1. Completed Application - Applications may be submitted online at MyLicense.IN.gov.
2. Application Fee - $100.00 application fee to be paid by credit or debit card for applications submitted online.  All application fees are nonrefundable.
3. Criminal Background Check
4. Positive Response Documentation: If you answer "Yes" to any questions on the application, explain fully in a statement that includes all details. Include the violation, location, date, cause number, and disposition. Submit copies of court documents for each instance to support the statement. Please upload at the time of application or log back into your account and use the License Update option.
5. Name Change Documentation: Documentation of any legal name change if your name differs from that on any of your documents. Documentation may include a copy of your marriage certificate or divorce decree.  Please upload at the time of application or log back into your account and use the License Update option.
6. Requirements - Transcripts must show your completed education.  Please upload at the time of application or log back into your account and use the License Update option. Meet one of the following:
   • Be a licensed HFA or a registered, certified, or licensed health care practitioner under IC 16 or IC 25.
   • Have at least one (1) year of management experience:
     • in health care;
     • in housing;
     • in hospitality; or
     • providing similar services to the elderly.
       Verification of Employment form - Can be uploaded to your application.
   • Possess an associate's degree in gerontology or health care.
   • Possess a bachelor's degree or higher degree from an accredited postsecondary educational institution.
   • Complete a 100-hour specialized course in residential care facility administration that is approved by the board.
   • Completed application with $100.00 application fee.
   • Official transcripts showing your degree has been conferred.

The Fair Information Practice Act:  In compliance with Ind. Code 4-1-6, this agency is notifying you that you must provide the requested information, or your application will not be processed. You have the right to challenge, correct, or explain information maintained by this agency. The information you provide will become public record. Your examination scores and grade transcripts are confidential except in circumstances where their release is required by law, in which case you will be notified.

Mandatory Disclosure of U.S. Social Security Number: Your social security number is being requested by this state agency in accordance with Ind. Code 4-1-8-1 and 25-1-5- 11(a). Disclosure is mandatory, and this record cannot be processed without it. Failure to disclose your U.S. social security number will result in the denial of your application. Application fees are not refundable.

Abandon Applications:  If an applicant does not submit all requirements within one (1) year after the date on which the application is filed, the application for licensure is abandoned without any action of the Board. An application submitted after an abandoned application shall be treated as a new application.

*PLEASE WAIT TO RECEIVE THE NOTIFICATION OF THE FAILED EXAM BEFORE MAILING IN THE REPEAT EXAM*

1. Completed Application - Applications may be submitted online at MyLicense.IN.gov. Be sure to indicate which examination you wish to retake in the "Obtained by Method" section.
2. Application Fee -
   • If you are repeating the NAB or Examination - $50.00 repeat application fee to be paid by credit or debit card for applications submitted online.  All application fees are nonrefundable.
   • If you are repeating the Indiana Jurisprudence Examination - $100.00 repeat application fee to be paid by credit or debit card for applications submitted online.  All application fees are nonrefundable.
3. Criminal Background Check

The Fair Information Practice Act:  In compliance with Ind. Code 4-1-6, this agency is notifying you that you must provide the requested information, or your application will not be processed. You have the right to challenge, correct, or explain information maintained by this agency. The information you provide will become public record. Your examination scores and grade transcripts are confidential except in circumstances where their release is required by law, in which case you will be notified.

Mandatory Disclosure of U.S. Social Security Number: Your social security number is being requested by this state agency in accordance with Ind. Code 4-1-8-1 and 25-1-5- 11(a). Disclosure is mandatory, and this record cannot be processed without it. Failure to disclose your U.S. social security number will result in the denial of your application. Application fees are not refundable.

Abandon Applications:  If an applicant does not submit all requirements within one (1) year after the date on which the application is filed, the application for licensure is abandoned without any action of the Board. An application submitted after an abandoned application shall be treated as a new application.

Reciprocity Standard

Must meet all of these standards:

• Passes criminal background check (in accordance with IC 25-1-21).
• Practiced in another state for at least 1 year as any of the following:
  • Licensed HFA (active and in good standing);
  • Chief executive officer of a hospital; or
  • Chief operations officer of a hospital.
• Passes Indiana’s jurisprudence examination.
• Passes the national examination.


OR

The applicant has a NAB HSE (National Association of Long Term Care Administrators Boards Health Services Executive) license in good standing.

The applicant to serve as preceptor shall file a new application for approval for each administrator-in-training applicant for whom the administrator desires to serve as preceptor. An application fee of $50.00 will need to be submitted with each application.

HFA Preceptor Requirements

• Hold an active HFA license in good standing.
• Complete a board approved educational program
• Meet any of the following:
  • Minimum of 2 years of work experience as an HFA
  • CEO of a CCRC; or
  • be employed as a regional manager for a health facility
  • Be approved by the Board prior to serving as the preceptor for an administrator-in-training.

