A Virginia license usually takes an Administrator-in-Training (AIT) program or a degree with an internship, then the two national NAB exams. An AIT needs only 60 semester hours of college to start, there is no state exam, and licenses renew by 31 March.
| Who licenses | The Virginia Board of Long-Term Care Administrators, in the Department of Health Professions (DHP) (Code § 54.1-3101) |
|---|---|
| Routes to a license | Four: a degree with an internship, a certificate with an internship, the AIT program, or NAB’s Health Services Executive (HSE) standards (18VAC95-20-220). See the routes below |
| AIT | 60 semester hours to enter, no degree needed (18VAC95-20-300). 2,000 hours within 24 months, cut to 1,500, 1,000 or 320 by your degree, or by up to 1,000 hours for experience (18VAC95-20-310) |
| National exams | NAB CORE and NHA Line of Service, both required (NAB); $480 for the two together, paid to NAB |
| State exam | None. “There is no state exam requirement” (the Board’s exams FAQ); 18VAC95-20 requires only the national examination |
| Continuing education | 20 hours each renewal year, at least 2 on cognitive impairment and dementia; none due at your first renewal (18VAC95-20-175) |
| License renewal | Every year by 31 March; $315 (18VAC95-20-170, 18VAC95-20-80) |
| Official sources | dhp.virginia.gov (the Board) · 18VAC95-20 and Code Title 54.1, Chapter 31 (law.lis.virginia.gov) · nabweb.org (national exams) |
Verified against the sources above, September 2026. The Code and 18VAC95-20 govern; a change to the preceptor rules is pending (see the AIT section).
Your license comes from the Virginia Board of Long-Term Care Administrators, part of the Department of Health Professions (DHP). It also regulates preceptors and assisted living facility administrators, and three of its nine members are licensed nursing home administrators (Code § 54.1-3101). To run a Virginia nursing home, it is “necessary to hold a nursing home administrator’s license issued by the Board” (§ 54.1-3102(A)).
The law is the Code of Virginia, Title 54.1, Chapter 31, “Nursing Home and Assisted Living Facility Administrators” (§§ 54.1-3100 to 54.1-3103.1). The rules are 18VAC95-20, “Regulations Governing the Practice of Nursing Home Administrators”, last broadly amended effective 9 April 2025.
| Website | dhp.virginia.gov/ |
|---|---|
| Phone | (804) 367-4595 |
| ltc@dhp.virginia.gov | |
| 9960 Mayland Drive, Suite 300, Henrico, VA 23233 |
18VAC95-20-220 sets four routes, and each one ends with the national exam.
| Route | What you need | Supervised training | 18VAC95-20 |
|---|---|---|---|
| Degree and practical experience | A bachelor’s or higher in a health care-related field that meets 18VAC95-20-221 | An internship of at least 320 hours in a licensed nursing home, within the degree program, under a preceptor | 220, 221 |
| Certificate program | Any bachelor’s degree, plus a 21-semester-hour health care-related certificate that meets 18VAC95-20-221 | An internship of at least 400 hours under a preceptor | 220, 221 |
| Administrator-in-Training (AIT) | 60 semester hours of college to enter; no degree needed | 320 to 2,000 hours, set by your education and experience (below) | 220, 300, 310 |
| Health Services Executive (HSE) | NAB’s minimum education, experience and examination standards for HSE | As NAB’s HSE standards set | 220 |
To enter an AIT you need a “passing grade on a total of 60 semester hours” from an accredited institution; a bachelor’s degree is not required (18VAC95-20-300). You find a registered preceptor, then send the AIT application, the $215 fee and the Domains of Practice form. The Board keeps an incomplete package for one year, then destroys it.
