What it takes to become a licensed nursing home administrator in Pennsylvania: the routes to the exams, including the optional Administrator-in-Training (AIT), the NAB exams, the State Based Licensing Exam and what it is drawn from, continuing education and renewal, and where to find a supervisor or an approved program. Figures come from the official sources listed on this page.
| AIT route | Optional route: 1,000 hours with a bachelor’s, 800 with an acceptable master’s (49 Pa. Code 39.5), or qualify through another listed route |
|---|---|
| National exams | NAB Core of Knowledge + NHA Line of Service (both required) |
| State exam | Required: the State Based Licensing Exam (Pennsylvania NHA), 35 scored items with a cut score of 26; the Board lists 42 CFR Part 483, 49 Pa. Code Chapter 39 and 28 Pa. Code Part IV Subparts A and C as its references Details ↓ |
| Continuing education | 48 clock hours per two-year period, including at least 12 in emergency preparedness and infection control (39.61) and 2 in child abuse recognition and reporting (per the Board) |
| License renewal | Every two years, in even-numbered years (39.11); licenses expire 30 June, per the Board; $297 (39.72) |
| Who licenses | State Board of Examiners of Nursing Home Administrators, in the Department of State (39.1) |
| Official sources | pa.gov (the Board) · 49 Pa. Code Chapter 39 · nabweb.org (national exams) |
Checked against the sources on this page, September 2026. Requirements change, and the Board’s current published rules govern.
In Pennsylvania the Administrator-in-Training (AIT) program is optional. It is one of the Board’s experience routes to the licensing exams, and it is open only if you hold a bachelor’s degree or an acceptable master’s degree, or are in the final year of one (49 Pa. Code 39.101(b)(1)). The other routes use assistant administrator, supervisory or director of nursing experience instead, and they are the only routes if you do not hold a bachelor’s or acceptable master’s degree.
To be admitted to the licensing examination, you must be at least 21, show good moral character and pay the fee (39.5(a)). Ask the Board what applies if you apply by endorsement. The Board’s Licensure Snapshot also requires 3 hours of Board-approved training in child abuse recognition and reporting before your first license; after that, 2 hours are needed each renewal period.
The Board’s Options to become qualified to sit for the NHA licensing exams lists 11 options. Grouped by education, from 39.5(b):
| Education | Experience, any one of | Section |
|---|---|---|
| Acceptable master’s degree | 6 months of full-time supervisory experience, or an 800-hour AIT | 39.5(b)(4)(ii) |
| Bachelor’s degree, plus the 120-hour program if it applies | 9 months as a full-time assistant administrator; or 18 months of supervisory experience with 1,000 hours in nursing home administration; or a 1,000-hour AIT | 39.5(b)(3)(iii) |
| 2 years of college, plus the 120-hour program | 18 months as an assistant administrator; or 3 years of supervisory experience with 1,000 hours of administration | 39.5(b)(1) |
| Registered nurse, plus the 120-hour program | 6 months as director of nursing and 12 months as an assistant administrator; or 2 years as director of nursing with 1,000 hours of administration | 39.5(b)(2) |
| High school diploma, plus the 120-hour program | 2 years of administration experience and 18 months as an assistant administrator; or 2 years of administration and 3 years of supervisory experience with 1,000 hours; this route also requires an appearance before the Board (39.5(b)(5)(ii)) | 39.5(b)(5) |
The Board-approved 120-hour program is not needed on the master’s routes, and it is waived for a bachelor’s degree in nursing home administration or its equivalent (39.5(b)(3)(ii)). In February 2026 the Board began discussing which master’s degrees should qualify; until a rule changes, the list in 39.5(b)(4)(i) applies, so check with the Board before you rely on a master’s route.
