The Nursing Home Administrator Examining Board conducted a comprehensive evaluation and update of chs. NHA 1 to 4 to ensure its rules relating to requirements for licensure, examinations, and approval of educational programs are consistent with current professional, academic, licensing, and examination practices and standards and applicable Wisconsin statutes. As a result, the following updates have been made:
Section NHA 2.01 is revised to reflect a change in July 2017 to the structure of the national examination administered by NAB. The examination for nursing home administrators now consists of 2 parts, the Core of Knowledge Examination for Long Term Care Administrators and the National Nursing Home Administrators Line of Service Examination.
Sections NHA 4.01 (1) (b) and (d) 4.03 (1) are revised to allow active certification as a health services executive granted by NAB to satisfy an applicant’s education, experience, and national examination requirements for licensure. An applicant with NAB certification is still required to pass an examination on laws and administrative rules of this state governing nursing home administration.
Section NHA 3.02 (4) is revised to comply with s. 440.03 (4m), Stats., as created by 2017 Wisconsin Act 59. Under this provision, the Board may require a credential holder to submit proof of completing continuing education programs or courses only if a complaint is made against the credential holder.
Other provisions throughout chs. NHA 1 to 4 have been revised to update notes, provide clarity, and conform to current drafting standards.Summary of, and comparison with, existing or proposed federal regulation:
42 USC § 1396a provides requirements state medical assistance plans must meet to be eligible for federal grants, including a requirement that states have a program for licensing nursing home administrators. Under 42 USC § 1396g (c) (1) to (6), a state agency or board that licenses nursing home administrators is required to:
“Develop, impose, and enforce standards which must be met by individuals in order to receive a license as a nursing home administrator, which standards shall be designed to insure that nursing home administrators will be individuals who are of good character and are otherwise suitable, and who, by training or experience in the field of institutional administration, are qualified to serve as nursing home administrators.”
“Develop and apply appropriate techniques, including examinations and investigations, for determining whether an individual meets such standards.”
“Issue licenses to individuals determined, after the application of such techniques, to meet such standards, and revoke or suspend licenses previously issued by the board in any case where the individual holding any such license is determined substantially to have failed to conform to the requirements of such standards.”
“Establish and carry out procedures designed to insure that individuals licensed as nursing home administrators will, during any period that they serve as such, comply with the requirements of such standards.”
“Receive, investigate, and take appropriate action with respect to, any charge or complaint filed with the board to the effect that any individual licensed as a nursing home administrator has failed to comply with the requirements of such standards.”
“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 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 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 rules were posted for a period of 14 days to solicit public comment on economic impact, including how the 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 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 Daniel.Hereth@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.) is amended to read:
NHA 1.02 (intro.) Definitions. As used in ch. 456, Stats., and in chs. NHA 1 to 5:
Section 3. NHA 1.02 (1g) is created to read:
NHA 1.02 (1g) “Board” means the nursing home administrator examining board.
Section 4. NHA (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 (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 of 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 of 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 of 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 of 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.
