RULES AND REGULATIONS
STATE BOARD OF EXAMINERS OF NURSING HOME ADMINISTRATORS
Continuing Education; Advance Notice of Final Rulemaking
[51 Pa.B. 1017]
[Saturday, February 27, 2021]The State Board of Examiners of Nursing Home Administrators (Board) is publishing an advance notice of final rulemaking (ANFR) seeking additional comment regarding the requirements for continuing education. The proposed rulemaking was published at 50 Pa.B. 668 (February 1, 2020).
Statutory Authority
Section 9(b) of the Nursing Home Administrators License Act (act) (63 P.S. § 1109(b)) requires licensees to complete not less than 24 hours of Board-approved continuing education courses and programs as a condition of biennial renewal. Section 4(a)(9) of the act (63 P.S. § 1104(a)(9)) provides the statutory authority for the proposed continued competency provision. Section 4(a)(9) also authorizes the Board to develop standards of professional practice and standards of professional conduct appropriate to establish and maintain a high level of integrity and performance in the practice of nursing home administration. Additionally, section 4(c) of the act authorizes the Board to promulgate regulations to effectuate the act.
Background and Summary
On February 1, 2020, the Board published the proposed rulemaking seeking, among other things, to reduce the number of continuing education clock hours required as a condition of biennial renewal from 48 to 36. The Board made this proposal because a review of the continuing education requirements for nursing home administrators in the Northeast geographic region, including Ohio, West Virginia, Maryland, Delaware, New Jersey, New York, Massachusetts, Rhode Island, Connecticut, New Hampshire, Vermont and Maine, indicated that the Board's requirement of 48 hours was one of the highest continuing education requirements in the region.
The Board entertained public comment for 30 days during which time the Board received comments from Leading Age PA and the Pennsylvania Coalition of Affiliated Healthcare and Living Communities (PACAH). Following the close of the public comment period, the Board received comments from the Independent Regulatory Review Commission (IRRC), as well as the House Professional Licensure Committee (HPLC).
Leading Age Pa indicated that they do not support the reduction of continuing education clock hours. The group spoke to the tremendous value of education and noted that some educational topics are needed but are not eligible for continuing education credit. Further, the group stated that many educational activities, such as reading articles to keep up on new trends and requirements, do not earn continuing education units. Members noted that they would prefer if a larger proportion of the continuing education units could be attained through serving as an instructor, authoring an article, or serving as a supervisor in a Board-approved Administrator in Training (AIT) program. They urged the Board to leave in place the 12 clock hours previously allocated to these continuing education units, rather than reducing them to 9 clock hours. They also suggest that the number of continuing education units available for published articles remain at 24 clock hours and that clock hours for supervising an AIT remain at 24 clock hours rather than being reduced to 18 clock hours.
The PACAH also opposed the proposed reduction on continuing education clock hours. Its comments cite to the reports released in 2016 from the Pennsylvania Auditor General and the Nursing Home Quality Improvement Task Force. Both reports indicate that Pennsylvania needs to focus on improving quality of care within facilities. In light of this, PACAH indicated that they do not support a reduction in the continuing education requirements for nursing home administrators. The association stated there is an obvious correlation between quality of care and increased education in any field, but especially healthcare. With an increasing aging population, increasing acuity levels and increasing regulatory requirements, there is no logical explanation for decreasing educational requirements, especially if there is a desire to enhance the quality of care. Additionally, PACAH members stated that they have no issue obtaining their 48 credit hours biennially. PACAH pointed out the continuing education requirements in other states. If Pennsylvania reduced its continuing education requirement from 48 to 36 continuing education units biennially, it would have one of the lowest continuing education requirements in the country.
The comments from the HPLC also concerned the proposed reduction in continuing education units and compared it to the requirements in other states. The Committee questioned whether the reduction would have any impact on Pennsylvania licensees seeking licensure in one of those contiguous states.
IRRC reiterated the opposition to reducing the continuing education requirements because it would result in Pennsylvania having a lower continuing education requirement than several contiguous states. IRRC expressed concern about the impact on Pennsylvania licensees who would seek licensure in any of those states. IRRC recommended the Board explain how lowering the continuing education requirement would adequately protect the public health safety and welfare as well as how it will affect the regulated community who seek licensure in other states.
The Board reviewed these comments, among others, and concluded that a reduction of the continuing education units from 48 biennial to 36 would not be in the best interests of the licensees or the public. Instead, the Board is now proposing to keep the current continuing education requirement at 48 clock hours biennially, but to require that 12 of the 48 clock hours be completed in the areas of emergency preparedness and infection control. During the course of developing the final-form rulemaking, the Board witnessed how the novel coronavirus (COVID-19) pandemic affected the industry and the importance of nursing home administrators being prepared to handle and navigate these difficult circumstances in order to protect the residents in the facilities which they oversee. Additionally, the Board proposes to revise the proposed rulemaking's allocation of continuing education clock hours for authoring various types of publications, and to restore the proportions of continuing education awarded for serving as an instructor or as a supervisor in a Board-approved AIT program.
To assure that the public has a full opportunity to comment on these proposed revisions to the final-form rulemaking, the Board voted to publish this ANFR seeking additional comments from the public.
Contact Person, Availability of Draft Final Regulations and Submission of Comments
The Board will accept written comments as well as comments transmitted by means of e-mail on the draft final-form rulemaking. Comments will not be accepted by facsimile, telephone or voice mail. Comments sent by means of e-mail must include the following in the subject heading of the transmission: ''Comments on 16A-6219—Continuing Education ANFR.'' E-mail transmissions as well as written comments must include the commentator's name and address. Written comments must be received by the Board within 30 days of the publication of this notice in the Pennsylvania Bulletin. To request a copy of the draft final-form rulemaking or to provide a comment, contact Alexandra Sacavage, Board Counsel, State Board of Examiners of Nursing Home Administrators, P.O. Box 65923, Harrisburg, PA 17106-9523, RA-STRegulatoryCounsel@pa.gov.
SHARON McDERMOND,
Chairperson
[Pa.B. Doc. No. 21-279. Filed for public inspection February 26, 2021, 9:00 a.m.]
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