Preceptor Application Information

1. Completed Application - The Health Facility Administrator that wishes to be a preceptor must apply here MyLicense.IN.gov and upload their preceptor certificate to the online application. 
   • Please note: The Board cannot locate a preceptor for you nor do they provide a listing of health facility administrators who are qualified to act as preceptors in the State of Indiana.
2. Location - The administrator-in-training program must be completed in a comprehensive care facility. You will serve as an administrator-in-training for a minimum of thirty-two (32) hours a week but no more than eight (8) hours daily. You are required to complete the program in a minimum of three (3) months and a maximum of twelve (12) months.
3. Not Required - You do not need to complete/submit the following forms:
   • Verification of Administrator-in-Training Program for Health Facility Administrator Licensure Form
   • Verification of Employment of Applicants for Health Facility Administrator Licensure Form

You MAY NOT begin your Administrator-In-Training program until you have received written approval from the Board. Along with this written approval, you will receive a packet of information that includes the following:

1. Start Notification Form
2. Notice of Change of Status and/or Discontinuance in AIT Program 3.
3. Affidavit of Completion

Once you are approved by the Board to begin your administrator-in-training program and receive your packet information, you will need to submit the Start Notification Form to the Professional Licensing Agency. This form is to be completed by you and your Preceptor.

When you complete your administrator-in-training program, you must submit the Affidavit of Completion and register for the NAB examination at their website www.nabweb.org. Once our office receives the the passing NAB results, you will be emailed the Intent to Take the Health Facility Jurisprudence Examination form that lists the available examination dates. Please see section titled EXAMINATION INFORMATION on pages 5 and 6 for further details on the examination process.

HFA Temporary Permit Information

Temporary Permit Repealed (IC 25-19-1-3.5)

1. Application - Apply online at https://mylicense.in.gov/eGov/ML1PLA.html
2. Application Fee - $100.00 application fee to be paid by credit or debit card.  All application fees are nonrefundable.
3. Required Documentation: Please be prepared to upload the following with your application
   • Organization Description - Provide a brief description of your organization, including organization philosophy, objectives, and organizational chart.
   • Organization Background - Provide a brief description of the organization's background in continuing education and log term care education.
   • Brochure - A sample of advertising brochure for your program(s) for health facility administrators
   • Evaluation Sample - Description of evaluation techniques that will be utilized (attach sample) and provide a statement of how evaluations are utilized by your organization.
   • Certificate Sample - Provide a sample certificate to be awarded for completion of the program
   • Attendance - Provide a description of monitoring techniques utilized to verify attendance.
   • Records - Provide a description of record keeping system for continuing education programs to be offered and length of time records are kept.
   • Statement  - Provide a statement regarding whether or not attendance at your programs are open to all health facility administrators.

Important Information:

• Sponsors of programs must file application with the board and be approved at least thirty (30) days prior to the date of the first presentation.
• Approval of a sponsor will be valid for a maximum period of one (1) year. All approvals expire on January 31 of each year.
• The sponsor is responsible for monitoring attendance of programs in such a way that verification of attendance throughout the program can be reliably assured.
• Approved continuing education sponsors must retain the attendance records for a period of five (5) years, during which time the board may request review of these records.

Indiana Jurisprudence Examination

Please be advised that IPLA proctors the HFA Jurisprudence Exam.  The Jurisprudence exam information is only given to approved applicants.  

Candidates for the Indiana State Jurisprudence Examination must meet all the education and experience requirements prior to being approved to take the examination. There is not an additional fee to take the Jurisprudence exam. All applicants for licensure must take and pass the Indiana Jurisprudence examination.

HFA Applicants

• The board may waive up to 30% (or 312 hours) of the required training hours for an HFA applicant with a high school diploma/equivalency who has served in a long-term care facility department manager position, based upon criteria approved by the board, provided the applicant's experience under consideration is verifiable to the board's satisfaction.

• HFA A.I.T. Waiver Request Form

You may satisfy the administrator-in-training requirements with one of the following:

1. one (1) year active work experience as a licensed health facility administrator in another state; OR
2. completion of a training program required for licensure as a health facility administrator in another state that is determined by the Board to be equivalent to the administrator-in-training requirements in this state; you will need to submit the Verification of Administrator-in-Training Program for Health Facility Administrator Licensure Form completed by the state that approved your administrator-in-training program; OR
3. completion of a residency-internship in health care administration completed as part of a degree requirement (possession of associate degree, bachelor degree or higher) that is determined by the Board to be equivalent to the administrator-in-training requirements of this state; you will be required to submit documentation of this residency-internship; OR
4. one (1) year active work experience as a chief executive officer or chief operations officer in a hospital; OR
5. a master's degree in health care administration and six (6) months of active work experience as a licensed health facility administrator in another state.

For additional information, you may contact the Board at 317-234-3022 or by e-mail at pla10@pla.in.gov.

• Application - Apply online at https://mylicense.in.gov/eGov/ML1PLA.html\

Upload a syllabus and course load. Once this application is complete, it will require an appearance at a board meeting before it can be licensed.

* Please note, anyone wanting to enter into the AIT program does not complete this application.  You will need to apply for the HFA license by exam*