How to Become a Nursing Home Administrator in California

How to Become a Nursing Home Administrator in California

In order to work as a nursing home administrator (NHA) in California, you must have both academic and practical qualifications. You may be able to substitute substantial experience as a registered nurse in place of some educational requirements. All of this must be completed before you can sit for the state and federal nursing home administrator examinations and begin looking for work. However, with six-figure salaries, the preparation may be worthwhile in the long run.

Part 1 Determining Eligibility

1. Discover what it’s like to be an NHA. You will be responsible for the efficient and safe operation of a nursing home, as well as ensuring full compliance with all federal and state health and safety regulations and requirements. Patient admissions, personnel management, budgeting, and facility management are just a few of an NHA’s responsibilities in California, which is why certification requirements are so stringent.

If you are a registered nurse in a long-term care facility with experience in employee management, budgeting, or event planning, this could be a great opportunity for you to advance your career.

Being an NHA requires years of education and training to ensure you fully understand and comply with a slew of federal and state healthcare regulations, so understand that you’ll need to invest time in your education on a regular basis.

Begin by interviewing or shadowing an NHA in your long-term care facility or a nearby facility. Inform them about the NHA application process. These firsthand accounts can provide valuable information.

2. Comply with the fundamental requirements. All NHAs must be at least 18 years of age. You must also be able to demonstrate that you are a citizen or legal resident of California with the right to work. You will be required to provide identification documentation, such as a driver’s licence, passport, birth certificate, social security card, or residency verification documents, to demonstrate this.

3. Demonstrate your trustworthiness. Every applicant for a licence as an NHA in the state of California will be subjected to a thorough background check. Aside from minor traffic violations, most criminal charges are disqualifying factors in most cases. Other infractions, however, may be waived with appropriate documentation by the National Association of Long Term Care Administrators Boards (NAB) and state qualifying agencies.

The NAB recognises the state agency’s requirement for a background check.

The California Department of Public Health’s Nursing Home Administrator Program (NHAP) requires all applicants to submit fingerprints via the Live Scan system for a criminal background check.

If you have been ordered to pay, serve time, volunteer, or otherwise make restitution for a criminal act, you must provide proof that you have followed all of the terms of your sentence. This includes things like paying speeding or parking tickets, staying current on alimony and child support, and other court-ordered obligations.

4. Comply with all local, state, and federal laws. This includes personal regulations in the state of California that require education, examination, and licencing. However, it is also critical to demonstrate that you have followed state and federal regulations throughout your career. This is critical if you want to waive some or all educational requirements based on job experience.

Request that your references include information about your compliance with regulations in their letters.

Make a list of the various tasks you regularly perform in accordance with state and federal regulations, and include documentation to back it up.

Nursing homes frequently require their employees to take annual exams to ensure they understand and comply with HIPAA, Occupational Safety and Health Administration standards, and sensitivity training. Documentation for these courses or exams should be included.

Part 2 Meeting Educational Requirements

1. A master’s degree in nursing home administration is required. Earning a bachelor’s degree in nursing, nursing home administration, or a related field is the most direct path to completing your educational requirements prior to taking the NHA qualifying exams. After that, pursue a graduate degree in health care administration, long-term care facility administration, or a related field. Following the completion of your graduate studies, you will be eligible to apply for the licencing exam.

The Commission on Accreditation of Healthcare Management Education maintains an online database of state and federal programmes (CAHME).

The NAB is compiling a list of accredited programmes across the United States, and as this list grows, these programmes will most likely set the standard for NHA education. When looking for a programme, this could be a good starting point.

Inquire about the educational backgrounds of other NHAs you know. This can be a great way to learn about educational programmes from the inside and choose a school that is a good fit for you.

2. Participate in an internship. During your graduate studies at a California-accredited university, you must complete 480 hours of hands-on training by interning or working in a nursing home. Internships in your area can be found by speaking with your professors, searching California’s NHAP site, or directly contacting long-term care facilities in your area.

You can take the state and federal NHA exams at any university in the United States, as well as some international programmes, but they may have different internship requirements. In such cases, you may be required to complete an Administrator in Training programme.

3. A bachelor’s degree in nursing home administration is required. If you have a bachelor’s degree in nursing, nursing home administration, ageing care, or a related field, you may be able to combine your education and experience to qualify for the NHA licencing exam. If you hold a bachelor’s degree, you must apply for a 1000-hour Administrator in Training (AIT) programme. After completing the AIT, if you are accepted into this programme, you will be eligible to take the federal and state licencing exams.

4. Job experience is required to qualify. If you’ve worked as a nurse or supervisor in a long-term care facility for at least ten years, you may be able to take the NHA licencing exams by completing the same 1000-hour AIT programme that bachelor’s degree holders do. At least the last five years of your experience must have been in a supervisory capacity.

