How to become a licensed nursing home administrator in South Dakota: who can apply, the Administrator-in-Training (AIT) program, the NAB exams and the Board’s state exam, fees, continuing education and renewal, with section numbers.
| Who licenses | The South Dakota Board of Nursing Facility Administrators, in the Department of Health (SDCL 36-28-1, 36-28-5) |
|---|---|
| Who can apply | Age 18 or older, with at least an associate’s degree; the rule lists no degree tiers or waivers (ARSD 20:49:04:01; SDCL 36-28-12) |
| AIT requirement | 240 hours within six consecutive months (the Board’s agreement credits at most 40 hours a week), or a completed long-term healthcare administration practicum; within 4 years of applying (ARSD 20:49:01:01, 20:49:04:01) |
| National exams | NAB Core of Knowledge (CORE) and NHA Line of Service, a scaled score of 113 on each, passed within 4 years before you apply (ARSD 20:49:03:01, 20:49:04:01) |
| State exam | Required: an online exam run by the Board on the Department of Health’s nursing facility rules, $100, 75 percent to pass, 3 retakes (ARSD 20:49:03:01, 03:07) Details ↓ |
| Continuing education | 40 hours every two years, in health care, health care administration or business administration (ARSD 20:49:08:03) |
| Renewal | By 31 December of even-numbered years; $390 (SDCL 36-28-18; ARSD 20:49:08:01, 08:01.01) |
| Official sources | doh.sd.gov (the Board) · SDCL chapter 36-28 · ARSD Article 20:49 · nabweb.org (national exams) |
Verified September 2026. “ARSD” is the Administrative Rules of South Dakota and “SDCL” the South Dakota Codified Laws. Rule and statute text is quoted from the South Dakota Legislature’s text service. The Board’s office answers questions on 605-224-1721.
The license comes from the South Dakota Board of Nursing Facility Administrators, which “shall continue within the Department of Health” (SDCL 36-28-1, 36-28-5). It has five members appointed by the governor: four active South Dakota licensed administrators and one public member (SDCL 36-28-2). Its Department of Health page lists PO Box 340, 1351 N. Harrison Ave., Pierre, SD 57501; phone 605-224-1721; email SDNFA@midwestsolutionssd.com.
The law is SDCL chapter 36-28, “Nursing Facility Administrators”, and the Board’s rules are ARSD Article 20:49. The rule text says “nursing facility administrator”; “nursing home administrator” is the common name for the same license. Nursing homes themselves are regulated by the South Dakota Department of Health under ARSD Article 44:73, Nursing Facilities.
The statute asks that you be at least 18, of good moral character and of sound physical and mental health, complete Board-prescribed training and pass a Board-approved exam (SDCL 36-28-12). It adds a fingerprint-based state and federal background check at your cost (SDCL 36-28-12.1). ARSD 20:49:04:01 then lists seven items for an initial license:
ARSD 20:49:01:01 defines the administrator-in-training program as “an internship completed under the supervision of a preceptor”, with “a minimum of 240 hours completed within six consecutive months”. It uses “an internship manual and reporting forms approved by the board”.
ARSD 20:49:01:01 defines a preceptor as “a licensee who has been licensed for at least four years in South Dakota”, with no revocation or suspension of a license or other action taken to protect the public, and “approved by the board to train administrators-in-training”. The Application for Certified Preceptor asks about the four years and about discipline in any state or country, under penalty of perjury. Certified preceptor status is renewed every two years, and each trainee needs a signed Preceptor Agreement (the Board’s preceptors page).
The Board points preceptors to the NAB-ACHCA online preceptor course, four modules of 1.25 hours each and CE-eligible (in the agreement above). Other states: AIT Hours by State.
The free AIT Planner helps you plan your AIT hours across facility departments. South Dakota does not name departments or set hours for each; the Board approves an internship manual. Any split is our planning aid, not a South Dakota rule, so agree on it with your preceptor. No account needed.
Open the free AIT PlannerSouth Dakota requires both NAB exams, the Core of Knowledge (CORE) and the NHA Line of Service (ARSD 20:49:03:01). NAB is the National Association of Long Term Care Administrator Boards, and you test through Pearson VUE. The figures are from the NAB 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 | A scaled score of 113 on each (ARSD 20:49:03:01) |
| 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) |
| South Dakota window | Both exams within four years before the application date (ARSD 20:49:04:01(6)) |
More in NAB Exam Format and The Core Domains Explained.
