The Board proposes the amendments to update and streamline the AIT Program.

 

DEPARTMENT OF HEALTH

Board of Nursing Home Administrators

RULE NOS.:RULE TITLES:

64B10-16.001General Information

64B10-16.002Preceptor

64B10-16.0021Change of Status of Preceptor.

64B10-16.0025Preceptor Training Seminar

64B10-16.003Facility at Which Training Takes Place

64B10-16.005Domains of Practice, Objectives, Reports

64B10-16.007Out-of-State Administrator-In-Training Programs

PURPOSE AND EFFECT: The Board proposes the amendments to update and streamline the AIT Program.

SUMMARY: Update rules.

SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS AND LEGISLATIVE RATIFICATION: The Agency has determined that this will not have an adverse impact on small business or likely increase directly or indirectly regulatory costs in excess of $200,000 in the aggregate within one year after the implementation of the rule. A SERC has not been prepared by the Agency.

Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.

RULEMAKING AUTHORITY: 468.1685(1), (2), (3), (4), 468.1695(2), (3), (4) FS

LAW IMPLEMENTED: 456.013, 468.1685(3), (4), 468.1695, (2), (3), (4), (5) FS

IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE SCHEDULED AND ANNOUNCED IN THE FAR.

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Anthony Spivey, Executive Director, Board of Nursing Home Administrators, 4052 Bald Cypress Way, Bin #C07, Tallahassee, Florida 32399-3257, [phone]

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

64B10-16.001 General Information; Monitors.

(1) An Administrator-in-Training program is a supervised training program internship during which the Administrator-in-Training (AIT) works under the supervision of a Board approved Ppreceptor, a licensed administrator meeting the qualifications in Rule 64B10-16.002, F.A.C.

(2) An applicant for the AIT program must meet those qualifications established by Section 468.1695, F.S. and Rule 64B10-11.002, F.A.C., at the time of application, including completion of an Application for Administrator-In-Training, form DH-MQA-NHA003 (Revised 10/2013), hereby adopted and incorporated by reference, and pay the application fee specified in Rule 64B10-12.013, F.A.C. The form can be obtained from the web at http://floridasnursinghomeadmin.gov/resources/ http://www.doh.state.fl.us/mqa/nurshome/ap_instr.pdf or at http://www.flrules.org/Gateway/reference.asp?No=Ref-03687. The applicant is required to indicate whether the applicant is applying for the AIT 1000-hour program or the AIT 2000-hour program as referenced in Rule 64B10-11.002, F.A.C.

(3) The Board must approve each facility at which the training will take place.

(3)(4) AIT The training must be under the full-time supervision of the Ppreceptor. A Ppreceptor shall supervise only one AIT or intern at any given time; however, if the facility has a minimum of 120 beds and more than one an assistant administrator duly licensed under Chapter 468, Part II, F.S., the Ppreceptor may then supervise a maximum of two AITs or interns, or a combination thereof.

(4)(5) The AIT shall serve his/her training in a normal work-week, containing a minimum of 30 hours and a maximum of 50 hours, with not less than six hours to be served daily between the hours of 7:00 a.m. and 10:00 p.m., except that during the year a minimum of 40 hours and a maximum of 80 160 hours are to be served between 10:00 p.m. and 7:00 a.m.

(5)(6) The AIT program shall begin on the first day of the month following Board the approval of the Board.

(6)(7) No change.

(7)(8) No change.

(8)(9) The Monitor shall for good cause Board may approve one a temporary discontinuance of the training for up to 1 year, but the AIT shall only retain credit for those quarters completed and for which reports have been submitted and approved by the Mmonitor. The Monitor may disapprove a request for temporary discontinuance if the Preceptor does not agree to the discontinuance.

(9)(10) The Board will approve an interruption of an AIT program for the compulsory active duty service of the AIT in the armed forces of the United States. The AIT may resume his or her training at any time within one year of his discharge from active duty.

(10)(11) Both the AIT and the Preceptor must report any discontinuance of training to the Board within 10 days. Failure to do so may subject the Preceptor to disciplinary action, and will result in the AIT loosing credit for the current and previous quarter and a three (3) month suspension from further participation in the program.

(11)(12) No change.

