A Nevada license takes a bachelor’s or master’s degree, an Administrator-in-Training (AIT) program of 1,000 or 1,200 hours, 8 hours of training in Nevada law and the two national NAB exams. There is no state exam.
| Who licenses | The Nevada State Board of Examiners for Long-Term Care Administrators (BELTCA), in Reno (beltca.nv.gov). The license is called Nursing Facility Administrator (NFA) |
|---|---|
| Education | A bachelor’s or master’s degree; there is no route without one. Minimum age 21 (NAC 654.100(1), as amended by R106-24A) |
| AIT | At least 1,000 hours with a degree in nursing facility administration or health care, or 1,200 hours with any other degree; at least 20 weeks, in a nursing facility of 40 or more beds. See the routes below |
| Nevada law training | 8 hours of Board-approved training on long-term care statutes and regulations (NAC 654.100(1)). It is training, not an exam |
| National exams | NAB CORE and NHA Line of Service, both required (NAC 654.1115; NAB); $480 for the two together, paid to NAB |
| State exam | None. Nevada’s own law requirement is the 8 hours of training above. After 3 consecutive NAB exam failures you wait 6 months (NAC 654.1115, as amended by R106-24A) |
| Continuing education | 30 units every two years, including 2 in ethics and 2 in long-term care statutes and regulations (NAC 654.130) |
| License renewal | Every two years; $350; no grace period (NRS 654.170; NAC 654.112) |
| Official sources | beltca.nv.gov (the Board) · NRS 654 (statute) · R106-24A (the current NAC 654 changes) · nabweb.org (national exams) |
Verified against the sources above, September 2026. The current statute and rules govern, so check anything you rely on with the Board before you apply.
Your license comes from the Board of Examiners for Long-Term Care Administrators (BELTCA), in Reno. That is its name in NRS 654.050; the Board’s website writes “Long Term Care” without the hyphen. The statute places it “within the Department of Human Services”, the name SB 494 (2025) gave the former Department of Health and Human Services. Six of its members are Governor appointees, including two nursing facility administrators (NRS 654.050, 654.060).
The Board issues three licenses: Nursing Facility Administrator (NFA), Residential Facility Administrator (RFA) for assisted living and group homes, and Health Services Executive (HSE). An HSE “has the powers and duties of ... a licensed nursing facility administrator” (NRS 654.158). “Nursing Facility Administrator” and “N.F.A.” are protected titles (NAC 654.144).
Which rule text to read. The law is NRS 654 and the rules are NAC 654. The Board amended the rules by LCB File R106-24A, effective 19 December 2024. The official online NAC at leg.state.nv.us has not been updated and still shows the old text, such as the removed ACHCA certificate route. This page follows the amended text, which the Board’s forms match, and cites changed sections as “NAC 654.100, as amended by R106-24A”.
| Website | beltca.nv.gov |
|---|---|
| Phone | (775) 384-1208 |
| beltca@beltca.nv.gov | |
| 6170 Mae Anne Ave, Suite 1, Reno, NV 89523 |
Under NAC 654.100(1), as amended by R106-24A, you must:
You also pass the NAB exams (NAC 654.1115, below) and submit fingerprints for a background check that includes the FBI (NRS 654.150; NAC 654.110). An application not completed within 1 year is void (NAC 654.105(4)).
The field of your degree sets your AIT hours. Find the row that matches you:
| Route | Degree | AIT hours | NAC 654.100 |
|---|---|---|---|
| Health care degree | A bachelor’s or master’s “in the administration of nursing facilities or the field of health care” | At least 1,000, in a Board- or NAB-approved AIT program or “an internship or residency program in a facility providing long-term nursing care” | (1) |
| Any other degree | A bachelor’s or master’s “in any field” | At least 1,200, in a Board- or NAB-approved program. The extra 200 hours are set by topic (below) | (1), (2) |
| No degree | Anyone without a bachelor’s or master’s degree | No route. R106-24A removed the ACHCA certificate route | (1) |
The extra 200 hours on the any-degree route are fixed by topic: 65 in resident care, 45 in personnel management, 25 in financial management, 25 in maintenance, housekeeping and laundry, and 40 in administration (NAC 654.100(2)). The Board’s AIT requirements sheet gives the same numbers.