South Dakota’s state exam is “A state examination provided by the board covering the rules of the South Dakota Department of Health that govern nursing facilities” (ARSD 20:49:03:01). Every applicant takes it, including those licensed in another state (ARSD 20:49:06:01).
| Who gives it | The Board, online. The application form says it is “administered online”, and once the Board has your fee you receive “an email containing examination information”. NAB does not run it, and it is not a Pearson VUE exam |
|---|---|
| Fee | $100, nonrefundable, paid before the test date (ARSD 20:49:03:01) |
| Passing score | 75 percent (ARSD 20:49:03:01) |
| Retakes | “a maximum of three times for each examination”, so four attempts in all, with a fee for each retake. After four failures you may “petition the board for reconsideration” (ARSD 20:49:03:07) |
| When | Passed within four years before the application date (ARSD 20:49:04:01(7)) |
| Format | The Board’s pages do not list the number of questions, the time limit, the question format, a study guide or a practice exam |
The rule names the Department of Health’s nursing facility rules, which are ARSD Article 44:73 (the Board’s forms cite “ARSD 20:44”; the rule governs). The Board’s pages list no content outline, so start with Article 44:73. Recent changes: 51 SDR 53 (11 November 2024) rewrote or moved much of it, 52 SDR 41 (27 October 2025) changed the reporting rules, and 53 SDR 34 (24 September 2026) changed nurse staffing and nurse aide registration. The rows and list below show where the rules differ from the federal rules; they are not a list of what the exam asks. More in State NHA Exams Explained.
Four places where South Dakota sets a different rule, or adds a requirement, compared with 42 CFR Part 483. All four come from the Department of Health’s nursing facility rules (ARSD Article 44:73):
| Topic | Federal rule (42 CFR 483) | South Dakota rule | ARSD |
|---|---|---|---|
| The administrator’s office | The administrator must be “Licensed by the State, where licensing is required” (483.70(d)(2)(i)); Part 483 does not mention an office on the premises | An “Administrator” is “A person licensed pursuant to SDCL chapter 36-28 and who maintains an office on the premises of the facility” | 44:73:01:01 |
| The director of nursing | A registered nurse as director of nursing on a full-time basis, unless waived (483.35(b)(2)); the director “may serve as a charge nurse only when the facility has an average daily occupancy of 60 or fewer residents” (483.35(b)(3)) | A full-time registered nurse director of nursing who serves during the day shift and may not serve in a dual role as the administrator. The director “may not serve as charge nurse in a facility with an average daily occupancy of sixty or more residents”. At exactly 60 residents the two rules differ: the federal rule allows it, South Dakota does not | 44:73:06:03; 44:73:06:07 (06:07 amended 24 September 2026) |
| Reporting suspected abuse or neglect | Alleged violations reported “immediately, but not later than 2 hours” if they involve abuse or result in serious bodily injury, otherwise within 24 hours (483.12(c)(1)) | One deadline: within 24 hours, orally or in writing, to the Department of Human Services, a law enforcement officer or the county state’s attorney, for “any reasonable cause to suspect abuse or neglect”. A federally certified facility is also under the two-hour rule | 44:73:01:07.01 (effective 27 October 2025) |
| Orientation and yearly training | A training program for all new and existing staff, volunteers and contractors, “consistent with their expected roles” (483.95), with topics such as resident rights, abuse, neglect and exploitation, and infection control; nurse aides get “no less than 12 hours per year” (483.95(g)). Part 483 sets no orientation deadline in days | Orientation “within thirty days of hire” and education every year on 12 topics: fire prevention, emergency procedures, infection control, accident prevention, restraints, resident rights, confidentiality, mandatory reporting, residents with unique needs, dining assistance and hydration, abuse and neglect, and advance directives. Staff with no resident contact are exempt from the restraint topic and topics 8 to 12 | 44:73:04:05 |
On staffing numbers: CMS repealed the 2024 federal minimum staffing standards, which were never enforced, by interim final rule published 3 December 2025 (90 FR 55687, effective 2 February 2026). What remains federally is “sufficient numbers” of nursing staff on a 24-hour basis, including licensed nurses (483.35(a)). ARSD 44:73:06:07, as amended 24 September 2026, asks for “adequate staff to meet the residents’ total care needs” and a nurse-to-CNA ratio “sufficient” for supervision.
The federal nursing home rules (42 CFR Part 483, Subpart B) apply only to facilities certified for Medicare or Medicaid, so a certified South Dakota home must meet both sets of rules. Federal text as of September 2026 (483.95 and 483.35 on Cornell LII, a mirror).
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. South Dakota is not built yet. Leave your email and we will tell you if we build it.
One email, only about a South Dakota practice set. We never share it.
Thanks. You are on the list for South Dakota.
Start with the Board. Its preceptors page links a list of current licensees and certified preceptors, and the AIT and Preceptor Agreement and the AIT forms are on the same site. The office answers questions on 605-224-1721 or SDNFA@midwestsolutionssd.com.
Preceptor training. The Board recommends the NAB-ACHCA online preceptor course for administrators who want to precept.
Professional groups. The ACHCA (American College of Health Care Administrators) Roughrider Chapter covers North Dakota, South Dakota, Nebraska and Montana (chapter list). SDAHO (South Dakota Association of Healthcare Organizations) is a hospital and long-term care membership group with a continuing education calendar; whether a course counts toward your 40 hours depends on the Board’s topic rule and approved providers (below).
For the full step-by-step on approaching facilities and preceptors, see How to Find an AIT Preceptor and an Approved Program.
