How to become a licensed nursing home administrator in Tennessee: the routes, the Administrator-in-Training (AIT) program, the NAB exams and the Board’s jurisprudence exam, fees, continuing education and renewal, with section numbers.
| Who licenses | The Tennessee Board of Examiners for Nursing Home Administrators, Department of Health (T.C.A. 63-16-102) |
|---|---|
| Who can apply | Five routes, from a Health Care Administration degree to an associate degree plus 5 years of management experience, and reciprocity (Rule 1020-01-.07) |
| AIT requirement | At least 6 months and at most 1 year, which the Board describes as 1,040 clock hours of full-time training; 400 hours only on the Health Care Administration degree and hospital routes (Rule 1020-01-.06, .07) |
| National exams | NAB Core of Knowledge (CORE) and NHA Line of Service, first attempted within 1 year of Board approval (Rule 1020-01-.10) |
| State exam | Required: the Board’s jurisprudence examination, given by the Board, 90 percent to pass, $150 each time, completed and returned within 90 days of eligibility (Rule 1020-01-.10) Details ↓ |
| Continuing education | 18 clock hours every calendar year (T.C.A. 63-16-107; Rule 1020-01-.12) |
| Renewal | Every 24 months, by the end of your birth month; $150 (Rule 1020-01-.02, .11). The Board’s March 2026 hearing notice proposed $450, and the Board lists a rule change effective 15 October 2026, so ask the Board which fee applies |
| Official sources | tn.gov/health/licensure/nha.html (the Board) · Rule chapter 1020-01 (Secretary of State) · T.C.A. Title 63, Chapter 16 (Justia mirror) · nabweb.org (national exams) |
Verified September 2026. “Rule” numbers are sections of Tenn. Comp. R. & Regs.; T.C.A. is the Tennessee Code Annotated. Rule text is quoted from the Justia and Cornell LII copies of the rules. Confirm your route with the Board before you apply.
The license comes from the Board of Examiners for Nursing Home Administrators, created by T.C.A. 63-16-102 and part of the Tennessee Department of Health’s Division of Health Related Boards. Its website, tn.gov/health/licensure/nha.html, says “Board of Nursing Home Administrators”. The office is at 665 Mainstream Drive, 2nd Floor, Nashville, TN 37243, phone (615) 532-5090; applications and renewals go through LARS.
The law is T.C.A. Title 63, Chapter 16, and the Board’s rules are Tenn. Comp. R. & Regs. chapter 1020-01. Nursing homes themselves are licensed by a different body, the Health Facilities Commission (T.C.A. 68-11-203), under its rule chapter 0720-18. The Board has a scheduled sunset review under T.C.A. 4-29-248, which lists it with a date of 30 June 2027.
Every applicant is at least 18, a U.S. citizen or legally present, with a high school diploma or equivalent (T.C.A. 63-16-104(a)), and the first application includes a criminal background check. Rule 1020-01-.07 then sets the routes below, by paragraph. You qualify under one: “Combining requirements from different categories is not permitted”. Every route also requires the exams in Rule 1020-01-.10.
| Route | What you need | Training | Rule 1020-01 |
|---|---|---|---|
| Health Care Administration degree | A bachelor’s, master’s or doctorate in Health Care Administration, including “a four hundred (400) hour internship taken for credit” in a licensed long-term care nursing facility | The 400-hour internship in the degree | .07(2) |
| Hospital CEO | A bachelor’s degree or higher, and 5 of the last 7 years as chief executive officer of a licensed hospital | A 400-hour Board-approved AIT, “completed in no less than three (3) months and no more than six (6) months” | .07(3) |
| Hospital COO | The same, with 5 of the last 7 years as “the chief operating officer of a licensed hospital” | The same 400-hour AIT | .07(4) |
| Any degree | A bachelor’s, master’s or doctorate in any field | A Board-approved AIT of at least 6 months | .07(5) |
| Associate degree and experience | “An associate degree and five (5) years of acceptable management experience” in a licensed long-term care facility | An AIT of at least 6 months | .07(6) |
| Licensed in another state | An active license in another state, plus one of four qualifications (below) | Depends on the qualification | .07(7) |
A note on 400 hours. NAB’s Tennessee summary lists “Minimum Education: Associate” and “Number of Hours Minimum: 400” in separate fields. No route pairs the two: the associate degree route takes 5 years of management experience and an AIT of at least 6 months, and 400 hours belongs to routes (2), (3) and (4).
The standard Administrator-in-Training program, for routes (5) and (6), lasts at least 6 months, and “Under no circumstances shall the program extend beyond one (1) year” (Rule 1020-01-.06(3)(b)(2)). The rule gives no clock-hour total. The Board’s website does: “A standard A.I.T. Program is 6-months and 1,040 clock hours of full-time training.”
Your preceptor is an administrator, assistant administrator or multi-facility regional administrator with a current Tennessee license, approved by the Board on application PH-3586 (Rule 1020-01-.06(1)):
Other states: AIT Hours by State.