Under NAC 654.100(2), as amended by R106-24A, the AIT is “completed in a nursing facility that has 40 or more beds”. It runs at least 1,000 hours “in topics covered by the examination” over not less than 20 weeks, and you complete “All the activities and forms provided in the Administrator Residency program” of NAB, which replaced NAB’s older five-step AIT manual in the rule.
The Board’s AIT page suggests weeks for 15 departments, from 5 weeks in Administration and 4 in Nursing to 1 week each in areas such as Rehab Services, Human Resources and Laundry. This is guidance, not law: the Board’s AIT requirements sheet says “actual time frames ... will be determined by the Preceptor”, and the Board also frames training by NAB’s domains.
Under NAC 654.100(3), as amended by R106-24A, your preceptor must:
Other states: AIT Hours by State.
The AIT Planner spreads your hours across facility departments, with a self-assessment that shapes the split. The split is our planning aid, not a Nevada rule: the Board suggests 15 departments and your preceptor sets the time frames, so agree on the plan together. No account needed.
Open the free AIT PlannerNevada requires both NAB exams. The Board’s NFA instructions say “Applicants must pass the CORE NAB Exam”, NAB’s Nevada page shows “NAB NHA & CORE National: Yes”, and NAC 654.1115, as amended by R106-24A, requires an exam “Prepared by the National Association of Long Term Care Administrator Boards”. You test at a Pearson VUE test center.
| CORE | 125 questions (100 scored, 25 pretest); 130 minutes to answer, within 150 minutes in all, per NAB’s Candidate Handbook (September 2026) |
|---|---|
| NHA Line of Service | 75 questions (60 scored, 15 pretest); 70 minutes to answer, within 90 minutes in all, per the same handbook |
| Passing score | A scaled score of 113, set by NAB (NAC 654.1115) |
| Attempts | Up to 4 attempts at each of CORE and NHA per cycle (1 July to 30 June), from 1 January 2026 (NAB). Nevada’s own retake rule below applies as well |
| Fee | $480 for CORE and NHA together, from 1 February 2026. Taken alone, CORE is $320 and NHA is $190 (NAB) |
More in NAB Exam Format and The Core Domains Explained.
Under NAC 654.1115, as amended by R106-24A, an applicant who “fails the examination on three consecutive occasions must wait 6 months”. The official online NAC still shows the old rule of two failures and a one-year wait. The Board’s fee schedule also lists a $25 “NAB Retesting Fee”, separate from what you pay NAB.
Nevada has no state exam. NRS 654.150 leaves the exam to the Board, and no state exam appears in the amended NAC 654, the Board’s NFA instructions or its fee schedule; NAB’s Nevada page shows only the national exams. What Nevada adds is the 8 hours of Board-approved training on long-term care statutes and regulations (NAC 654.100(1)). It is training, not an exam, for first-time, endorsement and re-licensure applicants alike. The Board’s instructions say only “Applicants must complete 8 hours of Regulation Training.”
