Oklahoma Nursing Home Administrator — Requirements & Free Practice
US-OK · License preparation
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Licenses, application pathways and examination requirements
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Provisional Long-Term Care Administrator License
Temporary authority to fill an unexpected administrator vacancy.
Licensing authority: Oklahoma State Department of Health · Application information
Provisional licensure for unexpected vacancy
- Consultant
- Experienced Oklahoma administrator of the same facility type acts as on-site consultant.
- Current AIT
- A current administrator-in-training must previously have passed the NAB NHA exam.
- Education
- Baccalaureate degree and formal study.
- Experience
- At least two years in a long-term-care facility.
- National Deferral
- Other NAB exams need not be passed before provisional issuance.
- Vacancy
- Single unexpected facility vacancy; one provisional term of at most six months.
Tier 1 Long-Term Care Administrator
License for administrators serving skilled nursing or nursing facilities or intermediate care facilities for individuals with intellectual disabilities with seventeen or greater beds; Tier 1 licensees may administer all long-term care facility types.
Licensing authority: Oklahoma State Department of Health · Application information
Licensure by endorsement or reciprocity
- Documentation
- Formal study, other licenses, discipline disclosures, and attestation.
- Experience
- Two consecutive years full-time administrator-of-record service or two of the last three years as a licensed administrator of the specific type.
- National Scores
- Evidence of prior applicable NAB passing scores may excuse retaking before issuance.
- Other License
- Current out-of-state administrator license with substantially equivalent requirements.
- Time Window
- One year to complete remaining reciprocity requirements.
Initial licensure with HSE qualification
- Application
- Correctly completed application and fee.
- Background
- Favorable background check.
- Hse
- Verified NAB Health Services Executive qualification.
Initial licensure by examination
- Degree
- Baccalaureate degree, or relevant associate degree plus five years of upper-level long-term-care management.
- Internship
- Required internship unless waived.
- Prior Oklahoma License
- A prior good-standing Tier 1 license with two of the last five years active in long-term care may support a training or internship waiver.
- Time Window
- Requirements completed within 24 months of initial application.
- Training
- Department-approved training unless waived.
Military spouse expedited reciprocity
- Military Spouse
- Qualifying out-of-state license and active-duty spouse transferred to Oklahoma under 59 O.S. §4100.5.
- Temporary Permit
- The Department may authorize a temporary permit while unmet Oklahoma requirements are completed.
Annual license renewal
- Renewal
- Contact information, practice location, applicable preceptor information, lawful-presence affidavit, fee, and continuing education.
Universal licensing recognition
- Discipline
- Other-state license good standing and complaint or discipline conditions under 59 O.S. §4150.1.
- Equivalent Exam
- Substantially similar examination from another state may satisfy the Oklahoma examination requirement as determined by the Department.
- Recognition
- Applicant moving to and residing in Oklahoma with qualifying out-of-state license and experience under 59 O.S. §4150.1.
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
Nursing Home Administrator
- Provider
- Oklahoma CareerTech Testing Center
- Passing score
- 75% or greater
Practice scope
Inferred from the examination name; the authority has not published an examination outline.
- Long-Term Care Administrator Licensing Act
- Long-Term Care Administrators
- Program for utilization of unused prescription drugs
- Barbara E. Hoover Act
- Nurse Aide Training and Certification
- Alzheimer's Disease Special Care Disclosure Act
- Alzheimer's Disease Special Care Disclosure Rules
- Nursing Home Care Act
- Nursing and Specialized Facilities
Examination sources
- ok-state-study-guide-2024.pdf
Study guide contents and Tier 1 assignment
- oac-310-679-2025.pdf
OAC 310:679-10-13(a)
- oac-310-679-2025.pdf
OAC 310:679-10-13(d)
- careertech-ltca.html
CareerTech assessment list
- oac-310-679-2025.pdf
OAC 310:679-10-13(c)
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