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Missouri Assisted Living Administrator — Requirements & Free Practice

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Residential Care and Assisted Living Administrator (RCAL)

Separate administrator licence restricted to assisted living facilities and qualifying residential care facilities formerly licensed as residential care II, under RSMo 344.020.

Licensing authority: Missouri Board of Nursing Home Administrators

Initial licensure after prescribed administrator training
Application
Signed Board-prescribed application, required fee, identification, official academic transcripts where applicable, experience verification and Board approval. Foreign education is evaluated; applicants hired as elder-care workers register with the Family Care Safety Registry within 15 days.
Character
Good moral character; provide criminal background screening, explanations and final court dispositions. Criminal disqualification is governed by current RSMo 344.050 and the referenced RSMo 324.012, rather than an unconditional inference from the older rule’s conviction language.
Education
High school diploma or equivalent; college qualifications must be from an accredited institution.
Examination timing
Take required examinations within 12 months of Board evaluation and qualification or reapply. If one examination is failed and not passed within 12 months, both must be passed again; after a third failure complete the Board-prescribed course and pass approved examinations, with no outside national scores recognized after the third failure.
Licensed facilities
RSMo 344.020 limits the separate licence to assisted living facilities and residential care facilities licensed as residential care II on or before August 27, 2006 that continue to meet that date’s standards.
Minimum age
Rule 19 CSR 73-2.022(2)(A) requires age 21 or over; the Board’s current RCAL checklist instead states “18 years of age or older”. The rule governs; the conflicting checklist statement is retained for the applicant.
Nab core
The Board identifies NAB CORE alongside the RCAL Line of Service examination; CORE is a currently offered national examination absent from the supplied registrations and is therefore recorded as a condition pending nationwide registration.
Qualification path
When direct qualification is not approved, complete a Board-approved curriculum and internship under 19 CSR 73-2.031. Submit curriculum for prior approval within six months; additional qualification information may be submitted at least two weeks before the next Board meeting. High-school applicants: 315 formal instruction and 2000 internship hours; LPN: 225 formal instruction and 800 internship hours; associate degree: 640 internship hours; three-year nursing diploma, bachelor or master degree: 500 internship hours. Courses require a C or better, with a portion permitted from an approved intensive seminar of at least 40 hours; a qualified preceptor supervises the entire RCAL internship in a licensed residential care or assisted living facility with at least 30 beds.
Initial licensure with associate degree
Application
Signed Board-prescribed application, required fee, identification, official academic transcripts where applicable, experience verification and Board approval. Foreign education is evaluated; applicants hired as elder-care workers register with the Family Care Safety Registry within 15 days.
Character
Good moral character; provide criminal background screening, explanations and final court dispositions. Criminal disqualification is governed by current RSMo 344.050 and the referenced RSMo 324.012, rather than an unconditional inference from the older rule’s conviction language.
Education
High school diploma or equivalent; college qualifications must be from an accredited institution.
Examination timing
Take required examinations within 12 months of Board evaluation and qualification or reapply. If one examination is failed and not passed within 12 months, both must be passed again; after a third failure complete the Board-prescribed course and pass approved examinations, with no outside national scores recognized after the third failure.
Licensed facilities
RSMo 344.020 limits the separate licence to assisted living facilities and residential care facilities licensed as residential care II on or before August 27, 2006 that continue to meet that date’s standards.
Minimum age
Rule 19 CSR 73-2.022(2)(A) requires age 21 or over; the Board’s current RCAL checklist instead states “18 years of age or older”. The rule governs; the conflicting checklist statement is retained for the applicant.
Nab core
The Board identifies NAB CORE alongside the RCAL Line of Service examination; CORE is a currently offered national examination absent from the supplied registrations and is therefore recorded as a condition pending nationwide registration.
