Delaware Nursing Home Administrator — Requirements & Free Practice
US-DE · License preparation
602 free questions · Answer explanations · No signup required
Choose what to practice
Start with an exam below. Your examination requirements depend on your application pathway. View licensing requirements
Combined practice
Loading selected examination banks…
Licenses, application pathways and examination requirements
Each license and applicant pathway has its own requirements and exemptions. Choosing practice questions does not determine your eligibility.
Nursing Home Administrator
Licensing authority: Delaware Board of Examiners of Nursing Home Administrators · Application information
Licensure after administrator in training
- Background
- State and FBI criminal-history checks; Board reviews disqualifying administrative, impairment and competency history.
- Education
- A Board-approved course of study and qualifying degree or current Delaware RN license.
- Exam approval
- Board approval before taking the NAB examination.
- Exam score
- At least 75 percent within two years of Board approval and no more than four attempts.
- Training
- Board registration and a preapproved six-, nine-, or twelve-month AIT program under an approved preceptor, according to education.
Placement of active license in inactive status
- Practice
- Do not practice while inactive.
- Request
- Written request and Board approval while the license remains eligible; inactive status lasts up to three years.
Official no-examination sources
Effective from 2026-09-22.
- Delaware Code, Title 24, Chapter 52, Subchapter II
§5215(d) inactive
- Delaware Administrative Code, Title 24, Rule 5200
Rule 7.5.1
Late renewal within one year of expiration
- Continuing education
- Submit evidence of required prior-biennium continuing education.
- Fees
- Renewal fee plus late fee.
- Timing
- Apply within one year following expiration; do not practice until active.
Official no-examination sources
Effective from 2026-09-22.
- Delaware Administrative Code, Title 24, Rule 5200
Rule 7.4.1
- Nursing Home Administrator License Renewal
Renewing an Expired License
Reactivation from inactive status
- Continuing education
- Twenty-four CE units for each annual period of inactive status, all completed within twelve months before the request.
- Request
- Written request during the three-year inactive period and prorated renewal fee.
Official no-examination sources
Effective from 2026-09-22.
- Delaware Code, Title 24, Chapter 52, Subchapter II
§5215(d) reentry
- Delaware Administrative Code, Title 24, Rule 5200
Rule 7.5.2
Licensure by reciprocity
- Background
- State and FBI criminal-history checks and Board review of criminal, administrative, impairment and competency history.
- Exam alternative
- The statute accepts a comparable alternative national examination, or a regional examination if no national examination was available at original licensure; historical or otherwise unidentified scores are applicant conditions.
- Prior license
- Current good-standing NHA license in another U.S. jurisdiction.
- Score transfer
- The Board application page asks all applicants, including reciprocity applicants, for NAB score verification or transfer.
- Similarity or practice
- Substantially similar licensure standards, or Board discretion after at least three years of licensed NHA practice in a jurisdiction with different standards.
Reinstatement after more than one year expired
- Application
- Complete a new applicant application; a resume may replace occupational and administrative history sections under Rule 7.4.2.
- Board page ce
- The Board page asks for 48 hours of continuing education in the preceding two years.
- Board page scores
- The Board reapplication page directs applicants to the all-applicant requirements, including NAB score transfer; Rule 7.4.2 expressly permits reinstatement without examination.
- Current qualifications
- Satisfy the Board as to current qualifications and provide the continuing education required by Rule 7.4.1.
Official no-examination sources
Effective from 2026-09-22.
- Delaware Administrative Code, Title 24, Rule 5200
Rule 7.4.2
- Nursing Home Administrator Licensure
Requirements for Reapplying
Biennial renewal of active license
- Background
- Criminal-history background checks under 24 Del. C. §5208.
- Continuing education
- Attest to required continuing education under Rule 5200 section 5, generally 48 hours per biennium with proration for new licenses.
- Renewal
- Submit biennial renewal form and fee.
Official no-examination sources
Effective from 2026-09-22.
