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PA Bulletin, Doc. No. 08-1291

RULES AND REGULATIONS

STATE BOARD OF EXAMINERS OF NURSING HOME ADMINISTRATORS

[ 49 PA. CODE CH. 39 ]

Administrator-in-Training Program

[38 Pa.B. 3811]
[Saturday, July 12, 2008]

   The State Board of Examiners of Nursing Home Administrators (Board) hereby amends §§ 39.1, 39.5, 39.61 and 39.72 and adds §§ 39.101--39.103 (relating to AIT Program), to read as set forth in Annex A.

Effective Date

   The final-form rulemaking will be effective on publication in the Pennsylvania Bulletin.

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 to receive a license as a nursing home administrator (NHA). These standards must be designed to ensure 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. Section 4(a)(1) further provides that these standards ''may include a requirement for supervised experience prior to licensure.'' This rulemaking creates an alternate method by which individuals may receive that supervised experience.

Background and Purpose

   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 adopted by this rulemaking, will give candidates who do not meet the experience requirements of existing § 39.5(b) (relating to requirements for admission to licensing examination; examination procedures) 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 gaining supervised experience to qualify to sit for the examination, more candidates would be encouraged to enter the field of nursing home administration.

Description of the Amendments

   The final-form rulemaking amends § 39.1 (relating to definitions) to define AIT and the AIT program. It further amends § 39.5 to establish the AIT program as an alternative method of obtaining required supervised experience for admission to the licensing examination.

   The final-form rulemaking amends § 39.61(b)(5) (relating to requirements) pertaining to continuing education clock hour requirements to allow a supervisor for the AIT program to receive credits for continuing education, and amends § 39.72 (relating to fees) to establish a $50 fee for an AIT application. Finally, the amendments adopt §§ 39.101--39.103 to implement the AIT program.

Response to Public Comment and Regulatory Review of Proposed Rulemaking

   Publication of proposed rulemaking at 37 Pa.B. 1494 (April 7, 2007) was followed by a 30-day public comment period during which the Board received favorable comments from the Pennsylvania Association of County Affiliated Homes (PACAH) and the Pennsylvania Health Care Association (PHCA). The PACAH indicated its support of the rulemaking, stating, ''As the shortage of qualified Nursing Home Administrators continues to worsen, the AIT program offers a practical approach to address the issue, and PACAH encourages the adoption of these rules as final.'' PHCA congratulated the Board on proposing the AIT program and asked the Board to seek to finalize the regulations as quickly as possible, noting that ''the current fiscal constraints in many cases make it nearly impossible to afford the salaries of assistant administrators thus making it difficult for interested individuals to obtain the required experience to become nursing home administrators. This is precisely the wrong time, with the growing demographics of older Pennsylvanians who will required care and services in our nursing homes, to have regulatory roadblocks in the way of fine individuals who have a desire to become nursing home administrators.''

   Following the close of the public comment period, the Board received comments from the House Professional Licensure Committee (HPLC) and the Independent Regulatory Review Commission (IRRC). The Board did not receive comments from the Senate Consumer Protection and Professional Licensure Committee (SCP/PLC). The following represents a summary of the comments received from the HPLC and IRRC, and the Board's response.

General Comments

   The HPLC questioned the Board's authority to promulgate regulations to create an AIT program and requested further explanation. As noted previously, under section 4(a)(1) of the act, the Board is authorized to develop, impose and enforce standards that must be met by individuals to receive a license as an NHA. These standards must be designed to ensure 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. Section 4(a)(1) of the act also provides that these standards ''may include a requirement for supervised experience prior to licensure.'' Under that authority, the Board had previously adopted the supervised experience requirements in § 39.5, which require candidates for licensure to gain experience by serving as a full-time assistant administrator, or by serving as a full-time supervisor in a nursing home or related health facility. In recent years, the profession has seen a significant decline in the number of NHAs. Additionally, many nursing homes cannot afford to employ full-time assistant administrators or supervisors. Therefore, under the authority granted in section 4(a)(1) of the act, the Board is recognizing an additional way for individuals, who cannot find employment either as an assistant administrator or supervisor in a nursing home, to gain the experience needed to qualify for licensure.