The free AIT Planner helps you plan your AIT hours across facility departments. Tennessee’s rule names six departments and sets no hours for each, so any split is our planning aid, not a Tennessee rule; agree on it with your preceptor. No account needed.
Open the free AIT PlannerTennessee requires both NAB exams: the Core of Knowledge (CORE) and the NHA Line of Service. NAB is the National Association of Long Term Care Administrator Boards, and you test at a Pearson VUE test center, where “Walk-in examinations are not available”. 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) |
| Tennessee window | You must “attempt to successfully complete the NAB examination within one (1) year from when Board approval to take the examination was granted” (Rule 1020-01-.10) |
| After two failures | An additional AIT “at least three (3) months in length”, or a Board-approved alternative program, before you test again (Rule 1020-01-.10; NAB Retake Policy, 1 June 2020). The Board has approved third and fourth attempts case by case (2024 minutes) |
More in NAB Exam Format and The Core Domains Explained.
Tennessee’s state exam is the Board’s jurisprudence examination (Rule 1020-01-.10); the Board’s minutes call it the “TN NHA Jurisprudence Exam”. Every applicant takes it, including those licensed in another state, who “must successfully pass the TN NHA Jurisprudence Exam before licensure” (minutes of 5 June 2023), and holders of NAB’s Health Services Executive (HSE) qualification: “The state regulatory exam is still required” (NAB’s Tennessee page).
| Who gives it | The Board, not NAB or Pearson VUE. NAB’s Tennessee page lists “State Exam Administration: State” |
|---|---|
| Deadline | Completed and “returned to the Board Administrative Office before the expiration of ninety (90) days” from your notice of eligibility, or you start the application over (Rule 1020-01-.10(2)(b)) |
| Passing score | “Correctly answering ninety percent (90%) of the examination questions” (Rule 1020-01-.10) |
| Fee | $150 “each time a person takes the Board’s jurisprudence examination” (Rule 1020-01-.02). The Board’s 2019 newsletter lists a “Jurisprudence Exam Retake” fee of $150 |
| Format and content | The Board does not publish the exam’s format, number of questions or content outline; Rule 1020-01-.10(2)(c) limits it to “statutes and rules governing practices and facilities”. The rule sets no retake limit for it. Ask the Board office |
The Board does not publish a content outline or study materials. The rule limits the exam to statutes and rules, so start with T.C.A. 63-16 and Rule 1020-01 for the license, and the Health Facilities Commission’s Rule 0720-18 for nursing homes. More in State NHA Exams Explained.
Four places where Tennessee sets a different number, or adds a requirement, compared with 42 CFR Part 483. All four come from the Health Facilities Commission’s rules (Rule 0720-18) and Tennessee statutes:
| Topic | Federal rule (42 CFR 483) | Tennessee rule | Section |
|---|---|---|---|
| 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 | A “full-time (working at least 32 hours per week) administrator licensed in Tennessee”, who “shall not function as the director of nursing” | 0720-18-.04(1) |
| Nurse staffing levels | Sufficient nursing staff, including licensed nurses, on a 24-hour basis (483.35(a)), with no hours-per-resident-day minimum; 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) | “A minimum of two (2) hours of direct care to each resident every day”, including 0.4 hours of licensed nursing time, and at least 2 nursing staff on every shift | 0720-18-.06(4)(a), (d) |
| Reporting abuse | 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)) | Homes outside the federal rule report abuse, neglect and misappropriation “to the commission within seven (7) business days” (T.C.A. 68-11-211(b)); anyone who suspects adult abuse reports it “immediately” to the Department of Human Services (Adult Protection Act, T.C.A. 71-6-103) | T.C.A. 68-11-211(b); 71-6-103; 0720-18-.11(2) |
| In-service training | Nurse aides get “no less than 12 hours per year”, including dementia management and abuse prevention (483.95(g)) | The director of nursing must “conduct monthly in-service education programs”: a frequency, not hours. Both rules apply | 0720-18-.06(4)(c)(8) |
The federal nursing home rules (42 CFR Part 483, Subpart B) apply only to facilities certified for Medicare or Medicaid, so a certified Tennessee home must meet both sets of rules. Federal text as of September 2026.
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Start with the Board. The Board recommends contacting its office before you apply to confirm the right route. Its website has the preceptor application (PH-3586) and the AIT progress forms.
Degree programs. The Board’s website lists three approved academic programs: the University of Memphis, the University of Tennessee, Knoxville, and Southern Adventist University.
The Tennessee Health Care Association (THCA). THCA runs an AIT Preceptor Training & Orientation course, 12 hours of NAB credit, for “administrators and assistant administrators who are interested in becoming preceptors”. The 2026 session was on 4 and 5 June in Brentwood ($875 for members).
Other groups. LeadingAge Tennessee, which describes itself as “an association of communities and professionals providing quality housing, health, community, and related services for older adults”, is another way to meet administrators. ACHCA publishes a national AIT Program Manual, and its chapter list has no Tennessee chapter.