The base program is “2,000 hours of continuous training”, finished within 24 months of approval; the Board may extend that case by case (18VAC95-20-310(A)). Your education or experience shortens it:
| Your background | AIT hours | 18VAC95-20-310 |
|---|---|---|
| Master’s or bachelor’s in a health care-related field that meets 18VAC95-20-221, without its internship | 320 | (C) |
| Master’s in another field | 1,000 | (C) |
| Bachelor’s in another field | 1,500 | (C) |
| 60 semester hours, no degree | 2,000 | (C) |
| Qualifying experience (listed below) | Up to 1,000 hours off the 2,000 | (B) |
Experience credit. Up to 1,000 hours come off the 2,000 for one of these (18VAC95-20-310(B)):
“Full time” means at least 35 hours a week (18VAC95-20-10).
Under 18VAC95-20-380 and 18VAC95-20-340, your preceptor:
Fast-track Action 6787, “Reduction of requirements for preceptors”, was published on 7 September 2026 (Va. Reg. Vol. 43, Iss. 2). As proposed, a preceptor could supervise 3 AITs instead of 2; the experience rule would become 2 years as administrator of record within the past 4; and a preceptor could be employed full time, work under a contract or written agreement with the facility, or be a regional administrator. Comments close on 7 October 2026, and the proposed effective date is 22 October 2026. It is pending; until a change is in effect, the rules above apply.
Other states: AIT Hours by State.
The AIT Planner spreads your hours across facility departments, with a self-assessment that shapes the split. Virginia sets no department rotations: your Board-approved training plan follows the NAB Domains of Practice (18VAC95-20-390). So the split is our planning aid, not a Virginia rule; agree on it with your preceptor. No account needed.
Open the free AIT PlannerVirginia requires “the national examination”, a test administered by NAB or another exam the Board approves (18VAC95-20-10, 18VAC95-20-220). That means the Core of Knowledge (CORE) and NHA Line of Service exams from NAB, the National Association of Long Term Care Administrator Boards; its Virginia page says “NAB NHA & CORE National: Yes”.
The order matters. The Board approves you to test only once your licensure application is complete (the Board’s exams FAQ). You then receive an Authorization to Test and book a Pearson VUE test center; Pearson VUE replaced PSI on 3 January 2025. Once you pass, the Board issues your license “within thirty (30) days” (its licensure FAQ).
| CORE | 125 questions (100 scored, 25 pretest); 130 minutes to answer, within 150 minutes in all, per NAB’s Candidate Handbook (September 2026) |
|---|---|
| NHA Line of Service | 75 questions (60 scored, 15 pretest); 70 minutes to answer, within 90 minutes in all, per the same handbook |
| Passing score | A scaled score of 113 (NAB) |
| Attempts | Up to 4 attempts at each of CORE and NHA per cycle (1 July to 30 June), from 1 January 2026 (NAB). Each retake needs a new application and fee |
| Fee | $480 for CORE and NHA together, from 1 February 2026. Taken alone, CORE is $320 and NHA is $190 (NAB) |
Retakes and the testing window. The Board’s exams FAQ says NAB does not limit the number of times you may retake, and that you test within 60 days of your Authorization to Test. NAB’s handbook caps attempts at 4 per cycle and says the exam is “scheduled and completed within 90 days”. Follow NAB’s handbook and the dates in your Authorization to Test. More in NAB Exam Format and The Core Domains Explained.
No state exam. The Board’s exams FAQ says: “There is no state exam requirement.” 18VAC95-20 has no jurisprudence exam, and the April 2025 amendments removed the application’s attestation about Virginia laws and regulations (18VAC95-20-230).