NAB National Core Knowledge Exam for Long-Term Care Administrators (CORE)
- Provider
- Pearson VUE
- Format
- Objective multiple-choice items with four response options, one correct; delivered by Pearson VUE
- Exam questions
- 125 (100 scored, 25 non-scored pretest)
- Time limit
- 150 minutes seat time; 2 hours 10 minutes to answer questions
- Passing score
- Scaled score of 113 on a 50-150 scale
- Exam fee
- CORE only $320; CORE and NHA combo $480 (effective 2/1/2026)
Examination outline
Care, Services, and Supports (39%)
- Quality of Care: Medical and Nursing Care Practices
- Quality of Care: Medication Management and Administration
- Quality of Care: Disease Management (e.g., acute vs. chronic conditions)
- Quality of Care: Nutrition and Hydration (e.g., specialized diets)
- Quality of Care: Activities of Daily Living (ADLs) and Independent Activities of Daily Living (IADLs)
- Quality of Care: Rehabilitation and Restorative Programs
- Quality of Care: Care Recipient Assessment and Interdisciplinary Care Planning
- Quality of Care: Clinical and Medical Records and Documentation Requirements (e.g., storage, retention, destruction)
- Quality of Care: Medical Director
- Quality of Care: Emergency Medical Services (e.g., CPR, first aid, Heimlich maneuver, AED)
- Quality of Care: Transition of Care (e.g., admission, move-in, transfer, discharge, and move-out)
- Quality of Care: Basic Healthcare Terminology
- Quality of Life: Psychosocial Needs (e.g., social, spiritual, community, cultural)
- Quality of Life: Person-Centered Care and Comprehensive Care Planning
- Quality of Life: Care Recipient Bill of Rights and Responsibilities
- Quality of Life: Care Recipient Safety (e.g., fall prevention, elopement prevention, adverse events)
- Quality of Life: Care Recipient (and Representative) Grievance, Conflict, and Dispute Resolution
- Quality of Life: Care Recipient Advocacy (e.g., Ombudsman, resident and family council)
- Quality of Life: Care Recipient Decision-Making (e.g., capacity, power of attorney, guardianship, conservatorship, code status, advance directives, ethical decision-making)
- Quality of Life: Care Recipient (and Representative) Satisfaction
- Quality of Life: Recognition of Maltreatment (e.g., abuse, neglect, exploitation)
- Quality of Life: Mental and Behavioral Health (e.g., cognitive impairment, depression, social support systems)
- Quality of Life: Trauma-Informed Care (e.g., PTSD)
- Quality of Life: Pain Management
- Quality of Life: Death, Dying, and Grief
- Quality of Life: Restraint Usage and Reduction
- Quality of Life: Foodservice (e.g., choice and menu planning, dietary management, food storage and handling, dining services)
- Quality of Life: Social Services Programs
- Quality of Life: Therapeutic Recreation and Activity Programs
- Quality of Life: Community Resources, Programs, and Agencies (e.g., meals on wheels, housing vouchers, Area Agencies on Aging, Veterans Affairs)
- Ancillary Services: Hospice and Palliative Care
- Ancillary Services: Specialized Medical Equipment (e.g., oxygen, durable medical equipment)
- Ancillary Services: Transportation for Care Recipients
- Ancillary Services: Telemedicine (e.g., e-health)
- Ancillary Services: Diagnostic Services (e.g., radiology, lab services)
- Ancillary Services: Dental and Oral Care Services
- Ancillary Services: Healthcare Partners and Clinical Providers (e.g., MD/DO, Nurse Practitioner, Psychiatrist, Podiatrist, Dentist)
- Ancillary Services: Volunteer Programs
Operations (37%)
- Financial Management: Budgeting and Forecasting
- Financial Management: Financial Analysis (e.g., ratios, profitability, debt, revenue mix, depreciation, operating margin, cash flow)
- Financial Management: Revenue Cycle Management (e.g., billing, accounts receivable, accounts payable, collections)
- Financial Management: Financial Statements (e.g., income/revenue statement, balance sheet, statement of cash flows, cost reporting)
- Financial Management: Revenue and Reimbursement (e.g., PDPM, PDGM, ACOs, HMOs, Medicaid, private payors)
- Financial Management: Financial Reporting Requirements (e.g., requirements for not-for-profit, for-profit, and governmental providers)
- Financial Management: Integration of Clinical and Financial Systems (e.g., EMR/HER, MDS)
- Financial Management: Internal Financial Management Controls (e.g., segregation of duties, access)
- Financial Management: Supply-Chain Management (e.g., inventory control)
- Financial Management: Resident Trust Accounts for Personal Funds
- Risk Management: OSHA Rules and Regulations
- Risk Management: Workers’ Compensation
- Risk Management: Ethical Conduct and Standards of Practice
- Risk Management: Compliance Programs
- Risk Management: Risk Management Process and Programs