   The HPLC also noted the requirement for criminal background checks to be completed upon employees of a nursing home under the Older Adults Protective Services Act (35 P. S. §§ 10225.101--10225.708). The HPLC also noted the absence of any provision which would apply this same standard to an AIT. The HPLC, therefore, requests that the AIT be required to also have a criminal background check.

   While the act does not explicitly require applicants to obtain a criminal background check, the act does require an applicant to submit ''evidence of good character and suitability prescribed by the board . . .'' (63 P. S. § 1106(a)). In addition, the Criminal History Record Information Act gives all boards and commissions the authority to deny a license if an applicant has been convicted of any felony or a misdemeanor related to the profession. 18 Pa.C.S.A. § 9124 (relating to use of records by licensing agencies). The HPLC pointed out, all employees of nursing homes are already subject to criminal background checks under the Older Adults Protective Services Act. Currently, all applicants for licensure are required to submit criminal background checks to the Board. Therefore, the Board has sufficient implicit authority to require criminal background checks of AITs and the AIT application will also require criminal background checks of all AIT program applicants.

§ 39.5. Requirements for admission to licensing examination; examination procedures.

   The HPLC noted that under the proposed amendments in § 39.5(b)(3)(ii), the burden is on the candidate to demonstrate that the candidate's degree is equivalent to one in nursing home administration and suggested that the Board provide minimum criteria for the candidate to do so. In determining equivalence, the Board will review the transcripts and course descriptions submitted by the candidate in comparison to the educational criteria in § 39.14(a)(2)(i)--(xvi) (relating to approval of programs of study) to make that determination. Similarly, IRRC questioned the criteria the Board will use under subsection (b)(3)(ii), which requires the Board to 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. In general, the Board will use the breakdown of subjects required in § 39.14(a)(2) to determine if a candidate has successfully completed the requirements of the 120-hour program. If a candidate is deficient in subject areas, the candidate will be permitted to complete the remaining hours/courses through a 120-hour program. The candidate will not be required to complete the full 120-hour program. In the final-form rulemaking, the Board has complied with IRRC's suggestion that § 39.14(a)(2) be cross-referenced.

   IRRC also noted that subsection (b)(3)(iii)(C) adds language that the candidate have 1,000 hours of experience working with an NHA licensed in this Commonwealth ''or in another state whose licensing standards are equal to those of the Commonwealth.'' IRRC noted a similar concern applies to subsection (b)(4)(ii)(B), and asked if the Board will publish a list of states whose licensing standards are ''equal'' to the Commonwealth's or if the information would be made available on the Board's web site. Currently, almost every state has licensing standards that are equal to or greater than the Pennsylvania requirements. In fact, the Commonwealth is one of the few states that will license a NHA without a college degree. The Board would encourage the General Assembly to amend the licensing statute to require a minimum of a baccalaureate degree. However, for purposes of determining whether the AIT supervisor qualifies under these regulations, the Board will be able to look at the other states' current licensing standards to determine whether those standards are equal to the standards of the Commonwealth. As licensing standards change periodically, the Board does not intend to publish or make available on its web site a list of the states whose licensing standards are ''equal'' to the Commonwealth.

§ 39.101. AIT.

   The HPLC noted that, under § 39.101(b)(1) (relating to AIT), an AIT applicant may be enrolled in the final year of a baccalaureate or master's degree program at an accredited college or university. The HPLC requested further information on whether the Board plans to coordinate the efforts of this program with colleges and universities and how the Board would facilitate this. The Board will encourage colleges and universities to establish relationships with local nursing homes to provide students who are in their final year of school opportunities to work as AITs at the local facilities. Provided the 120-hour program is included in the 4-year baccalaureate curriculum, the graduating individual who served as an AIT during the individual's final year of school would be able to sit for the nursing home examination immediately after graduation.

§ 39.102. AIT program.

