March 14, 2002 - Introduced by Representatives Johnsrud, J. Lehman,
Loeffelholz, Urban, Hines, Bies
and Kedzie, cosponsored by Senator Moen.
Referred to Committee on Health.
AB924,1,11 1An Act to repeal 456.04 (4); to renumber and amend 15.405 (7m); to amend
215.08 (1m) (b), 46.21 (1m) (am), 50.04 (2) (a), 59.79 (10), chapter 456 (title),
3456.01 (1), 456.01 (4), 456.01 (5), 456.02 (1), 456.02 (4), 456.02 (5), 456.02 (6),
4456.03, 456.04 (intro.), 456.05 (intro.), 456.05 (1), 456.05 (2), 456.05 (3), 456.07
5(1), 456.07 (2), 456.07 (3), 456.07 (4), 456.08, 456.09 (1) (b), 456.09 (1) (c), 456.09
6(1) (d), 456.09 (1) (e), 456.10 (1) (intro.), 456.10 (1) (bm), 456.10 (1) (c), 456.10
7(1) (d) and 456.10 (2); and to create 14.405 (7m) (c), 15.405 (7m) (a) 2., 440.08
8(2) (a) 38k., 456.01 (1g), 456.01 (1r), 456.01 (3m), 456.01 (5m), 456.04 (5), 456.04
9(6), 456.05 (4), 456.07 (2m), 456.07 (6), 456.072, 456.078 and 456.12 of the
10statutes; relating to: licensing hospital administrators and granting
11rule-making authority.
Analysis by the Legislative Reference Bureau
Under current law, a person may not practice as a nursing home administrator,
or use such a title, unless he or she is granted a license by the nursing home
administrator examining board (board). To obtain a license, a person must pass an
examination regarding the laws governing long-term care facilities, the

administration of such facilities, and the needs of persons served by the facilities.
A person may not take the examination unless he or she satisfies educational
requirements that the board considers are adequate preparation for nursing home
administration. In addition, a person may not take the examination if he or she has
an arrest or conviction record the circumstances of which substantially relate to
nursing home administration.
Also under current law, a nursing home administrator license expires on July
1 of each even-numbered year, unless the license is renewed. To renew a license, a
person must apply to the board for a certificate of registration. In addition, the board
may take disciplinary action against a person who is licensed, including suspending
or revoking a license, if he or she engages in specified prohibited conduct. For
example, the board may take disciplinary action if a person is incompetent or acts
in a manner inconsistent with the health and safety of the residents of a nursing
home, or if the nursing home that he or she administers has a pattern of serious
violations of federal or state laws.
This bill requires the board to also grant licenses to hospital administrators and
changes the name of the board to the hospital and nursing home administrator
examining board. Under the bill, except for a hospital administrator employed by
the federal government, a person may not practice as a hospital administrator, or use
such a title, unless he or she is licensed as a hospital administrator by the board. The
requirements for obtaining and renewing a hospital administrator license are
similar to the requirements for a nursing home administrator license. For example,
a person must pass an examination regarding the laws governing hospitals, the
administration of hospitals, and the needs of patients served by hospitals. In
addition, the bill requires both the hospital and nursing home administrator
examinations to test knowledge of federal and state health care reimbursement
programs.
The bill also imposes similar requirements that a person must satisfy to take
the hospital administrator examination. Like the nursing home administrator
examination, a person may not take the hospital administrator examination if he or
she has an arrest or conviction record the circumstances of which substantially relate
to hospital administration. In addition, a person may not take the hospital
administrator examination unless he or she has received a bachelor's degree in
administration of health care facilities or programs or has completed an educational
program that the board determines is substantially equivalent to receiving such a
degree. For a limited time, the board must waive this educational requirement for
a person who is primarily employed as a hospital administrator on the effective date
of the bill. Until five years after the bill goes into effect, such a person may take the
examination even if he or she does not satisfy the educational requirement.
However, when a person who receives a waiver applies to renew his or her license
that expires on July 1, 2008, the person must submit evidence that he or she satisfies
the educational requirement. If the person does not satisfy the educational
requirement by that date, his or her license may not be renewed, and he or she may
not continue to practice as a hospital administrator.

Also, the bill changes the educational requirements for a nursing home
administrator license. Under the bill, a person may not take the examination for that
license unless he or she has received a bachelor's degree in nursing home
administration or has completed an educational program that the board determines
is substantially equivalent to receiving such a degree.
