- “Conduct a continuing study and investigation of nursing homes and administrators of nursing homes within the State with a view to the improvement of the standards imposed for the licensing of such administrators and of procedures and methods for the enforcement of such standards with respect to administrators of nursing homes who have been licensed as such.”
The proposed rules will ensure the provisions for licensure, examinations, and approval of educational programs under chs. NHA 1 to 4 comply with the above requirements. Comparison with rules in adjacent states:
Illinois: Rules of the Illinois Department of Financial and Professional Regulation address the practice of nursing home administration in Illinois (68 Ill. Adm. Code 1310). The rules include provisions concerning examinations (68 Ill. Adm. Code 1310.30 and 1310.60), approved nursing home administration courses (68 Ill. Adm. Code 1310.40), and qualifying experience (68 Ill. Adm. Code Section 1310.50). The rules do not explicitly allow certification as a health services executive granted by NAB to satisfy any requirements for licensure.
Iowa: Rules of the Iowa Board of Nursing Home Administrators address the practice of nursing home administration in Iowa (645 IAC 141 to 144). The rules include provisions for licensure requirements (645 IAC 141.2), examination requirements (645 IAC 141.3), and educational qualifications (645 IAC 141.4). The rules do not explicitly allow certification as a health services executive granted by NAB to satisfy any requirements for licensure.
Michigan: Rules of the Michigan Department of Licensing and Regulatory Affairs address the practice of nursing home administration in Michigan (Mich Admin Code, R 339.14001 to R 339.14035). The rules include approval of courses of instruction and training (Mich Admin Code, R 339.14007), application requirements (Mich Admin Code, R 339.14008), and examinations (Mich Admin Code, R 339.14009 and R 339.14011). The rules do not explicitly allow certification as a health services executive granted by NAB to satisfy any requirements for licensure.
Minnesota: Rules of the Minnesota Board of Examiners for Nursing Home Administrators address the practice of nursing home administration in Minnesota (Minnesota Rules, chapter 6400). The rules include licensure requirements (Minnesota Rules, Part 6400.6000), applying for licensure (Minnesota Rules, Part 6400.6100), and course requirements (Minnesota Rules, Parts 6400.6400 to 6400.6660). The rules do not explicitly allow certification as a health services executive granted by NAB to satisfy any requirements for licensure.
Summary of factual data and analytical methodologies:
The proposed rules were developed by reviewing the provisions of chs. NHA 1 to 4 to ensure the rules are consistent with current professional, academic, licensing, and examination practices and standards and applicable Wisconsin statutes. Analysis and supporting documents used to determine effect on small business or in preparation of economic impact analysis:
The proposed rules were posted for a period of 14 days to solicit public comment on economic impact, including how the proposed rules may affect businesses, local government units, and individuals. No comments were received.
Fiscal Estimate and Economic Impact Analysis:
The Fiscal Estimate and Economic Impact Analysis document is attached.
Effect on small business:
These proposed rules do not have an economic impact on small businesses, as defined in s. 227.114 (1), Stats. The Department’s Regulatory Review Coordinator may be contacted by email at Kirsten.Reader@wisconsin.gov, or by calling (608) 267-2435. Agency contact person:
Dale Kleven, Administrative Rules Coordinator, Department of Safety and Professional Services, Division of Policy Development, P.O. Box 8366, Madison, Wisconsin 53708-8366; telephone 608-261-4472; email at DSPSAdminRules@wisconsin.gov. Place where comments are to be submitted and deadline for submission:
Comments may be submitted to Dale Kleven, Administrative Rules Coordinator, Department of Safety and Professional Services, Division of Policy Development, P.O. Box 8366, Madison, WI 53708-8366, or by email to DSPSAdminRules@wisconsin.gov. Comments must be received at or before the public hearing to be held at 9:30 a.m. on August 23, 2018, to be included in the record of rule-making proceedings. ------------------------------------------------------------------------------------------------------------
TEXT OF RULE
Section 1. NHA 1.01 is amended to read:
NHA 1.01 Authority. The rules in chs. NHA 1 to 5 are adopted pursuant to ss. 15.08 (5) (b), 227.11 (2), and 456.02, Stats.
