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Virginia Assisted Living Administrator — Requirements & Free Practice

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Acting Assisted Living Facility Administrator Certificate

Temporary acting-administrator authorization and Board certificate for acting administrators in an approved ALF AIT program, pending qualification for ordinary licensure.

Licensing authority: Virginia Board of Long-Term Care Administrators · Application information

Acting administrator enrolled in an approved AIT program
No examination is required for this applicant pathway.
Duration
Normally at most 150 days from predecessor's last employment; at most 90 days if no licensure application has been made. AIT completion within 150 days; extensions governed by statutory conditions.
Filing
If intending to assume the position permanently, submit AIT application within ten days of employment; identify self as acting administrator-in-training and post the Board certificate and preceptor license.
Preceptor
At least four hours weekly face-to-face instruction and performance review; facilities may use acting administration no more than twice in two years without case-specific DSS permission.
Qualification
Qualify educationally for AIT and have at least one year administrative/supervisory experience in a health care or long-term care facility, or have completed an AIT program and be awaiting licensure.
Vacancy
A licensed administrator has died, resigned, been discharged or become unable to perform duties; immediately notify DSS regional office and the Board of the vacancy and last employment date.

Official no-examination sources

Effective from 2026-09-22.

Acting administrator extension pending national examination results
NAB National Residential Care/Assisted Living Administrators Line of Service Exam (RC/AL)
Core Evidence
{"carrierClass":"implementation","checkedAt":"2026-09-30","locator":"Page 1, Transfer of exam scores","name":"Current Board-linked ALFA Application for Licensure Instructions, revised July 2020","quote":"TRANSFER OF EXAM SCORES – If you have taken and passed the National Residential Care/Assisted Living\n (RC/AL) and core exams administered by the National Association of Long Term Care Administrator Boards (NAB),\n please request that your scores be transferred by NAB to Virginia.","sourceFile":{"sha256":"4e0edcaed102e73148fbb50155f7b51b03db728ad6fd1532c626bd73b6a18a0b"},"url":"https://www.license.dhp.virginia.gov/apply/Forms/LTCA/ALFA_All_Instruct_Forms.pdf","version":"Revised July 2020 as stated on the file; linked by the current Board Applications and Forms page and consistent with March 2023 application and current examination FAQ."}
Duration
DSS may grant up to thirty extra days after the initial 150; no acting operation beyond 180 days from predecessor's last employment. Immediately notify the Board in writing.
Exam Timing
Await the results of the national examination; this currently offered examination remains a leaf even though already taken.
National Examinations
The Board identifies both NAB Residential Care/Assisted Living (RC/AL) and CORE. Passing both is required or accepted under this route; a previously obtained passing score is still an examination requirement, with scores transferred by NAB. RC/AL references the supplied current 2022 Domains version. CORE is currently offered but absent from the frozen nationwide registration context and is recorded here as an applicant condition pending national registration.
Other Board Approved Examination
18VAC95-30-10 defines the national examination as administered by NAB or another examination approved by the Board. Any unnamed approved alternative is an applicant condition; it is not an invented examination leaf.
Prior Role
Approved acting administrator following the statutory administrator vacancy; permanent licensure application submitted and AIT completed.

Assisted Living Facility Administrator License

License for general administration of assisted living facilities requiring a licensed administrator. A Virginia nursing home administrator license independently authorizes this practice under 54.1-3102(B); it is a qualification held in another profession, not an ALFA examination or a new ALFA license. Administrators of facilities licensed only for residential living care are exempt under that subsection. The Board explicitly states that no state examination is required.

Licensing authority: Virginia Board of Long-Term Care Administrators · Application information

