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  Application for Licensure as a Nursing Home Administrator
   

 


License Application

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Instructions

Welcome to the Board of Examiners for Nursing Home Administrators online license application services! You must be able to answer Yes to the following questions to submit an online application. Please check the appropriate answer below.
 
*Indicates required field
 
* Can you pay online by Visa, MasterCard or Discover?
* Does your Visa, MasterCard or Discover have a billing address in the USA?
  
 
All information provided is private until your application has been approved. Once it has been designated as an application, only your name, address and applicant status is considered public. Public information is available to any person upon request.

The Board of Examiners for Nursing Home Administrators is seeking data from you which may be considered private or confidential under the Minnesota Government Data Practices Act, Minn. Stat. § 13.01 et seq. Minn. Stat. § 13.04, subd. 2 requires the Board to notify you of the following four matters before you are asked to supply such information about yourself: (1) This data is being collected to determine whether you meet the requirements for application of your license as well as whether you have violated any statutes or rules the Board is empowered to enforce; (2) You are not legally required to complete and return this licensure application, but failure to do so may result in the denial of this licensure renewal application; (3) If you supply the data requested and it shows a violation of any of the statutes or rules enforced by the Board, you may be subject to disciplinary or other action by the Board. If you refuse to supply the data requested, your licensure application may be denied. In addition, falsification or omission of information may be used by the Board as a basis for disciplinary action; and (4) the data which you supply will be accessible to Board staff. The data you supply may also be released to other persons and/or governmental entities that have statutory authority to review the data, investigate specific conduct, and/or take appropriate legal action. If the Board institutes a formal disciplinary action against you, the information you supply could become public.

Please note that all fees submitted to the Board are nonrefundable.

In compliance with the Americans with Disabilities Act, this instruction sheet and all enclosed materials may be made available in alternative formats upon request.
 
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