DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS
DIRECTOR’S OFFICE
NURSING HOME ADMINISTRATORS
GENERAL RULES
Filed with the secretary of state on
These rules become effective immediately after filing with the secretary of state unless adopted under section 33, 44, or 45a(9) of the administrative procedures act of 1969, 1969 PA 306, MCL 24.233, 24.244, or 24.245a. Rules adopted under these sections become effective 7 days after filing with the secretary of state.
(By authority
conferred on the director of the department of licensing and regulatory affairs
by sections 16145, 16148, 16178, 16287, and 17309 of the public health code, 1978
PA 368, MCL 333.16145, 333.16148, 333.16178, 333.16287, and 333.17309 and
Executive Reorganization Order Nos. 1991-9, 1996-2, 2003-1, and 2011-4, MCL 338.3501,
445.2001, 445.2011, and 445.2030)
R 339.14001, R 339.14011, R 339.14012, R 339.14020, R 339.14020a, R 339.14026, R 339.14032 of the Michigan Administrative Code are amended, R 339.14005, R 339.14007, R 339.14008, R 339.14009, R 339.14022, R 339.14024, R 339.14024a, R 339.14026a, and R 339.14029 are rescinded, and R 339.14006, R 339.14014, R 339.14017, and R 339.14021 are added, as follows: PART 1. GENERAL PROVISIONS
R 339.14001 Definitions.
Rule 1. (1) As used in these rules:
(a) "Accredited
institution" means a college or university that meets the standards set
forth in R 339.14005339.14011.
(b) "Board" means the Michigan board of nursing home administrators.
(c) “CHEA” means the Council of Higher Education Accreditation.
(d) “Code” means the public health code, 1978 PA 368, MCL 333.1101 to 333.25211.
(de)
“Department” means the department of licensing and regulatory affairs.
(ef)
“Life Safety Code” means the National Fire Protection Association 101 Life
Safety Code, 2018 edition.
(g) “NAB” means the National Association of Long Term Care Administrator Boards.
(h) “NAB CORE” means the NAB core of knowledge examination for long term care administrators.
(i) “NAB NHA LOS” means the NAB nursing home administrators line of service examination.
(f) "Sponsor" means
a person or an organization offering continuing education courses relating to
the practice of nursing home administration.
(2) The terms defined in the code have the same meanings when used in these rules.
PART 2. EDUCATION
R 339.14005 Accreditation
standards; adoption by reference. Rescinded.
Rule 5. (1) The
department, in consultation with the board, adopts by reference the procedures
and criteria for recognizing accrediting organizations of the council of higher
education accreditation (CHEA), effective September 24, 2018, and the
procedures and criteria for recognizing accrediting agencies of the United
States Department of Education, effective July 1, 2010, as contained in 34 CFR part
602 (2010). The CHEA recognition standards may be obtained from the council’s website
at http://www.chea.org at no cost. The
federal recognition criteria may be obtained at no cost from the United States
Department of Education’s website at: http://www.ed.gov.
R 339.14006 Training standards for identifying victims of human trafficking;
requirements.
(a) Training content must cover all of the following:
(i) Understanding the types and venues of human trafficking in the United States.
(ii) Identifying victims of human trafficking in healthcare settings.
(iii) Identifying the warning signs of human trafficking in healthcare settings for adults and minors.
(iv) Identifying resources for reporting the suspected victims of human trafficking.
(b) Acceptable providers or methods of training include any of the following:
(i) Training offered by a nationally recognized or state-recognized health-related organization.
(ii) Training offered by, or in conjunction with, a state or federal agency.
(iii) Training obtained in an educational program that has been approved by the board for initial licensure or registration, or by a college or university.
(iv) Reading an article related to the identification of victims of human trafficking that meets the requirements of subdivision (a) of this subrule and is published in a peer-reviewed journal, healthcare journal, or professional or scientific journal.
(c) Acceptable modalities of training include any of the following:
(i) Teleconference or webinar.
(ii) Online presentation.
(iii) Live presentation.
