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

(1) A training plan for the Administrator-in-Training Program shall be prepared by the Preceptor and the AIT trainee, prior to the start of the program. This training plan shall include a pre-training assessment of the AIT’s background, educational level, pertinent experience, maturity, motivation and initiative. The pre-training assessment shall identify the AIT’s strengths and weaknesses with regard to the specific domains of practice and skills necessary to serve as a licensed administrator. Based on the assessment, the AIT and Preceptor will jointly develop a detailed goal oriented training plan with adequate supporting documentation which relates educational objectives, Domains of Practice, internship site(s), agencies involved, total hours for the internship, and a breakdown of the number of hours needed to master each Domain of Practice and its objectives.

(2) The preceptor and AIT must file reports with the Board. For 1,000 hour programs, reports shall be filed bi-monthly; for 2,000 hour programs, reports shall be filed quarterly. Reports for 1,000 hour programs shall be made on the State of Florida Administrator in Training Domains of Practice Quarterly Checklist For 1,000 Hour Programs, Form DH 5021-MQA, 09/16, which is hereby incorporated by reference and which can be obtained from the Board of Nursing Home Administrators’ website at http://floridasnursinghomeadmin.gov/applications/chklst-1k-nha.pdf or at http://www.flrules.org/Gateway/reference.asp?No=Ref-07722. Reports for 2,000 hour programs shall be made on the State of Florida Administrator in Training Domains of Practice Quarterly Checklist For 2,000 Hour Programs, Form DH-MQA 1209, 09/16, hereby adopted and incorporated by reference and which can be obtained from the Board of Nursing Home Administrators’ website at: http://floridasnursinghomeadmin.gov/applications/chklst-2k-nha.pdf or at http://www.flrules.org/Gateway/reference.asp?No=Ref-07723. Each report shall be co-signed by the Preceptor and AIT 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 used the following methods to further his or her training:

(a) On-the-job experience;

(b) Meetings attended;

(c) Surveys completed;

(d) Written reports;

(e) Texts or periodicals;

(f) Visits to other facilities;

(g) Academic programs, college or continuing education seminars.

(3) The AIT 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. To understand the need and procedures used in training personnel, including interviewing for vacant positions,

2. To become familiar with proper human relations regarding management, employees, patients and families,

3. To understand the organizational structure of the facility, the functions of each department, and the personnel relations within the facility,

4. To display the ability to instruct staff on conducting appraisals,

5. To demonstrate the knowledge of and use of appropriate supervisory techniques.

(b) FINANCE. Topics in this area should include accounting, budgeting, financial planning and asset management. Objectives of training are:

1. To understand accounting procedures, chart of accounts, profit and loss statements, balance sheets, cost reports, accounts receivable, and policies relative to accounts payable and collection of accounts receivable,

2. To understand the preparation of budgets,

3. To be familiar with cash flow preparations and needs,

4. To be familiar with third party payment organizations,

5. To possess the ability to prepare a business plan, a feasibility study, and a return on investment (ROI) proposal,

6. To understand how to develop, plan and manage an interdisciplinary budget.

(c) MARKETING. Topics in this area should include public relations activities and marketing programs. Objectives of training are:

1. To present to the public the essential medical relations and benefits of the facility to the welfare of the local community, the local health agencies, and other organizations such as church groups, social clubs, and service organizations,

2. To know and be able to utilize community volunteer agencies’ resources in the care of residents,

3. To be able to relate to a variety of community resources, such as churches, professional organizations and institutional structures that affect the facility.

(d) PHYSICAL RESOURCE MANAGEMENT. Topics in this area should include safety procedures, fire and disaster plans, and building and environment maintenance. Objectives of training are:

1. To develop an effective supply appreciation and supervisory knowledge and ability to keep all medical equipment and appliances necessary, available, and in good working order,

2. To have full knowledge of sanitation, communicable disease control, prevention of accidents and complete physical security for staff and patients, coordinating this information by application to safety codes and fire prevention,

3. To understand routine maintenance needs and procedures for buildings, surrounding grounds, vehicles and other equipment,

4. To use the concepts of disaster preparedness, and to demonstrate an understanding of the facility’s roles and vulnerabilities (including how to conduct an evacuation).

(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. To learn how to apply the state’s codes, rules, regulations, and laws relating to long-term care facilities,

2. To integrate current federal regulations pertaining to health care facilities with current state requirements,

3. To become familiar with requirements of Medicare and Medicaid, and to learn to cope with their problems,

4. To understand the basic insurance coverages,

5. To have a sense of the legal implications of various activities, procedures or decisions routinely taken or performed in the facility.

(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. To understand the roles of the medical director, the attending physicians, the director of nursing, the charge nurse, the physical therapist, occupational therapist, speech therapist, dietitians, pharmacist, licensed practical nurses and aides who provide the continuing essential medical care and rehabilitation of the patients in the facility,

2. 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. To develop the ability to function as a planner of the social, therapeutic, and supportive care program,

4. To study the emotional problems of aging in the lives of patients within the facility and to determine the role of the administrator in alleviating such characteristic feelings as loss, abandonment, dependency, depression, anxiety, or disengagement,

5. To determine the role of the administrator in relating to the patient, and the family, who is faced with death,

6. To determine the relationship between changes in a patient’s behavior and changes in his or her environmental, intrapsychic, and/or physical state,

7. To possess the ability to access and interpret facility quality indicators and quality measures,

8. To understand the concepts of benchmarking,

9. To be able to assess facility performance using self-assessment tools.

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

(a) PERSONNEL. A minimum of 15% of the program should be devoted to this area.

(b) FINANCE. A minimum of 15% of the program should be devoted to this area.

(c) MARKETING. A minimum of 5% of the program should be devoted to this area.

(d) PHYSICAL RESOURCE MANAGEMENT. A minimum of 10% of the program should be devoted to this area.

(e) LAWS, REGULATORY CODES AND GOVERNING BOARDS. A minimum of 10% of the program should be devoted to this area.

(f) RESIDENT CARE. A minimum of 20% of the program should be devoted to this area.

(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.

(5) Nothing in this rule is intended to preclude Preceptor from requiring the AIT complete any additional training as necessary to ensure the AIT is prepared to practice as a licensed nursing home administrator.

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, 1-9-17.