Long-Term Care Administration Concentration in Healthcare Administration

Key takeaway: Long-term care administration is the only healthcare administration track that ends in a state license. Nursing home administrators are licensed in all 50 states – typically requiring a bachelor’s degree, an administrator-in-training (AIT) internship approved by the state’s nursing home administrator licensing board, and a passing score on the NAB national exam. The destination occupation, medical and health services manager, pays a median $123,860 with 23.2% projected growth from 2024 to 2034 (BLS)¹.

A long-term care administration concentration prepares students to run nursing homes, assisted living communities, and continuing care retirement communities. It layers gerontology, long-term care regulation, and facility operations onto the healthcare administration core – and, in well-designed programs, satisfies the specific coursework your state licensing board requires.

Quick Answers

What is a long-term care administration concentration?

A specialization within a healthcare administration degree focused on managing nursing homes, assisted living, and senior care organizations – including the regulatory and licensure preparation unique to long-term care.

Do nursing home administrators need a license?

Yes, in every state. The standard pathway is a bachelor’s degree, an administrator-in-training internship approved by the state’s nursing home administrator licensing board (length varies by state), and the National Association of Long Term Care Administrator Boards (NAB) examination. Some states also license assisted living administrators.

How much do long-term care administrators earn?

Licensed nursing home administrators fall under the BLS medical and health services managers occupation, which paid a median $123,860 as of May 2025, with 597,080 employed nationwide and 23.2% projected growth through 2034¹.

Back to Healthcare Administration Concentrations

For an overview of all degree paths, see the Healthcare Administration Program Guide.

What you typically study

The licensure pathway

Key takeaway: Licensure is a four-step process, and your degree program should explicitly map to your state’s requirements – coursework rules differ state to state.

1. Earn the qualifying degree. Most states require a bachelor’s degree; some accept an associate degree with additional experience, and some require specific long-term care coursework. The bachelor’s in healthcare administration with this concentration is the standard route.
2. Complete an administrator-in-training (AIT) program. A supervised internship in a licensed facility, with required hours varying by state (commonly several months to a year). Ask online programs how they arrange AIT placements locally.
3. Pass the NAB exam. The National Association of Long Term Care Administrator Boards administers the national licensing exam (NHA core plus a line-of-service exam). States may add a state-specific exam.
4. Maintain the license through continuing education. Some states also offer assisted living administrator licensure via NAB’s RC/AL exam.

Career outlook

Key takeaway: Demographics drive this field: the destination occupation is projected to add 142,900 jobs between 2024 and 2034 (from 616,200 to 759,100), a 23.2% increase¹.

Source: U.S. Bureau of Labor Statistics, OEWS May 2025 and Employment Projections 2024–2034.¹

Career titles include licensed nursing home administrator (LNHA), assisted living executive director, regional director of operations for senior living companies, and continuing care retirement community administrator. Compliance-heavy roles in long-term care organizations also align with compliance officers, who earn a median $80,730¹.

Who this concentration fits

Key takeaway: Long-term care administration offers the fastest route to running an entire facility – nursing home administrators commonly hold full operational authority earlier in their careers than hospital administrators do – in exchange for high regulatory intensity and 24/7 accountability.

Choose this track if you:

• Want general-manager responsibility (census, staffing, budget, survey results) rather than a narrow functional role
• Are motivated by resident care quality and working with older adults and their families
• Handle regulatory pressure well – nursing homes are among the most heavily surveyed settings in U.S. healthcare
• Value a licensed credential that creates real scarcity in the hiring market

Skills you build: survey and compliance management, census and payer-mix economics, clinical staffing models, family and resident communication, and crisis operations – a portfolio that also transfers to assisted living, hospice, and senior living corporate roles.

Questions to ask before choosing this concentration

• Does the curriculum meet my state’s NHA licensure coursework requirements?
• Is an AIT practicum built into the program, and will the school help place me in a local facility?
• Does the program prepare specifically for the NAB exam domains?
• Are graduates eligible for assisted living (RC/AL) licensure where my state offers it?

How healthcare administration concentrations compare

Source: U.S. Bureau of Labor Statistics, OEWS May 2025; Employment Projections 2024–2034.¹

Because licensure rules are state-specific, start your school search locally: Healthcare Administration Programs by State. For executive-track preparation, see the online master’s (MHA).

Data verified: June 11, 2026. Salary, employment, and tuition figures on this page are sourced from the U.S. Bureau of Labor Statistics (OEWS May 2025; Employment Projections 2024–2034) and the U.S. Department of Education College Scorecard (2023 cohort). The source agency and data year are cited inline with every statistic.