Nursing Home Administrators: Education and Careers

A study from the National Center for Biotechnology Information found that by 2030, unprecedented numbers of people will be entering nursing homes as the baby boomer generation ages. To meet the demand, there need to be widespread reforms, such as requiring insurance to pay for older people’s nursing home expenses and making long-term care more accessible.

If you’re interested in running a business efficiently while also helping others, a career as a nursing home administrator may interest you.

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What Is a Nursing Home Administrator?

Nursing home administrators oversee all operations at nursing home facilities, including both clinical and administrative tasks. These tasks include dealing with budgetary issues, marketing, patient care, and staff management.

Nursing home administrators (NHAs) are a a type of long term care administrator (LTC). LTCs oversee facilities that care for people who are unable to adequately care for themselves. The umbrella of long term care administrator also includes licensed residential care and assisted living administrators (RCALs) and home- and community-based services administrators (HCBSs).

Salary and Job Growth for Nursing Home Administrators

According to Payscale.com, nursing home administrators earned an average salary of $90,528 as of May 2020. Per the Bureau of Labor Statistics (BLS), jobs for all medical and health services managers, which includes nursing home administrators, are expected to grow by 18% between 2018 and 2028. This is much faster than the national average for all jobs, which is 4% to 6%.

What Do Nursing Home Administrators Do?

Nursing home administrators run the operations of nursing homes. They must gain funding and manage the budget of the facility they operate so they can afford to pay qualified staff, obtain any medical equipment they need, and pay for advertisement. Additionally, they ensure federal and state safety standards are in place so their clients can live healthy and pain-free lives. Nursing home administrators also represent their facility at board or investor meetings.

In addition to their administrative duties, NHAs manage the staff members at their facility, including caretakers, nurses, and administrative assistants.. They set work schedules, carry out performance reviews, and make sure employees are following best practices for patient care.

Nursing Home Administrator Work Settings

Nursing home administrators are employed by a variety of facilities—not just traditional nursing homes. Below is information about many common workplaces they manage.

Adult day cares provide care for seniors during the daytime only. Unpaid caregivers of elderly family or friends may take advantage of these facilities’ services to get a break from their caregiving duties or attend work.
Skilled nursing facilities are for seniors who are unable to live independently and need round the clock care.
Continuing care retirement communities are designed to allow people to stay on one campus as they age and their needs change. They can start out in assisted living housing, where they live somewhat independently, and later move into a nursing home where they can receive 24/7 care.
Memory care facilities exist to provide care specifically to elderly people suffering from dementia or Alzheimer’s.
Department of Veteran Affairs (VA) nursing homes provide care for veterans. A portion of the veteran’s care is subsidized by the Veterans Aid & Attendance Pension Benefit.

How to Become a Nursing Home Administrator: Educational Paths

Most states require NHAs to earn a license to practice. The requirements for licensure vary by state, but common requirements include:

An associate or bachelor’s degree
Passing scores on a national and/or state exam
Anywhere from 200-2,080 hours of training, depending on the state and the level of degree you earn (for example, in Alabama, you need 2,000 hours of training if you earn an associate degree; if you earn a master’s, you only need 200 hours of training)
Continuing education (CE) credits so you can renew your license; the number of CE credits you need depends on the state you’re licensed in

You can check out the licensing information below for specifics on each state.

Earn an Associate Degree

Some states only require their nursing home administrators to have an associate degree, though the ones that have this educational requirement also require a substantial number of training hours. It’s important to note that even if a state only requires an associate for licensure, some employers may require more advanced degrees.

Most states that require only an associate degree require an Associate of Arts degree rather than an Associate of Science. Specific nursing home administrator associate degrees are rare, so you should pick a concentration in healthcare management. Examples of concentrations include:

Health Information Technician
Medical Billing and Coding
Medical Administration Assistant
Health Sciences
Medical Assisting

For any concentration, you should learn about medical terminology, U.S. healthcare systems, healthcare policy, and conflict resolution.

To be accepted into an associate program, you will need a high school diploma or GED and possibly take a placement exam. Associate programs typically take two years to complete. If you want to earn a bachelor’s or master’s degree in the field, you don’t need to obtain an associate degree—though if you choose to transfer credits from an associate program to a four-year school, you may save money in the long run.

