Mississippi Nursing Home Administrator License Requirements

How to become a licensed nursing home administrator in Mississippi: the 1,040-hour Administrator-in-Training (AIT) program, the NAB exams and the Board’s own state exam, fees, CE and renewal, with section numbers.

nhaexamprep.com · updated September 2026

Mississippi at a glance

Who licenses	The Mississippi State Board of Nursing Home Administrators, an independent state board (Miss. Code Ann. § 73-17-1 et seq.)
Education	A bachelor’s degree, or 64 college semester hours or an associate degree plus 2 consecutive years of full-time supervisory work in a Mississippi-licensed nursing home (Rule 1.1.A(4))
AIT requirement	1,040 hours in the facility-based AIT: 40 hours a week for at least 6 consecutive months, finished within 8 months of starting, any extension included (Rule 1.3.A(1)(a)); or a Board-approved academic AIT (Rule 1.1.A(6)(b))
National exams	NAB Core of Knowledge (CORE) and NHA Line of Service, both required (Rules 1.1.A(9), 1.7.A); $480 for the two applied for together, paid to NAB (NAB fee schedule)
State exam	Required: given in person at the Board’s Jackson office (Rule 1.5.B; Board exam calendar). 75 percent to pass (Rule 1.7), $225 (fee schedule) Details ↓
Continuing education	40 hours every two years, at least 20 of them from Board-approved courses (Rule 2.2)
Renewal	Every two years, by June 30; $550, and a $150 late fee (Rule 2.1; Board fee schedule)
Official sources	msnha.ms.gov (the Board) · Board rules, Parts 2701 and 2703 · Miss. Code Ann. § 73-17 (mirror) · nabweb.org (national exams)

Verified September 2026. “Rule” numbers are sections of the Board’s Part 2703; “R. 45” numbers are Health Department nursing home rules. Confirm with the Board before you apply.

Who licenses Mississippi administrators

The license comes from the Mississippi State Board of Nursing Home Administrators, an independent state board established in July 1972 and not part of the State Department of Health (MSDH); MSDH’s Division of Health Facilities Licensure and Certification licenses the facilities themselves. The Board’s office is at 1755 Lelia Drive, Suite 305, Jackson; phone (601) 362-6914.

The Board’s rules are 30 Miss. Admin. Code Parts 2701 and 2703, in a version effective 1 December 2023.

Who can apply

• Age and character. 21 or older, of good moral character and in good health (a physician’s statement), with three references and a criminal records check within 6 months before you apply (Rule 1.1.A(1) to (3) and (5); AIT packet). For $25, the Board will make a pre-licensure determination of whether a criminal record would disqualify you (Rule 1.1.A(12)).
• Education, one of four routes (Rule 1.1.A(4)):
  • (a) 64 semester hours of college work from an accredited institution, or (b) an associate degree, each plus two consecutive years of full-time (40 hours a week) supervisory work in a Mississippi-licensed nursing home, right before your AIT application;
  • (c) a bachelor’s degree in health care administration, a health care related field or business, or (d) a bachelor’s degree in any other field.
• Then the AIT, two required courses, and both the NAB exams and the state exam (Rule 1.1.A(6) to (9)). The Board says to expect 9 to 12 months for the whole process (AIT packet).

The AIT requirement in Mississippi

The AIT is either the facility-based program in Rule 1.3 or a Board-approved academic AIT at a college with NAB Program Approval (Rule 1.1.A(6)). The facility-based rules are in Rule 1.3:

• 1,040 hours. “A forty (40) hour per week program”, Monday to Friday between 7 a.m. and 7 p.m. unless the Board approves otherwise, and you must “complete the full six month program (1,040 hours)” (1.3.A(1)(b)). You must be employed at the approved facility for at least 40 hours a week.
• Length. At least six consecutive months. The Board may extend the program by up to two months, but “Under no circumstances shall the time to complete the A.I.T. Program extend beyond eight (8) months after the beginning of the A.I.T. Program” (1.3.A(1)(a)). An AIT not finished in eight months must reapply and start over.
• Before you start. The Board rejects an AIT application without a certified preceptor, and must approve the AIT before it begins; if you do not start within 90 days of approval, the application is abandoned (Rule 1.8; AIT packet).
• Paperwork. A Program Outline goes to the Board within ten days of starting, and monthly reports by the 15th of the next month; a report received 30 or more days after the month ends leads to termination of the AIT (1.3.A(1)(c)). Your preceptor sends evaluations at 3 and 6 months (1.3.A(2)(d)).
• Time limits. You may not sit for the NAB exam until you have finished the six months (1.3.A(1)(d)). “Failure to successfully complete licensing requirements within eighteen months after beginning the A.I.T. program will result in the loss of all accomplishments and fees” (1.3.A(1)(g)).