Fees are from the Board’s rules and forms, last amended by 50 SDR 71, effective 18 December 2023.
| Fee | Amount | Section |
|---|---|---|
| Initial license application, nonrefundable (prorated by application and renewal dates) | $390 | ARSD 20:49:04:01(1) |
| State exam, nonrefundable, paid before the test date; a fee applies to each retake | $100 | ARSD 20:49:03:01, 03:07 |
| Fingerprint background check (money order to the Division of Criminal Investigation) | $50 | Initial application form |
| NAB CORE and NHA together, paid to NAB, from 1 February 2026 | $480 | NAB exam information |
| Reciprocal license | $390 | ARSD 20:49:06:01 |
| Renewal, every two years | $390 | ARSD 20:49:08:01.01 |
| Emergency permit | $260 | ARSD 20:49:05:01 |
| Inactive status | $159 | ARSD 20:49:08:02 |
| Reactivation from inactive status | $300 | ARSD 20:49:08:02 |
You need “a minimum of 40 hours of board approved continuing education” every two years, “directly related to the duties of a nursing facility administrator” (ARSD 20:49:08:03).
Renewal. A license “expires on December thirty-first of even-numbered years and is renewable biennially” (SDCL 36-28-18; ARSD 20:49:08:01), so the license years end on 31 December 2026 and 31 December 2028. The fee is $390 (ARSD 20:49:08:01.01). Active practice is not required to renew (ARSD 20:49:08:01), and your first fee is prorated to the next renewal date (SDCL 36-28-15). A license “not renewed by December thirty-first of even-numbered years expires”, and it cannot be transferred (SDCL 36-28-16). Neither SDCL 36-28-16 nor ARSD 20:49:08:01 states a late fee, a grace period or a way to reinstate an expired license; ask the Board office.
Inactive status and reactivation. Inactive status costs $159 and reactivation $300, with 20 hours of board-approved CE earned in the 12 months before reactivation (ARSD 20:49:08:02). SDCL 36-28-18.2 allows reactivation “within five years of the date of inactivation” and also lists “passing the state examination”; the rule text lists only the $300 and the 20 hours. Ask the Board which applies.
Reciprocity (SDCL 36-28-14; ARSD 20:49:06:01). The Board may license administrators from other jurisdictions whose standards are “at least substantially equivalent”. The rule asks for the $390 fee, transcripts showing an associate’s degree, evidence, within four years, of an AIT, a practicum or six consecutive months as an administrator; identification; three reference letters; passing NAB exam scores; the South Dakota state exam within four years; and a certified license-status letter from every state where you hold or held a license.
Emergency permit (SDCL 36-28-13; ARSD 20:49:05:01, 05:02). When a facility has a vacancy, a person of authority at the facility applies for the permit, which costs $260. The rule allows “not more than one hundred eighty days” and renewal “only once”; the statute says up to one year, and the Department’s emergency permit page says no more than two six-month terms. The emergency administrator works under a preceptor who is “reasonably available” and observes at least two days a month.
Military. Under SDCL 36-1B-1 the Board must issue a license “within thirty days” to an active-duty service member, or a spouse, who holds a valid credential from another state and is subject to a military transfer to South Dakota. Under SDCL 36-1-1, a veteran licensed in good standing before service may apply “within six months from date of separation from service” and be restored without new exams.
The laws, rules and other sources cited on this page.
Citations verified September 2026. Section links open the Legislature’s text of each rule or statute; the Cornell LII links are labeled mirrors of the federal rule. For reference, not legal advice; the current official text governs.
240 hours within six consecutive months, or a completed long-term healthcare administration practicum from an accredited institution, within four years before you apply (ARSD 20:49:01:01, 20:49:04:01). The Board’s AIT and Preceptor Agreement credits no more than 40 hours a week, you need at least an associate’s degree, and your preceptor must have been licensed in South Dakota for at least four years.
The NAB Core of Knowledge and NHA Line of Service exams, with a scaled score of 113 on each, and the Board’s state exam on the Department of Health’s nursing facility rules, with 75 percent to pass (ARSD 20:49:03:01). All are passed within four years before you apply (ARSD 20:49:04:01).
An online exam run by the Board, not NAB or Pearson VUE, covering the Department of Health’s nursing facility rules (ARSD Article 44:73). It costs $100, you need 75 percent to pass, and you may retake it up to three times (ARSD 20:49:03:01, 20:49:03:07). The Board’s pages do not list the number of questions or the time limit.
40 hours every two years, in health care, health care administration or business administration, approved by the Board (ARSD 20:49:08:03). The license expires on 31 December of even-numbered years, and renewal costs $390 (SDCL 36-28-18; ARSD 20:49:08:01.01).
Start with the Board of Nursing Facility Administrators, whose preceptors page links a list of certified preceptors and the AIT forms. The Board recommends the NAB-ACHCA online preceptor course for those who want to precept.
A guided daily path of 100 NAB-style questions across all 4 domains, automatic weak-spot training, and a weekly timed Checkpoint Exam. Try 5 free questions first, no account needed.
Try 5 free questionsSee pricing