A nursing home administrator (NHA) oversees the operational success of a long-term care facility, guiding staff and shaping the environment to ensure residents receive high-quality care. This leadership role is responsible for managing finances, human resources, and compliance with healthcare regulations.
In Texas, aspiring administrators must complete a specific sequence of educational, experiential, and examination milestones to become licensed.
Meet the Core Educational and Experience Requirements
The journey to becoming a nursing home administrator in Texas begins with an educational foundation, as mandated by the Texas Health and Human Services Commission (HHSC). The primary requirement is a bachelor’s degree in any subject from an accredited university, which allows individuals from diverse academic backgrounds to pursue this career path.
If a candidate’s bachelor’s degree is not in a health-related field, they must complete at least 12 semester credit hours in long-term care administration. These courses must cover the four core domains from the National Association of Long Term Care Administrator Boards (NAB): care, services, and supports; operations; environment and quality; and leadership and strategy. This coursework ensures all applicants have foundational knowledge in facility management.
An alternative pathway exists for applicants holding a bachelor’s or master’s degree in health administration, health services administration, or a related discipline. If these programs already include the NAB domains, they may satisfy the state’s educational prerequisites and prepare students for the next phase of training.
Beyond academics, Texas requires prospective administrators to gain practical experience through an Administrator-in-Training (AIT) internship. This mandatory program consists of 1,000 hours of supervised work within a licensed nursing facility. The internship must be conducted under the guidance of an HHSC-approved preceptor, who is the licensed administrator of the training facility, to ensure the trainee gains comprehensive experience across all NAB domains of practice.
The required internship hours may be reduced to 500 for an applicant with a relevant health administration degree and specific management experience in a nursing facility. This reduction acknowledges prior professional experience and advanced academic preparation, streamlining the path for qualified candidates.
Pass the Required Examinations
After fulfilling the educational and internship prerequisites, candidates must demonstrate their competency by passing two examinations. The first is a national exam from the National Association of Long Term Care Administrator Boards (NAB). The second is a Texas-specific state exam.
The NAB exam assesses a broad range of knowledge for managing a long-term care facility, structured around the key domains of practice. It covers topics like resident care, human resources, finance, and leadership. Registration for the NAB exam is completed through its designated website.
The Texas state examination focuses on the unique laws and regulations governing nursing facilities within the state. It covers the Texas Health and Safety Code, HHSC administrative rules, resident rights, and state-specific life safety codes. This ensures administrators understand the legal framework they will operate within.
Preparation for both exams requires dedicated study. The NAB provides a variety of resources, including an exam candidate handbook, reference lists, and practice exams, to help applicants prepare. For the state exam, a thorough review of the Texas Administrative Code and other regulations published by HHSC is necessary. Candidates who fail either exam three consecutive times are required to complete an additional 1,000-hour AIT internship before they are eligible to retest.
Complete the State Licensing Application
Once an applicant has successfully passed both the national and state examinations, the next step is to formally apply for licensure with the Texas Health and Human Services Commission. This process is managed through the Texas Unified License Information Portal (TULIP), an online system for all licensing functions. The application compiles all previously met requirements for review.
The application packet requires several documents to verify qualifications. Applicants must submit the official application form, the non-refundable fee, and official proof of passing scores on both exams. Additionally, official academic transcripts must be sent directly from the educational institution to HHSC, along with documentation of the completed AIT internship under an approved preceptor.
Maintain Your Texas Nursing Home Administrator License
Obtaining a license is not the final step; it marks the beginning of a career that requires ongoing professional development. A Texas Nursing Home Administrator license is valid for a two-year period and must be renewed to remain active. License renewal is contingent upon meeting the state’s continuing education requirements.
To be eligible for renewal, an administrator must complete 40 hours of continuing education from NAB or HHSC-approved sources during each two-year licensure period. The coursework must relate to one of the NAB’s domains of practice. Within this 40-hour requirement, at least six hours must be in ethics, and a state-mandated course on infection control provided by HHSC is also required.
Job Outlook and Salary in Texas
The career outlook for medical and health services managers in Texas, including NHAs, is strong. The U.S. Bureau of Labor Statistics (BLS) projects a 29 percent growth in employment for this field nationally from 2023 to 2033. This demand is driven by the healthcare needs of an aging population, and in Texas, the projected job growth is forecasted to be 28.5% over the coming decade.
Salaries for nursing home administrators in Texas can vary based on several factors. Geographic location plays a role, with metropolitan areas like Dallas, Houston, and Austin often offering higher compensation than rural regions. Facility size, type, and the administrator’s years of experience also influence earning potential. According to BLS data, the median annual salary for medical and health services managers in Texas is approximately $106,590, with salaries ranging from $62,130 to $197,790.