PROPOSED RULEMAKING
STATE BOARD OF EXAMINERS OF NURSING HOME ADMINISTRATORS
[49 PA. CODE CH. 39]
Administrator-in-Training Program
[37 Pa.B. 1494]
[Saturday, April 7, 2007]The State Board of Examiners of Nursing Home Administrators (Board) proposes to amend §§ 39.1, 39.5, 39.61 and 39.72 and add §§ 39.101--39.103 (relating to AIT Program) to read as set forth in Annex A. The proposed rulemaking updates and amends the requirements for admission to the licensing examination.
A. Effective Date
The proposed rulemaking will be effective on final-form publication in the Pennsylvania Bulletin.
B. Statutory Authority
Under section 4(c) of the Nursing Home Administrators Licensing Act (act) (63 P. S. § 1104(c)), the Board is authorized to make rules and regulations as may be necessary for the proper performance of its duties. Under section 4(a)(1) of the act, the Board is authorized to develop, impose and enforce standards that must be met by individuals in order to receive a license as a nursing home administrator (NHA). These standards must be designed to insure that NHAs will be individuals who are of good character and are otherwise suitable and qualified by training or experience in the field of institutional administration to serve as NHAs.
C. Background and Need for Amendments
Section 39.5(a) (relating to requirements for admission to licensing examination; examination procedures) provides that a candidate who seeks admission to the licensing examination shall meet the following requirements: (1) be at least 21 years of age; (2) submit evidence of good moral character and suitability as prescribed by the Board in the examination application; and (3) pay the required fee for examination and licensure.
In addition to these general requirements, § 39.5(b) gives candidates the opportunity to sit for the examination provided they meet certain educational and experience requirements. Each of the five options requires candidates to serve 6 to 12 months as assistant NHAs prior to sitting for the examination. Many nursing homes simply cannot afford to hire and pay assistant administrators. Therefore, it is exceedingly difficult for candidates to obtain the requisite experience under the current regulations.
In a profession that has seen a significant decline of licensees over the past 5 years, the institution of an administrator-in-training program (AIT), as proposed by this rulemaking, will give candidates who do not meet the requirements of § 39.5(b) an incentive and an alternative option to become licensed NHAs. The Board believes that, by offering candidates who meet the rigid standards of higher education an additional means of qualifying to sit for the examination, more candidates would be encouraged to enter the field of nursing home administration.
The proposed AIT program will permit an individual with a baccalaureate or master's degree to serve as an AIT, or intern, under the supervision of an NHA, who will function as a mentor to the AIT. Under the NHA's supervision, a candidate with a baccalaureate degree will be required to obtain 1,000 hours of experience in the practice of nursing home administration, while a candidate with a master's degree will be required to obtain 800 hours. Each AIT program will be individualized and approved, in advance, by the Board. Each program must have a detailed, goal-oriented training plan with supporting documentation that relates educational objectives, subject areas of the required core of knowledge, estimated number of hours for mastering each objective and the total number of hours involved. This program must consist of no less than 20 hours nor more than 60 hours per week. At the completion of the AIT program, both the supervising NHA and candidate shall submit to the Board comprehensive documentation that the candidate is qualified to sit for the examination.
North Carolina, Ohio and Maryland currently have AIT programs in place. This proposed rulemaking is similar to the AIT regulations of those states. Those states, however, require that the supervising NHA attend a training course to become ''preceptors'' to the AIT. This proposed rulemaking requires that the supervisor to the AIT be licensed by the Board and be employed as the administrator-of-record at the facility where the AIT is training.
D. Description of Proposed Amendments
§ 39.1. Definitions.
The Board proposes to add definitions of ''AIT--administrator-in-training'' and ''AIT program'' to § 39.1.
§ 39.5. Requirements for admission to licensing examination; examination procedures.
The proposed amendments to § 39.5 would change the experience requirements to immediately precede the date of application, not date of examination.
Section 39.5(b)(3)(ii) would be amended to add a baccalaureate degree equivalent to nursing home administration as an alternative to a baccalaureate degree in nursing home administration and the requirement that the candidate who possesses the equivalent degree provide transcripts that demonstrate that the candidate has completed a 120-hour course in nursing home administration as part of the baccalaureate curriculum.