The two required courses

• Domains of Practice. Rule 1.1.A(7) requires “a Domains of Practice course to the satisfaction of the Board”. The AIT packet names the Board-approved Administrator-in-Training Educational Course sponsored by the Mississippi Health Care Association (MHCA).
• Two days with the Health Department. “A 2-day training course with the Office of Licensure and Certification” at MSDH (Rule 1.1.A(8)). The Health Department’s own rules separately require administrators licensed since 2002 to spend two days with it for training and mentoring within their first six months at a facility (R. 45.18.4).

Who can be your preceptor

Your preceptor must be certified by the Board and meet one of three tests: a Mississippi-licensed administrator with three consecutive years in Mississippi as an administrator or assistant administrator; a licensed administrator with three consecutive years of direct management responsibility over nursing homes in Mississippi; or a Mississippi administrator with ten or more years of Mississippi experience. A break in service of more than 90 days restarts the three-year clock, and discipline against the preceptor’s license in the past three years rules them out (Rule 1.3.A(2)).

The preceptor gives you “close, personal, and direct supervision” for at least 8 hours a week, on the premises of your facility or theirs, is reachable by phone at other times, and takes no more than two AITs at once. Certification starts on July 1 and lasts two years. Preceptors earn 5 CE hours per AIT, up to 10 a renewal period.

Other states: AIT Hours by State.

The exams you must pass

You need both the national exams and the Mississippi state exam (Rule 1.1.A(9); Miss. Code Ann. § 73-17-11). The national exam comes in “two sections (Core of Knowledge and the NHA Line of Service)”, and “Every candidate must successfully pass each section” (Rule 1.7.A). NAB gives them at Pearson VUE. Times are from NAB’s Candidate Handbook:

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
Passing score	Set by NAB (Rule 1.7): a scaled score of 113 on each exam (NAB Candidate Handbook), the same score endorsement applicants must show (Rule 1.2.B(4))
Fee	$480 for CORE and NHA applied for together, paid to NAB. The NAB handbook lists $320 for CORE or $190 for NHA taken alone
When	Only after the six months of AIT are done (Rule 1.3.A(1)(d))
Retakes	“No sooner than ninety (90) days after an unsuccessful attempt” (Rule 1.5.E). Since 1 January 2026, NAB also allows no more than 4 attempts at each exam per cycle (1 July to 30 June), each with a new application and fee

More in NAB Exam Format and The Core Domains Explained.

The Mississippi state exam

The Board gives this exam itself. Rule 1.5.B says it is “administered at such times and places as designated by the Board”, and the statute says the Board “may establish the frequency of the offering of those examinations and the contents thereof” (§ 73-17-11). You sit it in person at the Board office in Jackson (Board exam calendar), not through NAB or Pearson VUE. The Board posts its exam sessions on its website.

Passing score	“At least 75% of the questions answered correctly” (Rule 1.7)
Fee	$225 (Board fee schedule). NAB’s Mississippi page shows an older $150; the Board’s schedule governs
Study material	The Board sells a State Study Packet for $75 (Board fee schedule); ask the Board how to order it
Retakes	“No sooner than thirty (30) days after an unsuccessful attempt”. Fail either exam three times and you wait one calendar year before a new application (Rule 1.5.E). The same rule sets 90 days for NAB
Ask the Board	For the question count, time limit, format (paper or computer), content outline and what the study packet contains; the Board’s calendar gives each session’s start and end times

What the state exam draws from

The only published content list is Rule 1.6, for the examinations in general: “Customer Care, Support, and Services; Human Resources; Finance; Environment; Management and Leadership”, the five domains NAB used before its current four-domain outline (NAB has announced nine domains for exams from 1 July 2027). For the Mississippi side, the texts this page cites are the Board’s rules (Parts 2701 and 2703), the licensing statute (Miss. Code Ann. § 73-17) and MSDH Chapter 45, the Health Department’s “Minimum Standards for Institutions for the Aged or Infirm”: our reading, not a Board study list.

The Board also lists its own AIT Study Course, held by Zoom. More in State NHA Exams Explained.

