Retired Application Form

Any current licensed administrator may request to retire the license if s/he has maintained an active Missouri license at least ten (10) years and has retired from the practice of long term care administration. No person shall act or serve in the capacity of an administrator in this state or hold himself or herself out as an administrator if his or her license is retired. Retired licensees shall remain subject to disciplinary action for violations of Chapter 344, RSMo and the rules promulgated thereunder.

Request to Retire Administrator License:

  • Complete the Retired application available above.
  • Submit $50.00 fee with the Retired application via one of the following options.
    • Made payable online via electronic check or credit card at https://health.mo.gov/about/online-payment.php. Once electronic payment has been made and you received confirmation, email completed and signed Retired application to bnha@health.mo.gov or via fax to (573) 526-4314; or
    • Made payable in a check or money order to Board of Nursing Home Administrators.  Check or money order along with Retired application is to be mailed to Board of Nursing Home Administrators, ATTN: FEE RECEIPTS, PO Box 570, Jefferson City, MO 65102-0570.

Retired Returning to Active Status: (A retired license may be reactivated within five years of the granting of the retired license by submitting the following to the Board.)

  • Complete Application for License Renewal (please see the appropriate tab for your license type) showing satisfactory evidence of the completion of 20 clock hours* of board approved continuing education, as described in 19 CSR 73-2.050, for each calendar year the license was retired. All clock hours must be completed after the granting of the retired license or completed within the same licensure year the licensee was granted the retired license.
  • Submit $100.00 fee and Application for License Renewal via one of the following options:
    • Made payable online via electronic check or credit card at https://health.mo.gov/about/online-payment.php. Once electronic payment has been made and you received confirmation, email completed and signed Application for License Renewal to bnha@health.mo.gov or via fax to (573) 526-4314; or
    • Made payable in a check or money order to Board of Nursing Home Administrators.  Check or money order along with Application for License Renewal is to be mailed to Board of Nursing Home Administrators, ATTN: FEE RECEIPTS, PO Box 570, Jefferson City, MO 65102-0570.

*The Board may prorate the required clock hours for any portion of a calendar year as follows:

  1. Ten months or more, but less than twelve months - 20 clock hours including a minimum of 5 patient care hours;
  2. Seven months or more, but less than ten months - 15 clock hours including a minimum of 5 patient care hours;
  3. Four months or more, but less than seven months - 10 clock hours including a minimum of 2.5 patient care hours; or
  4. Less than four months - 5 clock hours including a minimum of 2.5 patient care hours.

If more than five (5) years have passed since the issuance of a retired license to a licensee, the licensee shall follow the procedures for initial licensure stated in section 344.030, RSMo. Please refer to tab for which type of license you wish to apply for as an initial applicant.

Retired Licensee Report