Qualification path
Associate degree and one year of health-care or aging-related experience, including six months of management responsibility and supervision of at least two staff persons.
Initial licensure with baccalaureate degree or beyond
Application
Signed Board-prescribed application, required fee, identification, official academic transcripts where applicable, experience verification and Board approval. Foreign education is evaluated; applicants hired as elder-care workers register with the Family Care Safety Registry within 15 days.
Character
Good moral character; provide criminal background screening, explanations and final court dispositions. Criminal disqualification is governed by current RSMo 344.050 and the referenced RSMo 324.012, rather than an unconditional inference from the older rule’s conviction language.
Education
High school diploma or equivalent; college qualifications must be from an accredited institution.
Examination timing
Take required examinations within 12 months of Board evaluation and qualification or reapply. If one examination is failed and not passed within 12 months, both must be passed again; after a third failure complete the Board-prescribed course and pass approved examinations, with no outside national scores recognized after the third failure.
Licensed facilities
RSMo 344.020 limits the separate licence to assisted living facilities and residential care facilities licensed as residential care II on or before August 27, 2006 that continue to meet that date’s standards.
Minimum age
Rule 19 CSR 73-2.022(2)(A) requires age 21 or over; the Board’s current RCAL checklist instead states “18 years of age or older”. The rule governs; the conflicting checklist statement is retained for the applicant.
Nab core
The Board identifies NAB CORE alongside the RCAL Line of Service examination; CORE is a currently offered national examination absent from the supplied registrations and is therefore recorded as a condition pending nationwide registration.
Qualification path
Baccalaureate degree or beyond and six months of health-care or aging-related experience including management responsibility and supervision of at least two staff persons.
Initial licensure by experience
Application
Signed Board-prescribed application, required fee, identification, official academic transcripts where applicable, experience verification and Board approval. Foreign education is evaluated; applicants hired as elder-care workers register with the Family Care Safety Registry within 15 days.
Character
Good moral character; provide criminal background screening, explanations and final court dispositions. Criminal disqualification is governed by current RSMo 344.050 and the referenced RSMo 324.012, rather than an unconditional inference from the older rule’s conviction language.
Education
High school diploma or equivalent; college qualifications must be from an accredited institution.
Examination timing
Take required examinations within 12 months of Board evaluation and qualification or reapply. If one examination is failed and not passed within 12 months, both must be passed again; after a third failure complete the Board-prescribed course and pass approved examinations, with no outside national scores recognized after the third failure.
Licensed facilities
RSMo 344.020 limits the separate licence to assisted living facilities and residential care facilities licensed as residential care II on or before August 27, 2006 that continue to meet that date’s standards.
Minimum age
Rule 19 CSR 73-2.022(2)(A) requires age 21 or over; the Board’s current RCAL checklist instead states “18 years of age or older”. The rule governs; the conflicting checklist statement is retained for the applicant.
Nab core
The Board identifies NAB CORE alongside the RCAL Line of Service examination; CORE is a currently offered national examination absent from the supplied registrations and is therefore recorded as a condition pending nationwide registration.
Qualification path
Two years of health-care or aging-related experience including management responsibility and supervision of two staff persons.
Reactivation of inactive licence
No examination is required for this applicant pathway.
Education window
RSMo 344.108(5) permits hours from six months before the request to twelve months after reactivation. 19 CSR 73-2.053(7) instead says “no later than six (6) months after the inactive license has been reactivated”; the statute governs.
Interim
If forty hours are not complete, a separate six-month interim licence issues and expires sooner when the hours are completed and evidence submitted.
Requirements
Written request, fee and satisfactory evidence of completion or plan to complete forty approved continuing-education hours; oath/affirmation that the licensee did not practise while inactive and is not currently practising in Missouri.