Section 39.5(b)(3)(iii)(C) and (4)(ii)(B) would be amended to add an experience alternative for candidates with baccalaureate or baccalaureate-equivalent degrees and master's degrees to participate in the AIT program in lieu of obtaining actual experience in a nursing home or health related facility prior to sitting for the examination.
§ 39.61. Requirements.
The Board proposes to add § 39.61(b)(5) to provide that up to 24 clock hours of continuing education may be obtained through serving as a supervisor in a Board-approved AIT program, when the AIT successfully completes the AIT program under § 39.103 (relating to AIT program reports).
§ 39.72. Fees.
The Board proposes to amend § 39.72 to include a $50 AIT application fee.
§§ 39.101--39.103. AIT Program.
The Board proposes to add §§ 39.101--39.103 to institute the AIT program.
Section 39.101 (relating to AIT) requires an AIT applicant to file an application with the Board and describes the criteria for approval as an AIT.
Section 39.102 (relating to AIT program) requires documentation for the individualized AIT program, which includes a pretraining assessment of the AIT's background and a written training plan prepared by the AIT and supervisor for approval by the Board. This section also sets forth the weekly and hourly requirements and that the program may not consist of more than 60 hours per week nor less than 20 hours per week. Further, this section sets forth procedures in the event the AIT program is discontinued or terminated before completion.
Section 39.103 sets forth the procedure for AIT program reports that must be submitted to the Board by both the AIT and the AIT's supervisor within 30 days of completion of the AIT program.
E. Fiscal Impact
The proposed rulemaking will have a limited fiscal impact on the Commonwealth and its political subdivisions. The proposed rulemaking establishes a new fee associated with the proposed AIT program. However, this fee is intended to defray a portion of the Board's operational costs. There are no other costs or savings to the State government associated with implementation of the proposed rulemaking.
F. Paperwork Requirements
The proposed rulemaking will require the Board to alter some of its forms to reflect the new fee and to create applications for AITs. The Board will further provide a detailed training plan to NHAs who supervise AITs. Further, the proposed rulemaking will create additional paperwork for AITs and supervisors, who will be responsible for submitting a detailed, individualized AIT framework for each AIT and documentation of progress and completion of the AIT program.
G. Sunset Date
The Board continuously monitors the effectiveness of its regulations. Therefore, no sunset date has been assigned.
H. Regulatory Review
Under section 5(a) of the Regulatory Review Act (71 P. S. § 745.5(a)), on March 28, 2007, the Board submitted a copy of this proposed rulemaking and a copy of a Regulatory Analysis Form to the Independent Regulatory Review Commission (IRRC) and to the Chairpersons of the Senate Consumer Protection and Professional Licensure Committee and the House Professional Licensure Committee. A copy of this material is available to the public upon request.
Under section 5(g) of the Regulatory Review Act, IRRC may convey any comments, recommendations or objections to the proposed rulemaking within 30 days of the close of the public comment period. The comments, recommendations or objections must specify the regulatory review criteria which have not been met. The Regulatory Review Act specifies detailed procedures for review, prior to final publication of the rulemaking, by the Board, the General Assembly and the Governor of comments, recommendations or objections raised.
I. Public Comment
Interested persons are invited to submit written comments, suggestions or objections regarding this proposed rulemaking within 30 days of publication of this proposed rulemaking to Christina Stuckey, Administrator, State Board of Examiners of Nursing Home Administrators, P. O. Box 2649, Harrisburg, PA 17105-2649, cstuckey@ state.pa.us. Reference No. 16A-627 (Administrator-in-Training Program) when submitting comments.
BARRY S. RAMPER, II,
ChairpersonFiscal Note: 16A-627. No fiscal impact; (8) recommends adoption.
Annex A
TITLE 49. PROFESSIONAL AND VOCATIONAL STANDARDS
PART I. DEPARTMENT OF STATE
Subpart A. PROFESSIONAL AND OCCUPATIONAL AFFAIRS
CHAPTER 39. STATE BOARD OF EXAMINERS OF NURSING HOME ADMINISTRATORS
GENERAL § 39.1. Definitions.
