Nursing Home Administrator

​​​Additional Resources

Other Forms

Statutes and Administrative Code

Continuing Education Information

Exam Information

Offenses that May Result in Refusal, Bar, or Termination of Licensure

Related Links

Nursing Home Administrator Examining Board

Orders and Disciplinary Actions

Conviction Self Report

Professional Assistance Procedure

Monitoring

File a Complaint


License Information

Fee Reduction

Pursuant to 2017 Wisconsin Act 319, beginning August 1, 2018, an applicant for an initial credential may apply for a reduction of the initial credential fee that is equal to 10% of the initial fee.  Qualification is based on the federal adjusted gross income being at or below 180% of the federal poverty guideline prescribed for the applicant's family household size by the United States Department of Health and Human Services. To determine eligibility please visit the United States Department of Health and Human Services website at https://aspe.hhs.gov/poverty-guidelines, prior to submitting Form 3217.

Per Wis. Stat. § 440.08 (2), the required renewal date for the Nursing Home Administrator credential is 06/30/even years.  Should you receive your initial credential in the months leading up to this date, you are still required to renew your license by the statutorily defined date.


Pre-Credential Education Information

Applicants must complete a regular course of study, a program of study, or complete specialized courses which the Nursing Home Administrator Examining Board considers adequate academic preparation for nursing home administration.

 ​Current NHA Approved Course List.pdf​​


Application for Licensure

FormDescription
1573Application for Examination
418Application for Nursing Home Administrator License
​3217​Application for Fee Reduction (If applying for a fee reduction, this form must accompany the application for the credential.)
71Verification of Experience in the Field of Institutional Administration (if applicable)
2470Reciprocity Experience Record (Reciprocal Applicants Only)
419Verification of Licensure (Reciprocal Applicants Only)
​3085​Application for Predetermination (Optional-Submit ONLY if you have been convicted of any felony, misdemeanor, or other violations of federal or state law in this state or any other and you desire a review of your conviction record before applying for a credential.)​
2252​Convictions and Pending Charges (if applicable)
3071​Fax Payment Form

Renewal Information

Requirements

  • FEE (See Renewal Dates and Fees)
  • SIG  (Signature regarding the completion of Continuing Education, see Continuing Education Information, included in on-line renewal and paper form)
  • If your legal status as a qualified alien or nonimmigrant lawfully present in the United States has changed since the issuance of your credential or your last renewal, please contact the Wisconsin Department of Safety and Professional Services at (608) 266-2112 or dsps@wisconsin.gov.

Renewal Methods

FormDescription
RDAFRenewal Dates and Fees
R210Active Duty/Discharge Renewal Extension
​2254​
​Convictions and Pending Charges (if applicable for renewal)

Wisconsin Act 210 (effective June 1, 2012)

This Act extends the license of a service member if the license expires while they are on active duty from 90 days to 180 days from the date of discharge. The same applies to a spouse of a service member if the spouse does not practice under their license while the service member is on active duty and does not practice because the service member is on active duty.

This Act repeals a provision of prior law that required a service member to meet all of the requirements for license extension or renewal, except for continuing education requirements, in order to have the license extended.

Service members and spouses may request extensions of licenses beyond 180 days from discharge and may request a waiver or extension of time to complete continuing education requirements due to hardship. Please view Active Duty/Discharge Renewal Extension Form #R210.