Earn an Associate’s in Health Administration

Earn a Bachelor’s Degree

Most states require at least a bachelor’s degree for licensure. Bachelor’s degrees in nursing home administration are rare, but many programs offer concentrations such as healthcare administration or health services administration.

To be accepted into a bachelor’s program, you will need a high school diploma, typically with a GPA of 2.0 or higher, or a GED. You may also need to submit letters of recommendation and a personal essay. Bachelor’s programs usually take four years (or 120 credit hours) to complete.

You can expect to take classes such as healthcare economics, healthcare marketing, healthcare quality management, and healthcare research. You may also be required to complete a capstone project.

Earn a Bachelor’s in Health Administration

Earn a Master’s Degree

Some states require you to have a master’s degree in healthcare administration to earn your license. Even if your state doesn’t require it, earning one can mean you need fewer training hours or you may be more competitive for certain jobs.

As with associate or bachelor’s degrees, master’s degrees specifically in nursing home administration are rare. Instead, you can earn your master’s in long-term care or healthcare administration. Other master’s degrees that may be useful or required are a Master of Science in gerontology or a Master of Business of Administration (MBA) in healthcare administration.

Master’s degrees typically take two years to complete. You may also be expected to complete a capstone project or thesis.

Earn a Master’s in Health Administration

Earn a Doctorate in Healthcare Administration (DHA)

Earning a Doctorate in Healthcare Administration may make you a more attractive candidate for jobs or boost your earning potential. You could also become a professor, teaching future generations to succeed in the nursing home administration field.

Doctoral degrees typically take four to six years to complete, and a dissertation will be required.

Earn a Doctorate in Health Administration

Earning Your Nursing Home Administrator License

Each state has different requirements for getting licensed as a nursing home administrator. All states require nursing home administrators to pass the long-term care national licensure exam. The national exam is sometimes referred to as the NAB, as the National Association of Long Term Care Administrator Boards (NAB) administers the exam.

Other common requirements for licensure include:

Passing a state exam
Being a minimum age of 18 to 21
Passing a background check
Having anywhere from 200 to 2,040 training hours—as previously mentioned, some states adjust how many training hours you need depending on the level of degree you’ve earned

To renew your license, you may have to earn continuing education credits.

Earning Continuing Education Credits

Most states require nursing home administrators to earn continuing education (CE) credits to renew their license. The number of CE hours required varies by state. For example, Alabama requires 24 hours of CE per year. North Carolina requires 30 hours every two years.

The National Continuing Education Review Service (NCERS) is NAB’s branch charged with reviewing and approving CE providers. They review courses and seminars offered as CE units to ensure they meet quality standards. Popular continuing education courses cover topics like abuse and neglect, customer service, and memory care and dementia and may often be completed online via services like CEU Academy.

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LNHA Requirements by State

The following information was gathered from National Association of Long Term Care Administrator Boards, Provider Management LLC, and state licensing boards.

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Alabama

Education Required: A.A.
Minimum Age: 19
Training Requirements: 2,000 hours with an A.A. OR 1,000 hours with a B.A. OR 200 hours an M.A.

This state does require you to pass an exam.

You will need to complete 24 continuing education units every year.

For more information, visit your state board

Alaska

Education Required: B.A.
Minimum Age: 19
Training Requirements: Unspecified

This state does not require you to pass an exam.

You will need to complete 18 continuing education units every year.

For more information, visit your state board

Arizona

Education Required: B.A.
Minimum Age: Unspecified
Training Requirements: 1,000 hours

This state does require you to pass an exam.

You will need to complete 50 continuing education units every 2 years.

For more information, visit your state board

Arkansas

Education Required: A.A.
Minimum Age: 21
Training Requirements: 3 months to 1 year of experience, depending on degree earned

This state does require you to pass an exam.

You will need to complete 20 continuing education units every year.

California

Education Required: M.A.
Minimum Age: 18
Training Requirements: 480 hours

This state does require you to pass an exam.

You will need to complete 40 continuing education units every 2 years.

For more information, visit your state board

Colorado

Education Required: A.A.
Minimum Age: 21
Training Requirements: 2,000 hours (waiver of 500 hours for 1 year of experience; waiver of 1,000 hours for 2 years of experience)

This state does require you to pass an exam.

You do not have to take continuing education credits.