In addition, the bill makes the following changes:
1. The bill requires a person who applies to renew a hospital administrator
license to submit evidence that he or she completed at least 24 hours of continuing
education during the preceding two-year period. Although current law requires a
nursing home administrator to complete continuing education requirements,
current law does not specify a minimum number of hours.
2. The bill requires the board to promulgate rules establishing a code of ethics
governing the professional conduct of hospital and nursing home administrators.
The rules may establish separate codes for each profession.
3. The bill allows the board to grant hospital administrator licenses to persons
licensed as hospital administrators in other states. The board has similar authority
under current law with respect to nursing home administrator licenses.
4. The board's authority to take disciplinary action is expanded so that the
board may also take such action against persons licensed as hospital administrators.
Therefore, for example, the board may take disciplinary action if a hospital
administrator is incompetent or acts in a manner inconsistent with the health and
safety of the patients in a hospital, or if the hospital that he or she administers has
a pattern of serious violations of federal or state laws.
5. The bill changes the membership of the board, which consists of the following
members under current law: five nursing home administrators, two public members,
one physician, one nurse, and, as a nonvoting member, the secretary of health and
family services or his or her designee. This bill eliminates two of the nursing home
administrators and replaces them with three hospital administrators. In addition,
the bill adds another nurse member to the board and requires one of the nurse
members to be employed in a nursing home and the other nurse member to be
employed in a hospital.
For further information see the state fiscal estimate, which will be printed as
an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB924, s. 1 1Section 1. 14.405 (7m) (c) of the statutes is created to read:
AB924,3,42 14.405 (7m) (c) One of the members appointed under par. (a) 4. must be
3employed in a nursing home and the other member appointed under par. (a) 4. must
4be employed in a hospital.
AB924, s. 2
1Section 2. 15.08 (1m) (b) of the statutes is amended to read:
AB924,4,102 15.08 (1m) (b) The public members of the chiropractic examining board, the
3dentistry examining board, the hearing and speech examining board, the medical
4examining board, the respiratory care practitioners examining council and, the
5council on physician assistants, the board of nursing, the hospital and nursing home
6administrator examining board, the veterinary examining board, the optometry
7examining board, the pharmacy examining board, the examining board of social
8workers, marriage and family therapists and professional counselors , and the
9psychology examining board shall not be engaged in any profession or occupation
10concerned with the delivery of physical or mental health care.
AB924, s. 3 11Section 3. 15.405 (7m) of the statutes is renumbered 15.405 (7m) (a) (intro.)
12and amended to read:
AB924,4,1813 15.405 (7m) (a) (intro.) Nursing Hospital and nursing home administrator
14examining board.
There is created a hospital and nursing home administrator
15examining board in the department of regulation and licensing consisting of 9
16members appointed for staggered 4-year terms and
the secretary of health and
17family services or a designee, who shall serve as a nonvoting member . Five, and the
18following members appointed for 4-year terms:
AB924,4,20 191. Three members shall be who are nursing home administrators licensed in
20this state
under ch. 456.
AB924,4,21 213. One member shall be who is a physician. One member shall be a nurse
AB924,4,22 224. Two members who are nurses licensed under ch. 441.
AB924,4,23 235. Two public members shall be public members.
AB924,4,25 24(b) No more than 2 members appointed under par. (a) 1. to 5. may be officials
25or full-time employees of this state.
AB924, s. 4
1Section 4. 15.405 (7m) (a) 2. of the statutes is created to read:
AB924,5,32 15.405 (7m) (a) 2. Three members who are hospital administrators licensed
3under ch. 456.
AB924, s. 5 4Section 5. 46.21 (1m) (am) of the statutes is amended to read:
AB924,5,165 46.21 (1m) (am) The county executive shall appoint under ss. 63.01 to 63.17
6an administrator of the county hospital. The appointment shall be made on the basis
7of recognized and demonstrated public interest in and knowledge of the problems of
8delivery of medical care and treatment, and with due regard to training, experience,
9executive and administrative ability and efficiency, and general qualifications and
10fitness for performing the duties of the office. An administrator may not be appointed
11under this paragraph unless he or she is licensed as a hospital administrator under
12ch. 456.
The administrator shall file an official oath and bond in the amount
13determined by the county board of supervisors. The county board of supervisors may
14create positions to assist the administrator. The administrator shall be appointed
15by the county executive in the unclassified civil service, and the appointment is
16subject to confirmation by the county board of supervisors under s. 59.17 (2) (bm).
