, intermediate care facilities and ICF/IID. When you search Kentucky’s own sites, search for the Kentucky title.
The licensing body is the Kentucky Board of Licensure for Long-Term Care Administrators, set up by KRS 216A.040, which places it in the Public Protection Cabinet. The board is administered by the Cabinet’s Department of Professional Licensing, which lists it among the 25 regulatory boards it supports with administrative and fiscal operations. The board has 10 members, including the Secretary of the Cabinet for Health and Family Services, or a designee, as an ex officio member. Five seats go to long-term care administrators: one from nominees of LeadingAge Kentucky and four from nominees of the Kentucky Association of Health Care Facilities (KRS 216A.040).
| Website | ltca.ky.gov |
|---|---|
| Address | Department of Professional Licensing, 500 Mero Street, 2SC32, Frankfort, KY 40601 |
| Phone and email | 502-892-4255 · LTCA@ky.gov |
| Renewals and eServices | The Department’s online portal at oop.ky.gov |
| License lookup | oop.ky.gov/lic_search.aspx |
NAB’s Kentucky page still lists an older address, PO Box 1360, and an older website, nha.ky.gov. Use ltca.ky.gov and the address above.
The statute sets the base. Under KRS 216A.080(1) you file a written application with the board; you are a citizen of the United States or have declared your intent to become one; you are “of good moral character” and otherwise suitable; and you have passed an examination the board approves. The board’s regulation, 201 KAR 6:020 (effective 15 December 2021), fills in the rest:
Check the form version before you file. The regulation incorporates the November 2021 Form 1, but the application checklist posted on ltca.ky.gov is marked Rev. 5/2018 and the posted Form 1 file is marked June 2021. Ask the board which version it wants. KRS 216A.080 and 201 KAR 6:020 set no minimum age; NAB’s summary page lists 21, so ask the board if your age is close to that.
Kentucky has no Administrator-in-Training (AIT) program. The words “administrator-in-training” and “preceptor” do not appear in 201 KAR 6:020, and the regulation sets no board process for approving AIT programs, preceptors or internship sites. What the regulation asks for instead is experience, shown in one of three ways (§2(3)):
| NAB-accredited degree | A bachelor’s or master’s degree from an academic program accredited by NAB, awarded within 2 years of your application (§2(3)(a)) |
|---|---|
| Internship in a degree | An internship “that is at least 1,000 hours in length,” completed as part of a degree in long-term care administration or a related field (§2(3)(b)) |
| Management experience | “Six (6) months of continuous management experience in a long-term care facility,” or, if part time, at least 1,000 hours within 24 months. It can be completed up to 2 years before or 1 year after you apply, and it is documented on Form 2, the Work Verification Form (§2(3)(c)) |
| Or: a current NAB HSE | A current NAB Health Services Executive (HSE) holder “shall be considered to have met the requirements of Section 2,” which covers the degree, the exam and the experience (§3) |
The management route has to be real management. The regulation says the experience must show responsibility for personnel management, budget preparation, fiscal management, public relations, and regulatory compliance and quality improvement. In practice that points to an assistant-administrator role, or a department-head role that carries all five of those responsibilities, in a licensed facility, rather than a training placement.
You may see Kentucky listed with a 1,080-hour AIT, and earlier versions of this page said so too. That number comes from NAB’s Kentucky summary page (“Minimum: 1080”). It is not in Kentucky’s statute or regulations. The board applies 201 KAR 6:020, and the only hour figures there are the 1,000-hour internship and the 1,000 part-time hours of management experience.
To see which states do require an AIT, and for how many hours, see AIT Hours by State.
Kentucky does not require an AIT. If you are doing a degree internship, or may later need an AIT in another state, the free AIT Planner turns an hours requirement into a plan across facility departments. No account needed.
Open the free AIT PlannerKentucky uses NAB’s exams and nothing else. 201 KAR 6:020 §1 makes the NAB examination the board-approved examination that KRS 216A.080 calls for. NAB, the National Association of Long Term Care Administrator Boards, lists two exams for Kentucky on its state page: the Core of Knowledge exam and the NHA Line of Service exam.
| Core of Knowledge | 125 questions (100 scored, 25 pretest), 150 minutes of seat time |
|---|---|
| NHA Line of Service | 75 questions (60 scored, 15 pretest), 90 minutes of seat time |
| Delivery | Computer-based, scheduled through Pearson VUE (800-834-1426) |
| Fee | $480 for the Core and NHA exams together, paid to NAB, effective 1 February 2026 |
| Attempts | Up to 4 attempts per cycle for each exam, effective 1 January 2026. The cycle runs 1 July to 30 June, and the count resets each 1 July |
| Score window | For a first Kentucky license, a passing score dated no more than 2 years before, or 1 year after, you file your application (201 KAR 6:020 §2(2)) |
| HSE | A current NAB Health Services Executive credential (Core, NHA, RCAL and HCBS) also meets the requirement (§3) |
Apply to the board first. NAB says candidates must be approved to test by their state licensure board before they apply to NAB. The Kentucky board’s application checklist says that once you are approved, you receive detailed information about computer-based testing.