(iv) Printed or electronic media.
(2) The department may select and audit an individual and request documentation of proof of completion of training. If audited by the department, the individual shall provide an acceptable proof of completion of training, including either of the following:
(a) Proof of completion certificate issued by the training provider that includes the date, provider name, name of training, and individual’s name.
(b) A self-certification statement by the individual. The self-certification statement must include the individual’s name and either of the following:
(i) For training completed pursuant to subrule (1)(b)(i) to (iii) of this rule, the date, training provider name, and name of training.
(ii) For training completed pursuant
to subrule (1)(b)(iv) of this rule, the title of the article, author, publication
name of peer reviewed journal, healthcare journal, or professional or
scientific journal, and the date, volume, and issue of publication, as applicable.
R 339.14007 Approved course of
instruction and training.Rescinded.
Rule
7. The department, in consultation with the board, approves a course of
instruction and training that meets all of the following:
(a) Complies with section 17309(2) of the code, MCL 333.17309(2).
(b) Includes, at a minimum, a total of 9 semester credits or 144 clock hours
of instruction. The instruction provided shall include all of the following
subjects:
(i) Administrative management of a nursing home.
(ii) Human resources management in a nursing home.
(iii) Financial management of a nursing home.
(iv) State and federal laws and regulations regarding the nursing home
industry, operation of a nursing home, emergency preparedness, including Medicare
and Medicaid provider compliance with the requirements of the Life Safety Code,
and the protection of patients’ health, safety, and welfare in a nursing home.
(v) Gerontology or the aging process.
(vi) Identification of elder abuse and neglect.
(c) Is offered by an accredited institution that meets the standards in R
339.14005.
PART 3. LICENSURE
R 339.14008 Application for nursing home
administrator license; requirements.
Rescinded.
Rule 8. (1) The department shall issue
a nursing home administrator license to an applicant who, in addition to satisfying
the requirements of the code, satisfies all of the following:
(a) Submits a completed application
on a form provided by the department.
(b) Pays the required fee to the department.
(c) Complies with either of the following:
(i) Completed a course of instruction
and training that meets the requirements of R 339.14007.
(ii) Had been employed as a chief
executive or administrative officer at a state-licensed hospital for not less than
5 of the 7 years immediately preceding the date of applying for a nursing home
administrator license, as provided in section 17309(3) of the code, MCL
333.17309.
(2) In addition to meeting the
requirements of subrule (1) of this rule, an applicant shall, within 2 years after
the date of the application, pass both of the following examinations:
(a) The National Association of Long-term
Care Administrator Board’s (NAB) Core of Knowledge Examination for Long Term Care
Administrators (CORE) administered by the professional examination service
of the NAB or its successor organization, pursuant to R 339.14011.
(b) The NAB National Nursing Home
Administrators Line of Service Examination (NHA LOS) administered by the professional
examination service of the NAB or its successor organization, pursuant to R 339.14011.
(3) An applicant may sit for the CORE
and the NHA LOS examinations a maximum of 4 times each.
R 339.14009 Eligibility
for examinations. Rescinded.
Rule 9. (1) An applicant may take the CORE
and the NHA LOS examinations required under R 339.14008(2) after the applicant
has received authorization from the department to take the examinations.
(2) The department shall authorize the
applicant to take the examinations when it has received the required fee and a
completed application on a form provided by the department and either of the
following:
(a) Documentation sent directly to
the department from an accredited institution verifying that the applicant has
met the educational requirements specified in R 339.14008(1)(c)(i).
(b) Documentation sent directly to
the department that the applicant has met the employment requirements specified
in R 339.14008(1)(c)(ii).
PART 2. EDUCATION, EXAMINATIONS, AND LICENSURE
R 339.14011 Passing
examination scores. Accreditation standards; adoption by
reference.
Rule 11. The passing score for
the CORE and for the NHA LOS examinations is the passing score recommended
by the NAB.