AB924, s. 6 17Section 6. 50.04 (2) (a) of the statutes is amended to read:
AB924,6,318 50.04 (2) (a) No nursing home within the state may operate except under the
19supervision of an administrator licensed under ch. 456 by the hospital and nursing
20home administrators administrator examining board. If the holder of a nursing
21home license is unable to secure a new administrator because of the departure of an
22administrator, such license holder may, upon written notice to the department and
23upon the showing of a good faith effort to secure a licensed administrator, place the
24nursing home in the charge of an unlicensed individual subject to conditions and
25time limitations established by the department, with advice from the hospital and

1nursing home administrator examining board. An unlicensed individual who
2administers a nursing home as authorized under this subsection is not subject to the
3penalty provided under s. 456.09.
AB924, s. 7 4Section 7. 59.79 (10) of the statutes is amended to read:
AB924,6,165 59.79 (10) County hospital. Determine policy for the operation, maintenance,
6and improvement of the county hospital under s. 49.71 (2) and, notwithstanding the
7powers and duties specified under s. 46.21 (2) (k), (3r), and (6) with respect to the
8county hospital and the administrator and specified under s. 46.21 (2) (b), (L), (m),
9(n), (nm), (o), (p), and (q) and (3g), provide for the management of the county hospital
10as the board considers appropriate, except that the employee positions at the
11hospital will be county employee positions and except that the board may not employ
12a person as a hospital administrator unless he or she is licensed as such under ch.
13456
. If the board acts under this subsection, the board may not discontinue
14operation, maintenance, and improvement of the county hospital under s. 49.71 (2)
15and shall exercise the duties under s. 46.21 (4m). This subsection does not apply if
16the board acts under s. 46.21 with respect to the county hospital under s. 49.71 (2).
AB924, s. 8 17Section 8. 440.08 (2) (a) 38k. of the statutes is created to read:
AB924,6,1918 440.08 (2) (a) 38k. Hospital administrator: July 1 of each even-numbered year;
19$53.
AB924, s. 9 20Section 9. Chapter 456 (title) of the statutes is amended to read:
AB924,6,2321 CHAPTER 456
22hospital and nursing home
23 administrator examining board
AB924, s. 10 24Section 10. 456.01 (1) of the statutes is amended to read:
AB924,7,2
1456.01 (1) "Examining board" means the hospital and nursing home
2administrator examining board.
AB924, s. 11 3Section 11. 456.01 (1g) of the statutes is created to read:
AB924,7,44 456.01 (1g) "Hospital" has the meaning given in s. 50.33 (2).
AB924, s. 12 5Section 12. 456.01 (1r) of the statutes is created to read:
AB924,7,96 456.01 (1r) "Hospital administrator" means any individual responsible for
7planning, organizing, directing, and controlling the operation of a hospital, or who
8in fact performs such functions, whether or not such functions are shared by one or
9more other persons.
AB924, s. 13 10Section 13. 456.01 (3m) of the statutes is created to read:
AB924,7,1211 456.01 (3m) "Practice of hospital administration" means the planning,
12organizing, directing, and controlling of the operation of a hospital.
AB924, s. 14 13Section 14. 456.01 (4) of the statutes is amended to read:
AB924,7,1514 456.01 (4) "Practice of nursing home administration" means the planning,
15organizing, directing, and control controlling of the operation of a nursing home.
AB924, s. 15 16Section 15. 456.01 (5) of the statutes is amended to read:
AB924,7,1817 456.01 (5) "Provisional license" is a temporary license issued to a provisional
18hospital or nursing home administrator under this chapter.
AB924, s. 16 19Section 16. 456.01 (5m) of the statutes is created to read:
AB924,7,2120 456.01 (5m) "Provisional hospital administrator" means an individual who has
21been licensed as such under this chapter.
