- General information
RCW 18.52.030 states that, “Nursing homes that operate in Washington State must be under the active, overall administrative charge and supervision of a licensed on-site full-time administrator.”
RCW 18.52.071 states that, “Applicants for licensure must have a baccalaureate degree from a recognized institution of higher learning, meet practical experience requirements and successfully complete an examination.
All applicants must pass the nursing home administrator national examination administered by the National Association of Long Term Care Administrator Boards (NAB).
Applicants must also complete an administrator-in-training (AIT) program approved by the Board before beginning the program. If an applicant is licensed in another state that has substantially equivalent requirements, the applicant may apply for licensure through endorsement. If an applicant is not eligible for endorsement, the applicant may qualify for licensure under an exemption to training.
License Requirement Checklist for Online Applicants
AIT Process Overview
- General Information
The AIT process is the route to licensure as a nursing home administrator in Washington State. Most applicants must complete a Washington State AIT program. Applicants who are licensed as an administrator in another state with requirements substantially equivalent to Washington State do not require an AIT. A list of states that have been found to be substantially equivalent is in the application packet. Other exemptions to the AIT program are in WAC 246-843-093.
Application for an AIT program requires you to submit proof that you have a bachelor's degree, complete a 1,500-hour (nine-month) AIT program, and successfully complete the nursing home administrator examination administered by the National Association of Long-term Care Administrators Boards (NAB.) The following steps below can help you through this process.
- Step 1: Find a preceptor
Find a nursing home administrator who is willing to be your preceptor or a company that offers an AIT program
An applicant for licensure needs to first work out an agreement with the preceptor, company or nursing home regarding the AIT program.
A preceptor is a skilled practitioner who gives personal instruction, training and supervision in the nursing home setting. This allows the AIT to gain practical experience. Your preceptor must meet the following requirements:
- The preceptor shall be employed as a licensed nursing home administrator for a total of at least three years.
- The preceptor shall be employed full time as the nursing home administrator in the facility where the AIT is trained.
- The preceptor shall have an unrestricted license.
See WAC 246-843-095 for criteria and duties of the preceptor.
The Department of Health does not have a list of preceptors. AIT programs must take place in a Washington state-licensed nursing home. You may want to contact nursing homes and ask about an AIT program. You could also contact one of the two associations that represent nursing home administrators. They are LeadingAge Washington and Washington Health Care Association.
- Step 2: Complete and submit the application for nursing home AIT with the required fee
WAC 246-843-091 allows for a reduced hours program based on previous experience. You should submit a request for the reduced hours if you meet the requirements. The request should include an outline of the experiences that meet the requirements. You should also submit the job description(s) that qualify you for the reduced hour program.
See below for what you should expect from the Department of Health (DOH) once you submit your application and during your AIT program:
- DOH will send you a letter stating that you qualify for an AIT program. The letter will inform you of the length of your AIT program. You will receive a “Proposed AIT Program” form with the letter. You will need to complete and return this form to DOH. Your program must comply with WAC 246-843-090.
- You will want to develop your program before submitting the “Proposed AIT Program.” Please see the next “drop down” box titled, “Develop a Training Plan” for more information.
- DOH will send you a letter stating that your AIT program has been approved. The letter will tell you the beginning and ending date for your program. It will also inform you of the dates reports are due.
DOH will set up a site visit for you near the end of your AIT program. A board member will visit you and your preceptor at the facility where your AIT program took place. The department works to schedule the site visit to take place within a week or two of the program completion date. The board member will ask about the nature of departmental rotations, assignments and responsibilities assumed, effect of the AIT project, and overall lessons learned through the AIT experience. Once the site visit is completed, the board member will notify DOH that your site visit is complete and that you are ready for examination.
- Step 3: Develop a training plan and resources for training plan development
You and your preceptor will work together to come up with a training plan unique to you based on your education, training, and experience. WAC 246-843-090 specifies the components that need to be included in the AIR prospectus.
The Board also supports using the National AIT Program Manual on the National Association of Long-Term Care Administrators Board (NAB) website. NAB does not charge a fee to use this resource. In addition, the NAB Career Development toolkit at that website may also be helpful.
While the Board does not require that your preceptor complete training, the Board does support the use of the Online Preceptor Four Part Module Course, also at the same website. Your preceptor can earn 1.25 NAB-approved continuing education credits for each module completed.
You will find the National AIT Program Manual and the Online Preceptor Course at the NAB AIT/Preceptor Training website.
- Step 4: Apply to NAB to take the national examination
- Once your AIT site visit is complete, you will receive notice that you are approved to take the National Association of Long-Term Care Administrators Board (NAB) examination.
- You can apply directly to NAB here.
- NAB verifies with the Department of Health that you are approved to take the examination. NAB then notifies you that you are approved to take the examination and gives you information regarding testing sites. You will contact a testing center to set the date and time of the examination.