   IRRC noted that § 39.102(a)(1) (relating to AIT program) requires the AIT and the AIT supervisor to jointly make a ''pretraining assessment'' of certain aspects of the AIT's background and training and asked what criteria will be required to be used to ensure that uniform assessments are made. As noted in § 39.102(a)(1), the assessments will be based on the AIT's educational level, experience, motivation and initiative. The AIT and AIT supervisor will then develop a training plan, under § 39.102(a)(2), the training plan will include educational objectives, subject areas, training sites, estimated number of hours needed for mastering each objective and the total number of hours in the training plan. Each training plan will be submitted to the Board for approval as required under § 39.102(a)(4). Each training plan will be individualized, according to the AIT's background. However, the Board will be able to determine, according to each individualized assessment, whether the proposed training program will enable the AIT to gain sufficient experience to become a licensed NHA.

   IRRC and the HPLC questioned what kind of ''agencies'' the Board is referring to in § 39.102(a)(2)(iii), which requires that the training plan include ''training sites or agencies involved.'' Because the required experience must be attained by working in nursing homes under the supervision of a NHAs, the Board has deleted the reference to ''agencies'' in the final-form rulemaking.

   Both the HPLC and IRRC questioned § 39.102(d)(4), which provides that only one discontinuance of an AIT program will be permitted. The HPLC asked for clarification. IRRC asked if this provision was intended to apply to those individuals who may have two or more discontinuances of their program due to involuntary military service. As a result of the comments, the Board has reconsidered this provision and has deleted subsection (d)(4) from the final-form rulemaking.

   The HPLC requested information regarding an AIT's remedy for discontinuance by a supervisor or inadequate supervision, under § 39.102(d)(3). The AIT should inform the Board that the supervisor has discontinued supervision of the AIT or that the supervision is inadequate. Depending on the individual circumstances, the Board may permit the AIT to obtain a new supervisor and receive credits for the amount of training the AIT already received.

   The HPLC also requested information regarding how the Board will monitor a supervisor or an AIT. Section 39.102(b) gives the Board ''the right to monitor and call for conference any AIT or AIT supervisor during the course of the AIT program.'' This will be determined by individual circumstances that require more direct Board involvement. For example, if the Board receives information pertaining to inadequate supervision by an AIT supervisor or an AIT who is not abiding by the training plan, the Board has the authority to schedule a conference with the parties involved.

§ 39.103. AIT program reports.

   Relating to program reports required at the completion of the AIT program, IRRC pointed out that § 39.103(2) and (3) (relating to AIT program reports), regarding training site and subjects covered during the training is redundant because this information is required in the pretraining assessment required by § 39.102(a)(2) and (3). The Board agrees and has deleted paragraphs (2) and (3) in the final-form rulemaking and renumbered the remaining items accordingly.

   IRRC also questioned how the AIT and supervisor will know if the Board requests other information under § 39.103(8) after the conclusion of the AIT program. IRRC also asked what type of ''other information'' would be included. Section 39.103 has been amended in the final-form rulemaking by breaking it down into two subsections. Subsection (a) lists all the information required in the report at the conclusion of the training program. Subsection (b) will be added, which will give the Board the option to request additional information after the report is submitted. Other information could include clarification of training the AIT received during the program.

Fiscal Impact and Paperwork Requirements

   The final-form rulemaking will have a limited fiscal impact on the Commonwealth or its political subdivisions. The final-form rulemaking establishes a new fee associated with the AIT program application. 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 rulemaking.

   The final-form 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 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.

Sunset Date

   The Board continuously monitors the effectiveness of its regulations. Therefore, no sunset date has been assigned.

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 the notice of proposed rulemaking, published at 37 Pa.B. 1494, to IRRC and the Chairpersons of the HPLC and the SCP/PLC for review and comment.

   Under section 5(c) of the Regulatory Review Act, IRRC, the HPLC and the SCP/PLC were provided with copies of the comments received during the public comment period, as well as other documents when requested. In preparing the final-form rulemaking, the Board has considered all comments from IRRC, the HPLC, the SCP/PLC and the public.

   Under section 5.1(j.2) of the Regulatory Review Act (71 P. S. § 745.5a(j.2)), on May 14, 2008, the final-form rulemaking was approved by the HPLC. On June 4, 2008, the final-form rulemaking was deemed approved by the SCP/PLC. Under section 5.1(e) of the Regulatory Review Act, IRRC met on June 5, 2008, and approved the final-form rulemaking.