Mind the score window if you tested some time ago. NAB says it has kept most scores from the past 30 years, but that it can confirm a score only once it has been transferred, and it charges $70 per jurisdiction for a transfer. For a first Kentucky license, the score also has to fall inside the window above. We do not quote a passing score here, because we have not checked NAB’s current score interpretation material; NAB publishes it.
Kentucky has no state exam and no jurisprudence exam. No other exam is named anywhere in KRS 216A or 201 KAR Chapter 6, and the board’s checklist mentions only the NAB computer-based testing. So Kentucky law is not tested separately; the Kentucky rules further down this page are ones you will work under. For the NAB exams themselves, we break down the structure in NAB Exam Format and the content in The Core Domains Explained.
Kentucky’s old fee regulation expired and was replaced this year. The old one, 201 KAR 6:060, is listed as expired by the Legislative Research Commission. The new regulation, 201 KAR 6:061, was first published in the December 2025 Administrative Register, amended during legislative committee review in March 2026, and took effect on 16 June 2026, with the same amounts:
| Application (board review) | $100, non-refundable (§1) |
|---|---|
| Initial licensure | $150 (§2) |
| Licensure by endorsement | $300 (§2) |
| Temporary permit | $75 (§3) |
| Renewal, every two years | $125 (§4) |
| Late renewal | $200 (§4) |
| Inactive license | $75 (§4) |
| Reactivation of an inactive license | $50 (§4) |
| Reinstatement | $300 (§4) |
| Duplicate license | $25 (§5) |
| Verification to another state | $25 (§6) |
| CE approval: an individual request / preapproval to present a single program | $25 / $50 (§7) |
What you actually pay the board: $250 for a first license ($100 application plus $150 initial licensure), $400 by endorsement ($100 plus $300), and $175 for a temporary permit ($100 plus $75). The board’s checklist shows the same totals.
One mismatch to know about: a Form 1 file on ltca.ky.gov (marked “Form 1, Revised June 2021”) labels the $250 line “Initial or Renewal Licensed Long-Term Care Administrator,” but the regulation sets renewal at $125, and the regulation governs. The renewal fee is waived for active-duty military under KRS 12.355 (§8), and military spouses are exempt from the fees in §§1 to 4 (§9).
The continuing education rule was replaced this year too. The old regulation, 201 KAR 6:070, expired on 18 November 2022; the new 201 KAR 6:071 took effect on 16 June 2026. The core requirement did not change: at least 30 hours in each two-year renewal period, “in or related to the field of long-term care administration” (§2(1), (2)).
201 KAR 6:071 has no carryover provision and no required topics such as ethics, dementia or infection control hours.
One quirk: the renewal regulation, 201 KAR 6:040, still cross-references the expired 6:060 and 6:070 rather than 6:061 and 6:071, and the endorsement regulation, 201 KAR 6:050, still points to 6:060 for its fee.
Kentucky licenses renew every two years. KRS 216A.090 says a licensee “shall renew his or her license biennially,” and 201 KAR 6:040 §1(1) counts the two years from the date of issue or the date of last renewal, so there is no single statewide renewal date. The fee is $125, and renewal runs through the Department of Professional Licensing portal.
Between renewals, 201 KAR 6:020 §5 gives you 30 days to tell the board about any of these: a change of home address or employer; any felony or misdemeanor conviction (with a copy of the judgment); or an Immediate Jeopardy or Substandard Level of Care notice at a facility where you are the administrator of record, with a copy of the inspection report and the plan of correction.
If you already hold a license in another state, KRS 216A.130 lets the board, “in its discretion,” license you by endorsement when two things are true: the other state’s standards were “substantially equivalent to those required in this state” when your license was issued, and your license was issued at least 2 years before you apply. The board may refuse an applicant who has been disciplined by the other state’s board in the past five years.
Under 201 KAR 6:050 you send:
There is no Kentucky exam to take as an endorsement applicant, because Kentucky has none.