Licensure by credentials
NAB National Residential Care/Assisted Living Administrators Line of Service Exam (RC/AL)
Application
Submit a completed application after qualification, the applicable fee, a current NPDB self-query, official education records, applicable license verification, and any additional eligibility documentation under 18VAC95-30-130 and the Board checklist. Former acting administrators may be asked for the most recent facility survey. Disciplinary and criminal-history questions require the Board-requested explanations and records.
Board Form Experience Statement
The March 2023 application asks: "Have you practiced as the administrator of record in an assisted living facility in another state for a period of two of the four years preceding application to the Board?" It alternatively asks about equivalent education/experience. The controlling current rule uses active practice as defined in section 10, rather than this older two-of-four-year formulation. The form demand is retained for the applicant.
Board Form Source
{"carrierClass":"implementation","checkedAt":"2026-09-30","locator":"Page 3, Credential applicants, questions 1-2","name":"ALFA Application for Licensure, revised March 2023","quote":"1. Have you practiced as the administrator of record in an assisted living facility in another state for a\n period of two of the four years preceding application to the Board?\n If yes, please submit documentation of employment on company letterhead with original signature.\n No copies or faxes will be accepted.\n OR\n 2. Do you have education and experience equivalent to the qualification for licensure?\n\n If yes, please submit documentation of employment on company letterhead with original signature\n and official transcript of education. No copies or faxes will be accepted. If a transcript was previously\n submitted with an AIT application, then an additional transcript is not required.","sourceFile":{"sha256":"c3a7681760f8cc32235c54d8853956fd5cf27459ea2fe72eb2ad1a3aaece977c"},"url":"https://ris.dls.virginia.gov/uploads/18VAC95/forms/LTCA_ALFA_Licensure_App_032023-20230316110036.pdf","version":"Revised March 2023; officially linked by the current regulation forms list, and consistent with the current Board-linked instructions and examination FAQ."}
Core Evidence
{"carrierClass":"implementation","checkedAt":"2026-09-30","locator":"Page 1, Transfer of exam scores","name":"Current Board-linked ALFA Application for Licensure Instructions, revised July 2020","quote":"TRANSFER OF EXAM SCORES – If you have taken and passed the National Residential Care/Assisted Living\n (RC/AL) and core exams administered by the National Association of Long Term Care Administrator Boards (NAB),\n please request that your scores be transferred by NAB to Virginia.","sourceFile":{"sha256":"4e0edcaed102e73148fbb50155f7b51b03db728ad6fd1532c626bd73b6a18a0b"},"url":"https://www.license.dhp.virginia.gov/apply/Forms/LTCA/ALFA_All_Instruct_Forms.pdf","version":"Revised July 2020 as stated on the file; linked by the current Board Applications and Forms page and consistent with March 2023 application and current examination FAQ."}
Discipline
No unremediated disciplinary violation in another jurisdiction, as determined by the Board; 18VAC95-30-120(B)(2).
National Examinations
The Board identifies both NAB Residential Care/Assisted Living (RC/AL) and CORE. Passing both is required or accepted under this route; a previously obtained passing score is still an examination requirement, with scores transferred by NAB. RC/AL references the supplied current 2022 Domains version. CORE is currently offered but absent from the frozen nationwide registration context and is recorded here as an applicant condition pending national registration.
Origin Jurisdiction
Apply from a jurisdiction not requiring ALFA licensure, certification, or registration; no such license evidence is required under 18VAC95-30-120(A).
Other Board Approved Examination
18VAC95-30-10 defines the national examination as administered by NAB or another examination approved by the Board. Any unnamed approved alternative is an applicant condition; it is not an invented examination leaf.
Qualification Alternative
Either active practice as ALFA in a facility providing assisted living care, or education and experience substantially equivalent to this chapter with written evidence; 18VAC95-30-120(B)(3). Active practice is at least 1,000 hours in the preceding 24 months under 18VAC95-30-10.
State Exam
The ALFA examination FAQ expressly states there is no state exam requirement.
Licensure by endorsement
NAB National Residential Care/Assisted Living Administrators Line of Service Exam (RC/AL)
Application
Submit a completed application after qualification, the applicable fee, a current NPDB self-query, official education records, applicable license verification, and any additional eligibility documentation under 18VAC95-30-130 and the Board checklist. Former acting administrators may be asked for the most recent facility survey. Disciplinary and criminal-history questions require the Board-requested explanations and records.
Core Evidence
{"carrierClass":"implementation","checkedAt":"2026-09-30","locator":"Page 1, Transfer of exam scores","name":"Current Board-linked ALFA Application for Licensure Instructions, revised July 2020","quote":"TRANSFER OF EXAM SCORES – If you have taken and passed the National Residential Care/Assisted Living\n (RC/AL) and core exams administered by the National Association of Long Term Care Administrator Boards (NAB),\n please request that your scores be transferred by NAB to Virginia.","sourceFile":{"sha256":"4e0edcaed102e73148fbb50155f7b51b03db728ad6fd1532c626bd73b6a18a0b"},"url":"https://www.license.dhp.virginia.gov/apply/Forms/LTCA/ALFA_All_Instruct_Forms.pdf","version":"Revised July 2020 as stated on the file; linked by the current Board Applications and Forms page and consistent with March 2023 application and current examination FAQ."}
Discipline
No unremediated disciplinary violation in another jurisdiction, as determined by the Board; 18VAC95-30-120(B)(2).
License Held
Hold a current unrestricted ALFA license, certificate, or registration from a jurisdiction requiring it; 18VAC95-30-120(A).
National Examinations
The Board identifies both NAB Residential Care/Assisted Living (RC/AL) and CORE. Passing both is required or accepted under this route; a previously obtained passing score is still an examination requirement, with scores transferred by NAB. RC/AL references the supplied current 2022 Domains version. CORE is currently offered but absent from the frozen nationwide registration context and is recorded here as an applicant condition pending national registration.
Other Board Approved Examination
18VAC95-30-10 defines the national examination as administered by NAB or another examination approved by the Board. Any unnamed approved alternative is an applicant condition; it is not an invented examination leaf.
Qualification Alternative
Either active practice as ALFA in a facility providing assisted living care, or education and experience substantially equivalent to this chapter with written evidence; 18VAC95-30-120(B)(3). Active practice is at least 1,000 hours in the preceding 24 months under 18VAC95-30-10.
State Exam
The ALFA examination FAQ expressly states there is no state exam requirement.
Initial licensure: administration coursework and AIT
NAB National Residential Care/Assisted Living Administrators Line of Service Exam (RC/AL)
Ait Completion
Board-approved registered preceptor and individualized training plan; normally complete AIT within 24 months, or 150 days when serving as an approved acting administrator, subject to individual Board extension; no more than 40 hours credit per week; all operational areas/shifts and cognitive/mental-impairment training; preceptor completion report due within 30 days.
Application
Submit a completed application after qualification, the applicable fee, a current NPDB self-query, official education records, applicable license verification, and any additional eligibility documentation under 18VAC95-30-130 and the Board checklist. Former acting administrators may be asked for the most recent facility survey. Disciplinary and criminal-history questions require the Board-requested explanations and records.
Core Evidence