- At the examination center, you will receive notice of a passing or failing grade. The Department of Health does not receive notice at the same time.
Once the department has received notice of your scores, it will take appropriate action. If your application has everything required and no further action is necessary, the department will issue your license.
Acknowledgement of receipt of your application You will receive a letter that includes information indicating what documentation is still needed to process your credential. 10 days Receive an answer to a request for a reduced program
This is the number of days from the date of request or the date documentation to support the request was received. This is the time it takes for the Department of Health to consult with board member(s) to determine if you qualify for an AIT reduction. During the review process, the reviewers may find that you didn't provide enough documentation for the review. If so, you'll receive a letter requesting more information by the end of this time-frame.
14-21 days Approval of AIT program This is the number of days once all required documentation has been received. If all documentation hasn't been received, you'll receive periodic letters asking for that documentation. The 14-day time frame doesn't begin until the last piece of documentation required is received. If you're asking for a reduced hour program and a decision regarding that is the last piece of documentation required, the 14 days will begin once our credentialing unit has received the decision from the board member(s). 14 days Site Visit
This is the number of days from the completion of your AIT program. Department of Health contacts you about two weeks before the end of your program to set this date.
14 days Approval to take the examination
This relates to the amount of time it will take for you to receive a letter from the Department of Health indicating that you are approved to take the examination. You must apply directly to NAB to take the examination.
7 days Licensure This begins when the Department of Health receives your test scores. 14-21 days
- Helpful hints
- Check your email, including your spam mail, for acknowledgement letters.The Department of Health uses email when available. Sometimes our letters end up in spam, depending on how your spam is set up.
- The preceptor and the AIT applicant should develop the learning plan together.
- Preceptors and AITs should have regular mentoring sessions.
- AIT support meetings
The board of nursing home administrators is offering a quarterly support meeting for administrators-in-training (AIT). These meetings are designed to help AIT’s to learn from each other. Board members will facilitate the meeting and answer questions. AIT’s should feel free to attend more than one meeting.
Meetings will take place through Microsoft Teams on the second Wednesday of February, May, August, and November at 11:30 a.m.
The dates for 2024 are as follows:
Date Time February 14, 2024 11:30 a.m. May 8, 2024 11:30 a.m. August 14, 2024 11:30 a.m. November 13, 2024 11:30 a.m.
No registration necessary. If you have questions, send a request to email@example.com.
Endorsement Process Overview
- General information
Nursing home administrators licensed in states that have requirements substantially equivalent to Washington may apply for licensure through endorsement. The license must be active and in good standing.
The licensing application packet (PDF) has a list of states found to be substantially equivalent. If you're not licensed in one of these states, you may not apply through endorsement. But you may still qualify for licensure through exemption to training. You're exempt if you're a licensed nursing home administrator who has worked for a minimum of two years, in the past five years. Other exemptions to training are in WAC 246-843-093.
If you want to apply for licensure through endorsement or exemption, you will need to do the following:
- Complete and submit the application for nursing home administrator, along with the applicable fee. Check the box that is applicable to you – either the “Endorsement” or “AIT Exemption” box.
- Request the school where you obtained your bachelor's degree (or higher) to submit transcripts directly to the Department of Health. If you hold a health services executive (HSE) designation from the National Association of Long Term Care Administrators Board (NAB), please have NAB send verification of the HSE in lieu of transcripts.
- Request your scores from the NAB examination be sent directly to the Washington State Department of Health. Please see page 17 of the NAB Candidate Handbook (PDF). If you hold a HSE designation from NAB, please have NAB send verification of the HSE in lieu of examination scores.
- Send requests to all states where you hold, or have held, a health care credential. The department needs verification of the status of all health care licenses.
- Submit any other documentation requested by the Department of Health.
The department may ask you to supply fingerprints for an FBI background check. If you are required to submit fingerprints, you will receive a letter and fingerprint card from the Department of Health. The letter will tell you how to obtain the fingerprint background check and will request you send it back with the required fee.
Sometimes a fingerprint cannot be read. If this happens to you, the department will ask you to complete another fingerprint card and return it. You may request a temporary practice permit if you meet all requirements but are still waiting on a fingerprint background check. The temporary practice permit allows you to practice while waiting for your full license to be issued. The temporary permit requires an application and fee. More information is available by calling 360-236-4700.
Apply for a license
- Apply online
The Washington State Department of Health requires that only the applicant or licensee may complete an attestation for an application, or for continuing education. This is a legal attestation. Completion of the attestation by anyone other than the applicant may constitute a reportable felony offense. The Department of Health can take action against people for perjury or for making a false statement they know to be false.