(1) The department, in consultation with the board, adopts by reference the standards and procedures for recognition of accrediting organizations of CHEA, effective January 1, 2022, and the procedures and criteria for recognizing accrediting agencies of the United States Department of Education, effective July 1, 2020, as contained in 34 CFR part 602 (2022). The CHEA recognition standards may be obtained from the council’s website at http://www.chea.org, at no cost. The federal recognition criteria may be obtained at no cost from the United States Department of Education’s website at: http://www.ed.gov.
(2) Copies of the standards and criteria recognizing accrediting agencies used by CHEA and the department of education are available for inspection and distribution at cost of 10 cents per page from the Board of Nursing Home Administrators, Bureau of Professional Licensing, Department of Licensing and Regulatory Affairs, 611 West Ottawa Street, P.O. Box 30670, Lansing, Michigan 48909.
R
339.14012 Training standards for identifying victims of human trafficking;
requirements. Educational
requirements; approved course of instruction and
training.
Rule 12. (1) An applicant for licensure shall have earned either of the following from an accredited college or university that satisfies the requirements of R 339.14011:
(a) If the applicant holds a valid, active license as a registered nurse, an associate
degree or higher in nursing.
(b) A bachelor’s degree.
(2) An applicant for licensure shall have earned not less than 9 semester hours or 144 clock hours of instruction in courses approved under subrule (3) of this rule. The instructional hours required by this subrule may be earned as a part of the applicant’s degree program that satisfied the educational requirement of subrule (1) of this rule.
(3) The department, in consultation with the board, approves a course of instruction and training offered by an institution that meets the accreditation standards in R 339.14011 and includes all of the following subjects:
(a) Administrative management of a nursing home.
(b) Financial management of a nursing home.
(c) Gerontology or the aging process.
(d) Human resources management in a nursing home.
(e) Identification of elder abuse and neglect.
(f) State and federal laws and regulations regarding the nursing home industry, operation of a nursing home, emergency preparedness, including Medicare and Medicaid provider compliance with the requirements of the Life Safety Code, and the protection of patients’ health, safety, and welfare in a nursing home.
(a) Pursuant to section 16148 of
the code, MCL 333.16148, an individual licensed or seeking licensure shall complete
training in identifying victims of human trafficking that meets the following standards:
(a) Training content must cover all of
the following:
(i) Understanding the types and
venues of human trafficking in Michigan or the United States.
(ii) Identifying victims of human
trafficking in health care settings.
(iii) Identifying the warning signs of human
trafficking in health care settings for adults and minors.
(iv) Resources for reporting the suspected
victims of human trafficking.
(b) Acceptable providers or methods
of training include any of the following:
(i) Training offered by a nationally
recognized or state-recognized, health-related organization.
(ii) Training offered by, or in conjunction
with, a state or federal agency.
(iii) Training obtained in an educational
program that has been approved by the board for initial licensure, or by a
college or university.
(iv) Reading an article related to the
identification of victims of human trafficking that meets the requirements of subdivision
(a) of this subrule and is published in a peer review journal, health care
journal, or professional or scientific journal.
(c) Acceptable modalities of training
include any of the following:
(i) Teleconference or webinar.
(ii) Online presentation.
(iii) Live presentation.
(iv) Printed or electronic media.
(2) The department may select and audit
a sample of individuals and request documentation of proof of completion of
training. If audited by the department, an individual shall provide an
acceptable proof of completion of training, including either of the following:
(a) Proof of completion certificate
issued by the training provider that includes the date, provider name, name of
training, and individual’s name.
(b) A self-certification statement by
an individual. The certification statement must include the individual’s name
and either of the following:
(i) For training completed pursuant
to subrule (1)(b)(i) to (iii) of this rule, the date, training provider name, and
name of training.
(ii) For training completed pursuant to
subrule (1)(b)(iv) of this rule, the title of article, author, publication name
of peer review journal, health care journal, or professional or scientific journal,
and date, volume, and issue of publication, as applicable.
(3) Pursuant to section 16148 of the
code, MCL 333.16148, the requirements specified in subrule (1) of this rule
apply to all license renewals and for initial licenses issued on or after March
17, 2021.
