How to become a licensed nursing home administrator in South Carolina: the routes, the Administrator in Residency (formerly the AIT), the NAB exams and the Board’s own state exam, fees, continuing education and renewal, with section numbers.
| Who licenses | The South Carolina Board of Long Term Health Care Administrators, S.C. Department of Labor, Licensing and Regulation (S.C. Code 40-35-10) |
|---|---|
| Who can apply | Age 21 or older, with a degree plus 1 to 3 years of practical experience, a bachelor’s plus the Administrator in Residency, or NAB’s HSE validation (S.C. Code 40-35-40(A); R.93-70, 93-80) |
| Administrator in Residency | Formerly the AIT: 6 months (720 hours) with a health care administration or related degree, 9 months (1,080 hours) with any other bachelor’s (Board AIR overview, Rev. 09/2026) |
| National exams | NAB Core of Knowledge (CORE) and NHA Line of Service, a scaled score of 113 on each |
| State exam | Required: the South Carolina Nursing Home Administrator (SCNHA) exam, prepared by the Board and registered through NAB, passing scaled score 38 (Board NHA overview, 2025) Details ↓ |
| Continuing education | The Board’s CE guidelines (Rev. 02/2022) show 20 hours, 5 in patient care; the May 2026 rule updates CE for biennial licensure (below) |
| Renewal | Every two years, by 30 June; $350 for an active license (R.10-21, as amended May 2025) |
| Official sources | llr.sc.gov/lthc (the Board) · Title 40, Chapter 35 and Chapter 93 (scstatehouse.gov) · R.60-17 (DPH) · nabweb.org (national exams) |
Verified September 2026. The codified Chapter 93 on scstatehouse.gov still shows the 2023 text, so “R.93” numbers here are cited as published before the May 2026 rewrite; where the Board’s current pages differ, this page notes it.
The license comes from the South Carolina Board of Long Term Health Care Administrators (S.C. Code 40-35-10), part of the S.C. Department of Labor, Licensing and Regulation (LLR): 110 Centerview Dr, Columbia, phone (803) 896-4544. Its website is llr.sc.gov/lthc; the older /ltc address no longer works.
The law is S.C. Code Title 40, Chapter 35; the Board’s rules are Chapter 93 of the S.C. Code of Regulations (R.93-50 to R.93-260), and its fees are in R.10-21. Nursing homes themselves have been licensed by the S.C. Department of Public Health (DPH) since DHEC’s 1 July 2024 split (Act 60), under R.60-17 since 23 May 2025.
The May 2026 rewrite. The Board’s new Chapter 93 took effect on 22 May 2026 (State Register Vol. 50, Issue 5, Doc. No. 5419); its preamble lists changes to the AIT program’s name (now the Administrator in Residency), dual licensure, the Health Services Executive (HSE) designation, licensure by endorsement, inactive and lapsed licenses, and biennial licensure and CE.
Every applicant “is at least twenty-one years of age”, is of good character without disqualifying convictions, pays the fees and passes the exams (S.C. Code 40-35-40(A)). The statute then sets education and experience tiers, and the regulations add two alternatives:
| Route | What you need | Experience or training | Section |
|---|---|---|---|
| Health care administration degree | A “baccalaureate degree or higher in health care administration or related health care degree” | 1 year of practical experience | 40-35-40(A) |
| Any other bachelor’s | A bachelor’s degree in another field | 2 years of practical experience | 40-35-40(A) |
| Health-related associate degree | A “health-related associates degree” | 3 years of practical experience | 40-35-40(A) |
| Administrator in Residency | A bachelor’s degree, or enrollment in “a course of study that will award such a degree” | The AIR (6 or 9 months, below) in place of the experience years | R.93-80(A), (L) |
| NAB Health Services Executive | “Validation by the NAB as meeting the minimum education and experience requirements to be a qualified HSE” | Covered by the HSE validation | R.93-70(A) |
The 2026 rule’s preamble says the “Administrator-in-Training program... is now referred to as the Administrator in Residency” (AIR). Its length depends on your degree: “six (6) months” with a bachelor’s or higher in health care administration or a related health care degree, “nine (9) months” with any other bachelor’s (AIR overview, Rev. 09/2026; R.93-80(A)). The Board’s completion affidavits (Rev. 9/2026) set 720 hours for 6 months and 1,080 hours for 9. Its AIR page also posts a 1-year completion affidavit; ask the Board which candidates that track covers.
The Board sets minimum hours in each area (completion affidavits, Rev. 9/2026):
| Area | 6 months | 9 months |
|---|---|---|
| Administration | 200 | 300 |
| Human Resources | 75 | 100 |
| Nursing / Health Care Services | 150 | 200 |
| Rehabilitation | 30 | 50 |
| Medical / Resident Records | 35 | 50 |
| Activities | 20 | 40 |
| Social Services / Admissions | 30 | 50 |
| Business Office | 100 | 150 |
| Dietary | 30 | 50 |
| Housekeeping / Laundry | 25 | 40 |
| Maintenance / Environmental | 25 | 50 |
| Total | 720 | 1,080 |
Other states: AIT Hours by State.