Once you run a Virginia nursing home, you work under the Code of Virginia and the Virginia Department of Health’s (VDH) nursing facility rules, 12VAC5-371, and under 42 CFR Part 483, Subpart B, which applies only if the home is certified for Medicare or Medicaid. Five differences that matter on the job, each with the Virginia section:
| Topic | Federal rule (42 CFR 483) | Virginia rule | Virginia section |
|---|---|---|---|
| The administrator | The administrator is “Licensed by the State, where licensing is required” (483.70(d)(2)(i)). The section sets no full-time rule and no deadline to fill a vacancy | An administrator “on a full-time basis, to serve as its on-site agent”, with a written alternate for absences. When the administrator leaves, the home tells VDH’s Office of Licensure and Certification (OLC) in writing within 5 working days and appoints a qualified administrator within 90 days (30 more on request if licensure is pending) | 12VAC5-371-130 |
| Criminal background checks | The facility may not employ people with certain findings of abuse, neglect or misappropriation (483.12(a)(3)). Part 483 sets no State Police check deadline | An original Virginia State Police criminal record clearance “within 30 days of employment”, no older than 90 days before hire; until it arrives, no unsupervised direct care. A barrier crime conviction bars hiring, except a single non-abuse misdemeanor at least 5 years old | Code § 32.1-126.01; 12VAC5-371-75 |
| Reporting abuse | Report to the administrator and officials including the State Survey Agency “immediately, but not later than 2 hours” for abuse or serious bodily injury, otherwise within 24 hours, and send investigation results within 5 working days (483.12(c)(1), (4)) | Staff are mandated reporters and report “immediately” to the local department of social services or the Adult Protective Services (APS) hotline, or to the person in charge, who reports immediately. Failing to report risks a civil penalty of up to $500 for a first failure and $100 to $1,000 after that. Homes train all staff on reporting (12VAC5-371-260(G)). This duty runs alongside the federal one | Code § 63.2-1606 |
| Liability insurance | Part 483 sets no insurance requirement | “non-eroding general liability insurance coverage in a minimum amount of $1 million per occurrence”, plus professional liability at the Code § 8.01-581.15 cap per occurrence | Code § 32.1-127(B)(17) |
| State plan of correction | Federal plans of correction run separately (42 CFR 488.402(d)) | From 13 August 2026, the administrator sends OLC a state licensure plan of correction “no more than 15 business days after receipt” of the inspection report. The correction date is no more than 45 business days after the exit date; failure can lead to denial or revocation of the license | 12VAC5-371-55 |
Staffing. Federal rules require sufficient nursing staff (483.35(a)), and an RN “at least 8 consecutive hours a day, 7 days a week” plus a full-time RN director of nursing, unless waived (483.35(b)). CMS’s 2024 minimum staffing standards, which were never enforced, were repealed by an interim final rule published 3 December 2025 and effective 2 February 2026 (90 FR 55687). Virginia requires nurses and aides “in sufficient number to meet the assessed nursing care needs” (12VAC5-371-210). A 2023 law set 3.08 hours of case-mix-adjusted total nurse staffing per resident per day, but that standard no longer appears in Code § 32.1-127 and has no implementing regulation.
Crimes against residents. In federally funded homes, each covered individual reports a reasonable suspicion of a crime against a resident to the State Agency and one or more law enforcement entities, within 2 hours if there is serious bodily injury, otherwise within 24 hours (483.12(b)(5); section 1150B of the Social Security Act).
Virginia: law.lis.virginia.gov and the Virginia Register. Federal: the eCFR. In a certified home you meet both.
From 18VAC95-20-80 unless the row names another source. “Fees shall not be refunded once submitted” (18VAC95-20-130(B)).
| AIT program application | $215 |
|---|---|
| Preceptor registration / annual renewal | $65 / $65 |
| Licensure application | $315 |
| Annual license renewal | $315 |
| Late renewal | $110, plus the renewal fee |
| Inactive license renewal | $150 a year |
| Reinstatement | $435 |
| Reinstatement after disciplinary action | $1,000 |
| NAB exams, CORE and NHA together | $480, paid to NAB (NAB handbook, from 1 February 2026) |
Ask the NPDB what it charges for that report.
You need “20 hours of approved continuing education for each renewal year”, the year that ends on 31 March (18VAC95-20-175).
The Board’s CE page still asks for the “signature of an authorized representative”; the April 2025 amendments removed that requirement, and the regulation governs.