R 339.14014 Examination approval and adoption; passing score; limitations.
Rule 14. (1) The board approves and adopts the NAB CORE and the NAB NHA LOS examinations developed, administered, and scored by the NAB or its successor organization.
(2) The accepted passing score for the NAB CORE and the NAB NHA LOS examinations is the passing score established by the NAB or its successor.
(3) An applicant may retake the NAB CORE and the NAB NHA LOS in compliance with the limitations established by the NAB or its successor organization.
R 339.14017 Application for initial nursing home administrator license;
requirements.
Rule 17. The department shall issue a license to an applicant who, in addition to satisfying the requirements of the code and these rules, satisfies all of the following:
(a) Submits a completed application on a form provided by the department.
(b) Pays the required fee to the department.
(c) Complies with either of the following:
(i) Has completed the educational requirement and the course of instruction and training that meets the requirements of R 339.14012.
(ii) Has been employed as a chief executive or administrative officer at a state-licensed hospital for not less than 5 of the 7 years immediately preceding the date of applying for a nursing home administrator license, as provided in section 17309(3) of the code, MCL 333.17309.
(d) Passes both of the following examinations:
(i) The NAB CORE administered by the professional examination service of the NAB or its successor organization.
(ii) The NAB NHA LOS administered by the professional examination service of the NAB or its successor organization.
R 339.14020 Relicensure.
Rule 20. (1) An
applicant for relicensure whose Michigan license has lapsed, under the provisions
of 16201(3) or (4) of the code, MCL 333.16201, as applicable, may be
relicensed by complying with the following requirements as noted by (√):
|
|
Lapsed 0-3
|
Lapsed
|
|
provided by the department, together with the requisite fee. |
√
|
√
|
|
character as that term is defined in, and determined under 1974 PA 381, MCL 338.41 to 338.47. |
|
√ |
|
16174(3) of the code, MCL 333.16174. |
|
√ |
|
|
|
√ |
|
education credits as required by R
|
√ |
√ |
|
An applicant who is or has ever been licensed, registered, or certified in a health profession or specialty by another state, the United States military, the federal government, or another country, shall do both of the following: (A) Disclose each license, registration, or certification on the application form. (B) Satisfy the requirements of section 16174(2) of the code, MCL 333.16174, including verification from the issuing entity showing that disciplinary proceedings are not pending against the applicant and sanctions are not in force at the time of application.
|
√ |
√ |
|
under section 16201(4) of the code, MCL 333.16201, if the applicant satisfies all of the following: |
Lapsed 0-3
|
Lapsed
|
|
provided by the department, together with the requisite fee. |
√ |
√ |
|
moral character as that term is defined in, and determined under, 1974 PA 381, MCL 338.41 to 338.47. |
|
√ |
|
16174(3) of the code, MCL 333.16174. |
|
√ |
|
education credits
as required by R
|
√ |
√ |
|
(v) An applicant who is or has ever been licensed, registered, or certified in a health profession or specialty by another state, the United States military, the federal government, or another country, shall do both of the following: (A) Disclose each license, registration, or certification on the application form. (B) Satisfy the requirements of section 16174(2) of the code, MCL 333.16174, including verification from the issuing entity showing that disciplinary proceedings are not pending against the applicant and sanctions are not in force at the time of application.
|
√ |
√ |
(2) If relicensure is granted and it is determined that a sanction has been imposed by another state, the United States military, the federal government, or another country, the disciplinary subcommittee may impose appropriate sanctions under section 16174(5) of the code, MCL 333.16174.
R 339.14020a Licensure by endorsement.
Rule 20a. (1) An
applicant for a nursing home administrator license licensure by
endorsement, in addition to meeting the requirements of the code and these
rules, shall submit the required fee and a completed application on a form
provided by the department.
(2) If an applicant holds a current, valid health services executive designation granted by the NAB, the applicant is presumed to meet the requirements of section 16186(1)(b) of the code, MCL 333.16186.