The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise:
AIT--Administrator-in-training--An individual registered with the Board under § 39.101 (relating to AIT), to serve a period of practical training and experience under the supervision of a licensed nursing home administrator.
AIT program--A program established by the Board as a means for an applicant for licensure as a nursing home administrator to obtain practical training and experience under the supervision of a licensed nursing home administrator.
* * * * * § 39.5. Requirements for admission to licensing examination; examination procedures.
* * * * * (b) A candidate who seeks admission to the licensing examination shall also meet one of the following sets of education and experience requirements. The candidate shall:
(1) Have:
(i) [Commencing March 1, 1993, successfully] Successfully completed 120 clock hours in a program of study approved by the Board as prescribed in § 39.14(a)(2) (relating to approval of programs of study).
* * * * * (iii) Done one of the following:
(A) During the 18 months immediately preceding the date of [examination] application, acquired experience in the practice of nursing home administration by having served satisfactorily in a nursing home or related health facility as a full-time assistant administrator under the supervision of a full-time nursing home administrator licensed in this Commonwealth or in another state whose licensing standards are equal to those of [this] the Commonwealth.
(B) During 3 of the 5 years immediately preceding the date of [examination] application, served satisfactorily as a full-time supervisor in a nursing home or related health facility, 1,000 hours of which service shall have been in the practice of nursing home administration under the supervision of a full-time nursing home administrator licensed in this Commonwealth or in another state whose licensing standards are equal to those of the Commonwealth.
(2) Have:
(i) [Commencing March 1, 1993, successfully] Successfully completed 120 clock hours in a program of study approved by the Board as prescribed in § 39.14(a)(2).
* * * * * (iii) Done one of the following:
(A) [Served] During the 18 months immediately preceding the date of the application, served satisfactorily as a full-time Director of Nursing for 6 months and, during the 12 months immediately preceding the date of [examination] application, but not concurrent with the service as a Director of Nursing, acquired experience in the practice of nursing home administration by having served satisfactorily as a full-time assistant administrator in a nursing home or related health facility under the supervision of a full-time nursing home administrator licensed in this Commonwealth or in another state whose licensing standards are equal to those of [this] the Commonwealth.
(B) During 2 of the 5 years immediately preceding the date of [examination] application, served satisfactorily as a full-time Director of Nursing in a nursing home or related health facility, 1,000 hours of which service shall have been in the practice of nursing home administration under the supervision of a full-time nursing home administrator licensed in this Commonwealth or in another state whose licensing standards are equal to those of the Commonwealth.
(3) Have:
* * * * * (ii) [Commencing March 1, 1993, successfully] Successfully completed 120 clock hours in a program of study approved by the Board as prescribed in § 39.14(a)(2), unless the candidate has a baccalaureate degree in nursing home administration or a baccalaureate degree in a program equivalent to nursing home administration. The burden is on the candidate to demonstrate that the baccalaureate degree that the candidate has earned is equivalent to a baccalaureate degree in nursing home administration. Baccalaureate degree equivalency will be determined by the Board based upon the applicant's transcripts and course descriptions. Candidates who have successfully completed a baccalaureate curriculum which is not in nursing home administration or equivalent to nursing home administration, but incorporates the 120-hour program as part of the curriculum, are not required to complete the 120-hour program separately. The burden is on the candidate to demonstrate that the 120-hour program is incorporated in the baccalaureate curriculum. The Board will evaluate the transcripts and course descriptions of the candidate to determine if the 120-hour program was successfully completed as part of the baccalaureate curriculum.
(iii) Done one of the following:
(A) During the 9 months immediately preceding the date of [examination] application, acquired experience in the practice of nursing home administration by having served satisfactorily in a nursing home or related health facility as a full-time assistant administrator under the supervision of a full-time nursing home administrator licensed in this Commonwealth or in another state whose licensing standards are equal to those of the Commonwealth.