- Risk Management: Quality Improvement Processes (e.g., root cause analysis, PDCA/PDSA)
- Risk Management: Scope of Practice and Legal Liability
- Risk Management: Internal Investigation Protocols and Techniques (e.g., incidents, adverse events)
- Risk Management: Mandatory Reporting Requirements (e.g., incidents, adverse events, abuse, neglect, financial exploitation, fraud)
- Risk Management: Insurance Coverage (e.g., liability, property)
- Risk Management: Healthcare Record Requirements (e.g., confidentiality, disclosure, safeguarding, HIPAA, HITECH)
- Risk Management: Security (e.g., cameras, monitoring systems, locks, staff location reporting)
- Risk Management: Contracted Services (e.g., roles, responsibilities, oversight, background checks)
- Human Resources: Federal Human Resources Laws, Rules, and Regulations (e.g., ADA, FMLA, Wage and Hour, FLSA)
- Human Resources: Selection and Hiring Practices (e.g., EEOC, interviewing, adverse impact, protected classes, occupational qualifications)
- Human Resources: Compensation and Benefits Programs (e.g., time off, healthcare insurance, employee pay and payroll)
- Human Resources: Organizational Staffing Requirements and Reporting (e.g., PBJ)
- Human Resources: Staff Certification and Licensure Requirements
- Human Resources: Professional Development (e.g., maintenance of credentials, continuing education)
- Human Resources: Employee Training and Orientation
- Human Resources: Performance Evaluation
- Human Resources: Human Resource Policies (e.g., drug-free workplace, discipline, job classification, photography and video, social media usage, mobile phone usage)
- Human Resources: Employee Record-Keeping Requirements
- Human Resources: Employee Grievance, Conflict, and Dispute Resolution
- Human Resources: Employee Satisfaction, Engagement, and Retention
- Human Resources: Cultural Competence and Diversity Awareness
- Human Resources: Labor Relations (e.g., union, collective bargaining [CBA], contract/pool staff)
Environment and Quality (13%)
- Care Setting: Federal Codes and Regulations for Building, Equipment, Maintenance, and Grounds
- Care Setting: Person-Centered Environment (e.g., home-like environment)
- Care Setting: Safety and Accessibility (e.g., ADA, safety data sheets)
- Care Setting: Facility Management and Environmental Services
- Care Setting: Information Systems Infrastructure (e.g., configurations, data security, technical controls)
- Care Setting: Preventative and Routine Maintenance Programs (e.g., pest control, equipment, mechanical systems)
- Care Setting: Infection Control and Sanitation (e.g., linens, kitchen, hand washing, healthcare-acquired infections, hazardous materials)
- Care Setting: Disaster and Emergency Planning, Preparedness, Response, and Recovery (e.g., Appendix Z)
- Regulatory Compliance: Federal Healthcare Laws, Rules, and Regulations
- Regulatory Compliance: Government Programs and Entities (e.g., Medicare, Medicaid, waivers)
- Regulatory Compliance: Certification and Licensure Requirements for the Organization
Leadership and Strategy (11%)
- Leadership: Organizational Structures (e.g., departments, functions, systemic processes)
- Leadership: Organizational Change Management
- Leadership: Organizational Behavior (e.g., organizational culture, team building, group dynamics)
- Leadership: Leadership Principles (e.g., communication, styles, mentoring, coaching, personal professional development)
- Leadership: Governance (e.g., board of directors, governing bodies, corporate entities, advisory boards)
- Leadership: Professional Advocacy and Governmental Relations
- Organizational Strategy: Mission, Vision, and Value Statements
- Organizational Strategy: Strategic Business Planning (e.g., new lines of service, succession management, staffing pipeline)
- Organizational Strategy: Business Analytics (e.g., evidence-based practice, data analytics)
- Organizational Strategy: Business Development (e.g., sales, marketing, partnerships, ACOs, contracts and agreements, negotiations)
- Organizational Strategy: Public Relations and External Stakeholders (e.g., hospitals, referrals sources, local community, donors)
Examination sources
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.16 NAB examination specifications table, heading
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.16 specifications table, Domain 1 row
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.16 specifications table, Domain 2 row
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.16 specifications table, Domain 3 row
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.16 specifications table, Domain 4 row
- NAB CORE Domains of Practice (2022)
p.1 title
- NAB CORE Domains of Practice (2022)
page footer
- NAB CORE Domains of Practice (2022)
p.1 item 1A1
- NAB CORE Domains of Practice (2022)
