Oklahoma Nursing Home Administrator License Requirements

How to become a licensed nursing home administrator in Oklahoma: the license tiers, the Administrator-in-Training (AIT) internship, the NAB exams and the Oklahoma State Standards examination, fees, continuing education and renewal, with section numbers.

nhaexamprep.com · updated September 2026

Oklahoma at a glance

Who licenses	The Oklahoma State Department of Health (OSDH), through its Long Term Care Administrator Licensing Program (63 O.S. 1-1949.3(A))
License types	Tier 1 for nursing facilities; Tier 2 for assisted living, adult day care and small ICF/IID homes; Certified Assistant Administrator (63 O.S. 1-1949.2; OAC 310:679)
AIT requirement	A 750-hour internship for Tier 1, finished within 24 months, at most 40 hours a week, with a preceptor OSDH approves first (OAC 310:679-10-41)
National exams	NAB Core of Knowledge (CORE) and NHA Line of Service for Tier 1 (OAC 310:679-10-3(c))
State exam	Required: the Oklahoma State Standards examination, given by the state at CareerTech test sites, 75 percent to pass, $100 per attempt, passed before a license is issued (OAC 310:679-10-13) Details ↓
Continuing education	24 clock hours each license year for Tier 1 (OAC 310:679-9-4)
Renewal	Every year by 31 December; $200 for Tier 1, with a late fee of $100 for each calendar week (63 O.S. 1-1949.3(G); OAC 310:679-7-2)
Official sources	OSDH licensing program · OAC 310:679 (OSDH copy) · 63 O.S. 1-1949.1 (Justia mirror) · nabweb.org (national exams)

Verified September 2026. OAC is the Oklahoma Administrative Code and O.S. the Oklahoma Statutes. Rule text is quoted from the copy of OAC 310:679 that OSDH posts, amended through 11 August 2025; statute text is from the Justia copy of the 2025 Oklahoma Statutes.

Who licenses Oklahoma administrators

The license comes from the Oklahoma State Department of Health (OSDH), through its Long Term Care Administrator Licensing Program. The law says the “State Department of Health shall have authority to issue licenses or certifications” (63 O.S. 1-1949.3(A)). Contact: 123 Robert S. Kerr Ave., Ste. 1702, Oklahoma City, OK 73102; (405) 426-8970; longtermcareadminlicensing@health.ok.gov. Applications and renewals go through the online portals on the program page.

What changed in 2023. Licensing used to sit with the Oklahoma State Board of Examiners for Long Term Care Administrators. HB 2824, signed on 22 May 2023 (Laws 2023, c. 271), moved its powers, employees and funds to OSDH, effective 1 November 2023. The statutes were renumbered from 63 O.S. 330.51 and following to 63 O.S. 1-1949.1 and following, the Long-Term Care Administrator Licensing Act, and the rules moved from OAC Title 490 to OAC 310:679. OSDH rewrote 310:679 effective 11 August 2024, revoking the old Board’s subchapter, and amended it effective 11 August 2025, including the fee schedule and the internship section. The old web address, oklahoma.gov/osbeltca, now shows the OSDH program.

OSDH also regulates the nursing homes themselves, under the Nursing Home Care Act (63 O.S. 1-1901 and following) and OAC 310:675.

License types and who can apply

Oklahoma licenses administrators in tiers (63 O.S. 1-1949.2; OAC 310:679):

Tier 1	Nursing facilities, including skilled nursing, and ICF/IID homes with 17 or more beds. A Tier 1 license also covers every other type of long-term care facility. The rest of this page follows Tier 1
Tier 2	Assisted living and residential care, adult day care, and ICF/IID homes with 16 or fewer beds. The ICF/IID-16 internship is 500 hours
Certified Assistant Administrator (CAA)	A high school diploma or GED, Department-approved training, the State Standards exam, NAB CORE, and either 1 year of management, leadership or supervisory experience in long-term care or an approved internship (OAC 310:679-15-3). A CAA serves one nursing facility only and spends at least 80 percent of working time on site (15-4)

• Everyone. At least 21 when the license is issued, a U.S. citizen or qualified alien, and a background check under 63 O.S. 1-1950.1 (OAC 310:679-10-2.1).
• Education (OAC 310:679-10-3(b), consistent with 63 O.S. 1-1949.3(D)). Either a “Baccalaureate degree from an institution of higher education”, in any field, or an “Associate degree in a health- or business-related field or other relevant field and not less than five (5) years of experience in upper-level management of a long-term care facility”.
• Within 24 months of applying (10-3(c)): Department-approved training, the internship, and three exams (the Oklahoma State Standards examination, NAB CORE and the NAB NHA Line of Service).

