As an addition to my original comment, I would like to express one considerable concern about the state exam that has been brought to my attention, and that is the delay in the examination process if the decision is made to use a state rather than a national exam.   Because the national exam has already been developed and tested, it is vetted as a valid testing instrument.  The process to do the same for the state exam will take considerable time, further delaying the upgrade in the licensing process.  As a compromise, requiring the national exam until such time as the state exam can be developed, tested, and determined to be valid would allow Virginia to move ahead to ensure its assisted living administrators are qualified at an appropriately high standard.