p.4 item 4B5
- NAB Domains of Practice page
Domains of Practice page, 2022 vs. 2026 table, 2022 column heading
- NAB Domains of Practice page
Domains of Practice page, current domains download paragraph
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.17 Exam question types
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.17 Answering exam questions
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.18 Score reporting, scaled score paragraph
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.17 Answering exam questions, pretest paragraph
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.8 Exam structure, CORE paragraph
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.6 CORE description, timing
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.11 Exam fees, first paragraph
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.8 Exam structure, readmission sentence
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.8 Exam structure, consecutive scheduling paragraph
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.17 Answering exam questions, combo exam note
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.11 National exam fees table, CORE only row
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.11 National exam fees table, CORE and NHA row
- NAB Exam Information page
Exam Information, February 2026 fee notice
NAB National Nursing Home Administrators Line of Service Exam (NHA)
- Provider
- Pearson VUE
- Format
- Objective multiple-choice items with four response options, one correct; delivered by Pearson VUE
- Exam questions
- 75 (60 scored, 15 non-scored pretest)
- Time limit
- 90 minutes seat time; 1 hour and 10 minutes to answer questions
- Passing score
- Scaled score of 113 on a 50-150 scale
- Exam fee
- NHA only $190; CORE and NHA combo $480 (effective 2/1/2026)
Examination outline
Care, Services, and Supports (45%)
- Quality of Care: Medical and Nursing Care Practices
- Quality of Care: Medication Management and Administration
- Quality of Care: Nutrition and Hydration (e.g., specialized diets)
- Quality of Care: Rehabilitation and Restorative Programs
- Quality of Care: Care Recipient Assessment and Interdisciplinary Care Planning
- Quality of Care: Clinical and Medical Records and Documentation Requirements (e.g., storage, retention, destruction)
- Quality of Care: Medical Director
- Quality of Care: Emergency Medical Services (e.g., CPR, first aid, Heimlich maneuver, AED)
- Quality of Care: Transition of Care (e.g., admission, move-in, transfer, discharge, and move-out)
- Quality of Life: Psychosocial Needs (e.g., social, spiritual, community, cultural)
- Quality of Life: Person-Centered Care and Comprehensive Care Planning
- Quality of Life: Care Recipient Bill of Rights and Responsibilities
- Quality of Life: Care Recipient Safety (e.g., fall prevention, elopement prevention, adverse events)
- Quality of Life: Care Recipient (and Representative) Grievance, Conflict, and Dispute Resolution
- Quality of Life: Care Recipient Advocacy (e.g., Ombudsman, resident and family council)
- Quality of Life: Care Recipient Decision-Making (e.g., capacity, power of attorney, guardianship, conservatorship, code status, advance directives, ethical decision-making)
- Quality of Life: Recognition of Maltreatment (e.g., abuse, neglect, exploitation)
- Quality of Life: Mental and Behavioral Health (e.g., cognitive impairment, depression, social support systems)
- Quality of Life: Trauma-Informed Care (e.g., PTSD)
- Quality of Life: Pain Management
- Quality of Life: Death, Dying, and Grief
- Quality of Life: Restraint Usage and Reduction
- Quality of Life: Foodservice (e.g., choice and menu planning, dietary management, food storage and handling, dining services)
- Quality of Life: Social Services Programs
- Quality of Life: Therapeutic Recreation and Activity Programs
- Ancillary Services: Hospice and Palliative Care
- Ancillary Services: Transportation for Care Recipients
- Ancillary Services: Diagnostic Services (e.g., radiology, lab services)
- Ancillary Services: Dental and Oral Care Services
- Ancillary Services: Healthcare Partners and Clinical Providers (e.g., MD/DO, Nurse Practitioner, Psychiatrist, Podiatrist, Dentist)
- Ancillary Services: Volunteer Programs
Operations (28%)
- Financial Management: Revenue and Reimbursement (e.g., PDPM, PDGM, ACOs, HMOs, Medicaid, private payors)
- Financial Management: Financial Reporting Requirements (e.g., requirements for not-for-profit, for-profit, and governmental providers)
- Financial Management: Integration of Clinical and Financial Systems (e.g., EMR/EHR, MDS)
- Financial Management: Resident Trust Accounts for Personal Funds
- Risk Management: OSHA Rules and Regulations
- Risk Management: Compliance Programs
- Risk Management: Scope of Practice and Legal Liability