The order OSDH gives on its program page:

1. Apply through the OSDH portal, before you start approved training.
2. Complete the approved training.
3. Take the Oklahoma State Standard Exam.
4. Complete the internship with an OSDH-approved preceptor.
5. Take the NAB exams.
6. Final review by OSDH.

Waivers. OSDH may waive the training for a degree in long-term care administration from a NAB-accredited institution, for a former Oklahoma Tier 1 licensee in good standing who has been active in long-term care for 2 of the last 5 years, or for out-of-state training that “meets or exceeds NAB recommendations” (10-3(e)). It may waive the internship, wholly or in part, for a documented internship that meets or exceeds NAB or Department requirements (10-3(f), 10-42), and training, the internship or both for a former Oklahoma licensee on the same conditions (10-3(h)). The route for NAB’s Health Services Executive (HSE) qualification is below.

The AIT requirement in Oklahoma

Oklahoma’s rules call the AIT an internship. For Tier 1 it is 750 hours: “Tier 1 administrator applicants must complete a 750 hour internship with a Department-approved preceptor” (OAC 310:679-10-41(a), amended effective 11 August 2025). NAB’s Oklahoma summary shows a different figure; the OSDH rule governs, and it sets no longer or shorter internship by type of degree.

• Time limit. Applicants “have twenty-four (24) months to complete the required internship” (10-41(c)).
• Hours a week. Applicants “cannot complete greater than 40 internship hours per week” (10-41).
• Approval first. OSDH must approve your preceptor before you begin; hours completed before approval do not count toward the 750 (OSDH program page).
• The facility. Licensed by OSDH and “in substantial compliance” (10-30).
• Your plan. You and your preceptor assess your background “to determine specific areas of concentration within the domains of practice and departmental rotations” (10-34). The rule sets no number of departments. Progress is tracked “through each NAB module of training” on a checklist kept at the facility (10-35, 10-37).

Who can be your preceptor

• License and experience. A current Oklahoma administrator license, and experience “operating as a licensed administrator for the twenty-four (24) months immediately preceding the internship or thirty-six (36) of the last sixty (60) months” (10-32).
• Role. The facility’s full-time administrator-of-record or that administrator’s licensed direct supervisor, who meets with you regularly and signs the attestation when your hours are done (10-33).
• Two at a time. “A preceptor may not oversee more than two (2) interns at a time” (10-44).
• Concerns. The preceptor tells OSDH of concerns about an intern “within ten (10) days” (10-39).
• The preceptor’s CE. “3 CEUs for every 500 hours completed”, up to 12 a calendar year (10-36).

Other states: AIT Hours by State.

The exams you must pass

Oklahoma Tier 1 applicants take both NAB exams, the Core of Knowledge (CORE) and the NHA Line of Service; a CAA takes CORE only (OAC 310:679-10-3(c), 15-3). NAB is the National Association of Long Term Care Administrator Boards, and you test at a Pearson VUE test center. The figures 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
Passing score	A scaled score of 113 on each
Fee	$480 for CORE and NHA applied for together, from 1 February 2026, paid to NAB. Taken alone, CORE is $320 and NHA is $190
NAB attempts	Since 1 January 2026, up to 4 attempts at each exam per cycle (1 July to 30 June)
Oklahoma window	All exams, with the training and internship, within 24 months of applying (OAC 310:679-10-3(c))

More in NAB Exam Format and The Core Domains Explained.

The Oklahoma state exam

Oklahoma’s state exam is the Oklahoma State Standards examination (OAC 310:679-10-3(c)); OSDH’s website says “Oklahoma State Standard Exam”. “Applicants must pass the applicable State Standards examination prior to a license being issued” (10-13). Tier 1 applicants take it with NAB CORE and NHA, CAA applicants with NAB CORE (15-3), and holders of NAB’s HSE qualification take it too (10-3(g)).

Who gives it	The state, not NAB or Pearson VUE. NAB’s Oklahoma summary lists “State Exam Administration: State”. OSDH lists it after training and before the internship
Where	Oklahoma CareerTech test sites. OSDH links to CareerTech’s list “Health and Professional Certification Projects” (revised 9 February 2026), which lists the exam (“LTCAdmin”) at technology centers such as Moore-Norman Technology Center in Norman and Oklahoma City
How to register	Through OSDH’s Testing Questionnaire. First, “An applicant’s training instructor must attest to the readiness of an applicant” (10-3)
Passing score	“Seventy-Five percent (75%) or greater” (10-13)
Fee	$100 per attempt (OAC 310:679-7-2), paid to the testing center. The study guide of 20 August 2024 also shows “$500.00 per examinee” for an “unscheduled examination”; the current fee schedule lists only the $100 per attempt
Format	OSDH does not publish the number of questions, the time limit, retake rules or waiting periods, or how long a passing score stays valid