The free AIT Planner helps you plan your hours across facility departments. South Carolina sets its own eleven areas and minimum hours (the table above), and those are the figures that count, so check any plan against them and agree on it with your preceptor. No account needed.
Open the free AIT PlannerSouth Carolina requires three exams: NAB’s Core of Knowledge (CORE) and NHA Line of Service, and the Board’s state exam (NHA overview, Rev. 08/11/2025). NAB is the National Association of Long Term Care Administrator Boards. You apply to the Board first, then register with NAB within 30 days; the Authorization to Test gives “a 60-day window” (Board exam page), and NAB lists Pearson VUE for scheduling. The NAB 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, the figure the Board’s overview also gives |
| 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) |
More in NAB Exam Format and The Core Domains Explained.
The Board calls it the South Carolina Nursing Home Administrator (SCNHA) exam (endorsement overview, Rev. 08/2025). Under R.93-110, NAB prepares the national portion and the “South Carolina portion is prepared by the South Carolina Board”. Administrators licensed in another state take it too: endorsement requires having “passed the national and South Carolina portions” (S.C. Code 40-35-45(F)).
| How you register | Through NAB, alongside the national exams: the Board’s exam page tells approved candidates to “register for the national and/or state exam with” NAB |
|---|---|
| Passing score | A “passing scaled score of 38” (NHA and endorsement overviews, 2025). The 2023 text of R.93-110(B) states the pass mark as a “raw score of seventy-five (75%) percent”; the overviews are the more recent source |
| Questions | “50 multiple-choice questions on the state exam”, according to the Board’s FAQ |
| Retakes | A first-time candidate who passes one portion keeps “credit for the portion passed” (R.93-110(E)). Candidates who “fail to pass the examination three times must petition the Board” (R.93-110(G); NHA overview, Rev. 08/11/2025). Each re-examination application is $135 (R.10-21) |
| Fee and time limit | $210, with a two-hour limit (NAB Candidate Handbook, September 2026, which lists the exam as NHA-SC) |
The Board’s exam page names one source: the state’s nursing home licensing standards, now R.60-17, Standards for Licensing Nursing Homes (formerly R.61-17), administered by DPH. R.93-110 adds that the state portion “examines applicants on regulations”. Below are places where South Carolina’s facility rules depart from the federal rules you study for the NAB exams. More in State NHA Exams Explained.
Three places where South Carolina sets a different number, or adds a requirement, compared with 42 CFR Part 483. All three come from R.60-17, the Board’s own rules and South Carolina statutes:
| Topic | Federal rule (42 CFR 483) | South Carolina rule | Section |
|---|---|---|---|
| Licensed nurses | Sufficient nursing staff, including licensed nurses, on a 24-hour basis, with a licensed nurse designated as charge nurse on each tour of duty and no hours-per-resident-day minimum (483.35(a)); a registered nurse “for at least 8 consecutive hours a day, 7 days a week” (483.35(b)(1)); each waivable (483.35(e), (f)). 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) | At least one licensed nurse “per shift for each staff work area”, and a registered nurse “on duty in the facility, or on call, whenever residents are present” | R.60-17 §605.A |
| The administrator | The administrator must be “Licensed by the State, where licensing is required” (483.70(d)(2)(i)); Part 483 sets no weekly hours and no one-home limit | A “full-time licensed Administrator”, and “No individual may be the Administrator of more than one (1) nursing home.” The Board defines full time as “no fewer than thirty (30) hours per week” | R.60-17 §602.A, F; R.93-50 |
| Reporting abuse | Alleged violations reported “immediately, but not later than 2 hours” if they involve abuse or serious bodily injury, otherwise within 24 hours, to the administrator and to officials including the State Survey Agency (483.12(c)(1)) | Mandated reporters, facility staff among them, report “within twenty-four hours or the next working day”; for a nursing home the report goes to the Long Term Care Ombudsman Program, and R.60-17 directs the administrator or a designee to report to the Ombudsman. Law enforcement must be called immediately for emergencies, serious injury or suspected sexual assault (43-35-25(G)). Knowingly failing to report is a misdemeanor (43-35-85). Both clocks apply in a certified home | S.C. Code 43-35-25(D), (G), 43-35-85; R.60-17 §701.H |
The federal nursing home rules (42 CFR Part 483, Subpart B) apply only to facilities certified for Medicare or Medicaid, so a certified South Carolina home must meet both sets of rules. Federal text as of September 2026. R.60-17 §605.B lists nurse aide ratios by shift; ask DPH which nurse aide staffing standard applies this year.
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Start with the Board. South Carolina’s program is the Administrator in Residency, and you must “Secure a Board approved Preceptor”. The Board’s AIR Preceptor Directory has 44 entries (generated 20 March 2026): 35 for nursing homes and 9 for residential care. Its AIR page has the AIR Participant/Preceptor Agreement Form.