{"carrierClass":"implementation","checkedAt":"2026-09-30","locator":"Page 1, Transfer of exam scores","name":"Current Board-linked ALFA Application for Licensure Instructions, revised July 2020","quote":"TRANSFER OF EXAM SCORES – If you have taken and passed the National Residential Care/Assisted Living\n (RC/AL) and core exams administered by the National Association of Long Term Care Administrator Boards (NAB),\n please request that your scores be transferred by NAB to Virginia.","sourceFile":{"sha256":"4e0edcaed102e73148fbb50155f7b51b03db728ad6fd1532c626bd73b6a18a0b"},"url":"https://www.license.dhp.virginia.gov/apply/Forms/LTCA/ALFA_All_Instruct_Forms.pdf","version":"Revised July 2020 as stated on the file; linked by the current Board Applications and Forms page and consistent with March 2023 application and current examination FAQ."}
Education And Training
At least 30 semester hours at an accredited institution with client/resident care, human resources management, financial management, physical environment, leadership and governance coursework, and 480 ALF AIT hours; 18VAC95-30-100(A)(1)(d).
Health Degree Course Content
Where subsection 100(B) applies, an official transcript must show 21 semester hours in administration/management of health care services: six in customer care, supports and services; three each in human resources, finance, environment, leadership/management, and internship/practicum.
High School
Hold a high school diploma or GED under 18VAC95-30-100(A).
Military Credit
54.1-118 permits substantially equivalent military education, training, or experience to be credited for an honorably discharged service member; proof and Board equivalency assessment remain applicant conditions.
National Examinations
The Board identifies both NAB Residential Care/Assisted Living (RC/AL) and CORE. Passing both is required or accepted under this route; a previously obtained passing score is still an examination requirement, with scores transferred by NAB. RC/AL references the supplied current 2022 Domains version. CORE is currently offered but absent from the frozen nationwide registration context and is recorded here as an applicant condition pending national registration.
Other Board Approved Examination
18VAC95-30-10 defines the national examination as administered by NAB or another examination approved by the Board. Any unnamed approved alternative is an applicant condition; it is not an invented examination leaf.
Prior Experience Credit
Under 18VAC95-30-150(B), Board-approved credit reduces AIT to 320 hours for a qualifying assistant administrator/hospital administrator with one full-time year in the previous four years, or a qualifying RN with one year of administrative nursing supervision in that period; a qualifying LPN with such supervisory experience completes 480 hours.
State Exam
The ALFA examination FAQ expressly states there is no state exam requirement.
Training Facilities
Training or internships must meet 18VAC95-30-170; prohibited sites include residential-only facilities, licensed capacity below 20, and the specified provisional or conditional-license facilities.
Initial licensure: health care experience and AIT
NAB National Residential Care/Assisted Living Administrators Line of Service Exam (RC/AL)
Ait Completion
Board-approved registered preceptor and individualized training plan; normally complete AIT within 24 months, or 150 days when serving as an approved acting administrator, subject to individual Board extension; no more than 40 hours credit per week; all operational areas/shifts and cognitive/mental-impairment training; preceptor completion report due within 30 days.
Application
Submit a completed application after qualification, the applicable fee, a current NPDB self-query, official education records, applicable license verification, and any additional eligibility documentation under 18VAC95-30-130 and the Board checklist. Former acting administrators may be asked for the most recent facility survey. Disciplinary and criminal-history questions require the Board-requested explanations and records.
Core Evidence
{"carrierClass":"implementation","checkedAt":"2026-09-30","locator":"Page 1, Transfer of exam scores","name":"Current Board-linked ALFA Application for Licensure Instructions, revised July 2020","quote":"TRANSFER OF EXAM SCORES – If you have taken and passed the National Residential Care/Assisted Living\n (RC/AL) and core exams administered by the National Association of Long Term Care Administrator Boards (NAB),\n please request that your scores be transferred by NAB to Virginia.","sourceFile":{"sha256":"4e0edcaed102e73148fbb50155f7b51b03db728ad6fd1532c626bd73b6a18a0b"},"url":"https://www.license.dhp.virginia.gov/apply/Forms/LTCA/ALFA_All_Instruct_Forms.pdf","version":"Revised July 2020 as stated on the file; linked by the current Board Applications and Forms page and consistent with March 2023 application and current examination FAQ."}
Education And Training
At least three years full-time-equivalent health care experience within five years before application, including at least one consecutive year in a managerial/supervisory role supervising two or more staff in a listed health care setting, and 640 ALF AIT hours; 18VAC95-30-100(A)(1)(g).
Health Degree Course Content
Where subsection 100(B) applies, an official transcript must show 21 semester hours in administration/management of health care services: six in customer care, supports and services; three each in human resources, finance, environment, leadership/management, and internship/practicum.
High School
Hold a high school diploma or GED under 18VAC95-30-100(A).
Military Credit
54.1-118 permits substantially equivalent military education, training, or experience to be credited for an honorably discharged service member; proof and Board equivalency assessment remain applicant conditions.
National Examinations
The Board identifies both NAB Residential Care/Assisted Living (RC/AL) and CORE. Passing both is required or accepted under this route; a previously obtained passing score is still an examination requirement, with scores transferred by NAB. RC/AL references the supplied current 2022 Domains version. CORE is currently offered but absent from the frozen nationwide registration context and is recorded here as an applicant condition pending national registration.
Other Board Approved Examination
18VAC95-30-10 defines the national examination as administered by NAB or another examination approved by the Board. Any unnamed approved alternative is an applicant condition; it is not an invented examination leaf.
Prior Experience Credit
Under 18VAC95-30-150(B), Board-approved credit reduces AIT to 320 hours for a qualifying assistant administrator/hospital administrator with one full-time year in the previous four years, or a qualifying RN with one year of administrative nursing supervision in that period; a qualifying LPN with such supervisory experience completes 480 hours.
State Exam
The ALFA examination FAQ expressly states there is no state exam requirement.
Training Facilities
Training or internships must meet 18VAC95-30-170; prohibited sites include residential-only facilities, licensed capacity below 20, and the specified provisional or conditional-license facilities.
Initial licensure: health related degree without practicum and AIT
NAB National Residential Care/Assisted Living Administrators Line of Service Exam (RC/AL)
Ait Completion
Board-approved registered preceptor and individualized training plan; normally complete AIT within 24 months, or 150 days when serving as an approved acting administrator, subject to individual Board extension; no more than 40 hours credit per week; all operational areas/shifts and cognitive/mental-impairment training; preceptor completion report due within 30 days.
Application
Submit a completed application after qualification, the applicable fee, a current NPDB self-query, official education records, applicable license verification, and any additional eligibility documentation under 18VAC95-30-130 and the Board checklist. Former acting administrators may be asked for the most recent facility survey. Disciplinary and criminal-history questions require the Board-requested explanations and records.
Core Evidence
{"carrierClass":"implementation","checkedAt":"2026-09-30","locator":"Page 1, Transfer of exam scores","name":"Current Board-linked ALFA Application for Licensure Instructions, revised July 2020","quote":"TRANSFER OF EXAM SCORES – If you have taken and passed the National Residential Care/Assisted Living\n (RC/AL) and core exams administered by the National Association of Long Term Care Administrator Boards (NAB),\n please request that your scores be transferred by NAB to Virginia.","sourceFile":{"sha256":"4e0edcaed102e73148fbb50155f7b51b03db728ad6fd1532c626bd73b6a18a0b"},"url":"https://www.license.dhp.virginia.gov/apply/Forms/LTCA/ALFA_All_Instruct_Forms.pdf","version":"Revised July 2020 as stated on the file; linked by the current Board Applications and Forms page and consistent with March 2023 application and current examination FAQ."}