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 notice for its rulemaking hearing of 9 March 2026 proposed raising two fees: the application fee from $300 to $400 and the renewal fee from $150 to $450. The notice gives no effective date. The Board’s website lists a rule change as effective on 15 October 2026, so ask the Board which amounts apply from that date. The other amounts below are from Rule 1020-01-.02; the notice covers only the application and renewal fees.
| Fee | Now | Proposed in the March 2026 notice |
|---|---|---|
| Application, each filing | $300 | $400 |
| Renewal, every two years | $150 | $450 |
| State regulatory fee, at licensure and each renewal | $10 | $10 |
| Jurisprudence exam, each time | $150 | $150 |
| Late renewal | $200 | $200 |
| Temporary license | $50 | $50 |
| Duplicate license; certificate of fitness | $50 each | $50 each |
NAB exam fees are paid to NAB. NAB’s Tennessee page and the 2017 application form show a total of $460 at application; ask the Board office what applies from 15 October.
You need “eighteen (18) clock hours of Board approved continuing education within every calendar year”, by 31 December (Rule 1020-01-.12). The statute says “continuing education is required on an annual basis” (T.C.A. 63-16-107), though the license renews every two years.
Renewal. Renewal is due by “the last day of the month in which a licensee’s birthdate falls” (Rule 1020-01-.11). The first license runs at least 12 months; after that it “will expire every 24 months” (Board website). Online renewal opens 70 days before expiration (the Board’s About page; its 2019 newsletter said 60). The fee is $150, plus the $10 state regulatory fee. The March 2026 hearing notice proposed $450, and the Board lists a rule change effective 15 October 2026, so ask the Board which fee applies. T.C.A. 63-16-107 speaks of odd-numbered years but lets the division stagger renewals, and the rule uses birth months.
If your license lapses. A license not renewed within 60 days after the due date is “automatically revoked without further notice or hearing” (T.C.A. 63-16-107). Rule 1020-01-.11 lists what reinstatement takes: a Board appearance or a notarized statement, past-due fees (capped at twice the current renewal and regulatory fees), the $200 late fee, and CE, up to 36 hours (54 for preceptors). Under the Board’s lapsed license policy (18 November 2024), working on a lapsed license has a 30-day grace period, then $100 for each month worked, through an agreed citation, if under 6 months; at 6 months or more, formal discipline of up to $500 a month.
Reciprocity (Rule 1020-01-.07(7)). You need “An active license as a nursing home administrator in another state”, plus one of these: (a) requirements substantially equivalent to routes (2) to (6); (b) requirements equivalent to certification by the “American College” (ACHCA); (c) NAB’s HSE qualification; or (d) 5 of the last 7 years as a licensed administrator in another state, in place of a degree or AIT. You also pass the jurisprudence exam (Rule 1020-01-.10). The Board’s application form asks for employer letters for the last 3 years and NAB exam passage.
Temporary license (T.C.A. 63-16-104(b); Rule 1020-01-.05). When a position “unexpectedly becomes vacant”, the Board can issue a temporary license, which “shall not to exceed six (6) months”, to someone licensed in another state or who meets most of the Board’s standards. It costs $50 and is revoked if the holder fails the required exam. NAB’s Tennessee page lists “Offer Temporary/Provisional License: No”; the statute and rule provide one. For the home’s own timeline, see T.C.A. 68-11-225 above.
Military. T.C.A. 68-1-101(b) expedites licensure for those licensed in another state: military spouses who transfer to Tennessee, and service members who apply within 180 days of retirement, discharge or release to the reserves (forms PH-4279 and PH-4280); a temporary permit is possible under T.C.A. 63-1-142. Licensees called to active duty may renew without late fees (Division policy 404.02).
The laws, rules and other sources cited on this page.
Citations verified September 2026. The official rule chapters are on the Tennessee Secretary of State’s site; the Justia links are labeled mirrors. For reference, not legal advice; the current official text governs.
It depends on your route. The standard AIT lasts at least 6 months and at most 1 year, which the Board describes as 1,040 clock hours of full-time training (Rule 1020-01-.06, .07). 400 hours applies only to the internship in a Health Care Administration degree and to the AIT for hospital CEOs and COOs.
The NAB Core of Knowledge and NHA Line of Service exams, with a scaled score of 113 on each, first attempted within 1 year of Board approval, and the Board’s jurisprudence examination, with 90 percent to pass (Rule 1020-01-.10). The jurisprudence exam costs $150 each time.
The Board’s jurisprudence examination, given by the Board, not NAB or Pearson VUE. You complete it and return it to the Board office within 90 days of eligibility (Rule 1020-01-.10(2)(b)). Every applicant takes it, including reciprocity applicants and HSE holders. The Board does not publish its format or number of questions.
18 clock hours every calendar year, approved by NAB’s NCERS or the Board, with at most 12 hours from multimedia courses (T.C.A. 63-16-107; Rule 1020-01-.12); preceptors need 27. The license renews every 24 months, by the end of your birth month.
Start with the Board office, which approves your AIT and your preceptor. THCA runs the 12-hour preceptor training course.
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