What the state exam draws from

OSDH’s study guide (8-20-24) says “The State Standards exam consists of content taken directly from rule and law”. It lists what to study:

• Every applicant: the Long-Term Care Administrator Licensing Act (63 O.S. 1-1949.1 and following); OAC 310:679; the pharmacy statute, 59 O.S. 367.3; the resident electronic monitoring statutes, 63 O.S. 1-1956.1 and following, which the guide calls the “Barbara J. Hoover Act”; and OAC 310:677, on nurse aides.
• Tier 1 adds: the Alzheimer’s Special Care Disclosure Act; OAC 310:673; the Nursing Home Care Act (63 O.S. 1-1901 and following); and OAC 310:675, the nursing home rules.

More in State NHA Exams Explained.

Where the Oklahoma rules differ from the federal rules

Three places where Oklahoma sets a number, or adds a requirement, that 42 CFR Part 483 does not. All three come from Oklahoma statutes and OSDH’s nursing home rules (OAC 310:675, on the Tier 1 study list):

Topic	Federal rule (42 CFR 483)	Oklahoma rule	Section
Direct-care staffing	Sufficient nursing staff, including licensed nurses, on a 24-hour basis (483.35(a)), with no staff-to-resident ratio; a registered nurse “for at least 8 consecutive hours a day, 7 days a week”, and a registered nurse as full-time director of nursing, unless waived (483.35(b)(1), (2)). CMS repealed the 2024 minimum staffing standards, which were never enforced, by interim final rule published 3 December 2025 (90 FR 55687, effective 2 February 2026)	Since 1 October 2019, minimum direct-care-staff-to-resident ratios: 1 to 6 on the day shift (7 a.m. to 3 p.m.), 1 to 8 on the evening shift (3 p.m. to 11 p.m.) and 1 to 15 at night (11 p.m. to 7 a.m.); since 2020, the 2.9-hour alternative below	63 O.S. 1-1925.2
Reporting incidents	Alleged violations reported “immediately, but not later than 2 hours” if they involve abuse or serious bodily injury, otherwise within 24 hours (483.12(c)(1)); investigation results within 5 working days (483.12(c)(4))	A report to OSDH “within twenty-four (24) hours of the reportable incident unless otherwise noted”, a follow-up within 5 Department business days, and a final report within 10 Department business days. In a certified home, the federal 2-hour clock still applies	OAC 310:675-7-5.1(a)
The administrator’s time	The administrator must be “Licensed by the State, where licensing is required” (483.70(d)(2)(i)), responsible for management of the facility and accountable to the governing body (483.70(d)(2)); Part 483 sets no time on site	The administrator “must devote at least one-half (1/2) of such person’s working time to on-the-job supervision” of the facility	63 O.S. 1-1949.2(1)

The federal nursing home rules (42 CFR Part 483, Subpart B) apply only to facilities certified for Medicare or Medicaid, so a certified Oklahoma home must meet both sets of rules. Federal text as of September 2026.

Figures worth knowing, with their conditions

• 63 O.S. 1-1925.2The staffing alternative to the shift ratios, since 1 January 2020: a 24-hour schedule of at least 2.9 direct-care hours per resident per day, never below 1 direct-care staff per 15 residents, with two direct-care staff awake at all times
• OAC 310:679-10-51Running more than one home: an administrator is administrator-of-record of one facility, with exceptions: ICF/IID homes of 16 or fewer beds within a 15-mile radius, up to 6 facilities and 64 beds; and a Tier 1 nursing facility plus one assisted living, residential care or adult day care site with the same owner, within 15 miles and 130 occupied beds
• OAC 310:675-7-1.1(b)When the administrator is away: the administrator or owner “shall designate a person in the facility to act on behalf of the administrator during the administrator’s absence”
• 42 CFR 483.12(b)(5); Social Security Act section 1150BReporting a crime in a federally funded facility, a separate federal duty: each covered individual (owner, operator, employee, manager, agent or contractor) reports a reasonable suspicion of a crime to the State Agency and at least one local law enforcement entity, within 2 hours if there is serious bodily injury, otherwise within 24 hours

Where to find an AIT program or preceptor in Oklahoma

In Oklahoma the AIT is the internship, and the training that comes before it is Department-approved training (OAC 310:679-10-3(c)).

Start with OSDH. The Long Term Care Administrator Licensing Program posts its Approved Training Programs list (marked “Updated 2.26”) and the preceptor forms on its program page. The list covers training programs only: OSDH approves each preceptor for each intern (10-31, 10-32), so you find a preceptor who meets the rules above and apply for approval before you start.