Education And Training
A master's or baccalaureate degree in a health care-related or comparable field meeting 18VAC95-30-100(B), without internship/practicum, and 320 ALF AIT hours; 18VAC95-30-100(A)(1)(e).
Health Degree Course Content
Where subsection 100(B) applies, an official transcript must show 21 semester hours in administration/management of health care services: six in customer care, supports and services; three each in human resources, finance, environment, leadership/management, and internship/practicum.
High School
Hold a high school diploma or GED under 18VAC95-30-100(A).
Military Credit
54.1-118 permits substantially equivalent military education, training, or experience to be credited for an honorably discharged service member; proof and Board equivalency assessment remain applicant conditions.
National Examinations
The Board identifies both NAB Residential Care/Assisted Living (RC/AL) and CORE. Passing both is required or accepted under this route; a previously obtained passing score is still an examination requirement, with scores transferred by NAB. RC/AL references the supplied current 2022 Domains version. CORE is currently offered but absent from the frozen nationwide registration context and is recorded here as an applicant condition pending national registration.
Other Board Approved Examination
18VAC95-30-10 defines the national examination as administered by NAB or another examination approved by the Board. Any unnamed approved alternative is an applicant condition; it is not an invented examination leaf.
Prior Experience Credit
Under 18VAC95-30-150(B), Board-approved credit reduces AIT to 320 hours for a qualifying assistant administrator/hospital administrator with one full-time year in the previous four years, or a qualifying RN with one year of administrative nursing supervision in that period; a qualifying LPN with such supervisory experience completes 480 hours.
State Exam
The ALFA examination FAQ expressly states there is no state exam requirement.
Training Facilities
Training or internships must meet 18VAC95-30-170; prohibited sites include residential-only facilities, licensed capacity below 20, and the specified provisional or conditional-license facilities.
Initial licensure: licensed practical nurse and AIT
NAB National Residential Care/Assisted Living Administrators Line of Service Exam (RC/AL)
Ait Completion
Board-approved registered preceptor and individualized training plan; normally complete AIT within 24 months, or 150 days when serving as an approved acting administrator, subject to individual Board extension; no more than 40 hours credit per week; all operational areas/shifts and cognitive/mental-impairment training; preceptor completion report due within 30 days.
Application
Submit a completed application after qualification, the applicable fee, a current NPDB self-query, official education records, applicable license verification, and any additional eligibility documentation under 18VAC95-30-130 and the Board checklist. Former acting administrators may be asked for the most recent facility survey. Disciplinary and criminal-history questions require the Board-requested explanations and records.
Core Evidence
{"carrierClass":"implementation","checkedAt":"2026-09-30","locator":"Page 1, Transfer of exam scores","name":"Current Board-linked ALFA Application for Licensure Instructions, revised July 2020","quote":"TRANSFER OF EXAM SCORES – If you have taken and passed the National Residential Care/Assisted Living\n (RC/AL) and core exams administered by the National Association of Long Term Care Administrator Boards (NAB),\n please request that your scores be transferred by NAB to Virginia.","sourceFile":{"sha256":"4e0edcaed102e73148fbb50155f7b51b03db728ad6fd1532c626bd73b6a18a0b"},"url":"https://www.license.dhp.virginia.gov/apply/Forms/LTCA/ALFA_All_Instruct_Forms.pdf","version":"Revised July 2020 as stated on the file; linked by the current Board Applications and Forms page and consistent with March 2023 application and current examination FAQ."}
Education And Training
Complete an LPN educational program, hold a current unrestricted license or multistate privilege, and complete 640 ALF AIT hours; 18VAC95-30-100(A)(1)(b).
Health Degree Course Content
Where subsection 100(B) applies, an official transcript must show 21 semester hours in administration/management of health care services: six in customer care, supports and services; three each in human resources, finance, environment, leadership/management, and internship/practicum.
High School
Hold a high school diploma or GED under 18VAC95-30-100(A).
Military Credit
54.1-118 permits substantially equivalent military education, training, or experience to be credited for an honorably discharged service member; proof and Board equivalency assessment remain applicant conditions.
National Examinations
The Board identifies both NAB Residential Care/Assisted Living (RC/AL) and CORE. Passing both is required or accepted under this route; a previously obtained passing score is still an examination requirement, with scores transferred by NAB. RC/AL references the supplied current 2022 Domains version. CORE is currently offered but absent from the frozen nationwide registration context and is recorded here as an applicant condition pending national registration.
Other Board Approved Examination
18VAC95-30-10 defines the national examination as administered by NAB or another examination approved by the Board. Any unnamed approved alternative is an applicant condition; it is not an invented examination leaf.
Prior Experience Credit
Under 18VAC95-30-150(B), Board-approved credit reduces AIT to 320 hours for a qualifying assistant administrator/hospital administrator with one full-time year in the previous four years, or a qualifying RN with one year of administrative nursing supervision in that period; a qualifying LPN with such supervisory experience completes 480 hours.
State Exam
The ALFA examination FAQ expressly states there is no state exam requirement.
Training Facilities
Training or internships must meet 18VAC95-30-170; prohibited sites include residential-only facilities, licensed capacity below 20, and the specified provisional or conditional-license facilities.
Initial licensure: postsecondary education and AIT
NAB National Residential Care/Assisted Living Administrators Line of Service Exam (RC/AL)
Ait Completion
Board-approved registered preceptor and individualized training plan; normally complete AIT within 24 months, or 150 days when serving as an approved acting administrator, subject to individual Board extension; no more than 40 hours credit per week; all operational areas/shifts and cognitive/mental-impairment training; preceptor completion report due within 30 days.
Application
Submit a completed application after qualification, the applicable fee, a current NPDB self-query, official education records, applicable license verification, and any additional eligibility documentation under 18VAC95-30-130 and the Board checklist. Former acting administrators may be asked for the most recent facility survey. Disciplinary and criminal-history questions require the Board-requested explanations and records.
Core Evidence
{"carrierClass":"implementation","checkedAt":"2026-09-30","locator":"Page 1, Transfer of exam scores","name":"Current Board-linked ALFA Application for Licensure Instructions, revised July 2020","quote":"TRANSFER OF EXAM SCORES – If you have taken and passed the National Residential Care/Assisted Living\n (RC/AL) and core exams administered by the National Association of Long Term Care Administrator Boards (NAB),\n please request that your scores be transferred by NAB to Virginia.","sourceFile":{"sha256":"4e0edcaed102e73148fbb50155f7b51b03db728ad6fd1532c626bd73b6a18a0b"},"url":"https://www.license.dhp.virginia.gov/apply/Forms/LTCA/ALFA_All_Instruct_Forms.pdf","version":"Revised July 2020 as stated on the file; linked by the current Board Applications and Forms page and consistent with March 2023 application and current examination FAQ."}
Education And Training
At least 30 semester hours at an accredited institution, at least 15 in business or human services or a combination, and 640 ALF AIT hours; 18VAC95-30-100(A)(1)(a).
