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Summary 2026/2027 Michigan Nursing Home Administrator (NHA) Ultimate Exam Prep & Regulatory Study Guide

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Dominate your licensure journey with this S-Tier, comprehensive study resource for the Michigan Nursing Home Administrator (NHA) exams. Updated for 2026/2027, this guide is the "gold standard" for candidates navigating the complex intersection of state and federal regulatory requirements. Comprehensive Regulatory Coverage: Master the Michigan Public Health Code and the latest OBRA 1987 standards. 2026 NAB Exam Readiness: Deep dive into the new nine stand-alone Domains of Practice and actionable Task Statements. Critical Fiscal & Clinical Mastery: Essential insights into PDPM ICD-10 mapping changes, Medicaid eligibility (2026 limits), and resident trust fund requirements. Workforce & Compliance Law: Full breakdown of the OBBBA of 2025 impact, new mandatory overtime prohibitions for RNs, and direct care wage pass-through guidelines. Survey Preparedness: Expert analysis of updated CMS State Operations Manual guidance and Facility Assessment requirements. Strategic Insights: Perfect for candidates preparing for both the NAB CORE and NHA line-of-service assessments. Note: This is an expert-level, high-yield summary designed to distill thousands of pages of regulatory text into a single, high-impact study companion.

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Analytical Framework of the

2026/2027 Michigan Nursing

Home Administration Practice

Environment: Regulatory

Compliance, Clinical

Governance, and Fiscal

Stewardship
The professional landscape for nursing home administrators in Michigan has undergone a
transformative shift as of 2026, transitioning from a historical focus on documentation to a
contemporary mandate for data-driven accountability and high-stakes clinical stewardship. This
transition is anchored by the dual pressures of the Michigan Department of Licensing and
Regulatory Affairs (LARA) educational mandates and the sweeping federal reforms introduced
by the One Big Beautiful Bill Act (OBBBA) of 2025. To achieve licensure and maintain
operational excellence, the modern administrator must navigate a complex intersection of the
Michigan Public Health Code, the National Association of Long-Term Care Administrator Boards
(NAB) core competencies, and the nuanced fiscal realities of the Patient-Driven Payment Model
(PDPM). The following report provides an exhaustive analysis of the licensure requirements,
examination blueprints, and regulatory shifts defining the field in 2026.

Statutory Foundations and Licensure Prerequisites in
Michigan

, The regulatory authority for nursing home administration in Michigan is established under the
Public Health Code, Act 368 of 1978, with specific administrative rules codified in R 339.14001
through R 339.14035. As of May 7, 2026, a significant revision in the state's entry requirements
took effect, mandating a bachelor’s degree from an accredited institution for all initial licensure
applicants. This represents a hardening of the professional standard, although an equivalency
exists for registered nurses who hold an active license and an associate degree in nursing from
a Council for Higher Education and Accreditation (CHEA) accredited college.
The educational pathway involves a specialized 144-clock-hour course of instruction or a
9-semester-hour equivalent that covers ten critical subject areas, including administrative and
financial management, gerontology, human resources, and state and federal laws. Institutions
such as Western Michigan University and Michigan State University provide these foundational
credits through courses designed to prepare candidates for the administrative complexities of
skilled nursing and inpatient rehabilitation.

Licensure Fees and Administrative Components (2026)
Licensure Component Current Requirement/Fee (2026)
Initial NHA License (By Exam or Endorsement) $150.80
Relicensure Application (Lapsed License) $170.80
Continuing Education (CE) Requirement 36 hours per 2-year cycle
Mandatory Pain and Symptom Management 2 hours minimum
CE
Implicit Bias Training 1 hour per year of the license cycle
Human Trafficking Training One-time requirement (Rule 339.14006)
NAB CORE + NHA LOS Exam Application Fee $480.00 (Effective Feb 1, 2026)
A critical administrative responsibility involves the verification of these credentials. Educational
institutions must submit certification forms directly to LARA, ensuring an unalterable audit trail of
the applicant's qualifications. Furthermore, applicants must demonstrate "Good Moral
Character," a subjective but legally defined standard assessed through a series of behavioral
and history-based questions designed to ensure the public is served in an honest and open
manner.

The 2026 NAB Professional Practice Analysis and
Examination Blueprint
The National Association of Long Term Care Administrator Boards (NAB) recently completed the
2026 Professional Practice Analysis (PPA), resulting in a transition from a domain/subdomain
structure to nine stand-alone Domains of Practice. While the foundational knowledge required
for Nursing Home Administrators (NHA) remains consistent with previous standards, this new
structure is designed to clarify how content is organized and assessed across exams. Starting
July 1, 2027, the NHA exams and related reporting will be based on these nine independent
domains; however, candidates testing in 2026 must still be intimately familiar with the core
competencies that inform these categories.

Transition to the Nine Stand-Alone Domains of Practice

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