(B) During 18 months of the 5 years immediately preceding the date of [examination] application, served satisfactorily as a full-time supervisor in a nursing home or related health facility, 1,000 hours of which service shall have been in the practice of nursing home administration under the supervision of a full-time nursing home administrator licensed in this Commonwealth or in another state whose licensing standards are equal to those of the Commonwealth.
(C) [During 2 of the 5 years preceding the date of examination, which date of examination may not be later than August 31, 1995, served satisfactorily as a full-time chief administrator in a nursing home or related health facility.] During the 2 years immediately preceding the date of application, acquired 1,000 hours of experience in the practice of nursing home administration by having served satisfactorily as an AIT in a nursing home under the supervision of a full-time nursing home administrator licensed in the Commonwealth or in another state whose licensing standards are equal to those of the Commonwealth, in accordance with §§ 39.101--39.103 (relating to AIT Program).
(4) Have:
* * * * * (ii) [Either] Done one of the following:
(A) During the 5 years immediately preceding the date of application, either acquired 6 months of satisfactory full-time supervisory experience in the administration of a nursing home under the supervision of a full-time nursing home administrator licensed in this Commonwealth or in another state whose licensing standards are equal to those of the Commonwealth or acquired 6 months of satisfactory full-time experience in the administration of a related health facility under the supervision of a full-time nursing home administrator licensed in this Commonwealth or in another state whose licensing standards are equal to those of the Commonwealth[, except that an individual who is acquiring satisfactory full-time experience in the administration of a related health facility on December 31, 1994, even though the experience is not being acquired under the supervision of a full-time nursing home administrator licensed in this Commonwealth or in another state whose licensing standards are equal to those of the Commonwealth, shall have until June 30, 1995, to apply for admission to the licensing examination under the regulations in effect immediately prior to December 31, 1994].
(B) During the 2 years immediately preceding the date of application, acquired 800 hours of experience in the practice of nursing home administration by having served satisfactorily as an AIT in a nursing home under the supervision of a full time nursing home administrator licensed in this Commonwealth or in another state whose licensing standards are equal to those of the Commonwealth, in accordance with §§ 39.101--39.103.
(5) Have:
(i) [Commencing March 1, 1993, successfully] Successfully completed 120 clock hours in a program study approved by the Board as prescribed in § 39.14(a)(2).
* * * * * (iii) Done one of the following:
(A) During the 18 months immediately preceding the date of [examination] application, acquired experience in the practice of nursing home administration by having served satisfactorily in a nursing home or related health facility as a full-time assistant administrator under the supervision of a full-time nursing home administrator licensed in this Commonwealth or in another state whose licensing standards are equal to those of the Commonwealth.
(B) During 3 of the last 5 years immediately preceding the date of [examination] application, served satisfactorily as a full-time supervisor in a nursing home or related health facility, 1,000 hours of which service shall have been in the practice of nursing home administration under the supervision of a full-time nursing home administrator licensed in this Commonwealth or in another state whose licensing standards are equal to those of the Commonwealth.
(c) The [1,000] hours of experience in the practice of nursing home administration required of a candidate qualifying under subsection (b)(1)(iii)(B), (2)(iii)(B), (3)(iii)(B) or (C), (4)(ii)(B) or (5)(iii)(B) is designed to insure that the candidate has been exposed to hands-on practical application of the areas of educational training required in § 39.14(a)(2). The [1,000] hours of experience [shall] must include a minimum of 300 hours in general administration, a minimum of 250 hours in patient services and care and a minimum of 250 hours in health and social service delivery systems. [The 200] Any remaining hours may be distributed as needed to obtain the best results for each individual candidate. The nursing home administrator who supervised the candidate shall certify that the candidate has acquired the minimum number of hours for each area.
* * * * *
CLOCK HOURS REQUIREMENT § 39.61. Requirements.
* * * * * (b) Of the 48 hours required, the following [applies] apply:
* * * * * (5) Up to 24 clock hours may be obtained by serving as a supervisor in a Board-approved AIT program, when the AIT successfully completes the AIT program.