Health Degree Course Content
Where subsection 100(B) applies, an official transcript must show 21 semester hours in administration/management of health care services: six in customer care, supports and services; three each in human resources, finance, environment, leadership/management, and internship/practicum.
High School
Hold a high school diploma or GED under 18VAC95-30-100(A).
Military Credit
54.1-118 permits substantially equivalent military education, training, or experience to be credited for an honorably discharged service member; proof and Board equivalency assessment remain applicant conditions.
National Examinations
The Board identifies both NAB Residential Care/Assisted Living (RC/AL) and CORE. Passing both is required or accepted under this route; a previously obtained passing score is still an examination requirement, with scores transferred by NAB. RC/AL references the supplied current 2022 Domains version. CORE is currently offered but absent from the frozen nationwide registration context and is recorded here as an applicant condition pending national registration.
Other Board Approved Examination
18VAC95-30-10 defines the national examination as administered by NAB or another examination approved by the Board. Any unnamed approved alternative is an applicant condition; it is not an invented examination leaf.
Prior Experience Credit
Under 18VAC95-30-150(B), Board-approved credit reduces AIT to 320 hours for a qualifying assistant administrator/hospital administrator with one full-time year in the previous four years, or a qualifying RN with one year of administrative nursing supervision in that period; a qualifying LPN with such supervisory experience completes 480 hours.
State Exam
The ALFA examination FAQ expressly states there is no state exam requirement.
Training Facilities
Training or internships must meet 18VAC95-30-170; prohibited sites include residential-only facilities, licensed capacity below 20, and the specified provisional or conditional-license facilities.
Initial licensure: registered nurse and AIT
NAB National Residential Care/Assisted Living Administrators Line of Service Exam (RC/AL)
Ait Completion
Board-approved registered preceptor and individualized training plan; normally complete AIT within 24 months, or 150 days when serving as an approved acting administrator, subject to individual Board extension; no more than 40 hours credit per week; all operational areas/shifts and cognitive/mental-impairment training; preceptor completion report due within 30 days.
Application
Submit a completed application after qualification, the applicable fee, a current NPDB self-query, official education records, applicable license verification, and any additional eligibility documentation under 18VAC95-30-130 and the Board checklist. Former acting administrators may be asked for the most recent facility survey. Disciplinary and criminal-history questions require the Board-requested explanations and records.
Core Evidence
{"carrierClass":"implementation","checkedAt":"2026-09-30","locator":"Page 1, Transfer of exam scores","name":"Current Board-linked ALFA Application for Licensure Instructions, revised July 2020","quote":"TRANSFER OF EXAM SCORES – If you have taken and passed the National Residential Care/Assisted Living\n (RC/AL) and core exams administered by the National Association of Long Term Care Administrator Boards (NAB),\n please request that your scores be transferred by NAB to Virginia.","sourceFile":{"sha256":"4e0edcaed102e73148fbb50155f7b51b03db728ad6fd1532c626bd73b6a18a0b"},"url":"https://www.license.dhp.virginia.gov/apply/Forms/LTCA/ALFA_All_Instruct_Forms.pdf","version":"Revised July 2020 as stated on the file; linked by the current Board Applications and Forms page and consistent with March 2023 application and current examination FAQ."}
Education And Training
Complete an RN educational program, hold a current unrestricted license or multistate privilege, and complete 480 ALF AIT hours; 18VAC95-30-100(A)(1)(c).
Health Degree Course Content
Where subsection 100(B) applies, an official transcript must show 21 semester hours in administration/management of health care services: six in customer care, supports and services; three each in human resources, finance, environment, leadership/management, and internship/practicum.
High School
Hold a high school diploma or GED under 18VAC95-30-100(A).
Military Credit
54.1-118 permits substantially equivalent military education, training, or experience to be credited for an honorably discharged service member; proof and Board equivalency assessment remain applicant conditions.
National Examinations
The Board identifies both NAB Residential Care/Assisted Living (RC/AL) and CORE. Passing both is required or accepted under this route; a previously obtained passing score is still an examination requirement, with scores transferred by NAB. RC/AL references the supplied current 2022 Domains version. CORE is currently offered but absent from the frozen nationwide registration context and is recorded here as an applicant condition pending national registration.
Other Board Approved Examination
18VAC95-30-10 defines the national examination as administered by NAB or another examination approved by the Board. Any unnamed approved alternative is an applicant condition; it is not an invented examination leaf.
Prior Experience Credit
Under 18VAC95-30-150(B), Board-approved credit reduces AIT to 320 hours for a qualifying assistant administrator/hospital administrator with one full-time year in the previous four years, or a qualifying RN with one year of administrative nursing supervision in that period; a qualifying LPN with such supervisory experience completes 480 hours.
State Exam
The ALFA examination FAQ expressly states there is no state exam requirement.
Training Facilities
Training or internships must meet 18VAC95-30-170; prohibited sites include residential-only facilities, licensed capacity below 20, and the specified provisional or conditional-license facilities.
Initial licensure: unrelated degree and AIT
NAB National Residential Care/Assisted Living Administrators Line of Service Exam (RC/AL)
Ait Completion
Board-approved registered preceptor and individualized training plan; normally complete AIT within 24 months, or 150 days when serving as an approved acting administrator, subject to individual Board extension; no more than 40 hours credit per week; all operational areas/shifts and cognitive/mental-impairment training; preceptor completion report due within 30 days.
Application
Submit a completed application after qualification, the applicable fee, a current NPDB self-query, official education records, applicable license verification, and any additional eligibility documentation under 18VAC95-30-130 and the Board checklist. Former acting administrators may be asked for the most recent facility survey. Disciplinary and criminal-history questions require the Board-requested explanations and records.
Core Evidence
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Education And Training
A master's or baccalaureate degree in an unrelated field and 480 ALF AIT hours; 18VAC95-30-100(A)(1)(f).
Health Degree Course Content
Where subsection 100(B) applies, an official transcript must show 21 semester hours in administration/management of health care services: six in customer care, supports and services; three each in human resources, finance, environment, leadership/management, and internship/practicum.
High School
Hold a high school diploma or GED under 18VAC95-30-100(A).
Military Credit
54.1-118 permits substantially equivalent military education, training, or experience to be credited for an honorably discharged service member; proof and Board equivalency assessment remain applicant conditions.
National Examinations
The Board identifies both NAB Residential Care/Assisted Living (RC/AL) and CORE. Passing both is required or accepted under this route; a previously obtained passing score is still an examination requirement, with scores transferred by NAB. RC/AL references the supplied current 2022 Domains version. CORE is currently offered but absent from the frozen nationwide registration context and is recorded here as an applicant condition pending national registration.
Other Board Approved Examination
18VAC95-30-10 defines the national examination as administered by NAB or another examination approved by the Board. Any unnamed approved alternative is an applicant condition; it is not an invented examination leaf.