Where the Mississippi rules differ from the federal rules

Four places where Mississippi sets a different number, or adds a requirement, compared with 42 CFR Part 483:

Topic	Federal rule (42 CFR 483)	Mississippi rule	Section
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, 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))	“Two and eight-tenths (2.80) hours of direct nursing care per resident per twenty-four (24) hours”, with “Seven (7) day coverage on the day shift by a registered nurse” and a full-time director of nursing on the day shift, five days a week	R. 45.4.1
Physician visits	“At least once every 30 days for the first 90 days after admission, and at least once every 60 days thereafter” (483.30(c)(1)); a visit up to 10 days late is timely (483.30(c)(2)), and after the initial visit, visits may alternate with a nurse practitioner, physician assistant or clinical nurse specialist (483.30(c)(4); in NFs at State option, 483.30(f))	Residents are “seen by a physician or nurse practitioner/physician assistant every sixty (60) days”, looser than the federal schedule, which certified facilities still follow	R. 45.22.4
Administrator training with the state	No equivalent in Part 483	Administrators licensed on or after 1 January 2002 “shall be scheduled to spend two (2) concurrent days with the licensing agency for the purpose of training and mentoring”, within their first 6 months at a licensed facility; former MSDH surveyors are exempt. Separate from the Board’s 2-day course (Rule 1.1.A(8))	R. 45.18.4
One administrator, more than one home	The governing body appoints an administrator licensed by the State where licensing is required (483.70(d)(2)(i)); Part 483 sets no limit on serving more than one facility	“No administrator shall administer more than one nursing home”, except two facilities with separate provider numbers in the same building that share management and staff, or temporarily, with Board approval, when an administrator dies, becomes incapacitated or resigns unexpectedly: facilities within 100 miles, at least 16 weekday business hours a week on site at each, for 90 days with one 90-day extension (6 months at most), and one authorization and one extension per facility and per administrator in a calendar year	Board Rule 2703-2.7

The federal nursing home rules (42 CFR Part 483, Subpart B) apply only to facilities certified for Medicare or Medicaid, so a certified Mississippi home must meet both sets of rules. Mississippi: MSDH Chapter 45 and Board Rule 2703-2.7. Federal: eCFR, September 2026.

Figures worth knowing, with their conditions

• R. 45.16.3Fingerprint and criminal background checks for direct-care employees hired on or after 1 July 2003: they may give direct care only after the check shows no disqualifying record or a waiver is granted, or on a temporary basis once the facility has documented that fingerprints were submitted
• R. 45.16.5, 45.16.6TB screening for new employees, before resident contact: an IGRA blood test or a two-step Mantoux skin test, filed within 7 days of hire; a yearly symptom review only for employees with an earlier positive result, and the facility follows MSDH’s annual TB surveillance procedures
• Miss. Code Ann. § 43-47-37Abuse, neglect or exploitation of a resident, to be reported immediately by anyone who knows of it or has reasonable cause to believe it: the facility must report by phone within 24 hours of discovery (excluding weekends and legal holidays) to MSDH and the Attorney General’s Medicaid Fraud Control Unit, and in writing within 72 hours
• 42 CFR 483.12(c)(1), (b)(5)Federal abuse reporting in certified facilities, a separate duty: alleged abuse, neglect, exploitation or mistreatment, including injuries of unknown source and misappropriation of resident property, goes to the administrator and to other officials under State law, including the State Survey Agency and adult protective services where it has jurisdiction: “immediately, but not later than 2 hours” if it involves abuse or serious bodily injury, otherwise within 24 hours; each covered individual (owner, operator, employee, manager, agent or contractor) must also report a reasonable suspicion of a crime to the State Survey Agency and at least one local law enforcement agency, within 2 hours if there is serious bodily injury, otherwise within 24 hours (Social Security Act section 1150B; 483.12(b)(5))
• R. 45.2.24, 45.19.2Beds and rooms: no more than 60 beds on a nursing unit, and no more than 2 beds in a bedroom in new facilities. For initial licensure, new construction, additions and renovations, rooms need 100 square feet (single) or 80 per resident (shared), the same figures as federal 42 CFR 483.90(e)(1)(ii). Federal rules also limit bedrooms to 2 residents in facilities newly certified, or with construction plans approved, after 28 November 2016 (483.90(e)(1)(i))

Where to find an AIT program or preceptor in Mississippi

The Board’s certified preceptor list. The Certified Preceptor List by County lists certified preceptors by county; check with the Board that a preceptor’s certification is current. See also the preceptors page.

Preceptors, not programs. The facility-based AIT runs under a certified preceptor, so the Board publishes a preceptor list and no list of AIT programs. The other route is a Board-approved academic AIT (Rule 1.1.A(6)(b)).

The association. The Mississippi Health Care Association (MHCA) sponsors the Board-approved AIT Educational Course that the AIT packet requires. Ask MHCA for course dates when you apply.