| Length | 1,000 hours with a bachelor’s degree, 800 with an acceptable master’s degree (39.5(b)(3)(iii)(C), (b)(4)(ii)(B)) |
|---|---|
| Time window | Completed “During the 2 years immediately preceding the date of application” (same clauses) |
| Hours by area | At least 300 in general administration, 250 in patient services and care, and 250 in health and social service delivery systems (39.5(c)). On a 1,000-hour AIT the other 200 may be distributed as needed; on an 800-hour AIT the three minimums take all 800 |
| Weekly schedule | No fewer than 20 and no more than 60 hours a week, with at least 80 percent on weekdays between 7 a.m. and 7 p.m. (39.102(a)(4)). So 1,000 hours takes about 17 to 50 weeks, and 800 hours about 14 to 40 weeks |
| Supervisor | A full-time nursing home administrator licensed in Pennsylvania, or in a state with equal standards, in a nursing home (39.5(b)(3)(iii)(C), (b)(4)(ii)(B)). Hours in any other job there do not count (39.101(b)(2)) |
| Before you start | You and your supervisor make a pretraining assessment and a detailed training plan, which the Board approves before it begins (39.102(a)(1) to (3)). You apply on the Board’s form (39.101(a)); ask the Board how to submit it and your supervisor’s part. The fee is $50 (39.72) |
| When you finish | A report within 30 days, signed by you and your supervisor, listing the departments you trained in (initialed by their managers) and your hours by subject area (39.103(a)). The Board reviews it before admitting you to the exam (39.102(c)) |
| Breaks | An absence of more than 1 year, other than military service, ends the program (after military service you have a year to finish). If the break was beyond your or your supervisor’s control, you and your supervisor may ask the Board to credit the hours already done (39.102(d)) |
Other states: AIT Hours by State.
If you choose the AIT, the free AIT Planner turns your 800 or 1,000 hours into a draft plan across facility departments. Pennsylvania sets area minimums rather than fixed rotations, so agree the final plan with your supervisor before it goes to the Board. No account needed.
Open the free AIT PlannerPennsylvania uses the national exams from NAB (the National Association of Long Term Care Administrator Boards): the Core of Knowledge exam, 125 questions (100 scored) with 150 minutes of seat time, and the NHA Line of Service exam, 75 questions (60 scored) with 90 minutes of seat time. Both are computer-based and taken at Pearson VUE test centers. NAB’s candidate handbook sets a scaled score of 113 as the pass mark, and lists $480 for the two exams together from 1 February 2026. We break down the structure in NAB Exam Format and the content in The Core Domains Explained.
Pennsylvania is one of the states that adds an exam of its own. The Board calls it the State Based Licensing Exam (Pennsylvania NHA); the regulation calls it the “State part” of a two-part written examination. It is built on Pennsylvania’s rules, and NAB administers it at Pearson VUE test centers. Pearson VUE replaced PSI as NAB’s testing vendor, so registration instructions that name PSI are out of date.
The two parts are passed separately. Under 49 Pa. Code 39.5(g), a candidate who passes one part and fails the other retakes only the part failed, and after four failures the Board may require Board-approved courses of study before a further attempt.
49 Pa. Code 39.5(d)(2) defines the State part in one sentence:
“An examination on the regulations of the Department of Health in 28 Pa. Code Part IV Subpart C (relating to long term care facilities), known as the ‘State part.’”
So under the regulation the State part is an exam on Subpart C, which is Chapters 201 to 211; the Board’s published reference list, below, is wider. Separately, 49 Pa. Code 39.7 lists nine subject areas for the licensing examinations:
39.7 reads as a description of the licensing examination as a whole rather than of the State part specifically. It is still the only subject list in the regulation.
The Board publishes no content outline for the Pennsylvania exam. At the Board’s meeting of 14 August 2024 it was noted that NAB’s candidate handbook “does not speak to the content outlines or the domain areas of the Pennsylvania exam”, and the chair suggested posting the exam’s sources on the Board’s website. As of September 2026 the Board publishes exam specifications and a reference list, but still no content outline.
The Board’s Resources and Documents page gives the “new PA Exam Specifications”:
That list is wider than the definition in 39.5(d)(2), which names Subpart C only, so plan your study around the Board’s list.