Prior Experience Credit
Under 18VAC95-30-150(B), Board-approved credit reduces AIT to 320 hours for a qualifying assistant administrator/hospital administrator with one full-time year in the previous four years, or a qualifying RN with one year of administrative nursing supervision in that period; a qualifying LPN with such supervisory experience completes 480 hours.
State Exam
The ALFA examination FAQ expressly states there is no state exam requirement.
Training Facilities
Training or internships must meet 18VAC95-30-170; prohibited sites include residential-only facilities, licensed capacity below 20, and the specified provisional or conditional-license facilities.
Initial licensure: health care administration certificate program
NAB National Residential Care/Assisted Living Administrators Line of Service Exam (RC/AL)
Application
Submit a completed application after qualification, the applicable fee, a current NPDB self-query, official education records, applicable license verification, and any additional eligibility documentation under 18VAC95-30-130 and the Board checklist. Former acting administrators may be asked for the most recent facility survey. Disciplinary and criminal-history questions require the Board-requested explanations and records.
Core Evidence
{"carrierClass":"implementation","checkedAt":"2026-09-30","locator":"Page 1, Transfer of exam scores","name":"Current Board-linked ALFA Application for Licensure Instructions, revised July 2020","quote":"TRANSFER OF EXAM SCORES – If you have taken and passed the National Residential Care/Assisted Living\n (RC/AL) and core exams administered by the National Association of Long Term Care Administrator Boards (NAB),\n please request that your scores be transferred by NAB to Virginia.","sourceFile":{"sha256":"4e0edcaed102e73148fbb50155f7b51b03db728ad6fd1532c626bd73b6a18a0b"},"url":"https://www.license.dhp.virginia.gov/apply/Forms/LTCA/ALFA_All_Instruct_Forms.pdf","version":"Revised July 2020 as stated on the file; linked by the current Board Applications and Forms page and consistent with March 2023 application and current examination FAQ."}
Education And Training
An accredited unrelated-field baccalaureate or higher degree; a certificate with at least 21 semester hours meeting 18VAC95-30-100(B); and at least 320 internship/practicum hours in a licensed ALF under a preceptor as part of the certificate, addressing the 18VAC95-30-160 Domains of Practice; 18VAC95-30-100(A)(2).
Health Degree Course Content
Where subsection 100(B) applies, an official transcript must show 21 semester hours in administration/management of health care services: six in customer care, supports and services; three each in human resources, finance, environment, leadership/management, and internship/practicum.
High School
Hold a high school diploma or GED under 18VAC95-30-100(A).
Military Credit
54.1-118 permits substantially equivalent military education, training, or experience to be credited for an honorably discharged service member; proof and Board equivalency assessment remain applicant conditions.
National Examinations
The Board identifies both NAB Residential Care/Assisted Living (RC/AL) and CORE. Passing both is required or accepted under this route; a previously obtained passing score is still an examination requirement, with scores transferred by NAB. RC/AL references the supplied current 2022 Domains version. CORE is currently offered but absent from the frozen nationwide registration context and is recorded here as an applicant condition pending national registration.
Other Board Approved Examination
18VAC95-30-10 defines the national examination as administered by NAB or another examination approved by the Board. Any unnamed approved alternative is an applicant condition; it is not an invented examination leaf.
State Exam
The ALFA examination FAQ expressly states there is no state exam requirement.
Training Facilities
Training or internships must meet 18VAC95-30-170; prohibited sites include residential-only facilities, licensed capacity below 20, and the specified provisional or conditional-license facilities.
Initial licensure: health related degree and practical experience
NAB National Residential Care/Assisted Living Administrators Line of Service Exam (RC/AL)
Application
Submit a completed application after qualification, the applicable fee, a current NPDB self-query, official education records, applicable license verification, and any additional eligibility documentation under 18VAC95-30-130 and the Board checklist. Former acting administrators may be asked for the most recent facility survey. Disciplinary and criminal-history questions require the Board-requested explanations and records.
Core Evidence
{"carrierClass":"implementation","checkedAt":"2026-09-30","locator":"Page 1, Transfer of exam scores","name":"Current Board-linked ALFA Application for Licensure Instructions, revised July 2020","quote":"TRANSFER OF EXAM SCORES – If you have taken and passed the National Residential Care/Assisted Living\n (RC/AL) and core exams administered by the National Association of Long Term Care Administrator Boards (NAB),\n please request that your scores be transferred by NAB to Virginia.","sourceFile":{"sha256":"4e0edcaed102e73148fbb50155f7b51b03db728ad6fd1532c626bd73b6a18a0b"},"url":"https://www.license.dhp.virginia.gov/apply/Forms/LTCA/ALFA_All_Instruct_Forms.pdf","version":"Revised July 2020 as stated on the file; linked by the current Board Applications and Forms page and consistent with March 2023 application and current examination FAQ."}
Education And Training
An accredited health care-related baccalaureate or higher degree meeting 18VAC95-30-100(B), and at least 320 internship/practicum hours in a licensed ALF under a preceptor as part of the degree, addressing 18VAC95-30-160 Domains of Practice; 18VAC95-30-100(A)(3).
Health Degree Course Content
Where subsection 100(B) applies, an official transcript must show 21 semester hours in administration/management of health care services: six in customer care, supports and services; three each in human resources, finance, environment, leadership/management, and internship/practicum.
High School
Hold a high school diploma or GED under 18VAC95-30-100(A).
Military Credit
54.1-118 permits substantially equivalent military education, training, or experience to be credited for an honorably discharged service member; proof and Board equivalency assessment remain applicant conditions.
National Examinations
The Board identifies both NAB Residential Care/Assisted Living (RC/AL) and CORE. Passing both is required or accepted under this route; a previously obtained passing score is still an examination requirement, with scores transferred by NAB. RC/AL references the supplied current 2022 Domains version. CORE is currently offered but absent from the frozen nationwide registration context and is recorded here as an applicant condition pending national registration.
Other Board Approved Examination
18VAC95-30-10 defines the national examination as administered by NAB or another examination approved by the Board. Any unnamed approved alternative is an applicant condition; it is not an invented examination leaf.
State Exam
The ALFA examination FAQ expressly states there is no state exam requirement.
Training Facilities
Training or internships must meet 18VAC95-30-170; prohibited sites include residential-only facilities, licensed capacity below 20, and the specified provisional or conditional-license facilities.
Late active license renewal within one year
No examination is required for this applicant pathway.
Continuing Education
20 approved hours each year, including at least two on mental/cognitive impairment care; no more than ten internet/self-study hours; up to ten excess hours carry forward. First renewal after initial Virginia licensure is exempt. Preceptor-training credit, documented volunteer credit, record retention, audit duties and Board-granted extension/exemption apply as stated in 18VAC95-30-70.
Deadline
Renew by March 31 with the renewal form and applicable fee; an unrenewed license is invalid.
Deployment Extension
54.1-117 extends expiration during qualifying overseas armed-services/diplomatic service and 60 days thereafter, at most five years; accompanying military spouses are included. This is a renewal condition rather than a separate exam route.
Late Filing
Renewal request, renewal and penalty fees, and eligibility evidence must reach the Board within one year after initial expiration; postmarks do not count.

