UWEC CERCA 2026

This project examines potential administrative barriers to initial Nursing Home Administrator (NHA) licensure, with particular attention to the timeline required to obtain licensure after completing educational and experiential requirements. Over half of U.S. states recognize the National Association of Long Term Care Administrator Boards (NAB) Health Services Executive (HSE) Qualification as meeting eligibility standards for NHA licensure. To earn the HSE via the education pathway, applicants must graduate from a NAB HSE-accredited program, complete a 1,000-hour Administrator Residency (primarily in skilled nursing, with exposure to assisted living and home- and community-based services), and pass the NAB Core and three line-of-service examinations. However, in many states, applicants must first apply for initial licensure before receiving authorization to sit for these exams, potentially creating delays.Using a mixed-methods design, three trained data collectors in each of 51 U.S. jurisdictions evaluated timelines, communication processes, and barriers to licensure while posing as graduates of NAB HSE-accredited programs. Descriptive statistics and thematic qualitative analyses are underway. Preliminary findings suggest variability in exam authorization procedures, communication clarity, and overall processing timelines. Identifying administrative barriers may inform policy alignment and streamline licensure processes to support a competent leadership workforce amid growing long-term care demands.