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The national exams: CORE of Knowledge and Line of Service
Quick answer
How many national exams does a nursing home administrator take?
Two. Licensure sits on the national exams administered by the National Association of Long Term Care Administrator Boards (NAB): the CORE of Knowledge exam, shared by all long-term-care administrators, plus one Line-of-Service exam for your setting. For a nursing home you take the CORE (100 scored questions, 2 hours 30 minutes of seat time) plus the Nursing Home Administrator line (60 scored questions, 1 hour 30 minutes of seat time), each with a passing scaled score of 113. Some states add a separate state law exam on top.
The two national exams
A nursing home administrator credential is built on two national exams, not one. The first, the CORE of Knowledge exam, tests the knowledge every long-term-care administrator shares: resident care and quality, the physical environment and safety, human resources, finance, leadership and governance, and the regulatory framework. The second, a Line-of-Service exam, tests the knowledge specific to the setting you want to run. For a nursing home, that is the Nursing Home Administrator (NHA) line. Nearly every state requires both, and both are national exams, so they do not change when you move between states.
Why split it in two? Long-term care is not one setting. Rather than build a separate, mostly redundant exam for each, the shared foundation is examined once in the CORE, and the specialty is examined separately. That is also why adding a second credential later can be lighter: your CORE may already be behind you. The CORE vs Line-of-Service guide walks through the design in full.
Reading the diagram: the CORE of Knowledge exam is the shared foundation every long-term-care administrator takes; the Nursing Home Administrator Line-of-Service exam sits on top of it for this setting specifically. Passing both is the national requirement everywhere. A number of states then add their own state-specific exam as a third, separate layer, which each state page flags.
The three Lines of Service
On top of the CORE you take one Line-of-Service exam, matched to the setting you intend to administer:
| Line of Service | Setting it licenses you for |
|---|---|
| Nursing Home Administrator NHA | The Line of Service for a nursing-home (skilled nursing facility) administrator license. |
| Residential Care / Assisted Living RCAL | The Line of Service for a residential-care or assisted-living administrator license, where a state licenses that role. |
| Home and Community-Based Services HCBS | The Line of Service for home and community-based services administration, where a state licenses that role. |
You take only the line for the credential you are pursuing. If you later add an assisted living credential, you would add the Residential Care or Assisted Living line, and depending on the state your CORE may already count. See the dual-credential guide.
Exam structure, scoring, and fees
Both national exams are objective, multiple-choice, four-answer-choice questions. Each exam includes a block of non-scored pretest items mixed in with the scored items, so you cannot tell which questions count toward your score. Every NAB exam, CORE and each Line of Service, shares the same passing scaled score.
| Detail | CORE of Knowledge | NHA Line of Service |
|---|---|---|
| Total items | 125 (100 scored, 25 pretest) | 75 (60 scored, 15 pretest) |
| Seat time | 2 hours 30 minutes | 1 hour 30 minutes |
| Passing scaled score | 113 of 50 to 150 | 113 of 50 to 150 |
| Content domains | 4 | 4 (same four) |
| National exam fee | $320 CORE only | $190 NHA only |
The four content domains, shared by CORE and every Line-of-Service exam, are:
- Care, services, and supports. The largest content area on both CORE and each Line-of-Service exam.
- Operations. The second content area, covering day-to-day administrative operations.
- Environment and quality. Physical environment, safety, and quality-of-care content.
- Leadership and strategy. Governance, leadership, and strategic-management content.
Because scaled scoring adjusts for small differences in difficulty between exam forms, two candidates with the same raw score can land on different sides of the 113 cut. What matters for passing is the scaled score on your score report, not the raw count of questions you answered correctly.
When a state exam sits on top
The two national exams are not always the whole picture. Some states add a separate state law or jurisprudence exam, testing that state's own licensing statutes and administrative rules. This is not a Line-of-Service exam; it is an additional, state-specific requirement.
- Florida requires its own Nursing Home Administrator Laws and Rules examination in addition to the national NAB exam.
- Virginia requires only the national NAB exam, with no separate state exam.
Whether a state exam applies to you is a per-state fact. The requirements wizard flags it for your state, and each state page records it with its source and date.
How to prepare for a two-exam structure
Because the CORE is broad and shared, it rewards steady, wide preparation across every functional area of administration. The Line-of-Service exam rewards setting-specific depth. Plan your study to reflect that split rather than treating the two as one block. For where the exams sit in the whole licensure sequence, see how to become a licensed nursing home administrator.
Check what your state requires, free
Sources: Virginia Administrative Code 18VAC95-20-220 (national exam requirement), the Florida Board of Nursing Home Administrators (floridasnursinghomeadmin.gov, state Laws and Rules exam), the NAB Candidate Handbook published by Pearson VUE (item counts, seat time, content domains, exam fees) and NAB's Interpretation of NAB Exam Scores guide (passing scaled score). Confirmed and dated 2026-07-29.