Official no-examination sources

Effective from 2026-09-22.

Expedited endorsement for qualifying military spouses
NAB National Residential Care/Assisted Living Administrators Line of Service Exam (RC/AL)
Application
Submit a completed application after qualification, the applicable fee, a current NPDB self-query, official education records, applicable license verification, and any additional eligibility documentation under 18VAC95-30-130 and the Board checklist. Former acting administrators may be asked for the most recent facility survey. Disciplinary and criminal-history questions require the Board-requested explanations and records.
Core Evidence
{"carrierClass":"implementation","checkedAt":"2026-09-30","locator":"Page 1, Transfer of exam scores","name":"Current Board-linked ALFA Application for Licensure Instructions, revised July 2020","quote":"TRANSFER OF EXAM SCORES – If you have taken and passed the National Residential Care/Assisted Living\n (RC/AL) and core exams administered by the National Association of Long Term Care Administrator Boards (NAB),\n please request that your scores be transferred by NAB to Virginia.","sourceFile":{"sha256":"4e0edcaed102e73148fbb50155f7b51b03db728ad6fd1532c626bd73b6a18a0b"},"url":"https://www.license.dhp.virginia.gov/apply/Forms/LTCA/ALFA_All_Instruct_Forms.pdf","version":"Revised July 2020 as stated on the file; linked by the current Board Applications and Forms page and consistent with March 2023 application and current examination FAQ."}
Discipline
No unremediated disciplinary violation in another jurisdiction, as determined by the Board; 18VAC95-30-120(B)(2).
Examination Applicability
The general endorsement examination requirement is retained. Expedited processing and experience waiver alone do not establish waiver of the named national examination.
National Examinations
The Board identifies both NAB Residential Care/Assisted Living (RC/AL) and CORE. Passing both is required or accepted under this route; a previously obtained passing score is still an examination requirement, with scores transferred by NAB. RC/AL references the supplied current 2022 Domains version. CORE is currently offered but absent from the frozen nationwide registration context and is recorded here as an applicant condition pending national registration.
Other Board Approved Examination
18VAC95-30-10 defines the national examination as administered by NAB or another examination approved by the Board. Any unnamed approved alternative is an applicant condition; it is not an invented examination leaf.
Qualification Alternative
Either active practice as ALFA in a facility providing assisted living care, or education and experience substantially equivalent to this chapter with written evidence; 18VAC95-30-120(B)(3). Active practice is at least 1,000 hours in the preceding 24 months under 18VAC95-30-10.
Qualifying Spouse
Hold the same or a similar professional license elsewhere; accompany a spouse on federal active-duty orders, or a veteran who left active duty within one year before application, to Virginia or an adjoining state or the District of Columbia. The Board must find substantial equivalency and a complete application, with no disqualifying disciplinary conduct; experience requirements may be waived under 54.1-119(A).
State Exam
The ALFA examination FAQ expressly states there is no state exam requirement.
Reactivation from inactive to active licensure
No examination is required for this applicant pathway.
Competency Hours
Provide required continuing competency hours for the inactive period, capped at three years.
Fee
Pay the difference between the current-year inactive and active renewal fees.
Prior Status
Hold an inactive ALFA license.

Official no-examination sources

Effective from 2026-09-22.