You renew every year “not later than the expiration date of March 31”, with the $315 fee (18VAC95-20-170). “Postmarks shall not be considered”, and a license that is not renewed is not valid.
Endorsement. With a current, unrestricted license from another state or the District of Columbia, you qualify if you also have either active practice as a licensed administrator or education and experience equivalent to Virginia’s (18VAC95-20-225). “Active practice” means at least 1,000 hours as a licensed administrator in the preceding 24 months (18VAC95-20-10).
Temporary practice. 18VAC95-20 has no provisional or temporary license. The Board’s licensure FAQ applies Code § 54.1-2408.4, on the “temporary practice of an out-of-state practitioner”, to administrators; the statute speaks of health care practitioners and does not name administrators. Under it you may practice for one 90-day period while employed or contracted by a licensed nursing home. Before you start, the employer verifies your license, gets an NPDB report and notifies the Board. The period can be extended by 60 days while your Virginia application is pending.
Military. Boards must expedite licenses for applicants licensed elsewhere whose spouses are active-duty service members or recent veterans; if the Board cannot act “within 20 days of the receipt of a completed application”, it issues a temporary license of up to 12 months (Code § 54.1-119). A license does not expire during service outside the United States and for 60 days after, up to 5 years in all (Code § 54.1-117).
When a home loses its administrator. If the administrator dies, falls ill, resigns or is discharged, the home may run under a temporary supervisor, but “in no case for longer than is permitted by the licensing authority”, and that person must immediately notify the Board and the Commissioner of Health (Code § 54.1-3103). VDH’s rule sets the clock: written notice to OLC within 5 working days naming the replacement or acting administrator, and a qualified administrator within 90 days, with a possible 30-day extension if licensure is pending (12VAC5-371-130).
The Board does not publish a list of approved AIT programs. It approves each AIT and each training plan individually (18VAC95-20-300, 18VAC95-20-390), so what you look for is a training facility and a registered preceptor.
The Board. Its AIT and preceptor page links a Voluntary Preceptor Directory of preceptors “who volunteered their contact information”. It is a starting point, not a complete list, and your plan still needs the Board’s approval. The Board’s preceptor FAQ also suggests searching DHP’s License Lookup for preceptors by occupation and zip code.
LeadingAge Virginia. Its licensing pages set out the AIT steps, and it keeps a member preceptor directory.
NAB and ACHCA. NAB publishes the AIT Program Manual and runs the required preceptor course. ACHCA has AIT resources and the Rudy and Chris Michalek AIT Assistance Fund.
For approaching facilities and preceptors step by step, see How to Find an AIT Preceptor and an Approved Program.
The legal sources for nursing home administrator licensure in Virginia, and the facility rules cited above. Virginia has no state exam, but these are the rules you train and work under.
Citations verified September 2026 against law.lis.virginia.gov, dhp.virginia.gov, Virginia Regulatory Town Hall, NAB and the eCFR. Provided for reference, not legal advice; the current official text governs.
2,000 hours within 24 months with 60 semester hours of college, the minimum to enter (18VAC95-20-300); 1,500 with a bachelor’s or 1,000 with a master’s in another field; 320 with a qualifying health care-related degree. Experience can take up to 1,000 hours off the 2,000 (18VAC95-20-310).
No. The Board’s FAQ says “There is no state exam requirement.” You take the NAB CORE and NHA Line of Service exams.
20 hours each renewal year, at least 2 of them on cognitive impairment and dementia; up to 10 may be online or self-study (18VAC95-20-175). You are exempt at your first renewal, and every license renews by 31 March.
Yes, by endorsement: a current, unrestricted license elsewhere, plus active practice (at least 1,000 hours in the preceding 24 months) or equivalent education and experience (18VAC95-20-225).
The Board approves each AIT and training plan and does not publish a list of approved programs. Start with its voluntary preceptor directory, DHP’s License Lookup and LeadingAge Virginia’s member preceptor directory.
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