In California, in order to become a licensed nursing home administrator (LNHA) there are three threshold requirements: 1) you must be at least 18; 2) you must pass a moral character and criminal background check; and 3) you must be either a U.S. citizen or a legal resident with the right to work in California.
If you meet these threshold requirements, then the next step is to satisfy the educational and/or practical training requirements which California mandates for those who wish to become a LNHA in the state. Finally, after meeting the threshold requirements and the educational and/or practical training requirements you must pass two LNHA exams, a national exam and a California state-level exam.
For individuals who attend a graduate program their practical training is incorporated into the degree, but for all other individuals who aspire to become a LNHA in California your practical training requirement can only be satisfied by completing an Administrator-in-Training (AIT) Program, which is an internship where the AIT gains practical experience in long-term care administration under the supervision of a preceptor, which is a licensed administrator who has met certain qualifications specified by California law.
The purpose of the AIT Program is to facilitate the professional development of the AIT in the field of long-term care administration and prepare him/her for a career in this field through observation and participation in activities typically carried out by LNHA’s. In California, the AIT Program must be 1,000 hours long.
To qualify for the AIT Program, applicants must satisfy one of the following:
Have a doctorate degree in medicine and a current valid license as a physician and surgeon
Have a baccalaureate degree
Have ten years of full-time work experience and a current valid license as a registered nurse. At least the most recent five years of the 10 years of work experience shall be in a supervisory or director of nursing position.
Have ten years of full-time work experience in any department of a skilled nursing facility, an intermediate care facility, or an intermediate care facility/developmentally disabled with at least 60 semester units (or 90 quarter units) of college or university courses. At least the most recent five years of the 10 years of work experience shall be in a position as a department manager.
Have ten years of full-time hospital administration experience in an acute care hospital with at least 60 semester units (or 90 quarter units) of college or university courses. At least the most recent five years of the 10 years of work experience shall be in a supervisory position.
Each AIT Program is different and must be specifically tailored to the individual AIT based on his/her education, experience, knowledge, skills, and abilities. Each individual’s AIT Program must be designed by a joint effort between the AIT and his/her preceptor. Together, the AIT and the preceptor have the flexibility to create an AIT Program that is well-suited to the AIT.
Thus, the first step towards completing an AIT Program is to find a preceptor, which is a skilled nursing or intermediate care facility administrator who possesses a valid preceptor certificate. To do so, you can send an e-mail to NHAP@cdph.ca.gov and request an updated list of approved preceptors in the counties where you want to conduct your AIT Program.
After finding a preceptor you will work together with him/her to create a training outline suited your professional development, a determination must be based on a self-assessment of your education and work experience. The purpose of the self-assessment is to determine which aspects of long-term care you are familiar with and which areas you need more training on. After developing a training outline with your preceptor based on the self-assessment the training outline must be approved by the California state government’s Nursing Home Administrator Program (NHAP) in order to begin your AIT Program.
The training outline you create with your preceptor must include training in all of the following “modules”:
•Administration •Human Resources •Nursing •Business Office/Financial Management •Diet •Rehabilitation •Medical Records •Activities •Social Services/Admissions •Housekeeping/Laundry •Environmental Management/ Maintenance
If your self-assessment shows that you already have experience in one or more of these modules, then your training outline should be designed so that you spend less time training for these modules and more time training for modules in which you don’t have as much experience. However, during your AIT Program you should become familiar with all aspects of every module specified above through a combination of observation and participation.
Before submitting your AIT Program training outline to the California NHAP for approval you must undergo a criminal background check. This is done by filling out a Request for Live Scan form and taking it to a live scan provider, where an image of your fingerprints will be taken. If you have previously undergone a criminal background check this will not satisfy California’s AIT Program requirements so you must go through the process again.
After completing the criminal background check you must submit the following items to the California NHAP in order to obtain their approval of your AIT Program:
A completed Application for AIT Program (CDPH 502) (PDF), which is located on the NHAP website;
An outline of a 1,000-hour training program prepared by the applicant's preceptor based on an assessment of the applicant's individual needs;
Completed Live Scan Form (BCIA 8016) (PDF).
A recent photograph clearly picturing the applicant's face that is approximately 2" by 2", similar to a passport photograph;
A copy of one of the following:
State issued identification card (e.g. driver's license); or
Permanent resident card;
The appropriate non-refundable AIT fee established by the NHAP, which can be found on the NHAP website;
A copy of the applicant's Registered Nurse (RN) License or a copy of the on-line verification printed from the licensing entity's website if they qualify under the basis of ten years work experience as a RN; and
An official transcript from the applicant's college/university provided in an unopened envelope. The NHAP will return transcripts that appear to be opened without reviewing them.
The California NHAP will take about 30 days to process your application, and once NHAP has issued you an approval letter your training hours will start counting towards your 1,000-hour AIT Program requirement.
During the course of the AIT Program your preceptor may make slight modifications to the program such as changing training hours or making minor training outline changes. However, any major modifications of your AIT Program must be approved by the California NHAP.
Your preceptor must submit a report which evaluates your performance as an AIT to the California NHAP within 10 days of the end of each quarter (or every 250 hours) of your 1,000-hour AIT Program. After your AIT Program is complete and your preceptor submits his/her final evaluation report, you will be eligible to sit for the national and California LNHA exams. Passing these two exams is the last stage in the process of becoming a LNHA in California.