This is the structural point that changes how you should read everything else. Pennsylvania does not write its own version of the federal requirements. 28 Pa. Code 201.2(a) incorporates 42 CFR Part 483 Subpart B by reference as the licensing regulations for long-term care nursing facilities, with two carve-outs: 42 CFR 483.1, and the minimum data set reporting requirements unless the facility takes part in Medicare or Medical Assistance.
In Pennsylvania, then, most of the Subpart B federal text is state law, and the Board lists 42 CFR Part 483 among the State exam’s references. On top of the federal text, study what Pennsylvania adds, because that is where the Pennsylvania answer differs from the answer you learned for the NAB exams.
Subpart C was rewritten, effective 1 July 2023. Chapter 203, the Life Safety Code chapter, was deleted entirely, and a new Chapter 204 was added covering construction, alteration or renovation approved on or after that date. Chapter 207 (housekeeping and maintenance) is entirely reserved, with no rules in force, and Chapter 209 now retains only 209.3, on smoking. Anything still teaching you 28 Pa. Code Chapter 203 is describing a chapter that no longer exists.
On the State part, the federal rule you learned for the NAB exams is not always the Pennsylvania answer. Pennsylvania’s staffing rules in particular now have no federal counterpart: 42 CFR 483.35 sets no hours per resident day and no ratios, only “sufficient” staffing plus an RN for 8 consecutive hours a day, 7 days a week. Seven examples, each cited to its section:
| Topic | Federal or NAB answer | Pennsylvania answer | Section |
|---|---|---|---|
| Direct care hours | No hours-per-resident-day figure. “Sufficient” nursing staff (F725) | 3.2 hours per resident per 24 hours, averaged across the facility, since 1 July 2024 | 211.12(i)(2) |
| Staff ratios | None anywhere in Part 483 | Fixed ratios per shift for aides, LPNs and RNs | 211.12(f.1) |
| Restraint removal | No prescribed interval. Least restrictive alternative for the least time (F604) | Physical restraints removed at least 10 minutes out of every 2 hours during normal waking hours | 211.8(c.1)(3)(i) |
| Facility assessment | At least annually, 42 CFR 483.71 (F838) | Conducted as necessary, and at least quarterly | 201.14(j) |
| Medical director | Designate a physician. No CE requirement (F841) | PA-licensed, and at least 4 hours a year of CME in medical direction or post-acute and long term care medicine | 211.2(c) |
| Serious incidents | Abuse allegations within 2 or 24 hours (F609) | Incidents listed in 28 Pa. Code 51.3 reported as soon as possible, at the latest within 24 hours, to the Division of Nursing Care Facilities field office | 201.14(c) |
| Facility closure | The administrator gives at least 60 days’ notice, 42 CFR 483.70(k)(1)(i) | Notice and a closure plan to the Department for approval at least 75 days ahead; residents get 60 days | 201.23 |
The federal staffing answer changed recently. CMS added federal hours-per-resident-day figures in a rule of 10 May 2024, that rule was partly vacated in litigation and then barred from enforcement by statute until 2034, and CMS repealed the figures in an interim final rule effective 2 February 2026. So “no federal figure” is correct as we write this in September 2026, and was not correct for most of 2024 and 2025. Older study material may say either thing. Pennsylvania column verified against 28 Pa. Code, September 2026; federal column against the current eCFR text and the CMS F-tag list.
One staff member per this many residents. Note that the dates differ: only the nurse aide ratio was stepped up in 2024.
| Staff | Day | Evening | Overnight | In force from | Section |
|---|---|---|---|---|---|
| Nurse aides | 1 per 10 | 1 per 11 | 1 per 15 | 1 July 2024 | 211.12(f.1)(3) |
| LPNs | 1 per 25 | 1 per 30 | 1 per 40 | 1 July 2023 | 211.12(f.1)(4) |
| RNs | 1 per 250 | 1 per 250 | 1 per 250 | 1 July 2023 | 211.12(f.1)(5) |
Two conditions worth carrying with these. Under 211.12(f.2)(3)(ii) a facility with a census of 59 or under may substitute an LPN for the RN on the overnight shift if an RN is on call and within a 30-minute drive. And under 211.12(f.1) the director of nursing services does not count toward these ratios.
