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Become a Health Services Executive

Administrator in a three piece suit sits an a computer working.

The Health Services Executive is an aspirational and voluntary license for nursing home administrators that encompasses entry-level competencies of a nursing home administrator, an assisted living administrator, and a home and community-based services administrator.  It is a broader, more inclusive combination of education, experience, and examination.  The Health Services Executive raises the bar for the profession and does not replace the nursing home administrator license.

Ohio has long been recognized as a leader in the provision of long-term services and supports.  Being among the first states to adopt the Health Services Executive license will continue to keep Ohio at the forefront of innovation in the provision of long-term services and supports, allow professionally trained executives to assist people in making decisions about how best to get their needs met in the living environment of choice, and allow administrators to raise the bar of the profession and achieve a higher licensure status.

Ohio has a growing system of long-term services and supports and Administrators who need and desire additional education and a career ladder across the continuum.  The Health Services Executive License became law in Ohio on October 17, 2019

Experience-based pathway

To apply for the experience-based pathway to the HSE, you must meet the following criteria:

  1. A current LNHA license and at least 3 years of active engagement as an administrator of record, or as the individual supervising other administrators of record.
  2. Successful passing of the NAB RCAL (residential care and assisted living) and HCBS (home and community-based services) exams.
  3. Online HSE application completed and submitted through NAB Verify.
  4. Official Transcript (to NAB) verifying BA/BS from an accredited college or university.
  5. Review within the National Practitioner Data Bank (NPDB; to NAB) and finding no disqualifying actions.

Education-based pathway

To apply for the education-based pathway to the HSE, you must meet the following criteria:

  1. A graduate of a NAB accredited HSE program.
  2. Online HSE application completed and submitted through NAB Verify.
  3. Official Transcript from a NAB HSE Accredited college/university program showing completion. 
  4. Successful completion of NAB Examination(s) required of an HSE within the two (2) years following application. Requirements are:
    • Complete and pass a 100-item core exam 
    • Complete and pass three additional 50-item specialty exams (NHA, RCAL, and HCBS).  These do not have to be completed at the same time. 
  5. Review within the National Practitioner Data Bank (NPDB) and finding no disqualifying actions.

Go to www.nabweb.org/Health-Services-Executive for the most current information and to begin the NAB Verify process, which is a required element of obtaining the license in Ohio.


Once you meet the NAB HSE criteria, you may complete the BELTSS HSE application.  Complete and return this application via email, fax, or postal mail so that you can register as a candidate and pay your $100 license/application fee invoice.  (This invoice will not be generated until the office has received your application or you call the office to request that it be generated). 

You must also complete a criminal background check, which does not have to come to the Board directly from BCI, so you may get the check done at work if you have web check capabilities; instructions are posted.  If you are an out-of-state HSE wishing to transfer your license to Ohio, you must also pass the Ohio state examination covering Ohio’s laws and rules.

The BELTSS education committee and board must approve your application.  The board meets quarterly (March, June, September, or December).  All documentation must be received in the office before the license is granted. 

Your HSE license will be due for renewal at the same time your LNHA is due to be renewed and has the same criteria for timely renewal.  Four additional CE hours are required for the HSE license renewal.  There are penalties for late renewal, and those are listed in 4751.25 of the Ohio Revised Code, available at codes.ohio.gov. You must keep your LNHA license active in order to retain your HSE license.

If you have any questions about this process or the HSE, please contact Deborah Veley at dveley@age.ohio.gov or 614-466-5114 or go to the NAB website and click on the “Health Services Executive” link for more information.