Once you run a Nevada nursing facility, you work under Nevada’s skilled nursing rules in NRS and NAC 449, and under 42 CFR Part 483, Subpart B, which applies only if the home is certified for Medicare or Medicaid. Neither sets a staff-to-resident ratio. Both require a registered nurse on duty at least 8 consecutive hours a day, 7 days a week (NAC 449.74517(4); 483.35(b)(1)); beyond that, NAC 449.74517(1) asks for a “sufficient number” of nursing staff, and CMS’s 2024 minimum staffing standards, which were never enforced, were repealed by an interim final rule published 3 December 2025 and effective 2 February 2026 (90 FR 55687). Five differences that matter on the job, each with the Nevada section:
| Topic | Federal rule (42 CFR 483) | Nevada rule | Nevada section |
|---|---|---|---|
| The administrator | The governing body appoints the administrator, who must be “Licensed by the State, where licensing is required” (483.70(d)(2)(i)); 483.70 sets no on-site or one-facility rule | A skilled nursing facility may operate only under a licensed NFA or HSE “who is at the facility”. Being administrator of record of more than one nursing facility takes a $100 secondary license for each extra facility and is limited to 90 days in a calendar year unless the Board grants a waiver | NRS 449.187; NAC 654.250 |
| Reporting abuse | The facility reports alleged abuse, neglect, exploitation or mistreatment to the administrator and the State Survey Agency “immediately, but not later than 2 hours” if it involves abuse or serious bodily injury, otherwise within 24 hours (483.12(c)(1)) | Anyone who maintains or works for a facility that cares for older or vulnerable persons must report known or suspected abuse, neglect, exploitation, isolation or abandonment to the Aging and Disability Services Division, police or sheriff “not later than 24 hours after” knowing or suspecting it. Knowingly and willfully failing to report is a misdemeanor. Both clocks apply | NRS 200.5093 |
| Dementia training | All staff get dementia management training, with no set hours (483.95(c)(3)); nurse aide in-service training, at least 12 hours a year, includes it (483.95(g)) | Licensed or certified employees who give direct care to residents with dementia complete 8 hours of dementia continuing education within 30 days of starting work, then 3 hours a year, and the administrator must make sure they do | NRS 449.094(3); NAC 449.74522 |
| Cultural competency | No comparable training requirement | Medical facilities, including skilled nursing facilities, provide cultural competency training through a state-approved course: within 90 days of hire, then at least 2 hours every two years, for staff with weekly direct patient contact and their supervisors | NRS 449.103; NAC 449.011931 |
| Director of nursing | A full-time registered nurse as director of nursing, with no minimum years of experience (483.35(b)(2)) | A full-time registered nurse as chief administrative nurse, with at least 3 years of nursing experience in a hospital or long-term care, plus supervisory experience | NAC 449.74517 |
One more federal duty applies in every certified home. Each covered individual reports a reasonable suspicion of a crime against a resident to the State Agency and one or more law enforcement entities, within 2 hours if there is serious bodily injury and otherwise within 24 hours (483.12(b)(5); section 1150B of the Social Security Act). In Nevada it runs alongside the NRS 200.5093 report.
Nevada: NRS 200.5093, NRS 449 and NAC 449 (Justia’s unofficial copies), and NAC 654.250. Federal: 42 CFR Part 483, Subpart B, in the eCFR. In a certified home you meet both.
From the Board’s fee schedule, which is undated, unless the row names another source:
| NFA application (NAB exam route) | $645 |
|---|---|
| NFA endorsement (reciprocity) | $620 |
| HSE application | $550 |
| Renewal, every two years | $350 (also in NAC 654.112) |
| Inactive status | $50 a year, for up to 2 consecutive years |
| Secondary license | $100 for each additional facility (also in NAC 654.250) |
| Background check | $60 with fingerprint cards; $15 electronic |
| NAB retesting fee, paid to the Board | $25 |
| NAB exams, CORE and NHA together | $480, paid to NAB (NAB handbook, from 1 February 2026) |
The schedule does not itemize the $645. NAC 654.105(3) sets a $200 application fee plus a fee “to cover the actual cost of the training” (the 8-hour law course), and NRS 654.140 caps the NFA application fee at $250.
You need 30 units in the 2 years before each renewal: a licensee must have “completed 30 continuing education units” (NAC 654.130, as amended by R106-24A).
A license “expires 2 years after the last day of the calendar month in which it was issued” (NRS 654.170(2)), so each license has its own date. You renew “not more than 60 days before” it expires (NAC 654.112(1)) through the Board’s renewal page, with the $350 fee and your CE, and new fingerprints “If it has been four (4) years or more since your last background check”.