The statute allows a temporary permit only “when emergency conditions warrant,” for a period the board sets, “not to exceed nine (9) months and shall not be renewed” (KRS 216A.070(4), as amended effective 15 July 2020). The regulation, 201 KAR 6:030, was amended effective 16 June 2026. Under §1, the Department of Professional Licensing may, after consulting a board member, issue an emergency permit when all of these are true:
Section 2 adds a permit for an applicant who holds another state’s license and is the spouse of an active-duty service member stationed in Kentucky; the Department must issue it within 30 days. The limits in §3:
The nine months is new. The 2019 version of 6:030 limited every permit to six months; the 2026 amendment raised emergency permits to nine and kept military spouse permits at six. The permit costs $75 plus the $100 application fee. The old provisional license is gone: KRS 216A.100 was repealed in 2012.
Acting administrators. KRS 216A.030 says no licensed long-term care facility “shall operate except under the supervision of” a licensed long-term care administrator, “unless approved by the board through administrative regulation”; it does not apply to assisted living communities. In a facility licensed as a nursing home, the administrator must “Designate one (1) or more staff to act on behalf of the administrator” when absent (902 KAR 20:048 §2(2)(b)). Neither KRS 216A.030 nor 902 KAR 20:048 sets a limit on how long an unlicensed acting administrator may serve. When the facility administrator changes, though, the licensee must notify the Office of Inspector General within 10 calendar days (902 KAR 20:008 §3(3)(a)). The emergency permit is the formal route to fill a vacancy.
What did not change: 201 KAR 6:020 shows no change to the education, experience or exam rules from 2023 to 2026. For proposed changes, check the board’s Proposed Administrative Regulations page.
The Kentucky column is the part of Kentucky law that shapes your working week; Kentucky has no state exam. The federal column is different: NAB’s recommended reference list for the NHA exam includes CMS’s State Operations Manual Appendix PP, the guidance on 42 CFR Part 483. For a facility licensed as a nursing facility, 902 KAR 20:300 §1(1)(a) starts from the federal rule: “A nursing facility shall comply with the requirements of 42 C.F.R. 483.1-483.95.” The same section then adds Kentucky requirements on top. Facilities licensed as nursing homes are covered by a separate regulation, 902 KAR 20:048.
Five places where the Kentucky text asks for something the federal text does not, or says it differently:
| Topic | Federal rule (42 CFR 483) | Kentucky rule | Section |
|---|---|---|---|
| Survey findings and your license | Part 483 requires the governing body to appoint an administrator who is “Licensed by the State, where licensing is required,” is responsible for management of the facility, and reports to the governing body (483.70(d)(2)). It puts no duty on the administrator to report survey findings to the licensing board; instead the State must notify the administrator licensing board of substandard quality of care findings (42 CFR 488.325(h)(2)) | The administrator of record tells the licensing board in writing within 30 days of an Immediate Jeopardy or Substandard Level of Care notice, and sends the inspection report and the submitted plan of correction. The duty falls on you personally, as a licensee | 201 KAR 6:020 §5 |
| Reporting suspected abuse | The facility reports alleged abuse, neglect, exploitation or mistreatment, including injuries of unknown source and misappropriation of resident property, to the administrator and other officials, including the State Survey Agency, immediately, but not later than 2 hours after the allegation if it involves abuse or serious bodily injury, and otherwise not later than 24 hours (483.12(c)(1)). Separately, under section 1150B of the Social Security Act, added by the Elder Justice Act, each covered individual reports a reasonable suspicion of a crime against a resident to the State Survey Agency and law enforcement immediately, but not later than 2 hours after forming the suspicion if there is serious bodily injury, and otherwise not later than 24 hours (483.12(b)(5)) | Any person with reasonable cause to suspect abuse, neglect or exploitation of an adult makes an oral or written report “immediately to the cabinet”, and the facility keeps written policies assuring that reporting | KRS 209.030(2), (3); 902 KAR 20:300 §1(1)(m) |
| Licensed nurse on duty (facilities licensed as nursing homes) | Licensed nurses on a 24-hour basis in sufficient numbers, with a licensed nurse as charge nurse on each tour of duty (483.35(a)(1), (a)(2)), and a registered nurse at least 8 consecutive hours a day, 7 days a week (483.35(b)(1)), unless waived. The 2024 standards of 3.48 nurse hours per resident day and an on-site RN 24 hours a day were repealed effective 2 February 2026 (90 FR 55687) | At least one registered nurse or licensed practical nurse on duty at all times, with a registered nurse on call whenever an LPN is in charge | 902 KAR 20:048 §2(10)(l) |
| Director of nursing (facilities licensed as nursing homes) | A registered nurse designated as director of nursing on a full-time basis, unless waived (483.35(b)(2)) | A registered nurse who works full time during the day and devotes full time to the nursing services of the facility | 902 KAR 20:048 §2(10)(h) |
| Who runs the facility | An administrator licensed by the State, where licensing is required (483.70(d)(2)(i)) | No licensed long-term care facility may operate except under the supervision of a licensed long-term care administrator, unless the board approves otherwise by regulation (assisted living communities are excluded). In a facility licensed as a nursing home the administrator designates one or more staff to act in their absence | KRS 216A.030; 902 KAR 20:048 §2(2)(b) |
Kentucky column: KRS and KAR as published at apps.legislature.ky.gov, September 2026. Federal column: 42 CFR Part 483 as published in the eCFR, September 2026. Part 483 binds facilities certified for Medicare or Medicaid (483.1(b)); a facility licensed as a nursing home that is not certified follows only the Kentucky rule. The board’s rules limit only temporary permit holders to one facility at a time (201 KAR 6:030 §3(5)); ask the board about administrator hours or serving more than one facility.
