Administrator Licensing and the Board

About 4 of every 50 questions on a Missouri NHA State Exam practice exam come from this topic.

Sources checked November 13, 2026

What to know

Chapter 344, RSMo, requires anyone acting as a nursing home administrator to hold a license from the Missouri Board of Nursing Home Administrators; unlicensed practice is a misdemeanor, and an assisted living or residential care license does not cover intermediate care or skilled nursing facilities. Applicants must be high school graduates with qualifying education, experience or a Board course, and must pass the national exam (scale score 113) and the state exam (75%). Failing one exam and not passing it within a year means retaking both; a third failure requires a Board-prescribed course. That course runs 315 hours of instruction plus an internship of 500 to 2,000 hours depending on education, finished within 18 months under a preceptor who supervises one intern at a time. Licenses expire June 30 every other year, and each renewal needs 40 hours of continuing education, 10 in patient care. A license expired over 12 months requires initial licensure. Temporary emergency licenses last up to 120 days. Inactive licensees may not practice. The Governor appoints ten Board members, four of them administrators, to three-year terms.

Where it comes from

• Mo. Rev. Stat. §§ 344.020, 344.030, 344.040, 344.060, 344.100
• 19 CSR 73-2.031, 73-2.050, 73-2.053
• 19 CSR 73-2.070, 73-2.080, 73-2.130

Try a practice question

Ready for a full run? The Missouri Nursing Home Administrator State Exam Practice Test is 50 questions in 120 minutes, scored at 75%. For the official exam's details, see Missouri Nursing Home Administrator License Exam Requirements.