For more information, visit your state board

Connecticut

Education Required: B.A.
Minimum Age: Unspecified
Training Requirements: 900 hours with a B.A. OR 500 hours with an M.A.

This state does require you to pass an exam.

You will need to complete 40 continuing education units every 2 years.

For more information, visit your state board

Delaware

Education Required: A.A.
Minimum Age: 18
Training Requirements: 3 to 12 months, depending on degree

This state does not require you to pass an exam.

You will need to complete 48 continuing education units every 2 years.

For more information, visit your state board

District of Columbia

Education Required: B.A.
Minimum Age: 18
Training Requirements: 1 year with a B.A. OR 6 months with an M.A.

This state does require you to pass an exam.

You will need to complete 40 continuing education units every 2 years.

For more information, visit your state board

Florida

Education Required: B.A.
Minimum Age: 18
Training Requirements: If you have a B.A. in healthcare administration: 650 hours of internship OR If you have a B.A. in healthcare administration: 1,000 hours of an AIT program OR If you have a B.A. in non-healthcare field: 2,000 hours in an AIT program

This state does require you to pass an exam.

You will need to complete 40 continuing education units every 2 years.

For more information, visit your state board

Georgia

Education Required: B.A.
Minimum Age: 21
Training Requirements: 6 months

This state does not require you to pass an exam.

You will need to complete 40 continuing education units every 2 years.

For more information, visit your state board

Hawaii

Education Required: B.A.
Minimum Age: 21
Training Requirements: 2,080 hours

This state does not require you to pass an exam.

You do not have to take continuing education credits.

For more information, visit your state board

Idaho

Education Required: B.A.
Minimum Age: 21
Training Requirements: 1,000 hours

This state does require you to pass an exam.

You will need to complete 20 continuing education units every year.

For more information, visit your state board

Illinois

Education Required: A.A.
Minimum Age: Unspecified
Training Requirements: 2 years of experience with an A.A. OR No experience required with a B.A.

This state does require you to pass an exam.

You will need to complete 36 continuing education units every 2 years.

For more information, visit your state board

Indiana

Education Required: A.A.
Minimum Age: Unspecified
Training Requirements: 1,040 hours

This state does require you to pass an exam.

You will need to complete 40 continuing education units every 2 years.

For more information, visit your state board

Iowa

Education Required: B.A.
Minimum Age: Unspecified
Training Requirements: 720 training hours or 400 hours of a practicum

This state does not require you to pass an exam.

You will need to complete 40 continuing education units every 2 years.

For more information, visit your state board

Kansas

Education Required: B.A.
Minimum Age: 18
Training Requirements: 480 hours

This state does require you to pass an exam.

You will need to complete 50 continuing education units every 2 years.

For more information, visit your state board

Kentucky

Education Required: B.A.
Minimum Age: 21
Training Requirements: 1,080 hours

This state does not require you to pass an exam.

You will need to complete 30 continuing education units every 2 years.

For more information, visit your state board

Louisiana

Education Required: B.A.
Minimum Age: 21
Training Requirements: 1,040 hours

This state does require you to pass an exam.

You will need to complete 15 continuing education units every year.

For more information, visit your state board

Maine

Education Required: B.A.
Minimum Age: Unspecified
Training Requirements: 2,040 hours

This state does require you to pass an exam.

You do not have to take continuing education credits.

For more information, visit your state board

Maryland

Education Required: B.A.
Minimum Age: 21
Training Requirements: 2,080 hours

This state does require you to pass an exam.

You will need to complete 40 continuing education units every 2 years.

For more information, visit your state board

Massachusetts

Education Required: B.A.
Minimum Age: 18
Training Requirements: 1 year internship

This state does not require you to pass an exam.

You will need to complete 40 continuing education units every 2 years.

For more information, visit your state board

Michigan

Education Required: 9 semester credits or 144 hours of instruction in a state-approved program
Minimum Age: 18
Training Requirements: None

This state does require you to pass an exam.

You will need to complete 36 continuing education units every 2 years.

For more information, visit your state board

Minnesota

Education Required: B.A.
Minimum Age: 21
Training Requirements: None

This state does not require you to pass an exam.

You will need to complete 30 continuing education units every 2 years.