Official no-examination sources

Effective from 2026-09-22.

Late renewal within twelve months
No examination is required for this applicant pathway.
Lapse
Licence expired no more than twelve months; no practice while expired.
Requirements
File renewal application, renewal and penalty fees, required approved continuing education and signed attestation; submit employment status since expiration and written reasons for failure to renew. Licence takes effect when the Board approves.

Official no-examination sources

Effective from 2026-09-22.

Licensure by reciprocity — HSE qualified
State Examination (RCAL – MO) — Missouri Residential Care and Assisted Living Administrator
Hse
NAB Health Services Executive qualification substitutes for the national-score criterion; HSE is a prior qualification designation, not a separate examination.
Outside license
Valid current equivalent-level administrator licence in another state, a branch of the military, a territory or the District of Columbia; age at least 18.
Verification
Signed application and fee, jurisdictional licence verification or NAB verification for HSE, passing-score transfer where applicable, identification, education documentation and criminal background screening. Discipline and convictions are reviewed under RSMo 344.050, 324.009 and 324.012. Do not practise in Missouri before licensure.
Licensure by reciprocity — national examination and outside licensure
Nab core
The Board identifies NAB CORE alongside the RCAL Line of Service examination; CORE is a currently offered national examination absent from the supplied registrations and is therefore recorded as a condition pending nationwide registration.
Outside license
Valid current equivalent-level administrator licence in another state, a branch of the military, a territory or the District of Columbia; age at least 18.
Score and tenure
Passing national examination score and at least one year of equivalent outside administrator licensure in good standing; a qualifying statutory waiver is an applicant condition under RSMo 324.009.
Verification
Signed application and fee, jurisdictional licence verification or NAB verification for HSE, passing-score transfer where applicable, identification, education documentation and criminal background screening. Discipline and convictions are reviewed under RSMo 344.050, 324.009 and 324.012. Do not practise in Missouri before licensure.
Relicensure after expiration exceeding twelve months
Application
Signed Board-prescribed application, required fee, identification, official academic transcripts where applicable, experience verification and Board approval. Foreign education is evaluated; applicants hired as elder-care workers register with the Family Care Safety Registry within 15 days.
Board alternatives
19 CSR 73-2.055(6) additionally lists reciprocity and limited-NHA rules among relicensure alternatives. Initial licensure under RSMo 344.030 governs the ordinary RCAL route; an eligible applicant may separately use the established statutory recognition route.
Character
Good moral character; provide criminal background screening, explanations and final court dispositions. Criminal disqualification is governed by current RSMo 344.050 and the referenced RSMo 324.012, rather than an unconditional inference from the older rule’s conviction language.
Education
High school diploma or equivalent; college qualifications must be from an accredited institution.
Examination timing
Take required examinations within 12 months of Board evaluation and qualification or reapply. If one examination is failed and not passed within 12 months, both must be passed again; after a third failure complete the Board-prescribed course and pass approved examinations, with no outside national scores recognized after the third failure.
Lapse
Licence expired more than twelve months; RSMo 344.040(6) requires initial licensure.
Minimum age
Rule 19 CSR 73-2.022(2)(A) requires age 21 or over; the Board’s current RCAL checklist instead states “18 years of age or older”. The rule governs; the conflicting checklist statement is retained for the applicant.
Nab core
The Board identifies NAB CORE alongside the RCAL Line of Service examination; CORE is a currently offered national examination absent from the supplied registrations and is therefore recorded as a condition pending nationwide registration.
Active licence renewal
No examination is required for this applicant pathway.
Application
Board renewal application or electronic renewal, continuing-education attestation and renewal fee; excess June continuing education may carry to the next period as the rule permits.
Continuing education
40 approved clock hours per two-year period, including at least 10 patient-care hours and no more than 20 approved online hours; initial licensure is prorated at 1.5 hours per month, with no more than 50 percent online and required patient-care hours of eight for 18–23 months, six for 12–17, four for 6–11, or two for five months or less.
Current license
File renewal during May under RSMo 344.040(1); the rule specifies on or before May 30 so the licence can issue before June 30.

Official no-examination sources

Effective from 2026-09-22.

