Licensing Overview | AR Process Overview | Endorsement Process Overview | Apply for a License | Fee Schedule | Understanding your Application | Process for Approving/Denying Applications | Additional Licensing Information
License Requirement Checklist for Online Applicants
Licensing Overview
If you have questions about the application process, contact us via email: NHAapplication@doh.wa.gov
- General Information
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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 residency (AR) 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.
AR Process Overview
- General Information
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The AR process is the route to licensure as a nursing home administrator in Washington State. Most applicants must complete a Washington State AR program. Applicants who are licensed as an administrator in another state with requirements substantially equivalent to Washington State do not require an AR. A list of states that have been found to be substantially equivalent on the substantially equivalent page. Other exemptions to the AR program are in WAC 246-843-093.
Application for a nursing home administrator license requires you to submit proof that you have a bachelor's degree, complete a 1,500-hour (nine-month) AR program, and successfully complete the nursing home administrator examination administered by the National Association of Long-term Care Administrators Boards (NAB). The following steps can help you through the AR process.
- Step 1: Find a Preceptor
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Find a nursing home administrator who is willing to be your preceptor, or a company that offers an AR program
An applicant for licensure needs to first work out an agreement with the preceptor, company, or nursing home regarding the AR program.
A preceptor is a skilled practitioner who gives personal instruction, training, and supervision in the nursing home setting. This allows the AR 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 AR is trained.
- The preceptor shall have an unrestricted license.
- The preceptor shall submit proof that they have completed the National Association of Long Term Care Administrators Board (NAB) preceptor leadership course.
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 AR with the Required Fee
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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 AR program:
- DOH will send you a letter stating that you qualify for an AR program. The letter will inform you of the length of your AR 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 AR 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 AR program has been approved. The letter will tell you the beginning and ending dates for your program.
DOH will set up a site visit for you near the end of your AR program. A board member will visit you and your preceptor at the facility where your AR 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, the effect of the AR project, and overall lessons learned through the AR 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
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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 AR 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 on that website may also be helpful.
- Step 4: Apply to NAB to take the National Examination
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- Once your AR 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.
- Timelines
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Acknowledgement of receipt of your application You will receive a letter that includes information indicating what documentation is still needed to process your credential. Receive an answer to a request for a reduced program The Department of Health will consult with board member(s) to determine if you qualify for an AR 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.
Approval of AR program This is once all required documentation has been received. If all documentation hasn't been received, you'll receive periodic letters asking for that documentation. If you're asking for a reduced hour program this will happen once a decision is made from the board member(s). Site Visit This will be the completion of your AR program. Department of Health contacts you about six weeks before the end of your program to set this date.
Approval to take the examination This relates to the amount of time it will take for you to receive an email from the Department of Health indicating that you are approved to take the examination. You must apply directly to NAB to take the examination.
Licensure This is once all documentation, scores and fees have been received by the Department of Health. - Helpful Hints
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- 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 AR applicant should develop the learning plan together.
- Preceptors and ARs should have regular mentoring sessions.
- AR Support Meetings
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The board of nursing home administrators is offering a quarterly support meeting for administrator residents (AR) and preceptors. These meetings are designed to help AR’s to learn from each other and allow preceptors to connect with the board and other preceptors Board members will facilitate the meeting and answer questions. AR’s and preceptors should feel free to attend more than one meeting.
Meetings will take place through Microsoft Teams on Wednesday of January, May, August, and November at 11:30 a.m.
The dates for 2026 are as follows:
Date Time August 12, 2026 11:30 a.m. on Teams November 18, 2026 11:30 a.m. on Teams No registration necessary. If you have questions, send a request to nha@doh.wa.gov.
Endorsement Process Overview
- General Information
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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 substantially equivalent page 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 an 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.
- If you are applying for AIT exemption, 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.
- If you are applying for AIT exemption, request your scores from the NAB examination be sent directly to the Washington State Department of Health. Please see 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 can be found in WAC 246-843-231.
Apply for a License
- Apply Online
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Getting started
Online Application Instructions
Online application instructions are on our website.