For more information, visit your state board

Mississippi

Education Required: 64 college credit hours
Minimum Age: 21
Training Requirements: 2 years of experience with less than a B.A. OR No experience required with a B.A.

This state does require you to pass an exam.

You will need to complete 40 continuing education units every 2 years.

For more information, visit your state board

Missouri

Education Required: A.A.
Minimum Age: 18
Training Requirements: 2 years of experience with an A.A. OR 1 year of experience with a B.A. or M.A.

This state does require you to pass an exam.

You will need to complete 40 continuing education units every 2 years.

For more information, visit your state board

Montana

Education Required: High school diploma
Minimum Age: 18
Training Requirements: 1,200 hours of course instruction, training, and/or experience

This state does require you to pass an exam.

You will need to complete 25 continuing education units every year.

For more information, visit your state board

Nebraska

Education Required: A.A.
Minimum Age: 19
Training Requirements: 640 hours

This state does not require you to pass an exam.

You will need to complete 50 continuing education units every 2 years.

For more information, visit your state board

Nevada

Education Required: B.A.
Minimum Age: 21
Training Requirements: 1,000 hours

This state does not require you to pass an exam.

You will need to complete 30 continuing education units every 2 years.

For more information, visit your state board

New Hampshire

Education Required: B.A.
Minimum Age: 21
Training Requirements: 1 year

This state does require you to pass an exam.

You will need to complete 40 continuing education units every 2 years.

For more information, visit your state board

New Jersey

Education Required: B.A.
Minimum Age: 18
Training Requirements: 870 hours

This state does not require you to pass an exam.

You will need to complete 60 continuing education units every 3 years.

For more information, visit your state board

New Mexico

Education Required: B.A.
Minimum Age: Unspecified
Training Requirements: None

This state does require you to pass an exam.

You will need to complete 24 continuing education units every year.

For more information, visit your state board

New York

Education Required: B.A.
Minimum Age: 21
Training Requirements: 1 year

This state does not require you to pass an exam.

You will need to complete 48 continuing education units every 2 years.

For more information, visit your state board

North Carolina

Education Required: Minimum of 1 year of college
Minimum Age: 18
Training Requirements: 2 years of experience with no college OR No experience required with 1 year of college compelted

This state does require you to pass an exam.

You will need to complete 30 continuing education units every 2 years.

For more information, visit your state board

North Dakota

Education Required: A.A.
Minimum Age: 18
Training Requirements: 480 hours

This state does require you to pass an exam.

You will need to complete 20 continuing education units every year.

For more information, visit your state board

Ohio

Education Required: B.A.
Minimum Age: 18
Training Requirements: 1,500 hours

This state does require you to pass an exam.

You will need to complete 20 continuing education units every year.

For more information, visit your state board

Oklahoma

Education Required: B.A.
Minimum Age: 21
Training Requirements: 560 hours

This state does require you to pass an exam.

You will need to complete 24 continuing education units every year.

For more information, visit your state board

Oregon

Education Required: B.A.
Minimum Age: Unspecified
Training Requirements: 960 hours

This state does require you to pass an exam.

You will need to complete 20 continuing education units every year.

For more information, visit your state board

Pennsylvania

Education Required: 120 hours of study, experience, and/or training
Minimum Age: 21
Training Requirements: 800 hours

This state does require you to pass an exam.

You will need to complete 48 continuing education units every 2 years.

For more information, visit your state board

Rhode Island

Education Required: B.A.
Minimum Age: 18
Training Requirements: 350 hours

This state does not require you to pass an exam.

You will need to complete 40 continuing education units every 2 years.

For more information, visit your state board

South Carolina

Education Required: B.A.
Minimum Age: 21
Training Requirements: None

This state does require you to pass an exam.

You will need to complete 20 continuing education units every year.

For more information, visit your state board

South Dakota

Education Required: B.A.
Minimum Age: 18
Training Requirements: 240 hours

This state does require you to pass an exam.

You will need to complete 40 continuing education units every 2 years.

For more information, visit your state board

Tennessee

Education Required: A.A.
Minimum Age: 18
Training Requirements: 400 hours

This state does require you to pass an exam.

You will need to complete 18 continuing education units every year.

For more information, visit your state board

Texas

Education Required: B.A.
Minimum Age: Unspecified
Training Requirements: 1,000 hours

This state does require you to pass an exam.