(12)(13) One member of the Board shall function as a Monitor of each AIT program. More than one Board Member may function as a Monitor, but only one Monitor shall be assigned to each AIT program. Each Board Member who functions as a Monitor shall be a licensed nursing home administrator. The Monitor shall evaluate the progress of the AIT in the AIT program in the following manner:

(a) The Monitor shall review the required quarterly reports, and other information required by Rule 64B10-16.005, F.A.C.;

(b) The Monitor shall determine whether the report and information submitted meet the requirements of Rule 64B10-16.005, F.A.C. for each reporting period quarter;

(c) Should the Monitor determine the requirements of Rule 64B10-16.005, F.A.C., have not been met, the Monitor shall take one or more of the following actions:

1. No change.

2. Refuse to award the AIT credit toward the AIT program for hours completed within the reporting period quarter;

3. Require the AIT and Ppreceptor to revise and resubmit the report;

4. Require the AIT and/or Ppreceptor to submit additional documentation demonstrating hours completed in each domain area for that reporting period quarter; and/or

5. No change.

(d) The Monitor shall maintain communication with the AIT and Preceptor, and report to the Board on the progress of the AIT.

(e) The Monitor shall notify the Board whether the AIT has satisfactorily completed the AIT program.

1. No change.

2. If the required reports or the AIT's progress in the program is inadequate, upon notification by the Monitor, tThe Board shall require the AIT to do further work toward meeting objectives or attaining the core of knowledge, or to work with a different Preceptor, if reports and progress in the program are inadequate. The Board shall specify the additional time period granted to the AIT in which to satisfactorily complete the AIT program.

3. If the Monitor notifies the Board that the AIT has failed to satisfactorily complete the AIT program within the time frames established by subsection (13), the Board may either authorize an additional time period in which to satisfactorily complete the AIT program or may terminate the AIT program and refuse to certify the AIT for examination.

(13) All AIT programs must be completed within fifteen (15) months of beginning, excepting periods of interruption and discontinuance authorized by subsections (7) - (9), or additional time authorized by the Board pursuant to subparagraph (12)(e)2.

Rulemaking Authority 468.1685(1), 468.1695(2) FS. Law Implemented 456.013, 468.1695(2), (4) FS. History–New 9-24-81, Formerly 21Z-16.01, Amended 12-18-88, 1-22-90, 11-11-92, 12-18-88, 1-22-90, 11-11-92, Formerly 21Z-16.001, Amended 8-29-93, Formerly 61G12-16.001, Amended 6-2-96, Formerly 59T-16.001, Amended 10-12-97, 6-5-07, 11-9-08, 1-7-10, 2-11-14,                                  .

 

64B10-16.002 Preceptor.

(1) Each person desiring to be a Preceptor must submit a completed application The Board will approve persons to act as preceptors in Administrator-in-Training (AIT) programs based on the information contained in the completed application form Preceptor Certification, DOH/NHA014 (Revised 01/2014), incorporated herein by reference, which and an oral review. The approval shall be effective indefinitely, so long as the preceptor maintains an active license to practice nursing home administration in this state, there is no disciplinary action taken against the licensee, and the licensee is in compliance with the requirement of subsection (4) below. Form DOH/NHA014 (Revised 01/2014) can be obtained from http://www.flrules.org/Gateway/reference.asp?No=Ref-04143 or the web at http://floridasnursinghomeadmin.gov/resources/ http://www.floridahealth.gov/licensing-and-regulation/nursing-home/index.html.

(2) The Board will approve persons to act as Preceptors in Administrator-in-Training (AIT) programs based on the information contained in the completed application form and gained through an oral review.  The Board Chair, or any other Board member designated by the Chair, shall conduct the oral review. Each person desiring to be a preceptor must submit a completed application with the appropriate fees as required by Rule 64B10-12.012, F.A.C. The applicant shall include the states and dates of issuance of all the applicant’s professional licenses, including those as a nursing home administrator.

(3) Preceptor approval shall be effective indefinitely, so long as the Preceptor maintains an active license to practice nursing home administration in this state, there is no disciplinary action taken against the licensee, and the licensee is in compliance with the requirement of subsection (5) below.

(4)(3) Preceptor applicants Each person desiring to be a preceptor must have practiced as a be a practicing nursing home administrator in any jurisdiction for three of the last five years and must have had no disciplinary action taken against him or her during that time frame. The applicant shall list the states and dates of issuance of all the applicant's professional licenses, including those as a nursing home administrator.

(5)(4) Preceptor The applicants must have attended a six-hour preceptor training seminar approved by the Board as set forth in Rule 64B10-16.0025, F.A.C., within the three years immediately preceding the application and a two-hour refresher course as set forth in Rule 64B10-16.0025, F.A.C., every biennium thereafter. Both courses must be approved by the Board pursuant to Rule 64B10-16.0025, F.A.C. Failure to complete the refresher course shall result in the loss of preceptor certification.