Reinstatement after lapse: active practice
No examination is required for this applicant pathway.
Application
Submit the Board reinstatement application, reinstatement fee, NPDB report and applicable primary-source license/work verification; reinstatement is discretionary.
Lapse
License not renewed within one year after initial expiration.
Qualifying Evidence
Provide evidence of active practice elsewhere in the United States or in the armed services while Virginia licensure was lapsed; 18VAC95-30-90(B)(2).

Official no-examination sources

Effective from 2026-09-22.

Reinstatement after revocation
NAB National Residential Care/Assisted Living Administrators Line of Service Exam (RC/AL)
Additional Credentials
Supply any other credentials prescribed by the Board under 18VAC95-30-90(D).
Core Evidence
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Hearing
Board investigation and hearing; applicant must prove safety and competence by clear and convincing evidence; affirmative vote of three-fourths of members at the hearing.
National Examinations
The Board identifies both NAB Residential Care/Assisted Living (RC/AL) and CORE. Passing both is required or accepted under this route; a previously obtained passing score is still an examination requirement, with scores transferred by NAB. RC/AL references the supplied current 2022 Domains version. CORE is currently offered but absent from the frozen nationwide registration context and is recorded here as an applicant condition pending national registration.
Original Requirements
54.1-2408.2 considers reinstatement in the same manner as original licensure; 18VAC95-30-100 and -110 identify the education/training and national examination. The Board may grant reinstatement without further examination; that applicant-specific discretion remains a condition.
Other Board Approved Examination
18VAC95-30-10 defines the national examination as administered by NAB or another examination approved by the Board. Any unnamed approved alternative is an applicant condition; it is not an invented examination leaf.
Waiting Period
At least three years after revocation for this profession; apply and pay the disciplinary reinstatement fee.
Reinstatement after lapse: continuing education
No examination is required for this applicant pathway.
Application
Submit the Board reinstatement application, reinstatement fee, NPDB report and applicable primary-source license/work verification; reinstatement is discretionary.
Lapse
License not renewed within one year after initial expiration.
Qualifying Evidence
Provide 20 hours of continuing education for each year since last renewal, capped at 60 hours; 18VAC95-30-90(B)(1).

Official no-examination sources

Effective from 2026-09-22.

Reinstatement after lapse through requalification
NAB National Residential Care/Assisted Living Administrators Line of Service Exam (RC/AL)
Application
Submit a completed application after qualification, the applicable fee, a current NPDB self-query, official education records, applicable license verification, and any additional eligibility documentation under 18VAC95-30-130 and the Board checklist. Former acting administrators may be asked for the most recent facility survey. Disciplinary and criminal-history questions require the Board-requested explanations and records.
Core Evidence
{"carrierClass":"implementation","checkedAt":"2026-09-30","locator":"Page 1, Transfer of exam scores","name":"Current Board-linked ALFA Application for Licensure Instructions, revised July 2020","quote":"TRANSFER OF EXAM SCORES – If you have taken and passed the National Residential Care/Assisted Living\n (RC/AL) and core exams administered by the National Association of Long Term Care Administrator Boards (NAB),\n please request that your scores be transferred by NAB to Virginia.","sourceFile":{"sha256":"4e0edcaed102e73148fbb50155f7b51b03db728ad6fd1532c626bd73b6a18a0b"},"url":"https://www.license.dhp.virginia.gov/apply/Forms/LTCA/ALFA_All_Instruct_Forms.pdf","version":"Revised July 2020 as stated on the file; linked by the current Board Applications and Forms page and consistent with March 2023 application and current examination FAQ."}
Lapse
License not renewed within one year after initial expiration; apply on the reinstatement form and pay the fee.
National Examinations
The Board identifies both NAB Residential Care/Assisted Living (RC/AL) and CORE. Passing both is required or accepted under this route; a previously obtained passing score is still an examination requirement, with scores transferred by NAB. RC/AL references the supplied current 2022 Domains version. CORE is currently offered but absent from the frozen nationwide registration context and is recorded here as an applicant condition pending national registration.
Other Board Approved Examination
18VAC95-30-10 defines the national examination as administered by NAB or another examination approved by the Board. Any unnamed approved alternative is an applicant condition; it is not an invented examination leaf.
Requalification
Meet current educational/training requirements under 18VAC95-30-100 and national examination requirement under 18VAC95-30-110; this is one of the three alternative qualification pathways in 18VAC95-30-90(B).
Annual active license renewal
No examination is required for this applicant pathway.
Continuing Education
20 approved hours each year, including at least two on mental/cognitive impairment care; no more than ten internet/self-study hours; up to ten excess hours carry forward. First renewal after initial Virginia licensure is exempt. Preceptor-training credit, documented volunteer credit, record retention, audit duties and Board-granted extension/exemption apply as stated in 18VAC95-30-70.
Deadline
Renew by March 31 with the renewal form and applicable fee; an unrenewed license is invalid.
Deployment Extension
54.1-117 extends expiration during qualifying overseas armed-services/diplomatic service and 60 days thereafter, at most five years; accompanying military spouses are included. This is a renewal condition rather than a separate exam route.

Official no-examination sources

Effective from 2026-09-22.

SCRA recognition of a covered license
No examination is required for this applicant pathway.
Application
Submit military orders, spouse's marriage certificate where applicable, and notarized identity/truthfulness/requirements/scope/good-standing affidavit under 50 USC 4025a(c).
Compact Exception
An applicable interstate compact takes precedence under subsection (e); this route applies to a covered noncompact license.
Conditions Of Practice
Certify understanding of and compliance with Virginia licensing and scope requirements; Board may perform a background check. The Board military-services page identifies this portability application pathway. Existing covered-license evidence is an applicant condition; the portability statute enumerates no named licensing examination.
Covered License
A professional license in good standing, never revoked or disciplined, with no pending unprofessional-conduct investigation and no surrender during such investigation.
Military Relocation
A servicemember or spouse relocates residence under military orders from the licensing jurisdiction to Virginia.
Renewal
Virginia licensure and continuing-practice rules govern ongoing practice, rather than creating an additional examination leaf.

Official no-examination sources

Effective from 2026-09-22.

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