Each figure below is given with the condition it applies to:
State NHA Exams Explained covers how these exams work and which states have one.
We build practice sets for state exams one state at a time: questions drawn from the state’s own rules, each cited to its section, the way our Illinois supplement is built. Pennsylvania is not built yet. Leave your email and we will tell you if we build it.
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A supervisor and a nursing home. The Board publishes no list of supervisors or AIT sites, so finding both is up to you. Worth knowing when you ask: a supervising administrator can count up to 24 of their 48 continuing education hours for supervising an AIT who completes the program (39.61(c)(4)).
The 120-hour program. If your route needs it, the Board’s list of approved providers (revised May 2025) names Harrisburg Area Community College, Keystone Institute of Health Sciences in State College, Penn State (University Park, Abington, Beaver and DuBois) and the Philadelphia College of Osteopathic Medicine.
State associations. LeadingAge PA’s AIT grant offers “$60,000 to support the hosting of an Administrator-in-Training”, open to its provider members in Philadelphia, Montgomery and Delaware Counties. The member supplies its own mentor, so it is not a matching service; the 2027 cycle closed on 3 August 2026. The Pennsylvania Health Care Association (PHCA) lists no AIT or preceptor program.
For the full step-by-step on approaching facilities and preceptors, see How to Find an AIT Preceptor and an Approved Program.
The Board’s fees are set in 49 Pa. Code § 39.72; the exam fees are paid to NAB.
| License application | $40 (§ 39.72) |
|---|---|
| NAB Core and NHA exams | $480 for the two, paid to NAB |
| Pennsylvania state exam | $330, paid to NAB (NAB Candidate Handbook, revised September 2026) |
| AIT application | $50 (§ 39.72) |
| Renewal, every two years | $297 (§ 39.72) |
| Temporary permit | $145 (§ 39.72) |
| Out-of-state license | No separate fee line in § 39.72; the pending § 39.8a would charge the $40 license application fee (see the next section) |
The Board’s Licensure Snapshot lists the same $40 initial fee and $297 renewal fee. NAB administers the state exam (NAB’s Pennsylvania page), and its candidate handbook lists the Pennsylvania exam (NHA-PA) at $330. Our estimate for a first license: $40 + $480 + $330 = $850, plus $50 if you take the AIT route, and the cost of the 120-hour program if your route needs it. § 39.72 lists no separate initial license fee beyond the application fee.
Licenses expire on 30 June of every even-numbered year (the Board’s renewal page; 39.11 sets renewal in even years), so the current period runs to 30 June 2028. You renew in PALS, the Board emails notices about 60 days ahead, and the fee is $297 (39.72). The Board has a fee rulemaking under way (16A-6223), so check the current fee when you renew.
Two legal routes cover an out-of-state license, and a rule for the second is still pending. The first is the Board’s rule in force, 49 Pa. Code § 39.8, under section 10 of the Nursing Home Administrators License Act (63 P.S. § 1110). The second is licensure by endorsement under Act 41 of 2019, codified since 2020 at 63 Pa.C.S. § 3111, which the Board is putting into its rules through rulemaking 16A-6220. Section 3111(c) says it does not replace the endorsement or reciprocity provisions in a board’s own statute. The Board’s Licensure Snapshot says administrators “licensed in another state may apply for a Pennsylvania license by endorsement”, and that Act 41 lets boards endorse licensees from other jurisdictions with substantially equivalent requirements who are active, in good standing and without discipline or criminal conviction.