(6)(5) A Preceptor must either be the administrator of record for the facility or facilities approved for training as specified in Rule 64B10-16.003, or be otherwise approved by the Board.  In determining whether to approve as Preceptors licensed administrators who are not administrators of record at a training facility, the Board shall consider factors such as the applicant's degree of oversight over training facilities, the number of facilities overseen by the applicant, the number of licensed administrators in the facilities overseen, the distance between facilities, and any other factors which demonstrate the applicant will adequately supervise and train the AIT as required by these rules. Each application for approval of an Administrator-In-Training program shall include an application for approval of each nursing home facility at which the training will take place.

(7)(6) A preceptor shall not supervise the training of a member of his or her immediate family.

(7) A preceptor must be in direct management control of the facility or facilities at which the training is to take place.

(8) The Board shall disapprove a preceptor who has failed to remain in compliance with the requirements of this rule.

(9) A member of the Board may conduct the oral review and report to the Board.

Rulemaking Authority 456.013(1)(a), 468.1685(1), 468.1695(4) FS. Law Implemented 468.1695 FS. History–New 9-24-81, Formerly 21Z-16.02, Amended 12-18-88, 11-11-92, Formerly 21Z-16.002, Amended 2-28-94, Formerly 61G12-16.002, Amended 2-22-96, 9-4-96, 10-20-96, Formerly 59T-16.002, Amended 10-12-97, 6-5-07, 10-2-08, 3-25-09, 10-24-10, 5-29-14,                          .

 

64B10-16.0021 Change of Status of Preceptor.

(1) If a Ppreceptor’s license becomes inactive or reverts to a delinquent status, prior to reinstatement as a Preceptor, the Ppreceptor must complete the six-hour preceptor training seminar set forth in Rule 64B10-16.0025, F.A.C., and pay all fees required by Rule 64B10-12.012 prior to reinstatement as a preceptor.

(2) The preceptor shall pay all fees required by Rule 64B10-12.012, F.A.C.

Rulemaking Specific Authority 468.1685(1), 468.1695(2), (3), (4) FS. Law Implemented 468.1695(2), (3), (4) FS. History–New 7-4-06,               .

 

64B10-16.0025 Preceptor Training Seminar.

(1) No change.

(2) To receive continue Board approval, preceptor refresher courses shall consist of two (2) hours of training in the areas listed in subsection (1).

Rulemaking Authority 468.1685(1) FS. Law Implemented 468.1695(5) FS. History–New 11-21-95, Formerly 59T-16.0025, Amended 8-6-97, 10-24-10,                                       .

 

64B10-16.003 Facility at Which Training Takes Place.

(1) The Board must approve each facility at which the training will take place.

(2)(1) In order to approve facilities, tThe Administrator in Training must provide, at a minimum, the following application form will request general information about the nursing home facilities: facility which will include its addresses;, the names, employment dates, work hours, and the license numbers of registered or licensed professionals which head the various departments;, and the bed capacities of each facility; in each classification under the terms of subsections 10D-29.032(15), (36) and (39), F.A.C. (as effective 7-24-81).

(2) and The application must include a copy copies of the latest survey reports and any plans for correction. The survey report must show that each the facility is currently licensed by the Agency for Health Care Administration as a nursing home facility under the terms of Chapter 400, F.S., and has no serious operating deficiencies.

(3) Each The nursing home facility must have a capacity of at least 60 beds.

Rulemaking Specific Authority 468.1685(1), 468.1695(2) FS. Law Implemented 468.1695(2) FS. History–New 9-24-81, Formerly 21Z-16.03, 21Z-16.003, 61G12-16.003, 59T-16.003, Amended 5-15-00, 8-30-05,                           .

 

64B10-16.005 Domains of Practice, Objectives, Reports.

(1) A training plan for the Administrator-in-Training Program shall be prepared by the Ppreceptor and the AIT trainee, prior to the start of the program. This training plan shall include:;

(a) A pre-training assessment of the AIT's trainee’s background, in terms of educational level, pertinent experience, maturity, motivation and initiative. The pre-training assessment shall identify should underscore the AIT's particular trainee’s strengths and weaknesses with regard to the specific domains of practice and skills necessary to serve as a licensed administrator in the areas to be covered in the program (e.g. a person with a degree in business administration will have strengths in the finance area; a person with a personnel or management background will have strengths in those areas, etc.).