AB924, s. 17 22Section 17. 456.02 (1) of the statutes is amended to read:
AB924,8,323 456.02 (1) Develop, impose, and enforce standards which must be met by
24individuals in order to receive a license as a hospital or nursing home administrator,
25which standards shall be designed to insure that hospital or nursing home

1administrators will be individuals who are of good character and are otherwise
2suitable, and who, by training or experience in the field of institutional
3administration, are qualified to serve as hospital or nursing home administrators;
AB924, s. 18 4Section 18. 456.02 (4) of the statutes is amended to read:
AB924,8,75 456.02 (4) Establish and carry out procedures designed to insure that
6individuals licensed as hospital or nursing home administrators will, during any
7period that they serve as such, comply with the requirements of such standards;
AB924, s. 19 8Section 19. 456.02 (5) of the statutes is amended to read:
AB924,8,139 456.02 (5) Subject to the rules promulgated under s. 440.03 (1), receive,
10investigate, and take appropriate action with respect to, any charge or complaint
11filed with the examining board to the effect that any individual licensed as a hospital
12or
nursing home administrator has failed to comply with the requirements of such
13standards;
AB924, s. 20 14Section 20. 456.02 (6) of the statutes is amended to read:
AB924,8,2015 456.02 (6) In cooperation with other agencies and appropriate organizations,
16conduct a continuing study of the practice of hospital and nursing home
17administration within the state with a view to the improvement of the standards
18imposed for the licensing of such administrators and of procedures and methods for
19the enforcement of such standards with respect to administrators of hospitals or
20nursing homes who have been licensed as such;.
AB924, s. 21 21Section 21. 456.03 of the statutes is amended to read:
AB924,9,3 22456.03 Licenses. An applicant for a license as a hospital or nursing home
23administrator who has successfully complied with the requirements for licensure
24under this chapter and passed the examination shall be granted a license by the
25examining board, certifying that the applicant, depending on the license granted,

1has met the requirements of the laws and rules entitling the applicant to serve, act,
2practice, and otherwise hold himself or herself out as a duly licensed hospital or
3nursing home administrator.
AB924, s. 22 4Section 22. 456.04 (intro.) of the statutes is amended to read:
AB924,9,7 5456.04 Examination requirements. (intro.) The examining board shall
6allow any person to take the examination for licensure as a hospital or nursing home
7administrator who satisfies all of the following requirements:
AB924, s. 23 8Section 23. 456.04 (4) of the statutes is repealed.
AB924, s. 24 9Section 24. 456.04 (5) of the statutes is created to read:
AB924,9,1310 456.04 (5) For licensure as a nursing home administrator, received a bachelor's
11degree in nursing home administration or has completed an educational program
12that the examining board determines is substantially equivalent to receiving a
13bachelor's degree in nursing home administration.
AB924, s. 25 14Section 25. 456.04 (6) of the statutes is created to read:
AB924,9,1915 456.04 (6) Except as provided in s. 456.072 (1), for licensure as a hospital
16administrator, received a bachelor's degree in administration of health care facilities
17or programs or has completed an educational program that the examining board
18determines is substantially equivalent to receiving a bachelor's degree in
19administration of health care facilities or programs.
AB924, s. 26 20Section 26. 456.05 (intro.) of the statutes is amended to read:
AB924,9,25 21456.05 Examinations. (intro.) The examining board shall determine the
22subjects of examination for applicants for licensure as hospital or nursing home
23administrators, and the scope, content, and format of such examinations. The
24Depending on the license applied for, the examinations shall include examination of
25the applicant's knowledge of each of the following:
AB924, s. 27
1Section 27. 456.05 (1) of the statutes is amended to read:
AB924,10,42 456.05 (1) The laws governing the operation of hospitals or long-term care
3facilities and the protection of the interests, safety, and well-being of the patients or
4residents therein; and.
AB924, s. 28 5Section 28. 456.05 (2) of the statutes is amended to read:
AB924,10,76 456.05 (2) The elements of proper and effective administration of hospitals or
7long-term care facilities; and.
AB924, s. 29 8Section 29. 456.05 (3) of the statutes is amended to read:
AB924,10,109 456.05 (3) The psychological, physical, medical, and social needs of persons
10served in such hospitals or long-term care facilities.
AB924, s. 30 11Section 30. 456.05 (4) of the statutes is created to read:
AB924,10,1312 456.05 (4) The requirements and procedures of federal and state health care
13reimbursement programs.
AB924, s. 31 14Section 31. 456.07 (1) of the statutes is amended to read:
AB924,10,1815 456.07 (1) Every individual who holds a license as a hospital or nursing home
16administrator issued by the department shall biennially apply to the examining
17board for a new certificate of registration and report any facts requested by the
18examining board on forms provided for such purpose.
AB924, s. 32 19Section 32. 456.07 (2) of the statutes is amended to read:
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