(2)(3)
If an applicant does not satisfy subrule (2) of this rule but has been
registered or licensed as a nursing home administrator in 1 or more state for 5
years or more immediately preceding the date of filing an application for a Michigan
nursing home administrator license, then the applicant is presumed to
meet the requirements of
section 16186(1)(b) of the code, MCL 333.16186.
(3)(4)
If an applicant does not satisfy subrule (2) or (3) of this rule has
been registered or licensed as a nursing home administrator in 1 or more state
for less than 5 years immediately preceding the date of filing an application
for a Michigan nursing home administrator license, then the applicant shall
meet the requirements for initial licensure as specified in R 339.14008 339.14017.
(4)(5) Additionally, An
the applicant shall have his or her license or registration in good
standing verified by the licensing agency of any state of the United States in
which the applicant holds or ever held a license or registration as a nursing
home administrator. Verification must include the record of any disciplinary
action taken or pending against the applicant. comply with both
of the following:
(a) Disclose each license, registration, or certification in a health profession or specialty issued by another state, the United States military, the federal government, or another country on the application form.
(b) Satisfy the requirements of section 16174(2) of the code, MCL 333.16174, including verification from the issuing entity showing that disciplinary proceedings are not pending against the applicant and sanctions are not in force at the time of application.
PART 3. CONTINUING EDUCATION AND LICENSE RENEWAL
R 339.14021 License renewal; continuing education requirements; limitations.
documentation; waiver.
Rule 21. (1) An applicant for license renewal shall accumulate not less than 36 hours of continuing education credits approved by the board during each license cycle.
(2) Not less than 2 continuing education credit hours must be earned in pain and symptom management during each renewal cycle, as required under section 16204 of the code, MCL 333.16204.
(3) A licensee’s renewal submission is the certification that the licensee has accumulated the required continuing education during the preceding 2-year licensing cycle. The department may select and audit a licensee and request that the licensee produce documentation proving that the licensee complied with the continuing education requirements.
(4) A licensee shall retain documentation of the approved continuing education credit hours earned for a period of 4 years after renewal of the license.
(5) The continuing education credit hours earned during 1 renewal cycle must not be carried forward to the next renewal cycle.
(6) Except for the implicit bias training required under R 338.7004 that may be used to comply with R 338.7004 and a continuing education requirement, an applicant may not earn continuing education for a continuing education program that is identical to a program the applicant has already earned credit for during that renewal period.
(7) A request for a waiver under section 16205 of the code, MCL 333.16205, must be received by the department not less than 30 days before the last regularly scheduled board meeting before the expiration date of the license.
PART 4. CONTINUING
EDUCATION
R 339.14022 Required
continuing education; certification; documentation. Rescinded.
R 339.14022 Required continuing
education; certification; documentation.
Rule 22. (1) A licensee
shall accumulate not less than 36 hours of continuing education credits during each
license cycle from courses approved pursuant to R 339.14026 or R 339.14026a.
(2) A licensee’s renewal submission is
the certification that he or she has accumulated 36 hours of continuing
education during the preceding, 2-year licensing cycle.
(3) The board may require an applicant
or licensee to submit evidence to demonstrate compliance with this rule.
(4) The licensee shall retain
documentation of the approved continuing education credit hours earned for a
period of 4 years after renewal of the license.
(5) The department may select and audit
a sample of renewal applications and request a licensee to produce
documentation proving that the licensee complied with continuing education
requirement in subrule (1) of this rule.
(6) The department shall receive a
request for a waiver under section 16205 of the code, MCL 333.16205, before the
expiration date of the license.
R 339.14024 Credits earned; limit on
distance learning credits; required
credits. Rescinded.
Rule 24. (1) As
used in this rule, “participation” means education time, exclusive of any break.
(2) One continuing education credit
hour is earned for each 50 to 60 minutes of participation in an approved continuing
education course. After completion of the initial 60 minutes, continuing
education credit may be earned in tenth of an hour increments for each additional
6-minutes of participation in an approved continuing education course.
(3) Fifteen continuing education credit
hours are earned for each semester credit hour earned from an accredited
college or university.