Endorsement. NRS 654.180 lets the Board license you without examination. Under NAC 654.111, as amended by R106-24A, you need a bachelor’s or master’s degree and 1,000 AIT hours; a valid NAB score, meaning your out-of-state license has not lapsed or been suspended, revoked or restricted since the score was issued; a license in good standing “for the 2 years immediately preceding” your application; no discipline other than nonrenewal or CE lapses in jurisdictions where you were inactive; and the 8 hours of Nevada law training. The fee is $620. The amendment dropped the old requirement of 2 of the last 5 years as a full-time administrator of record.
Already licensed? The AIT and endorsement changes in R106-24A “do not apply to any person who is currently licensed”.
Provisional license. “The Board may issue a provisional license to an applicant pending final approval.” It “expires 90 days after the date it is issued” and may be renewed at the Board’s discretion (NAC 654.168). The Board’s application package does not mention it, so ask the Board.
A second facility. Being administrator of record of more than one nursing facility requires notice to the Board and a $100 secondary license for each additional facility, and is capped at 90 days “in a calendar year” unless the Board grants a waiver (NAC 654.250).
Military. NRS 622.510 requires every licensing board to “develop opportunities for reciprocity of licensure” for active-duty members, their spouses, veterans and surviving spouses, and NRS 622.530 sets deadlines for deciding endorsement applications.
The Board’s list. The Board posts a list of approved programs and preceptors: the PDF on its AIT page, and an .xlsx version on its NFA page. Each placement still needs Board approval, and under the amended rule the preceptor must work at your facility.
Associations. The Nevada Health Care Association (NVHCA), the AHCA/NCAL affiliate in Henderson, describes its work as “leadership, support and education” and offers a state-approved 3-hour cultural competency course. LeadingAge Pacific West is the LeadingAge state partner for Hawaii, Idaho and Nevada.
NAB and ACHCA. NAB’s AIT Program Manual, the residency program the rule requires, and its Preceptor Training Modules are at nabweb.org. ACHCA lists no Nevada chapter on its chapters page; members go to the nearest active chapter in their district.
For approaching facilities and preceptors step by step, see How to Find an AIT Preceptor and an Approved Program.
The legal sources for nursing facility administrator licensure in Nevada, and the facility rules cited above.
Citations verified September 2026 against the Legislature’s NRS and adopted-regulation texts, the Board’s forms, and Justia’s copies of the amended NAC 654 and of NAC 449 (unofficial mirrors). Provided for reference, not legal advice; the current official text governs.
At least 1,000 hours with a bachelor’s or master’s in nursing facility administration or health care, or at least 1,200 hours with a degree in any other field (NAC 654.100, as amended by R106-24A). The AIT runs at least 20 weeks in a nursing facility of 40 or more beds. There is no route without a degree.
No. You take the NAB CORE and NHA Line of Service exams. Nevada instead requires 8 hours of Board-approved training on long-term care statutes and regulations, which is training, not an exam (NAC 654.100(1)). After 3 consecutive exam failures you wait 6 months (NAC 654.1115, as amended by R106-24A).
30 units every two years, including 2 in ethics and 2 in long-term care statutes and regulations, with no more than 8 units in any 24 hours (NAC 654.130). The Board’s renewal instructions accept only BELTCA- or NAB-approved courses. There is no grace period.
Yes, by endorsement (NAC 654.111, as amended by R106-24A): a degree and 1,000 AIT hours, a valid NAB score, a license in good standing for the 2 years before you apply, and the 8 hours of Nevada law training. The fee is $620. The Board may also issue a 90-day provisional license pending final approval (NAC 654.168).
Start with the Board’s list of approved programs and preceptors on its AIT page. Each placement still needs Board approval, and a Nevada preceptor must work at your facility and complete Board-approved preceptor training (NAC 654.100(3)).
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