Do you take the state exam? The sources differ. The Board’s Licensure Snapshot says an endorsement applicant must pass the State Based Licensing Exam (Pennsylvania NHA). § 39.8 does not list that exam, and the pending § 39.8a does not require it: passing the Board’s licensure exams is one of several ways to meet § 39.11b, and the other ways need no exam. Neither rule mentions NAB scores. Plan for the state exam, as the Board says, and ask the Board in writing whether it applies to you and whether it needs your NAB scores. The Board’s Resources and Documents page lists no endorsement or reciprocity application form, so ask the Board how to apply as well.
Temporary permit. Under section 14 of the Act (63 P.S. § 1114) the Board may issue a temporary permit “without examination” in “unusual circumstances affecting the administration of a nursing home”; the Board’s application gives as examples “the death, disability, resignation or dismissal of the licensed administrator”. The fee is $145 (§ 39.72). The permit lets you serve in an emergency only in the facility named on your application, lasts no more than 1 year and cannot be renewed; it does not qualify you to sit for the licensing examination; and you must first appear before the Board with the manager, owner or a representative of the facility’s governing body (§ 39.4(3)). It exists for a facility’s emergency, not as a general bridge while an application is pending.
Provisional endorsement license. 63 Pa.C.S. § 3111(b) lets a board issue a provisional license while you satisfy the remaining requirements for endorsement. The pending § 39.8b would let the Board do so “in its discretion”, for up to 1 year, with an extension of no more than 1 year on written request and good cause, and only once per applicant. Until that rule takes effect, ask the Board whether it will issue one.
Military and military spouses. Act 35 of 2022, now 63 Pa.C.S. Chapter 33, applies to the licensing boards under the Bureau of Professional and Occupational Affairs; the Department of State’s military and veterans licensure page summarizes it and lists this Board among them. For a service member, veteran or military spouse:
These are the statute’s terms. Tell the Board on your application that you are a service member, veteran or military spouse, and ask how it applies to a nursing home administrator license. The official text of each rule governs.
The legal sources for nursing home administrator licensure in Pennsylvania, and the Board documents cited above.
Checked September 2026. The official text linked above governs. Not legal advice.
The State Based Licensing Exam (Pennsylvania NHA) is Pennsylvania’s own exam, administered by NAB at Pearson VUE. The Board’s published exam specifications give 35 scored items and 10 pretest items, with a cut score of 26 of 35 (about 74 percent), and base the content on 42 CFR Part 483, 49 Pa. Code Chapter 39 and 28 Pa. Code Part IV, Subparts A and C. The regulation’s own definition, 49 Pa. Code 39.5(d)(2), names only Subpart C (Chapters 201 to 211). Because 28 Pa. Code 201.2(a) incorporates most of 42 CFR Part 483 Subpart B, those federal requirements are Pennsylvania licensing rules too. The Board publishes no content outline or study guide.
The AIT is optional in Pennsylvania; it is one of the Board’s routes to the exams, and every route requires experience of some kind. If you take it, it is 1,000 hours with a bachelor’s degree or 800 with an acceptable master’s degree, completed within the 2 years before you apply (49 Pa. Code 39.5(b)(3)(iii)(C), (b)(4)(ii)(B)), with minimum hours in three areas (39.5(c)).
Candidates in Pennsylvania take the NAB Core of Knowledge exam and the NHA Line of Service exam, and Pennsylvania also requires a state exam. Confirm the current exam list with the Board before you apply.
48 clock hours each two-year period, mostly in courses preapproved by NAB or the Board, with at least 12 in emergency preparedness and infection control (49 Pa. Code 39.61). The Board also requires 2 hours in child abuse recognition and reporting under Act 31 of 2014, counted within the 48. Licenses expire 30 June of even-numbered years, renewal costs $297 (39.72), and apart from the 2 child abuse hours, no CE is required at your first renewal.
The Board publishes no list of supervisors or AIT sites, so you find a full-time licensed nursing home administrator and a nursing home yourself. For the 120-hour program, the Board lists approved providers, including Harrisburg Area Community College and Penn State. LeadingAge PA offers an AIT grant to member facilities in three counties; it is not a matching service.
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