Relicensure after retirement exceeding five years
Application
Signed Board-prescribed application, required fee, identification, official academic transcripts where applicable, experience verification and Board approval. Foreign education is evaluated; applicants hired as elder-care workers register with the Family Care Safety Registry within 15 days.
Character
Good moral character; provide criminal background screening, explanations and final court dispositions. Criminal disqualification is governed by current RSMo 344.050 and the referenced RSMo 324.012, rather than an unconditional inference from the older rule’s conviction language.
Education
High school diploma or equivalent; college qualifications must be from an accredited institution.
Examination timing
Take required examinations within 12 months of Board evaluation and qualification or reapply. If one examination is failed and not passed within 12 months, both must be passed again; after a third failure complete the Board-prescribed course and pass approved examinations, with no outside national scores recognized after the third failure.
Minimum age
Rule 19 CSR 73-2.022(2)(A) requires age 21 or over; the Board’s current RCAL checklist instead states “18 years of age or older”. The rule governs; the conflicting checklist statement is retained for the applicant.
Nab core
The Board identifies NAB CORE alongside the RCAL Line of Service examination; CORE is a currently offered national examination absent from the supplied registrations and is therefore recorded as a condition pending nationwide registration.
Retired period
More than five years after retired licence issuance requires initial licensure under RSMo 344.030.
Reactivation of retired licence within five years
No examination is required for this applicant pathway.
Continuing education
20 approved clock hours for each retired calendar year, earned after retirement or in the retirement licence year and completed before the request under RSMo 344.105(3). Proration: at least ten months 20 hours/minimum five patient care; seven to under ten months 15/five; four to under seven months ten/2.5; under four months five/2.5.
Retired period
Within five years of retirement; request reactivation and pay required fee.

Official no-examination sources

Effective from 2026-09-22.

Statutory military or law enforcement spouse recognition
No examination is required for this applicant pathway.
Board instruction
19 CSR 73-2.025(5) says: “Upon meeting the requirements of this rule and upon board approval, the applicant must complete and pass the state examination.” The higher-ranked RSMo 324.009(3)(2) requires waiver of any examination for this specific statutory route.
Eligibility
Outside licence must remain current and in good standing. No outside revocation, pending complaint or investigation, unresolved discipline, or criminal disqualification; compact-derived licences are ineligible. Resolved discipline is evaluated; Missouri statutory refusal grounds continue to apply. Required fees, bonds, insurance and fingerprints are not waived.
Outside license
Current valid licence for at least one year in the same occupation and practice level from another state, military branch or unit, US territory or the District of Columbia.
Spouse status
Resident or nonresident military or law-enforcement spouse as defined in RSMo 324.009(1), with qualifying transfers, domicile or employment arrangements; provide status and marriage evidence.
Waiver
Within 30 days the oversight body must waive any examination, education and experience requirements and issue the licence if statutory eligibility is met.

Official no-examination sources

Effective from 2026-09-22.

Statutory licensure recognition
State Examination (RCAL – MO) — Missouri Residential Care and Assisted Living Administrator
Board instruction
19 CSR 73-2.025(2)(B)2 states: “Obtained a passing score on the national examination and has held in good standing for at least one (1) year a current administrator license”. The statutory waiver governs applicants satisfying RSMo 324.009(3)(1).
Eligibility
Outside licence must remain current and in good standing. No outside revocation, pending complaint or investigation, unresolved discipline, or criminal disqualification; compact-derived licences are ineligible. Resolved discipline is evaluated; Missouri statutory refusal grounds continue to apply. Required fees, bonds, insurance and fingerprints are not waived.
Outside license
Current valid licence for at least one year in the same occupation and practice level from another state, military branch or unit, US territory or the District of Columbia.
Qualification verification
The outside jurisdiction must verify that the applicant met its minimum education and, where applicable, work-experience and clinical-supervision requirements. The Board waives national examinations, education and experience within six months; it may retain its Missouri-law examination.

Residential Care and Assisted Living Administrator — Probationary License

Probationary form issued by Board discretion instead of refusing the RCAL licence.