Contact Person

   Further information may be obtained by contacting Christina Stuckey, Administrator, State Board of Examiners of Nursing Home Administrators, P. O. Box 2649, Harrisburg, PA 17105-2649, cstuckey@state.pa.us.

Findings

   The Board finds that:

   (1)  Public notice of proposed rulemaking was given under sections 201 and 202 of the act of July 31, 1968 (P. L. 769, No. 240) (45 P. S. §§ 1201 and 1202) and the regulations promulgated thereunder, 1 Pa. Code §§ 7.1 and 7.2.

   (2)  A public comment period was provided as required by law and all comments were considered.

   (3)  This final-form rulemaking does not enlarge the purpose of proposed rulemaking published at 37 Pa.B. 1494.

   (4)  The final-form rulemaking adopted by this order is necessary and appropriate for administering and enforcing the authorizing act identified in Part B of this Preamble.

Order

   The Board, acting under its authorizing statutes, orders that:

   (a)  The regulations of the Board, 49 Pa. Code Chapter 39, are amended by amending §§ 39.1, 39.5, 39.61 and 39.72; and by adding §§ 39.101--39.103 to read as set forth in Annex A, with ellipses referring to the existing text of the regulations.

   (b)  The Board shall submit this order and Annex A to the Office of General Counsel and to the Office of Attorney General for approval as required by law.

   (c)  The Board shall certify this order and Annex A and deposit them with the Legislative Reference Bureau as required by law.

   (d)  This order shall take effect on publication in the Pennsylvania Bulletin.

BARRY S. RAMPER, II,   
Chairperson

   (Editor's Note: For the text of the order of the Independent Regulatory Review Commission relating to this document, see 38 Pa.B. 3461 (June 21, 2008).)

   Fiscal Note: Fiscal Note 16A-627 remains valid for the final adoption of the subject regulations.

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.

   (a)  A candidate who seeks admission to the licensing examination shall meet the following requirements. The candidate shall:

   (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.

   (3)  Pay the required fee for examination and licensure.

   (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)  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).

   (ii)  Successfully completed 2 academic years of college-level study, 30 semester hours each year, in an accredited institution of higher learning.

   (iii)  Done one of the following:

   (A)  During the 18 months immediately preceding the date of 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 5 years immediately preceding the date of 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)  Successfully completed 120 clock hours in a program of study approved by the Board as prescribed in § 39.14(a)(2).

   (ii)  Been issued a registered nurse license in this Commonwealth which is currently renewed.

   (iii)  Done one of the following:

   (A)  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 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 the Commonwealth.

   (B)  During 2 of the 5 years immediately preceding the date of 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:

   (i)  Been awarded a baccalaureate degree from an accredited college or university.

   (ii)  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 and compare them to the requirements of § 39.14(a)(2) 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 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 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 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 this 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:

   (i)  Been awarded, from an accredited college or university, a master's degree in nursing home administration, in hospital administration, in public health administration or in another academic area, including social gerontology, in which there is an emphasis in related health facility administration.

   (ii)  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.

   (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)  Successfully completed 120 clock hours in a program of study approved by the Board as prescribed in § 39.14(a)(2).

   (ii)  Acquired 2 years of satisfactory practical experience in the administration of a nursing home or related health facility, 1,000 hours of which practical experience shall have been 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. A candidate will be required to appear personally before the Board to present documentation of the satisfactory practical experience claimed which includes a general knowledge of each of the following areas that are generally dealt with by a nursing home administrator: budget, hiring and firing, planning, personnel, supervision of staff, psychology of patients, medical and legal terminology, Federal and State rules and regulations governing nursing homes, rights of patients, basic principles of contract and tort law, principles of safety, purchasing, dietetic requirements and patient care.

   (iii)  Done one of the following:

   (A)  During the 18 months immediately preceding the date of 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 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 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 hours of experience 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. 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.

   (d)  A candidate shall pass a written examination that comprises two parts. Both parts of the examination are administered by a professional testing organization.