(4) Ten continuing education credit
hours are earned for each academic quarter credit hour earned from an
accredited college or university.
(5) A maximum of 20 continuing
education credit hours may be earned through online or electronic media, such
as videos, internet web-based seminars, video conference, online continuing
education programs, or through any other media that do not permit live
interaction between the presenter and the licensee.
(6) A minimum of 2 continuing education
credit hours must be earned in pain and symptom management during each renewal cycle,
as required under section 16204 of the code, MCL 333.16204.
(7) A minimum of 1 continuing education
credit hour must be earned in state specific laws and regulations pertaining to
licensed nursing home and nursing care facilities during each renewal cycle.
R 339.14024a Carry over credit; duplicate
continuing education credit; limitation. Rescinded.
Rule 24a. (1) The continuing education credit hours earned during 1 renewal cycle
shall not be carried forward to the next renewal cycle.
(2) A licensee shall not earn continuing education credit for completing the
same course twice within the same renewal cycle.
R 339.14026 Approved continuing education courses.
Rule 26. If a continuing education course covers a qualifying subject specified in R 339. 14032, the following continuing education courses are approved by the board:
(a) A continuing education course approved by the NAB.
(b) A An
academic or continuing education course offered by a college or university that
meets the accreditation standards adopted in R 339.14005 339.14011.
R 339.14026a Application
for board approval of continuing education course.
Rescinded.
Rule 26a. (1)
If a continuing education course is not approved pursuant to R 339.14026, the sponsor
of the course may seek board approval by complying with both of the following:
(a) Completing and submitting an
application on the form provided by the department not less than 120 days
before the first date of instruction.
(b) Submitting with the application all
of the following materials:
(i) A detailed course outline that must
include the length of time designated for each topic.
(ii) A list of instructional materials.
(iii) A copy of each instructor’s résumé.
(iv) A description of the methodology to
be used to monitor and verify attendance and the sponsor’s policy for retention
of documents verifying course completion.
(v) A written policy describing the
sponsor’s refund policy.
(2) If the sponsor of the course is seeking approval for credits that may be
used to satisfy the pain and symptom management continuing education required
by R 339.14024(6), the board may approve credit or credits that could be
applied toward that requirement based on the length of time the topic will be
covered in the course.
(3) At the conclusion of each board-approved
course, the sponsor of the course shall award to each participant a certificate
or written evidence of attendance that indicates all of the following:
(a) The participant’s name.
(b) The date the course was offered.
(c) The location of where the course
offered.
(d) The sponsor approval number.
(e) The number of hours of continuing
education earned.
(f) If applicable, the hours of continuing
education earned that may satisfy the pain and symptom management continuing education
required by R 339.14024(6).
(4) The sponsor of the course shall maintain
attendance records for 4 years from the date of the course.
(5) The board shall not approve any
application that was filed after the first date of instruction.
R 339.14029 Withdrawal
of board approval of continuing education course. Rescinded.
Rule 29.
Approval of a continuing education course may be withdrawn by the board for
failure to comply with the requirements of R 339.14026a.
R 339.14032 Qualifying continuing education subjects.
Rule 32. One or more qualifying subjects
shall must be covered in a course for the participant to receive
continuing education credit. Qualifying subjects are those that contribute to
the professional competency of a licensee, including 1 or more of the following:
(a) Behavioral science.
(b) Economics, finance, marketing, or
management. Communications or information technology.
(c) Geriatrics, gerontology, or aging.
Economics, finance, marketing, or management.
(d) Health care, patient care, or
elder abuse and neglect identification. Geriatrics, gerontology, or
aging.
(e) Pharmacology and toxicology. Healthcare,
patient care, or elder abuse and neglect identification.
(f) Human resources.
(g) State and federal laws and
regulations regarding the nursing home industry. Implicit bias training.
(h) Communications or information
technology. Pain and symptom management.
(i) Pain and symptom management.
Pharmacology and toxicology.
(j) State and federal laws and regulations regarding the nursing home industry.