Licensing authority: Missouri Board of Nursing Home Administrators

Initial licensure subject to Board probation
Application
Signed Board-prescribed application, required fee, identification, official academic transcripts where applicable, experience verification and Board approval. Foreign education is evaluated; applicants hired as elder-care workers register with the Family Care Safety Registry within 15 days.
Character
Good moral character; provide criminal background screening, explanations and final court dispositions. Criminal disqualification is governed by current RSMo 344.050 and the referenced RSMo 324.012, rather than an unconditional inference from the older rule’s conviction language.
Education
High school diploma or equivalent; college qualifications must be from an accredited institution.
Examination timing
Take required examinations within 12 months of Board evaluation and qualification or reapply. If one examination is failed and not passed within 12 months, both must be passed again; after a third failure complete the Board-prescribed course and pass approved examinations, with no outside national scores recognized after the third failure.
Minimum age
Rule 19 CSR 73-2.022(2)(A) requires age 21 or over; the Board’s current RCAL checklist instead states “18 years of age or older”. The rule governs; the conflicting checklist statement is retained for the applicant.
Nab core
The Board identifies NAB CORE alongside the RCAL Line of Service examination; CORE is a currently offered national examination absent from the supplied registrations and is therefore recorded as a condition pending nationwide registration.
Probation
Board may issue a probationary licence instead of refusal, with terms it finds appropriate. Applicant must satisfy one of the RCAL experience, education or AIT initial-qualification pathways and the applicable examinations.
HSE qualified reciprocity subject to Board probation
State Examination (RCAL – MO) — Missouri Residential Care and Assisted Living Administrator
Outside license
Valid current equivalent-level administrator licence in another state, a branch of the military, a territory or the District of Columbia; age at least 18.
Probation
Board exercises RSMo 344.050(1) discretion rather than refusing licensure; applicant is HSE qualified and subject to Board probation terms.
Verification
Signed application and fee, jurisdictional licence verification or NAB verification for HSE, passing-score transfer where applicable, identification, education documentation and criminal background screening. Discipline and convictions are reviewed under RSMo 344.050, 324.009 and 324.012. Do not practise in Missouri before licensure.
National score reciprocity subject to Board probation
Nab core
The Board identifies NAB CORE alongside the RCAL Line of Service examination; CORE is a currently offered national examination absent from the supplied registrations and is therefore recorded as a condition pending nationwide registration.
Outside license
Valid current equivalent-level administrator licence in another state, a branch of the military, a territory or the District of Columbia; age at least 18.
Probation
Board exercises discretion rather than refusing licensure; equivalent outside licence held in good standing at least one year, prior national passing score and Board probation terms.
Verification
Signed application and fee, jurisdictional licence verification or NAB verification for HSE, passing-score transfer where applicable, identification, education documentation and criminal background screening. Discipline and convictions are reviewed under RSMo 344.050, 324.009 and 324.012. Do not practise in Missouri before licensure.
Probationary licence renewal
No examination is required for this applicant pathway.
Requirements
Existing probationary licensee satisfies ordinary renewal application, forty-hour continuing-education and fee requirements and the Board’s probation terms. Discretionary disciplinary examination orders are recorded separately in the restoration/probation note.

Official no-examination sources

Effective from 2026-09-22.

Statutory spouse recognition subject to Board probation
No examination is required for this applicant pathway.
Eligibility
Outside licence must remain current and in good standing. No outside revocation, pending complaint or investigation, unresolved discipline, or criminal disqualification; compact-derived licences are ineligible. Resolved discipline is evaluated; Missouri statutory refusal grounds continue to apply. Required fees, bonds, insurance and fingerprints are not waived.
Outside license
Current valid licence for at least one year in the same occupation and practice level from another state, military branch or unit, US territory or the District of Columbia.
Probation
The Board may impose applicable probation terms under RSMo 344.050 rather than refuse issuance; substantive statutory refusal grounds remain applicable.
Spouse status
Qualifying resident or nonresident military or law-enforcement spouse under RSMo 324.009(1).
Waiver
The specific statutory spouse route waives any examination within thirty days; the contrary Board state-exam instruction in 19 CSR 73-2.025(5) remains an applicant condition.

Official no-examination sources

Effective from 2026-09-22.

Statutory recognition subject to Board probation
State Examination (RCAL – MO) — Missouri Residential Care and Assisted Living Administrator
Eligibility
Outside licence must remain current and in good standing. No outside revocation, pending complaint or investigation, unresolved discipline, or criminal disqualification; compact-derived licences are ineligible. Resolved discipline is evaluated; Missouri statutory refusal grounds continue to apply. Required fees, bonds, insurance and fingerprints are not waived.
Outside license
Current valid licence for at least one year in the same occupation and practice level from another state, military branch or unit, US territory or the District of Columbia.
Probation
The Board exercises RSMo 344.050 discretion and imposes applicable probation terms rather than refusing issuance.
Qualification verification
Outside jurisdiction verifies the statutory minimum education and applicable work-experience or clinical-supervision qualifications; national examinations are waived, while the state-law examination may be retained.

