Learn how to apply for or renew your Provisional Nursing Home Administrator license or permit.
A provisional license cannot be renewed for more than 24 total combined months in an entire career. The 24 months in service are not required to be consecutive, however, a new application is required for each appointment period.
Application fee is $120. All application fees are nonrefundable.
Documentation & Questions
Documentation and questions may be submitted by email: plpublic@idph.iowa.gov.
Fee
The application fee is $120. All application fees are nonrefundable.
Proof of Licensure Duration
Attach evidence that provisional appointment will not exceed 24 calendar months in duration for the entirety of the applicant's career. If the applicant has previously served in this capacity, the following can be provided. Email the documents to plpublic@idph.iowa.gov if there are any issues attaching.
- Written employment verification signed by a facility designee.
- Written attestation signed by facility designee.