For the full step-by-step on approaching facilities and preceptors, see How to Find an AIT Preceptor and an Approved Program.

What the license costs

Board fees come from the fee schedule effective 1 December 2023; the Board’s rules make all fees non-refundable.

AIT application	$325
State exam	$225, paid to the Board
State Study Packet	$75
NAB CORE and NHA exams	$480 for the two applied for together, paid to NAB; the NAB handbook lists $320 for CORE or $190 for NHA taken alone
Renewal, every two years	$550, the most the statute allows (§ 73-17-11)
Late renewal	$150
Endorsement from another state	$325
Temporary permit	$300 application plus $100 for the permit
Reinstatement	$325 application plus $550 for the license

Our estimate on the usual route: $325 + $225 + $480 = $1,030 in Board and NAB fees for a first attempt at each exam, plus $75 if you buy the study packet and the cost of the required courses.

Continuing education and renewal

You need at least 40 classroom or clock hours each two-year period, and “A minimum of twenty (20) hours shall be earned from Board approved courses” (Rule 2.2, in the Board’s CE excerpt revised 18 March 2026; an older copy online with a 10-hour distance cap is out of date).

• Programs approved by NAB’s NCERS count, up to 20 hours for each program, and no more than 20 hours a period from NCERS-approved self-study and distance learning.
• Programs the Board approves for you individually count for up to 10 hours a period; ask at least 30 days ahead ($75).
• A 3-hour college semester course counts as 20 clock hours, one a period. For new licensees, the requirement is “prorated at 1.5 hours per month”.

Distance learning: two dates, two answers. The 18 March 2026 excerpt caps NCERS-approved self-study and distance learning at 20 hours. The Board’s newsletter of 2 September 2026 says it “finalized a rule amendment that allows all CEUs for renewal to be earned via distance learning” and gives no effective date. Ask the Board which applies to your renewal.

Renewal. Registration “shall expire biennially June 30”, and filing on or before June 30 keeps your license in effect (Rule 2.1). The fee is $550, plus $150 if late, and the Board may revoke a license after a late filing, with notice and a hearing. To reinstate a license lapsed 3 to 5 years, you need a 12-week internship under an approved preceptor and a pass on the state exam; over 5 years, you apply again under the current rules (Rule 2.1.I).

Licensed elsewhere, temporary and military

Endorsement (Rule 1.1.B; § 73-17-11). You need a license in good standing in another state whose standards are at least the “substantial equivalent” of Mississippi’s (§ 73-17-11), no license revoked or suspended in any state, a NAB scale score of at least 113 (Rule 1.2.B(4)), and a pass on the Mississippi state exam within 120 days. For the AIT, you show a completed “1,040 hour A.I.T. program”, 10 years of full-time experience as a licensed administrator, or 2 of the past 3 years as one (Rule 1.3.B).

Temporary and emergency. A temporary permit lasts no more than three months, and a facility may not be run by a permit holder for more than 3 months in a calendar year (Rule 1.1.B(3)(e)). In a declared state of emergency, an administrator licensed elsewhere may work for up to 60 days (Rule 1.1.B(4)).

Military and universal recognition. Rule 1.1.C applies the Military Family Freedom Act (§ 73-50-1) to military-trained applicants and spouses; Rule 1.1.D applies universal recognition (UROLA, § 73-50-2), with a $325 application.

The rules behind the Mississippi license

The laws, rules and other sources cited on this page.

• Licensing statuteMiss. Code Ann. § 73-17-1 et seq.: Nursing Home Administrators · § 73-17-11 (Justia mirror) · § 43-47-37, abuse reporting in care facilities (Justia mirror)
• Board rules30 Miss. Admin. Code Parts 2701 and 2703: Board of Nursing Home Administrators rules · CE excerpt, revised 18 March 2026 · Part 2703 (Justia mirror)
• Board documentsFee schedule · AIT application packet · Preceptor eligibility · Exam calendar (Board home page) · Newsletter, 2 September 2026
• Facility rulesMSDH Chapter 45, Minimum Standards for Institutions for the Aged or Infirm · Chapter 45 (Justia mirror)
• National examsNAB Candidate Handbook · NAB exam information · NAB Mississippi page
• Federal rule42 CFR Part 483, Subpart B (eCFR) · 90 FR 55687 (Federal Register, staffing repeal) · Social Security Act section 1150B (ssa.gov)

Citations verified September 2026; Justia links are labeled mirrors. For reference, not legal advice; the current official text governs.

Common questions