   (1)  An examination on the general principles of nursing home administration that are common to all jurisdictions that license nursing home administrators, known as the ''uniform part.''

   (2)  An examination on the regulations of the Department of Health in 28 Pa. Code Part IV Subpart C (relating to long term care facilities), known as the ''State part.''

   (e)  To pass the examination, a candidate shall achieve a passing score on both the uniform and State parts as set by the Board.

   (f)  Upon a timely request, the Board may allow a candidate to take the examination with the aid of a proctor, if the candidate is unable, because of physical problems, to take the examination under ordinary circumstances.

   (g)  A candidate who passes one part of the examination and fails the other is required to retake only the part failed. A candidate for reexamination on one or both parts of the examination shall submit an application to the Board and pay the required examination fee. As a condition precedent to reexamination after four failures, the Board may require the candidate to attend Board-approved courses of study in subjects prescribed by the Board.

   (h)  A special examination will not be given to a candidate except as provided in subsection (f).

CLOCK HOURS REQUIREMENT

§ 39.61. Requirements.

   (a)  A licensee shall complete at least 48 clock hours during the preceding biennial period.

   (b)  Of the 48 hours required, the following apply:

   (1)  At least 24 hours shall be taken in lecture or computer interactive courses approved by NAB or the Board.

   (2)  Up to 24 clock hours may be taken through college or university courses, including distance learning, approved by NAB or the Board.

   (3)  A maximum of 12 clock hours may be taken in the following categories:

   (i)  Individual study using NAB or Board-approved correspondence courses.

   (ii)  Serving as an instructor of a NAB or Board-approved continuing education program or a college or university course. Instructors may earn 1 clock hour for each hour of instruction up to 12 clock hours.

   (4)  Authoring an article on long-term care. Authors whose articles relating to long-term care are published in professional journals may earn 3 clock hours per article, up to a maximum of 12 clock hours per biennium. Additional credit per article, up to 12 of the required clock hours, may be awarded based on the complexity of the subject matter or work. In exceptional circumstances, when the article is published in a refereed journal, and the subject matter or work is complex, a licensee may be awarded up to 24 clock hours. Published articles used for continuing education credit shall be submitted to the Board within 30 days of publication. Upon review of the published article, the Board will determine the appropriate number of clock hours to be awarded based upon the complexity of the subject matter or work.

   (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).

   (c)  A licensee who obtains a license after the biennial period begins shall complete a prorated amount of clock hours equal to 2 clock hours per month through the end of the biennial period. For the purpose of calculating the number of clock hours required, partial months shall count as whole months.

   (d)  A licensee suspended for disciplinary reasons is not exempt from the continuing education requirements in subsection (a).

   (e)  A licensee who cannot meet the continuing education requirement due to illness, emergency or hardship may apply to the Board in writing prior to the end of the renewal period for a waiver. The request must explain why compliance is impossible, and include appropriate documentation. Waiver requests will be evaluated by the Board on a case-by-case basis.

   (f)  A licensee will not be credited for repeating a program in the same renewal period unless the subject matter has substantially changed during that period.

RENEWAL

§ 39.72. Fees.

   The following is the schedule of fees charged by the Board:

Biennial renewal of nursing home administrators license$297
License application fee$40
Temporary permit fee$145
Certification of examination scores$25
Verification of licensure or temporary permit$15
Continuing education provider application fee$40
Continuing education program application fee per clock hour$15
Continuing education individual program application fee$20
AIT application fee $50

AIT PROGRAM

§ 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 (b)(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 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 shall 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 his progress in the manner required by § 39.103.

   (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.

§ 39.103. AIT program reports.

   (a)  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)  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.

   (3)  The number of hours the AIT has completed during the program in each subject area.

   (4)  A description of the administrative activities in which the AIT has participated.

   (5)  Suggestions for improvement in the program.

   (b)  The Board reserves the right to request additional information from the AIT and the AIT's supervisor on a case-by-case basis.

[Pa.B. Doc. No. 08-1291. Filed for public inspection July 11, 2008, 9:00 a.m.]



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