Section 2. NHA 1.02 (intro.), (2) (intro.), (a) (intro.) and 1. to 4., (b) (intro.) and 1. to 6., (c) (intro.) and 1. to 8., (d) (intro.) and 1. to 8., and (e), (3), (3m), (5m) (intro.) and (a) to (f), (6) (intro.) and (a) to (d), (7), and (8) (intro.) are amended to read:
NHA 1.02 (intro.) Definitions. As used in ch. 456, Stats., and in chs. NHA 1 to 5:
(2) (intro.) “Experience in the field of institutional administration" means work experience acquired in any consecutive 36-month period within the 5-year period immediately preceding the date of application for licensure, as an employee, student, trainee, or intern in the total operation and activities of a nursing home under the supervision of persons licensed under ch. 456, Stats., or holding the equivalent license in another state recognized by the board, and exposure to and knowledge of each of the following:
(a) (intro.) Fiscal management, including, but not limited to all the following:
1. Financial planning, forecasting, and budgeting,.
2. Accounting practices and principles,.
3. Fiscal intermediaries,.
4. Public finance programs, and.
(b) (intro.) Environmental services, including, but not limited to all the following:
1. Preventive maintenance programs for buildings and equipment;.
2. Sanitation procedures, practices, and policies;.
3. Design needs of the disabled;.
4. Environmental safety practices, policies, and procedures and accident prevention;.
5. Maintenance, housekeeping, laundry, and security functions;.
6. Relationship between health facility management; and.
(c) (intro.) Resident services, including, but not limited to all the following:
1. Therapy services,.
2. Physician services,.
3. Social services,.
4. Resident food services,.
5. Resident activities,.
6. Patient care,.
7. Drug handling and control,.
8. Nursing services, and.
(d) (intro.) Personnel management, including, but not limited to all the following:
1. Recruiting, interviewing, hiring, and training,.
2. Reviewing, disciplining, and supervising of employees,.
3. Record-keeping, Recordkeeping.
4. Preparation of statistical reports,.
5. Wage and salary administration,.
6. Health care staffing patterns,.
7. Human relations,.
8. Administering fringe benefit programs, and.
(e) State and federal inspections for compliance with applicable nursing home laws, rules, and regulations.
(3) “NAB" means the national association National Association of boards of examiners of long term care administrators Long Term Care Administrator Boards.
(3m) “Nursing home" has the meaning given under in s. 456.01 (2), Stats.
(5m) (intro.) “Pattern of serious violations of federal or state statutes, rules, or regulations" means the occurrence of any of the following:
(a) One or more class “A” violations, as defined in s. 50.04 (4) (b) 1., Stats., in each of at least 2 inspections within any consecutive 36-month period.
(b) One or more deficiencies related to participation requirements under 42 CFR sections 483.13, 483.15, or 483.25, which constitute immediate jeopardy to a resident's health or safety, in each of at least 2 inspections within any consecutive 36-month period.
(c) One or more deficiencies related to participation requirements under 42 CFR sections 483.13, 483.15, or 483.25, which constitute a pattern of actual harm, but which does not constitute immediate jeopardy to a resident's health or safety, in each of at least 2 inspections within any consecutive 36-month period.
(d) One or more deficiencies related to participation requirements under 42 CFR sections 483.13, 483.15, or 483.25, which constitute widespread actual harm, but which does not constitute immediate jeopardy to a resident's health or safety, in each of at least 2 inspections within any consecutive 36-month period.
(e) One class “A” violation, as defined in s. 50.04 (4) (b) 1., Stats., and one deficiency of any type specified in par. (b), (c), or (d), within 36 months of each other, but resulting from different inspections.
(f) At least 2 Two or more deficiencies in any combination of single deficiencies of the types specified in par. (b), (c), or (d), within 36 months of each other, but resulting from different inspections.
(6) (intro.) “Program of study" means a prescribed sequence of courses that is offered by a university or college, accredited by a regional or national accrediting agency recognized by the U.S. department of education, which and that consists of at least one course of 3 credit hours in each of the following:
(a) Laws governing the operation of licensed nursing homes;.
(b) Elements of proper and effective administration of licensed nursing homes;.
(c) Protection of the interests, safety, and well-being of residents; and.
(d) Psychological, physical, medical, and social needs of residents.
(7) “Regular course of study" means a prescribed program of courses offered by a university or college, accredited by a regional or national accrediting agency recognized by the U.S. department of education, which leads to an associate, baccalaureate, master, or doctoral degree and which that includes a program of study and a supervised clinical practicum.
(8) (intro.) “Specialized courses" means individual courses that are offered by one or more educational institutions or course providers which and that lead to adequate preparation in each of the following general subject areas in nursing home administration:
Section 3. NHA 2.01 is repealed and recreated to read:
NHA 2.01 Examinations. An applicant for a license as a nursing home administrator shall pass all the following examinations:
(1) The Core of Knowledge Examination for Long Term Care Administrators administered by NAB.