5. Completing the Administrator in Training (AIT) programme is required. Finding a preceptor is the first step in completing this programme. If you are qualifying based on work experience, you should begin by asking the NHA in your long-term care facility to serve as your preceptor. If you have a bachelor’s degree and do not currently work in a long-term care facility, you may need to look a little further to find a qualified preceptor.

You can get a list of qualified preceptors in your area by contacting California’s NHAP.

Before beginning an AIT, you must first obtain approval from the NHAP exam board. You will be approved after submitting the qualifications of your preceptor, an outline of the 1000 hours of training, an application form, and the necessary fees.

From the time your AIT is approved, you have one year to complete the programme.

6. Establish proof that you completed the educational requirements. The NAB will require transcripts from all of your course work. These should be requested from your university and sent to the NAB directly. You will also be required to provide documentation of your internship hours or AIT curriculum.

Internships completed as part of your graduate studies will be documented on your transcript.

As part of your verification documentation, if you complete an AIT programme, your preceptor will need to complete and submit an evaluation form.

7. Apply to have your educational requirements waived. If you work in a long-term care facility run by a religious organisation and your ability to complete traditional education is hampered for some reason, you can apply to waive your educational requirements. You must, however, have a high school diploma or GED and have completed an AIT programme.

You must provide sufficient documentation to show that you are unable to attend traditional college or university training because of your religious practises or beliefs. This can include religious texts, letters from religious leaders, and historical documentation demonstrating that other NHAs in your facility have not received conventional educational training.

You will also be required to provide documentation proving that the nursing facility for which you are applying is a 501(3)(c) non-profit organisation recognised by the Internal Revenue Service.

Your AIT should be completed in a nursing home run by your religious organisation.

If you are granted an educational waiver, you may only be hired to work for religiously affiliated long-term care facilities.

8. Maintain the requirements for continuing education. Every two years, all NHAs in California are required to complete at least 40 hours of advanced training. This helps to ensure that you are aware of any policy changes and new administrative criteria.

Contact state and national NHA organisations to learn about seminars, webinars, courses, and other opportunities for continuing education in your area.

College courses taken during the semester earn 15 hours of credit, while courses taken during the quarter earn 10 hours of continuing education credit.

If you give seminars or teach courses to other NHAs, you can apply 16 hours of that time to your own continuing education hours.

Preceptors may log up to 20 hours of training time for NHA candidates toward their own continuing education hours.

Part 3 Taking the State and National Exams

1. Prepare for national and state licencing exams. Your education, internship, AIT programme, and real-world experiences will almost certainly have prepared you to know and understand the topics covered by your state and national licencing exams. However, it is critical to review the various subjects covered by each test. Taking practise exams will also prepare you for the types of questions you’ll be asked.

The federal exam has 150 multiple-choice questions. 38 percent of these were related to resident-centered care, 13% to human resources, 13% to finance, 15% to the environment, and 21% to leadership and management. contains recommended reading, practise exams, and other resources.

California’s exam consists of 100 multiple-choice questions. It covers the Omnibus Budget Reconciliation Act (OBRA), the California Code of Regulations, Title 22, Division 5, and other California-specific aspects of nursing home administration performance and requirements.

2. Fill out an application to take the National Nursing Home Administration Examination. It’s time to apply for the National Nursing Home Administration Exam after you’ve met the basic requirements and completed your educational prerequisites. To be accepted to sit for the national exam, you must meet all of these requirements prior to taking the exam and provide documentation proving your education and training. The entire application procedure is carried out online.

When you apply, the credit or debit card associated with your application is validated, and the examination fee is charged. The fee was $375 as of December 2016.

You will receive an email confirming the receipt of your application and payment.

The California state board will be notified of your application, and they will notify you and the NAB within four months whether you are eligible to take the exam.

After the California board approves your application, you will receive an email from the NAB with an Authorization-to-Test letter.

After receiving the NAB’s Authorization-to-Test letter, you will have sixty days to schedule and complete the exam.

3. After being approved, you must pass the federal exam. To be considered eligible to take the NHA test in California, you must score at least 75% on all aspects of the NAB exam. You will be able to take the test three times within one year of your initial examination application being accepted. If you do not pass the exam within the first year, you will have to restart the application process.

4. Register for the California Nursing Home State Exam. You are automatically eligible to sit for the California exam if you have taken and passed your federal examination. State exams are given four times a year. The examination dates are posted well in advance and are available through the California Department of Public Health, which is the state exam’s governing body.

You must fill out an application form. The application is only one page long and informs the California state exam board that you meet all of the basic and educational requirements to take the exam.