Associations. The South Carolina Health Care Association (SCHCA) describes itself as “representing more than 90 percent of the long-term care facilities in the state” and runs education webinars. LeadingAge South Carolina runs the Vickie Moody Leadership Academy, a year-long program for members that is not an AIR or licensure program. ACHCA has national Administrator Residency/AIT resources and a mentoring program; its chapters page lists no South Carolina chapter.
For the full step-by-step on approaching facilities and preceptors, see How to Find an AIT Preceptor and an Approved Program.
Board fees are set by R.10-21, as amended 23 May 2025 (SCSR 49-5, Doc. No. 5348).
| Fee | Amount | Source |
|---|---|---|
| Application for licensure | $200 | R.10-21 |
| Re-examination application | $135 | R.10-21 |
| Initial license | $175 | R.10-21 |
| Provisional license | $500 | R.10-21 |
| Renewal every two years, active | $350 | R.10-21 |
| Renewal every two years, inactive | $270 | R.10-21 |
| Reactivation | $100 | R.10-21 |
| Reinstating a lapsed license | $300 plus the renewal fee | R.10-21 |
| Late renewal | By month, from $50 (July) to $350 (June) | Board NHA page |
| AIR registration | $25 | Board AIR overview |
| AIR preceptor permit | No fee | Board preceptor page |
The Board’s fees page still lists “Annual Renewal” at $175, and its endorsement overview splits the same $375 as “$100 application fee + $275 initial license fee”. This page follows R.10-21.
Renewal is biennial. R.10-21 sets biennial renewal fees, and the May 2026 rule reflects biennial licensure. The Board’s NHA page says licenses expire “on June 30th of even numbered years”; its renewals page lists a “Next Renewal” of 30 June 2027. The 2026 renewal window opened on 1 April, with a 30 June deadline; online renewal ran through 31 July. Report a change of address or employment within 15 days (R.93-160).
CE hours. The Board’s CE guidelines (Rev. 02/2022) and the 2023 text of R.93-200(D) set “twenty (20) hours of continuing education for relicensure with five (5) hours in patient care”, for a period running “from July 1 to June 30”. The May 2026 rule reflects “biennial licensure, including its impact on continuing education hour requirements”, and the CE guidelines predate it, so confirm your figure with the Board at (803) 896-4544 or Contact.LTHCA@llr.sc.gov before you plan your hours.
Lapsed, inactive and retired (2023 text; the May 2026 rule revised these). Within 1 year, reinstatement takes the renewal fee, a penalty, CE proof and a statement of practice (R.93-210(A)); after that, a new application plus CE “for each year since the license expired”, or you “retake the national and state examinations” (R.93-210(B)). Retired status requires age 65 or 20 years licensed, and returning takes 6 CE hours in the prior 12 months plus 14 within 90 days (R.93-150).
Endorsement. “South Carolina does not issue a reciprocal license” (Board FAQ), but it licenses by endorsement when your state’s standards are “at least the substantial equivalent” and you have passed the national and South Carolina portions (S.C. Code 40-35-45(F)). NAB scores transfer, and you still pass the SCNHA exam with 38 (endorsement overview, Rev. 08/2025). The May 2026 rule revised the endorsement wording.
Provisional license (R.93-130, 2023 text). For an “unexpected vacancy caused by the death of an administrator, departure”, a candidate who meets S.C. Code 40-35-40 but “has not passed the examination” can hold the post, with a letter from the owner or a board officer. It costs $500 and expires “90 days from issue or upon the issue of an initial license”; an extension requires a consultant administrator for 16 hours a month. It ends if the same exam is failed twice, with a limit of 2 per licensure type.
Military. Spouses of active duty members can get a temporary license (S.C. Code 40-1-630), expedited through LLR. Military training counts (40-1-640), and license fees are waived in years of active duty (40-1-620).
The laws, rules and other sources cited on this page.
Citations verified September 2026. Chapter 93 links go to the codified 2023 text; the 2026 rule is linked as the Board posted it. For reference, not legal advice; the current official text governs.
The program is now the Administrator in Residency (AIR), formerly the AIT. It lasts 6 months (720 hours) with a bachelor’s in health care administration or a related health care degree, or 9 months (1,080 hours) with any other bachelor’s (Board AIR overview, 2026). It replaces the years of practical experience.
The NAB Core of Knowledge and NHA Line of Service exams, with a scaled score of 113 on each, and the Board’s South Carolina Nursing Home Administrator (SCNHA) exam, with a passing scaled score of 38. You register for all three through NAB.
The SCNHA exam, prepared by the Board (R.93-110) and based on the nursing home licensing standards, now R.60-17 (formerly R.61-17). The Board’s FAQ describes 50 multiple-choice questions. Applicants licensed in another state take it too.
The Board’s CE guidelines (Rev. 02/2022) show 20 hours with 5 in patient care, at least half live. The May 2026 rule updates CE for biennial licensure, and the guidelines predate it; ask the Board at (803) 896-4544.
Start with the Board’s AIR Preceptor Directory (generated 20 March 2026), which has 35 nursing home entries. SCHCA’s member facilities are a network for meeting administrators.
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