- Risk Management: Internal Investigation Protocols and Techniques (e.g., incidents, adverse events)
- Risk Management: Mandatory Reporting Requirements (e.g., incidents, adverse events, abuse, neglect, financial exploitation, fraud)
- Risk Management: Healthcare Record Requirements (e.g., confidentiality, disclosure, safeguarding, HIPAA, HITECH)
- Risk Management: Security (e.g., cameras, monitoring systems, locks, staff location reporting)
- Risk Management: Contracted Services (e.g., roles, responsibilities, oversight, background checks)
- Human Resources: Organizational Staffing Requirements and Reporting (e.g., PBJ)
- Human Resources: Staff Certification and Licensure Requirements
- Human Resources: Professional Development (e.g., maintenance of credentials, continuing education)
- Human Resources: Employee Training and Orientation
- Human Resources: Performance Evaluation
- Human Resources: Employee Record-Keeping Requirements
- Human Resources: Cultural Competence and Diversity Awareness
Environment and Quality (27%)
- Care Setting: Federal Codes and Regulations for Building, Equipment, Maintenance, and Grounds
- Care Setting: Person-Centered Environment (e.g., home-like environment)
- Care Setting: Safety and Accessibility (e.g., ADA, safety data sheets)
- Care Setting: Facility Management and Environmental Services
- Care Setting: Preventative and Routine Maintenance Programs (e.g., pest control, equipment, mechanical systems)
- Care Setting: Infection Control and Sanitation (e.g., linens, kitchen, hand washing, healthcare-acquired infections, hazardous materials)
- Care Setting: Disaster and Emergency Planning, Preparedness, Response, and Recovery (e.g., Appendix Z)
- Regulatory Compliance: Federal Healthcare Laws, Rules, and Regulations
- Regulatory Compliance: Government Programs and Entities (e.g., Medicare, Medicaid, waivers)
- Regulatory Compliance: Certification and Licensure Requirements for the Organization
- Regulatory Compliance: Regulatory Survey and Inspection Process
- Regulatory Compliance: Procedures for Informal Dispute Resolution (IDR)
- Regulatory Compliance: Centers for Medicare and Medicaid Services (CMS) Quality Measures
- Regulatory Compliance: Quality Assurance and Performance Improvement (QAPI)
- Regulatory Compliance: Bed-Hold Requirements
- Regulatory Compliance: Pre-Admission Screening Annual Review (PASRR)
- Regulatory Compliance: Facility Assessment
Examination sources
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.16 NAB examination specifications table, heading
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.16 specifications table, Domain 1 row
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.16 specifications table, Domain 2 row
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.16 specifications table, Domain 3 row
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.16 specifications table, Domain 4 row
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.16 specifications table, note
- NAB Nursing Home Administrator (NHA) Domains of Practice (2022)
p.1 title
- NAB Nursing Home Administrator (NHA) Domains of Practice (2022)
page footer
- NAB Nursing Home Administrator (NHA) Domains of Practice (2022)
p.1 item 1A1
- NAB Nursing Home Administrator (NHA) Domains of Practice (2022)
p.3 item 3B10
- NAB Domains of Practice page
Domains of Practice page, 2022 vs. 2026 table, 2022 column heading
- NAB Domains of Practice page
Domains of Practice page, current domains download paragraph
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.17 Exam question types
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.17 Answering exam questions
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.18 Score reporting, scaled score paragraph
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.17 Answering exam questions, pretest paragraph
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.8 Exam structure, multiple-choice paragraph
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.6 NHA description, question count
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.6 NHA description, timing
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.11 Exam fees, first paragraph
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.8 Exam structure, readmission sentence
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.8 Exam structure, consecutive scheduling paragraph
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.17 Answering exam questions, combo exam note
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.11 National exam fees table, NHA only row
- NAB Candidate Handbook (Pearson VUE publication #619900)
p.11 National exam fees table, CORE and NHA row
- NAB Exam Information page
Exam Information, February 2026 fee notice