If you receive at least a 75% on all aspects of the state exam, you will be notified via email of your eligibility to apply for NHA licencing in the state of California.

5. Make an application for your NHA licence. You must still complete the application process to receive your licence after receiving approval and proof of completion of your federal and state exams. The one-page form is available online at the NHAP page of the California Department of Public Health. The document itself is nearly identical to the state examination application. The only difference will be the fee amount. You must fill out the fee field with the current fee schedule at the time of your application. The licence fee was $350 as of July 2016.

Part 4 Landing a Nursing Home Administrator Job

1. Make your resume. You’ll need to create an adaptable document that lists your education, training, job experience, awards, and other information valuable to employers as you begin the job application process. Begin with a basic list of each topic, complete with date ranges. You may also want to include compensation for your job experience. Once you’ve completed this basic outline, you should be able to easily adapt your resume for NHA job postings at a specific long-term care facility.

If you are applying for a position in a nursing home that caters to more active seniors, you should highlight your previous experience in planning and implementing activities and events in long term care communities or at other points in your life. Planning an event for a college sorority necessitates many of the same budgeting, organisational, and other skills as planning events for seniors.

If you apply for a job that requires someone to implement employee performance reviews, training, and educational practises, emphasise any human resources experience you have.

Above all, try to use the same terminology as the job posting. Those reviewing your application materials are more likely to interpret your resume positively if you demonstrate your ability to speak the language of the long term care facility you wish to work for.

2. Request references. Writing a good, accurate resume that is tailored to a specific job posting is your chance to convince a company that you are the right person for the job. Most long-term care facilities will contact your previous employers to verify your employment history; however, your previous employers are unable to disclose much information to your potential employers without your prior consent. Inquire with your current supervisors, AIT preceptor, and some of your coworkers if they would be willing to be contacted and interviewed by potential employers.

When you apply for a job, notify your references that you will be contacting them. Usually, a quick email or phone call will suffice. As an example, say, “I applied for a position at a new long-term care facility. Would you still be interested in being contacted as a reference for me?”

Request letters of reference to back up the information on your resume. If you claim to have managed a large budget as a nursing home director, ask your administrator questions such as, “Would you be willing to write a letter of recommendation expressing your thoughts on my performance? Could you please explain how I managed the supply budgets over the last few years, and what that entailed?”

3. Join a professional NHA organisation in your state or on a national level. One of the primary advantages of joining these organisations is the opportunity to network. You’ll be able to meet others in your field, and in many cases, these organisations are where potential employers start looking for new NHAs.

In the state of California, the California Association of Health Facilities is an excellent resource for career opportunities, networking, and continuing education.

You can also become a member of the NAB. As a member of the NAB, you will have access to a wide range of national training resources, as well as up-to-date information about the NHA community and current job openings.

4. Look for job openings. In addition to searching professional organisation careers pages, you can also search for available positions on LinkedIn,, Indeed, and other general career resources. Furthermore, these sites frequently provide a faster application process by storing your education and job experience and auto-completing applications for you throughout the job search process.

5. Use a professional job placement agency to apply. Throughout California, healthcare staffing services are available. These employment agencies have team members who do the legwork to find you the best long-term care facility. Flexcare Medical Staffing, Maxim Staffing Solutions, and 365 Healthcare Staffing Services are three of the largest healthcare staffing agencies in California. These organisations have conducted research on current salaries and workplace benefits, and they have relationships with many of the state’s long-term care facilities.

Inquire with other NHAs you know if they used a staffing agency and what they thought of it.

Before agreeing to work with a staffing agency, request a detailed explanation of any placement or service fees associated with their firm. Most of the time, the employer pays for these, but this is not always the case.

6. Get ready for your interviews. Investigate any nursing homes that offer you a position to learn about their organisations and current state of affairs. Examine the facility’s website, read online reviews from residents and their families, and inquire about the facility’s standing with the Better Business Bureau and other similar organisations. Check out sites like Glassdoor to learn about current and former employees’ experiences.

Ask questions based on information from their website during your interview, especially if the facility appears to be proud of a specific event or service.

If you come across any issues that concern you while researching resident reviews, the Better Business Bureau, Glassdoor, and other websites, don’t be afraid to inquire about them. If you’re going to work for a long term care facility in an administrative role, you’ll need to have a complete understanding of these concerns going in to do an effective job.

Unless otherwise specified in the job advertisement, wait two weeks before following up on your job application and interview. Administrators are frequently overburdened with work and applicants and require time to review your qualifications.

7. Accept the appropriate position. Don’t feel obligated to accept the first job that comes your way. This can be the most costly mistake for a brand-new NHA. Choosing the wrong position can have a long-term negative impact on your feelings about the company. Allow yourself enough time to find the ideal location for you, your family, and your future career opportunities.

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