Approved Tier 1 training. OSDH’s own Tier 1 course, scheduled for 5 to 14 October 2026 at Rose State College; SWOSU, in person and online, (580) 774-7103; Long Tree and Associates, online; and Care Providers Oklahoma, in person, which also offers CAA training. The rule caps training fees at $200 a day (7-2).

Associations. Care Providers Oklahoma, (405) 524-8338, is on OSDH’s approved list for Tier 1 and CAA training. LeadingAge Oklahoma is another long-term care association and a way to meet administrators; its site does not describe internship or administrator training.

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

OSDH’s fees are in OAC 310:679-7-2, amended effective 11 August 2025:

Initial licensure application (all types)	$200
Tier 1 renewal, every year	$200
Certified Assistant Administrator renewal	$75
Late renewal	$100 “for each calendar week, or portion thereof”
State Standards exam	$100 per attempt, paid to the testing center
Administrator training	“Not to exceed $200.00 per day”
NAB CORE and NHA, applied for together (paid to NAB)	$480 since 1 February 2026

The fee schedule lists no separate internship fee; the internship application goes in with “A fee as prescribed by the Department” (10-29). NAB’s Oklahoma summary lists an AIT application fee of $350, which is not in the current rule, so ask OSDH what applies.

Continuing education and renewal

Tier 1 administrators and CAAs complete “twenty-four (24) clock hours of CEUs each license year” (OAC 310:679-9-4); Tier 2 licensees need 16. In your first year, it is “six (6) hours of continuing education for each quarter in which they hold a license”.

• What counts. CE must “relate to Long-Term Care Administration” (9-2), and programs approved by NAB’s NCERS “will count towards CE requirements” (9-1(d)).
• Daily limit. Department-approved programs include at most 7 clock hours a day, or 8 with a required lunch-hour presenter (9-2).
• Topics and carryover. Subchapter 9 names no required topics, and CE must be completed “within the licensure period” (9-4(d)).
• Proof. You upload your CE records in the online renewal portal when you renew, and CE must be complete before OSDH issues the renewal (9-4(g)).

Renewal. Every license “shall expire on the thirty-first day of December following its issuance” (63 O.S. 1-1949.3(G)), and you renew for the calendar year through the Licensee Portal. Tier 1 renewal is $200 (CAA $75), and the late fee is $100 for each calendar week or part of a week (7-2). Update the portal within 15 calendar days of a change of name, address, employment or employer (10-51). A suspended license “may be restored once all conditions for restoration have been met” (10-6); if your license has lapsed, ask OSDH before you work.

Licensed elsewhere, provisional licenses and military

Endorsement (OAC 310:679-10-4; the reciprocity checklist). The law asks for requirements “substantially equivalent to or greater than” Oklahoma’s (63 O.S. 1-1949.3(H)). You show a formal program of study, passing NAB scores, your current license from another state, “full-time service as administrator-of-record for the past two (2) consecutive years or … at least two (2) of the last three (3) years” in that license type, any past discipline, and an attestation. Applicants have “one year to complete any licensure or certification requirements” (10-10(b)). The state exam: 10-13(a) requires reciprocity applicants to pass “the current, applicable State Standards examination”.

HSE. “An applicant with a verified HSE qualification may be issued a license” once the applicant has passed the State Standards exam and cleared a background check (10-3(g)).

Provisional license (10-5). OSDH “may grant one (1) provisional license for a single period not to exceed six (6) months to fill an unexpected vacancy”. The candidate needs a bachelor’s degree and a formal program of study, 2 years of long-term care experience, a passing State Standards score, and an on-site consultant (an Oklahoma administrator with 2 or more years in the same facility type) who gives “at least eight (8) hours per week” of direct supervision, with no more than 10 days between visits. “Provisional licenses are non-renewable” (10-16).

Military. Applicants can mark the “59 O.S. 4100.5 et seq military reciprocity pathway” on the application (10-4(b)).

The rules behind the Oklahoma license

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

• Licensing statuteLong-Term Care Administrator Licensing Act, 63 O.S. 1-1949.1 and following · 1-1949.2 (license types) · 1-1949.3 (licenses, renewal) (Justia mirrors)
• Licensing rulesOAC 310:679, Long-Term Care Administrators (OSDH copy, amended through 11 August 2025)
• OSDH pagesLicensing program · State Standards study guide (8-20-24) · Approved Training Programs · Reciprocity checklist
• Nursing home law63 O.S. 1-1925.2 (staffing ratios) · OAC 310:675-7-5.1 (incident reports) (Justia mirrors) · OAC 310:675 (OSDH copy)
• HistoryHB 2824 (2023), bill status
• National examsNAB Candidate Handbook (September 2026) · NAB exam information · NAB Oklahoma summary
• 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. The Justia links are labeled mirrors. For reference, not legal advice; the current official text governs.

Common questions