You will need to complete 40 continuing education units every 2 years.

For more information, visit your state board

Utah

Education Required: B.A.
Minimum Age: Unspecified
Training Requirements: 1,000 hours

This state does not require you to pass an exam.

You will need to complete 40 continuing education units every 2 years.

For more information, visit your state board

Vermont

Education Required: B.A.
Minimum Age: 18
Training Requirements: 1,000 hours

This state does require you to pass an exam.

You will need to complete 40 continuing education units every 2 years.

For more information, visit your state board

Virginia

Education Required: B.A.
Minimum Age: Unspecified
Training Requirements: 2,000 hours

This state does not require you to pass an exam.

You will need to complete 20 continuing education units every year.

For more information, visit your state board

Washington

Education Required: B.A.
Minimum Age: Unspecified
Training Requirements: 1,500 hours

This state does not require you to pass an exam.

You will need to complete 36 continuing education units every 2 years.

For more information, visit your state board

West Virginia

Education Required: B.A.
Minimum Age: 21
Training Requirements: 2,040 hours

This state does require you to pass an exam.

You will need to complete 20 continuing education units every year.

For more information, visit your state board

Wisconsin

Education Required: A.A.
Minimum Age: 18
Training Requirements: None

This state does require you to pass an exam.

You will need to complete 24 continuing education units every 2 years.

For more information, visit your state board

Wyoming

Education Required: B.A.
Minimum Age: Unspecified
Training Requirements: 18 months

This state does not require you to pass an exam.

You will need to complete 25 continuing education units every year.

For more information, visit your state board

Resources for Nursing Home Administrators

The following resources may help NHA students and practitioners learn more about NHA careers and stay abreast of trends in the field.

National Association of Long Term Care Administrator Boards: This organization creates standards and best practices for health services executives. Their site contains information about licensing, exams, a database of approved CE providers, and training information.
American College of Healthcare Executives: This is an international society for people who work in healthcare administration. They offer education and events, publications, research, career resources, and more.
Medical Group Management Association: MGMA provides resources such as educational certifications, networking events, materials to help make long term care facilities succeed, and data tools to help healthcare professionals make informed decisions.
American Association of Healthcare Administrative Management: The AAHAM “provides information, education, and advocacy in the areas of reimbursement, admitting and registration, data management, medical records, patient relations, and so much more.” They offer advanced certifications and special events as well.
American College of Health Care Administrators: This nonprofit maintains a calendar of events by location, offers education opportunities, awards scholarships, and publishes a blog.
LeadingAge: LeadingAge is a nonprofit that promotes education and advocacy for the aged—their mission is “to provide a voice for the aging.” They accomplish their mission by offering events, a “newsroom” that provides up-to-date resources for nursing home administrators, podcasts, and other resources that can help NHAs make their facility thrive.

Health Administration Schools

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HEALTH ADMINISTRATION SCHOOLS

Additional Health Administration Schools

Alabama

The University of Alabama at Birmingham(Birmingham, AL)

Administration-Health Services, D.Sc (Executive Program)
Administration-Health Services, Ph.D. (Residential Program)

Alaska

Charter College(Anchorage, AK)

BS - Health Care Administration

Arizona

Arizona College(Glendale: Allied Health, AZ / Mesa: Allied Health, AZ)

Health Care Administration

Brookline College(Phoenix, AZ)

Associate of Science - Health Care Administration
(online)
Bachelor of Science - Health Care Administration
(online)

Northcentral University - Online(Prescott Valley, AZ)

DBA - Health Care Administration
(online)
PhD - Health Care Admininstration
PhD - Health Care Admininstration
(online)

California

Brandman University(Irvine, CA)

Certificate in Health Administration
(online)
MBA - Health Administration
(online)

California Coast University(Santa Ana, CA)

AS - Health Care Administration
(online)
BS - Health Care Administration
(online)

California State University-Long Beach(Long Beach, CA)

MS in Health Care Administration

Charter College(Oxnard, CA)

BS - Health Care Administration

San Joaquin Valley College(Bakersfield, CA / Fresno, CA / Hanford, CA / Hesperia, CA / Lancaster, CA / Modesto, CA / Ontario, CA / Visalia, CA)