(6) A maximum of 6 clock hours may be awarded retroactively for attending programs, to include lectures, and college or university courses, which have not been preapproved. The attendee shall submit a written request for approval within 30 days of attending the program and document attendance. The attendee shall demonstrate to the Board's satisfaction that the programs meet the requirements of §§ 39.14(a)(2) and 39.51 (relating to approval of programs of study; and standards for continuing education programs).
* * * * *
RENEWAL § 39.72. Fees.
The following is the schedule of fees charged by the Board:
* * * * * AIT application fee $50
AIT PROGRAM (Editor's Note: The following sections are new and are printed in regular type to enhance readability.)
§ 39.101. AIT.
(a) An applicant seeking to become an AIT shall file an application for approval on a form prescribed by the Board.
(b) To be approved as an AIT, the applicant shall:
(1) Have attained the general education requirements in § 39.5(b)(3)(i) or (4)(i) (relating to requirements for admission to licensing examination; examination procedures) or be enrolled in the final year of a baccalaureate or master's degree program at an accredited college or university.
(2) Verify that if the AIT is employed at the nursing home in any capacity other than that of AIT during the period of practical training and experience, that employment is in addition to the hours required for the AIT program.
§ 39.102. AIT program.
(a) The AIT program must provide documentation that the following requirements have been met:
(1) The AIT and the AIT's supervisor have jointly made a pretraining assessment of the AIT's background in terms of educational level, pertinent experience, maturity, motivation and initiative.
(2) Based on the pretraining assessment, the AIT and the AIT's supervisor jointly have developed a detailed, goal-oriented training plan with supporting documentation which includes:
(i) Educational objectives.
(ii) Subject areas of the core of knowledge as required by §§ 39.5(c) and 39.7 (relating to requirements for admission to licensing examination; examination procedures; and subject matter for examinations).
(iii) Training sites or agencies involved.
(iv) Estimated number of hours needed for mastering each objective.
(v) Total of hours in the training plan.
(3) Prior to its implementation, the training plan must be submitted for approval by the Board on forms provided by the Board. The training plan must include supporting documentation for the training plan, including the allocation of hours to the subject areas required by §§ 39.5(c) and 39.7.
(4) A minimum of 80% of the training must occur from Monday through Friday between 7 a.m. and 7 p.m. An AIT program may not consist of more than 60 hours per week nor less than 20 hours per week.
(b) The Board has the right to monitor and call for conference any AIT or AIT supervisor during the course of the AIT program.
(c) Following the completion of the AIT program and prior to admission to the examination for licensure, the Board will review the report required by § 39.103 (relating to AIT program reports) to determine if the applicant has received training consistent with this section.
(d) If the AIT program is discontinued prior to completion, the following apply:
(1) An AIT program which has been discontinued by a period of full-time military service may be completed within a year after that military service.
(2) An AIT program which has been discontinued for any reason other than military service may not be completed if the absence exceeds 1 year from the date of discontinuance.
(3) If an AIT program has been discontinued before completion for any reason beyond AIT or supervisor control, the AIT and supervisor may apply to the Board for consideration of credit for the period of time completed.
(i) The AIT requesting consideration shall explain why the AIT program was discontinued, how the AIT intends to complete the training and document progress in the manner required by § 39.104 (relating to AIT program reports).
(ii) The supervisor requesting consideration shall explain why the AIT program was discontinued and document the hours that the supervisor spent on the training program.
(4) Only one discontinuance will be permitted.
§ 39.103. AIT program reports.
Within 30 days of the completion of the AIT program, the AIT and supervisor shall submit to the Board a report on the AIT's progress on forms provided by the Board. The AIT and supervisor shall sign the report, verifying the accuracy of the information. The report must include, at a minimum:
(1) The names of the AIT and supervisor.
(2) The place of training.
(3) A statement of the subject areas covered during the program.
(4) A list of the departments in which the AIT trained, as well as initials of department managers to verify that the AIT trained in those departments.
(5) The number of hours the AIT has completed during the program in each subject area.
(6) A description of the administrative activities in which the AIT has participated.
(7) Suggestions for improvement in the program.
(8) Other information the Board requests.
[Pa.B. Doc. No. 07-596. Filed for public inspection April 6, 2007, 9:00 a.m.]
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