North Carolina NHA State Exam: What to Expect

The North Carolina NHA state exam is the state half of licensure, and it sits next to the national NAB exams rather than replacing them. The rule text readopted without change, effective October 1, 2015, is 21 NCAC 37D .0703. It sets a non-refundable processing fee of $150 each time you take the State Examination, requires a Test Confidentiality and Attestation Form, and requires you to pass the State Exam within one year of finishing the AIT program. If you want a North Carolina NHA state exam practice set while you read the rule, the daily questions are the place to start.

I am Chris Groves, a licensed nursing home administrator. This note stays inside the rule text published in the North Carolina Rules Review record and inside NAB’s exam pages for the national half. I am not going to state a passing percentage for the state exam. The grade rule has been amended since the flat figures people still repeat, and the safe instruction is to read the current rule and the NAB handbook before you pay.

What the state-exam rule actually says

The State Examination is given on dates the Board determines and publishes on the State Examination Application form on the Board’s website. The rule also allows other dates for some reciprocity applicants, and for AIT applicants who passed the National Examination but previously failed the State Examination, when they show good cause. Illness, weather, employment, and a survey are the examples the rule itself lists. That is a scheduling rule, not a promise that a date will be open when you want it.

The fee in the readopted rule is $150, and it is non-refundable, and it is due each time you take the State Examination. A second attempt is another $150. Budget the retake before you need it.

To sit, you submit a Test Confidentiality and Attestation Form. The rule describes it as a release stating that you will keep test questions confidential. The Board provides the form on its website and in the information package. Sign the form you are given. Do not treat a blog as the form.

The deadline is the one candidates miss when they treat AIT completion as the finish line. The rule says you shall pass the State Exam within one year of the date you complete the AIT program. Put that date on the calendar the week you finish training. A year is enough time to study and a short time if you wait for a perfect score on a practice set first.

The national exams are a separate step

North Carolina candidates also take the NAB exams. To sit for the National Exam, 21 NCAC 37D .0602 says you submit an exam application electronically to NAB. To release the NAB exam score, you pay the Board a processing fee of $50. That $50 is not the $150 state-exam fee, and it is not the NAB application fee. They are three different payments to two different organizations.

NAB’s current exam page is the source for the national structure: CORE is 100 scored questions plus 25 pretest questions, with 150 minutes of seat time, and the NHA line of service exam is 60 scored questions plus 15 pretest questions, with 90 minutes of seat time. NAB cannot approve your NHA application. Your board does. I wrote a separate note on those national exams, and the matching practice set is NHA Ready: NAB.

Effective February 1, 2026, NAB lists the CORE plus NHA combo application at $480. Confirm that figure on NAB’s page when you apply, because a fee page can change, and confirm with the Board which exams you are required to buy. Withdrawing an incorrect NAB application can cost a processing fee. The handbook is the document NAB tells you to read first.

What I will not invent

I will not put a passing percentage on the North Carolina state exam in this article. I will not invent the number of state questions or a state time limit, because the rule I cited does not publish them. I will not call a practice timer a Board time limit. NHA Ready NC times a 50-question practice exam at 60 minutes. That timer belongs to the practice app. It is not a figure from 21 NCAC 37D .0703.

The same restraint applies to the national passing standard. NAB’s score page says you see a preliminary PASS or FAIL immediately, and a detailed report after the state releases it. It does not, on that page, give you a number to memorize as a cutoff. Use the handbook and the current Board rule for the cutoff. Use the practice questions to learn the material.

How to get ready

• Write down the AIT completion date and the one-year state-exam deadline on the same line.
• Read 21 NCAC 37D .0703 and .0602 before you pay, and check the Board’s site for any later amendment.
• Apply for the NAB exams your Board requires, and keep the $50 score-release fee separate from the $150 state fee.
• Study state rules and the NAB domains on different days so a weak national domain does not hide inside state practice.
• Use the detailed NAB report, once the Board releases it, to choose what to restudy.

The confidentiality form means what it says. Do not ask anyone for live exam items, and do not post them. Practice material is original questions about the work. That is a different thing, and it is the only thing I am offering.

Practice for the state exam

NHA Ready NC has 126 original questions and a 50-question practice exam. Pro is $39 once. I wrote it. It is not affiliated with or endorsed by the North Carolina State Board of Examiners for Nursing Home Administrators, and it is not affiliated with NAB. The shop page is what to expect on the North Carolina NHA state exam. Five free questions a day fit the year you have after AIT better than a single cram weekend.

Sources

• NC Rules Review record: 21 NCAC 37D .0703 and .0602
• NAB exam information for the national CORE and NHA exams
• NAB Exam Candidate Handbook

Questions

NHA Ready NC is my practice set for the state exam. Five questions are free each day. Try 5 free questions a day

NHA Ready NC practice questions

Talk with Chris or call (828) 490-9271.