Medical Office - Bakersfield
Medical Office - Fresno
Medical Office - Hanford
Medical Office - Hesperia
Medical Office - Lancaster
Medical Office - Modesto
Medical Office - Ontario
Medical Office - Visalia

San Joaquin Valley College - Online(Visalia, CA)

Certificate - Medical Billing and Coding
(online)
Degree - Medical Billing and Coding
(online)

University of California Los Angeles(Los Angeles, CA)

Doctor of Philosophy (PhD) in Health Services
Doctor of Public Health (Dr.P.H.) in Health Services
Masters of Science in Health Services

West Coast University - Online(Los Angeles, CA)

MS in Health Administration - Los Angeles, CA

Colorado

Connecticut

Branford Hall Career Institute(Southington, CT / Windsor, CT)

Health Claims Specialist

Delaware

University of Delaware Online(Newark, DE)

Master of Business Administration - Healthcare Concentration
(online)

Florida

Keiser University(Fort Lauderdale, FL / Fort Myers, FL / Lakeland, FL / Orlando, FL / Port St. Lucie, FL / Sarasota, FL / Tallahassee, FL / Tampa, FL)

AA in Health Services Administration - Lakeland, FL
AA in Health Services Administration - Port St. Lucie, FL
Associate of Arts in Health Services Administration
Associate of Arts in Health Services Administration - Fort Myers, FL
Associate of Arts in Health Services Administration - Orlando
Associate of Arts in Health Services Administration - Port St. Lucie
Associate of Arts in Health Services Administration - Sarasota
Associate of Arts in Health Services Administration - Tallahassee
Associate of Arts in Health Services Administration - Tampa, FL
BA - Health Services Administration
(online)
BA in Health Services Administration - Lakeland, FL
BA in Health Services Administration - Port St. Lucie, FL
Bachelor of Arts in Health Services Administration
Bachelor of Arts in Health Services Administration - Orlando
Bachelor of Arts in Health Services Administration - Port St. Lucie
Bachelor of Arts in Health Services Administration - Sarasota
Bachelor of Arts in Health Services Administration - Tallahassee
Bachelor of Arts in Health Services Administration - Tampa
Bachelor of Arts in Health Services Administration- Fort Myers, FL
Health Science, DHSc
MBA - Health Services Administration - Lakeland, FL
MBA - Health Services Administration - Port St. Lucie, FL
MS in Education - Allied Health Teaching and Leadership - Lakeland, FL
MS in Education - Allied Health Teaching and Leadership - Port St. Lucie, FL
Master of Business Administration, MBA - Health Services Administration
Master of Business Administration, MBA - Health Services Administration - Orlando
Master of Business Administration, MBA - Health Services Administration - Port St. Lucie
Master of Business Administration, MBA - Health Services Administration - Sarasota
Master of Business Administration, MBA - Health Services Administration - Tallahassee
Master of Business Administration, MBA - Health Services Administration - Tampa
Master of Business Administration, MBA - Health Services Administration- Fort Myers, FL

University of South Florida(Tampa, FL)

Master of Health Administration

University of West Florida - Online(Pensacola, FL)

Master of Science in Health Care Administration

Georgia

Illinois

Benedictine University(Lisle, IL)

Accelerated MBA - Healthcare Administration
(online)
MBA - Health Care Administration
(online)

Rasmussen College(Aurora, IL / Romeoville/Joliet, IL)

Health Information Management Bachelor Degree
Health Sciences Associates Degree
Health and Wellness Bachelors Degree-Completion Program
Healthcare Management Bachelors Degree-Completion Program
Human Services Bachelor’s Degree-Completion Program

Iowa

Kaplan University(Cedar Rapids, IA / Davenport, IA / Des Moines, IA / Mason City, IA)

BS in Health Care Administration
BSHUS - Human Services Administration
BSHUS - Youth/Family Services and Administration
Master of Health Care Administration

University of Iowa(Iowa City, IA)

Master of Health Administration and Master of Public Health in Policy joint degree
Master of Health Administration in Health Management and Policy
Master of Health Administration/Juris Doctor in Law Joint Degree
Master of Health Administration/Master of Arts in Urban and Regional Planning Combined Degree
Master of Health Administration/Master of Business Administration Joint Degree

Kansas

Central Christian College of Kansas(McPherson, KS)