Once you have completed the process, you will find your pending credential number on the Provider Credential Search. Refer to this credential number any time you contact the Department of Health or submit paperwork.
- Apply on Paper
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The following PDF forms are required to complete the application process. Please download and print the forms.
Applications must be completed either by hand or typed via typewriter.
Email NHAapplication@doh.wa.gov for additional documentation.
- Additional Forms
- Renewal and Continuing Education
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Renewal Requirements
- Nursing home administrators must renew their license every year on or before their birthday. The licensee is required to submit the appropriate fee and renewal card.
Continuing Education
- Visit the nursing home administrator continuing education webpage to learn about requirements and regulations.
Fee Schedule
2024 Fiscal Year in Review (PDF)
- Licensing Fees
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- 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
- Retired active renewal - $150
- 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, per WAC 246-12-340.
Understanding your Application
All professions within the Department of Health (DOH) are unique. While the sections identified below can often be found on most applications, it is important to be aware of the requirements and rules of your specific credential(s).
After you submit your application, please watch for email communication from DOH. Throughout the application process promptly reply to all questions and requests. Delayed responses cause a longer wait for your credential to be issued. We highly encourage using our online application services.
- Demographic Information
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Demographic data is used to create an account within the DOH database, verify your identity, and collect contact information. Please carefully provide accurate and complete answers to all applicable demographic questions.
- Military
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It is valuable to indicate your military or spouse status on your DOH application. Appropriate documentation is necessary for all military-related applications, and it is important to be aware of the documents you need to provide to DOH. In some cases, military education, training, and experience may count towards attaining certain healthcare professional credentials. As a spouse or registered domestic partner of a service member, you may be eligible to have the processing time of your application expedited.
To find information and resources for military personnel and their spouses, visit the Military Resources website.
- Personal Data Questions
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All applicants must respond to the personal data questions, which focus on their ability to demonstrate the essential skills required for their profession.
Carefully review all questions. Please note that “yes” answers require an explanation and additional documentation as outlined on your application. If applicable, please be aware of the necessary documentation and provide it to DOH as soon as possible to avoid delays in processing your application.
- Other Licenses, Certifications, and Registrations
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DOH must verify all other credentials. List all states, including Washington State, where credentials are or were held. If you have applicable credentials to list, you may be required to provide an Out-of-State Credential Verification form. This form can be found in the paper application packet or on the Apply for License page. The form must be sent to each state listed and returned to DOH.
Please remember to provide all in-state and out-of-state credentials, including active, expired, and in-renewal. Individual states may require a fee for sending your verification to us. Please check in advance to help expedite this process.
- Education
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To verify your qualifications, we must review all educational preparation and post-graduate training. Applicants must request official transcripts from the school(s) attended, and the school needs to send them directly to DOH.
- Exam
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In some cases, passing an exam may be required to receive your credential. It is important to be aware of whether this applies to your credential. Exam scores must be sent from the exam host to the department. For more information on exams that may apply to your credential, visit your profession page.
- Supervised Experience
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Supervised experience may be necessary to receive your credential or maintain it as you practice. Supervision rules and requirements vary from profession to profession. Please visit your professions page to learn more about supervision requirements for your credential.
Important Reminders
- Fees
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Fees must be paid when an application is submitted. You can pay online while using the online application portal, or by sending a check or money order to the appropriate P.O. Box as listed on your application.
Applications with unpaid fees cannot be processed until payment is received.
- Background Check
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A background check is processed for every applicant. DOH may need to obtain a fingerprint-based background check with the Washington State Patrol and the Federal Bureau of Investigation (FBI). If this is required for your application, you will be contacted by DOH and it is your responsibility to complete the required steps to submit this background check.
- Exception Application
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A small number of applications, based on applicant-provided information or background-check findings, undergo additional review. These are known as “exceptions”; watch the introductory video on exceptions to learn more.
Process for Approving/Denying Applications
We finish the 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 that the applicant meets all requirements. We'll formally notify applicants of a denial. Those applicants may request a hearing to appeal the decision.