Only one state requires all three lines of service to hold a license at the present time (Oklahoma). The mission of LTC Administrator Boards should encompass the notion of public safety as the core of the work of the board and, therefore, it is consistent to believe new administrators/executives/leaders should have broader exposure to and comprehension of the full continuum of care. The HSE academic accreditation exceeds all states’ individual academic, classroom training and field experience when both elements are combined. It is estimated that two years of academic course work focused on the long term care professional practice analysis (the science behind the requirements) amounts to 4,120 hours in additional to the minimum 1,000 hours required to apply the knowledge to actual practice required in the Health Service Executive. If a state cannot agree to that principle of combined classroom and experiential knowledge, they may not be able to participate. Currently, no state requires more than 2,500 hours of combined classroom and field experience.