(b) Based on the this assessment, the AIT trainee and Ppreceptor will jointly develop a detailed goal oriented training plan with adequate supporting documentation which relates educational objectives, subject areas of the internship, internship site(s), agencies involved, total hours for the internship, and a breakdown of the number of hours needed to master each area and its objectives.

(c) Supporting documentation for the training plan shall include, but is not limited to, qualifications of the preceptor, the director of nursing in the program site, and such descriptive documentation for the program site and its staff to determine its adequacy for the specific objectives and areas of the program.

(c)(d) The Ppreceptor and AITAdministrator-in-Training must file regular reports with the Board every 90 days. For 1,000 hour programs, reports shall be filed bi-monthly; for 2,000 hour programs, reports shall be filed quarterly. The Rreports shall be made on the State of Florida AIT Domains of Practice Quarterly Checklist, Form DH-MQA 1209 (revised 07/10, hereby adopted and incorporated by reference) which can be obtained from the Board of Nursing Home Administrators’ website at: http://floridasnursinghomeadmin.gov/resources/ http//www.doh.state.fl.us/mqa/nurshome/index.html or at http://www.flrules.org/Gateway/reference.asp?No=Ref-00783. Each report shall be co-signed by the Ppreceptor and AIT Administrator-in-Training and shall be filed within two weeks after the completion of each reporting period of the program. Failure to file the report on the correct form or within the stated time period may result in non-acceptance of the report. The reports shall contain a synopsis of the areas covered in the program and a narrative describing relevant learning experiences. The reports shall show how the AIT Administrator-in-Training used the following methods to further his or her training:

1. through 7. No change.

(2) The AIT Administrator-in-Training Program shall cover the following domains of practice:

(a) PERSONNEL. Topics in this area should include recruitment, interviewing, employee selection, training, personnel policies, health and safety. Objectives of training are:

1. through 5. No change.

(b) through (d) No change.

(e) LAWS, REGULATORY CODES AND GOVERNING BOARDS. Topics in this area should include federal, state and local rules and regulations. Objectives of training are:

1. through 2. No change.

3. To become familiar with requirements of Mmedicare and Mmedicaid, and to learn to cope with their problems;

4. through 5. No change. 

(f) RESIDENT CARE. Topics in this area should include nursing, food, social and recreational services, pharmacy, rehabilitation, physician services and medical records. Objectives of training are:

1. No change.

2. To enable the trainee to develop an ability to understand the various components of personal, social, therapeutic and supportive care programs and their application in the total care program of the resident;

3. through 7. No change.

8. To understand the concepts of benchmarking benchmaking;

9. No change.

(3) In order to afford flexibility, and to account for a particular AIT's trainee’s strengths or weaknesses in any particular area, the following minimum percentages in eachevery area are established:.

(a) through (f) No change.

(g) The remaining 25% of the program may be in any domain of practice, but shall be designed to provide additional training in those areas of weakness identified by the pretraining assessment and the AIT's detailed training plan.

(4) Nothing in this rule is intended to preclude any Ppreceptor from requiring the AIT complete any additional training as necessary to ensure the AIT is prepared to practice as a licensed nursing home administrator areas in the program, objectives, or reports.

Rulemaking Authority 468.1685(1), (3), (4) FS. Law Implemented 468.1685(3), (4) FS. History–New 12-18-88, Formerly 21Z-16.005, 61G12-16.005, 59T-16.005, Amended 1-8-06, 1-9-12,                      .

 

64B10-16.007 Out-of-State Administrator-In-Training Programs.

(1) If an applicant has completed an AIT program outside of Florida, the Board will review the AIT program and determine whether the program substantially fulfills the requirements of a Florida AIT program. It is the responsibility of tThe applicant is required to provide all documentation necessary for to the Board to make this determination.concerning the out-of-state AIT program, the facility where the program was completed and the qualifications and training of the preceptor.

(2) If, after review, the Board determines the out of state program fails to fulfill one or more requirements of the Florida program, the Board shall allow an AIT who meets the requirements of Rule 64B10-16.001(2), F.A.C. to participate in a Florida AIT program to remedy any deficiencies.  The Board may, upon request by the Applicant, modify or limit the program to satisfaction of deficiencies.

RulemakingSpecific Authority 468.1685(1), (2), 468.1695(2) FS. Law Implemented 468.1695(2) FS. History–New 7-21-97, Formerly 59T-16.007, Amended 9-4-06,                                  .

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Board of Nursing Home Administrators

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Board of Nursing Home Administrators

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: November 20, 2015

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: March 10, 2016