A NAB-accredited degree. NAB’s list of accredited programs shows Western Kentucky University, “Baccalaureate (HSE),” active since June 2019. Bellarmine University (Graduate, RCAL) is listed as inactive, with accreditation ending 10 June 2026. WKU’s own page describes a 15-hour long-term care administration certificate and a B.S. in Health Care Administration with a “NAB required internship.” Remember the degree route counts only if the degree was awarded within 2 years of your application.
State associations: KCARE, the Kentucky Coalition for Aging Resources and Empowerment, and LeadingAge Kentucky, whose site lists management, survey and clinical risk, director of nursing and life safety training. Neither site lists an AIT or preceptor program, but they can still be useful places to make contacts with member facilities for a management role.
If you are doing a degree internship, or plan to seek a license in a state that requires an AIT, our guide How to Find an AIT Preceptor and an Approved Program covers approaching facilities.
These are the legal sources that govern long-term care administrator licensure in Kentucky, and the facility rules cited above. Kentucky has no state exam, so the Kentucky rules are not tested separately; they are the rules you apply for under and work under.
Citations verified against official sources, September 2026. Provided for reference, not legal advice; the current official text governs. Mirrors are labeled where an official public link is not available.
None. Kentucky has no Administrator-in-Training requirement. Instead, 201 KAR 6:020 §2(3) asks for one of three routes, described above: a recent NAB-accredited degree, an internship of at least 1,000 hours within a degree, or six months of long-term care management experience. NAB’s summary page lists 1,080 hours, but that figure is not in Kentucky’s statute or regulations.
Kentucky licenses long-term care administrators. The license is issued by the Kentucky Board of Licensure for Long-Term Care Administrators (KRS 216A.040). The statute places the board in the Public Protection Cabinet, and the Cabinet’s Department of Professional Licensing administers it. Its website is ltca.ky.gov.
Only the NAB Core of Knowledge and NHA Line of Service exams; Kentucky has no state exam and no jurisprudence exam (201 KAR 6:020 §1). Your passing score must date from no more than 2 years before, or 1 year after, you file your application. A current NAB HSE also qualifies.
Under 201 KAR 6:061, effective 16 June 2026, the board charges $250 for a first license ($100 application plus $150 initial licensure), $400 by endorsement, $175 for a temporary permit, and $125 to renew every two years. The NAB exams, $480 for the Core and NHA, are paid separately to NAB.
At least 30 hours in each two-year renewal period, in or related to long-term care administration, with no more than 15 hours from one calendar day (201 KAR 6:071, effective 16 June 2026). Up to 15 percent of licensees are audited each period. 201 KAR 6:071 has no carryover provision and no required topics.
Every two years, counted from the date your license was issued or last renewed, so there is no single statewide date (KRS 216A.090; 201 KAR 6:040). Renewal costs $125. You may renew up to 60 days late with a $200 late fee; after that the license expires and you may not practice in Kentucky.
Yes, at the board’s discretion, if your other state’s standards were substantially equivalent when your license was issued, and it was issued at least 2 years before you apply (KRS 216A.130). You also show that you meet Kentucky’s current requirements or hold ACHCA certification or a current NAB HSE, with a license in good standing (201 KAR 6:050).
Only in an emergency, unless you hold another state’s license and are the spouse of an active-duty service member stationed in Kentucky (a separate six-month permit). An emergency permit requires a facility with no licensed administrator available, a written request, and all requirements but the exam and management experience; it lasts up to nine months, without renewal (201 KAR 6:030).
Through one of the three routes: a NAB-accredited degree (NAB lists Western Kentucky University’s baccalaureate program as active), an internship within a degree, or a management role in a long-term care facility, such as an assistant-administrator role, or a department-head role that carries responsibility for all five areas the regulation lists, documented on the Work Verification Form.
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