For further information please see:Continuing Education; WAC 246-12-180; How to prove compliance Initial and renewal credentialing of practitioners; WAC 246-12-020; How to obtain an initial credential
Once you have completed the process you will receive an email with your pending credential number, or you may look on Provider Credential Search. Refer to this credential number any time you contact Department of Health or submit paperwork.
If you have questions, contact our Customer Service staff at 360-236-4700.
Online Application Instructions
Online application instructions are on our website. Online applications are accessed through SecureAccess Washington (SAW) security portal. You'll need to add the Department of Health Online Application Portal service to access the online applications. The first time you add the service, you'll be prompted to answer several questions to verify your identity. The questions will match the name and address you provide with the existing public record information. Because the questions come from public record, you need to provide a complete address and your full legal name as it appears on your driver's license or birth certificate. You may find you have to enter a former address, especially if your address has changed recently (within the past one or two years) to get the right questions that pertain to your identity. If don't have sufficient information in the public record to verify your identity and aren't currently credentialed by the Department of Health, then you'll need to submit a paper application, as you won't be able to access the Online Application Portal.
Washington State law authorizes the Department of Health to obtain fingerprint-based background checks for licensing purposes. This check may be through the Washington State Patrol and the Federal Bureau of Investigation. We may require this if you have lived in another state or if you have a criminal record in Washington State. This would be at your own expense.
You must pay the application fee at the time you apply. You may use a credit or debit card with a VISA or MasterCard logo, or pay by ACH/E-Check. Please make sure your address on the payment information screen matches the address your financial institution has on file for you. This fee is non-refundable. There is a convenience fee to apply online.
If we need additional documentation, we'll notify you by email.
There are additional items you may need, in addition to your application:Credential Verification (PDF)
- Applications and forms
Apply on paper
The following PDF forms are required for completing the application process. Please download and print forms.
- See fee information below
Non-Refundable Fee Type Fee Amount Application (original license) $805 Administrator-in-training (AIT) $285 Application (endorsement) $805 Temporary permit $325 Renewal $975 Late renewal penalty $300 Expired license reissuance $285 Inactive license renewal $315 Inactive late renewal penalty $160 Expired inactive license reissue $190 Duplicate license $10 Verification of license $25
Fees submitted with applications for initial credentialing, examinations, renewal and other fees associated with the licensing and regulation of the profession are nonrefundable.
Make checks or money orders payable to the Department of Health. Practitioners should include their credential number on the check, draft or money order. Applicants should include profession(s) for which they're applying on the check, draft or money order.
Send check, draft or money order to:
Department of Health
Health Systems Quality Assurance
P.O. Box 1099
Olympia, WA 98507-1099
- See licensing requirements below
For information on the process used to apply for licensure, please see the licensing overview section on this page.
Bachelor's degree from a recognized institution of higher learning. Official transcript with degree and date posted, received directly from applicant's program. Transcripts not in English must have an official translation.
Postgraduate professional work experience
Professional experience in the health care and management field, including services in the armed forces.
Applicant provides details of experience to include:
- name and address of employer
- type of business
- position title
- name of supervisor
- detailed description of duties
- number of employees supervised for each qualifying position.
Proposed AIT program required for initial licensure
Please see the AIT process located on this webpage.
Pass national exam (NAB)
Pass national exam (NAB). Scores will be obtained directly from NAB.
State license verification
Applicant lists all states where credentials are or were held, including where applicant has applied but a credential was not granted. A verification form must be completed and submitted by the jurisdiction where the applicant is or was credentialed. Applicant sends form to jurisdiction for completion. The jurisdiction sends completed form directly to the department.
Personal data questions
Applicant must answer the following personal data questions:
- Physical and mental health status
- Lack of impairment due to chemical dependency/substance abuse
- History of loss of license, certification or registration
- Felony convictions
- Loss or limitations of privileges
- Disciplinary actions, professional liability claims history
An appropriate explanation and required documentation must be sent with positive answers. If there is a positive answer to the professional liability claims history question, the applicant must send an explanation of the nature of the case, data and summary of care given, copies of the original complaint, and the settlement or final disposition. If pending, applicant must indicate status
Additional information/documents required
If national examination was taken in another state, the passing score must be verified directly from NAB.
Process for approving/denying applications
We finish final review for approval after a credentialing specialist verifies that the application is fully complete, and complies with requirements in chapter 18.52 RCW and chapter 246-843 WAC. We complete background checks and make sure applicants have submitted required fees. Credentialing supervisors and lead workers have the authority to approve routine applications. The disciplining authority may conduct further review if the credentialing supervisor can't verify the applicant meets all requirements. We'll formally notify applicants of a denial. Those applicants may request a hearing to appeal the decision.
Nursing home administrators must renew their license every year on or before their birthday. Licensee is required to submit the appropriate fee and renewal card and complete 36 hours of continuing education every two years.