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Rhode Island Nursing Home Administrator — Requirements & Free Practice

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Nursing Home Administrator's License

License to administer a Rhode Island nursing home.

Licensing authority: Rhode Island Department of Health · Application information

Licensure by examination
NAB National Nursing Home Administrators Line of Service Exam (NHA)
Age
At least 18 years old.
Character
Two good-moral-character letters and a criminal-background check.
Education
Bachelor's degree in health care administration, or bachelor's degree plus 15 credit hours covering the five areas in § 32.3.2(A)(1).
Score
The October 2024 Department application states a minimum passing score of 113.
Sequence
Complete all other licensure requirements before sitting for the written exam.
Training
350 hours of administrator-in-training field experience within 12 months in a licensed nursing facility.
Endorsement with ACHCA certification
No examination is required for this applicant pathway.
Certification
Current ACHCA certification in good standing.
Continuing education
40 hours in the two years before application.
Existing license
Current nursing home administrator license in good standing in another jurisdiction; Rhode Island must find substantially equivalent standards.
Verification
All licensing jurisdictions must verify good standing and absence of specified adverse facility findings in the past three years.

Official no-examination sources

Effective from 2026-09-22.

Endorsement based on bachelor's degree and experience
NAB National Nursing Home Administrators Line of Service Exam (NHA)
Application difference
The Department application's By Endorsement checklist does not list an exam; § 32.3.4(B)(1)(d)(3)(CC) expressly requires prior success on the national exam.
Continuing education
40 hours in the two years before application.
Education
Bachelor's degree.
Exam history
Successful completion of the national examination under § 32.3.4(A)(1)(a); endorsement does not require sitting again.
Existing license
Current nursing home administrator license in good standing in another jurisdiction; Rhode Island must find substantially equivalent standards.
Experience
At least three years within the past five as a licensed nursing home administrator, or in management directly overseeing three or more licensed administrators.
Verification
All licensing jurisdictions must verify good standing and absence of specified adverse facility findings in the past three years.
Endorsement based on Rhode Island qualifications
NAB National Nursing Home Administrators Line of Service Exam (NHA)
Application difference
The Department application's By Endorsement checklist does not list an exam, while § 32.3.4(B)(1)(d)(1) refers to all § 32.3.2 qualifications; checklist: 'By Endorsement:'
Continuing education
40 hours in the two years before application.
Education and training
Meet the Rhode Island qualifications in § 32.3.2, including degree and field experience.
Exam history
This branch references § 32.3.2, which includes completion of the licensing examination; endorsement does not require sitting for a new examination.
Existing license
Current nursing home administrator license in good standing in another jurisdiction; Rhode Island must find substantially equivalent standards.
Verification
All licensing jurisdictions must verify good standing and absence of specified adverse facility findings in the past three years.
Reinstatement after lapse
No examination is required for this applicant pathway.
Application
Submit reinstatement application and current renewal fee.
Continuing education
Complete required continuing education during the immediately preceding two years.
Eligibility
License lapsed from failure to renew and has not been suspended or revoked.

Official no-examination sources

Effective from 2026-09-22.

Biennial renewal
No examination is required for this applicant pathway.
Application
Submit renewal application by June 1 with renewal fee.
Continuing education
40 hours in the preceding two years, subject to prorating for a shorter initial licensure period.
Discipline
Renewal is subject to grounds for suspension or revocation.

Official no-examination sources

Effective from 2026-09-22.

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