State Examination (RCAL – MO) — Missouri Residential Care and Assisted Living Administrator

Passing score
75%
Examination outline
  • 19 CSR 30-86 — Residential Care Facilities and Assisted Living Facilities
  • 19 CSR 30-87 — Sanitation Requirements for Long-Term Care Facilities
  • 19 CSR 30-88 — Resident’s Rights and Handling Resident Funds and Property in Long-Term Care Facilities
  • 19 CSR 30-91 — Authorized Electronic Monitoring in Long-Term Care Facilities
  • 19 CSR 73-2 — General Rules
  • Chapter 198, RSMo — Nursing Homes and Facilities
  • Chapter 344, RSMo — Nursing Home Administrators
Examination sources

NAB National Residential Care/Assisted Living Administrators Line of Service Exam (RC/AL)

Provider
National Association of Long Term Care Administrator Boards (NAB); delivered at Pearson VUE test centers
Format
Objective multiple-choice items with four answer choices, one correct; line of service exam taken after or together with the separately scored CORE exam
Exam questions
75 (60 scored, 15 non-scored pretest)
Time limit
1 hour 30 minutes seat time; 1 hour and 10 minutes to answer questions
Passing score
Scaled score of 113 on a 50-150 scale
Exam fee
RC/AL only $190; CORE and RC/AL combo $480 (effective 2/1/2026)
Examination outline
  • Domain 1: Care, Services, and Supports (75% of the RC/AL exam) (75%)
    • 1A1 Quality of Care: Medical and Nursing Care Practices
    • 1A2 Quality of Care: Medication Management and Administration
    • 1A4 Quality of Care: Nutrition and Hydration (e.g., specialized diets)
    • 1A6 Quality of Care: Rehabilitation and Restorative Programs
    • 1A7 Quality of Care: Care Recipient Assessment and Interdisciplinary Care Planning
    • 1A8 Quality of Care: Clinical and Medical Records and Documentation Requirements (e.g., storage, retention, destruction)
    • 1A11 Quality of Care: Transition of Care (e.g., admission, move-in, transfer, discharge, and move-out)
    • 1B1 Quality of Life: Psychosocial Needs (e.g., social, spiritual, community, cultural)
    • 1B2 Quality of Life: Person-Centered Care and Comprehensive Care Planning
    • 1B3 Quality of Life: Care Recipient Bill of Rights and Responsibilities
    • 1B4 Quality of Life: Care Recipient Safety (e.g., fall prevention, elopement prevention, adverse events)
    • 1B5 Quality of Life: Care Recipient (and Representative) Grievance, Conflict, and Dispute Resolution
    • 1B6 Quality of Life: Care Recipient Advocacy (e.g., Ombudsman, resident and family council)
    • 1B7 Quality of Life: Care Recipient Decision-Making (e.g., capacity, power of attorney, guardianship, conservatorship, code status, advance directives, ethical decision-making)
    • 1B8 Quality of Life: Care Recipient (and Representative) Satisfaction
    • 1B14 Quality of Life: Restraint Usage and Reduction
    • 1B15 Quality of Life: Foodservice (e.g., choice and menu planning, dietary management, food storage and handling, dining services)
    • 1B16 Quality of Life: Social Services Programs
    • 1B17 Quality of Life: Therapeutic Recreation and Activity Programs
    • 1C3 Ancillary Services: Transportation for Care Recipients
    • 1C8 Ancillary Services: Volunteer Programs
  • Domain 2: Operations (12% of the RC/AL exam) (12%)
    • 2A5 Financial Management: Revenue and Reimbursement (e.g., PDPM, PDGM, ACOs, HMOs, Medicaid, private payors)
    • 2B7 Risk Management: Scope of Practice and Legal Liability
  • Domain 3: Environment and Quality (13% of the RC/AL exam) (13%)
    • 3A2 Care Setting: Person-Centered Environment (e.g., home-like environment)
    • 3B3 Regulatory Compliance: Certification and Licensure Requirements for the Organization
    • 3B4 Regulatory Compliance: Regulatory Survey and Inspection Process
Examination sources