Ohio Admin. Code 4751-1-09 - Administrator residency program

(A) Introduction: The board has established the administrator-in-training ("AIT") administrator residency program as the way for a person who seeks initial licensure as a nursing home administrator to obtain a period of practical training and experience ("internship") ("residency") in nursing home administration under direct supervision of a licensed nursing home administrator ("preceptor") who is in full-time practice in a nursing home that the board approved as the AIT's administrator resident's training agency ("internship residency site").

(B) Dates: All internships residencies in the AIT administrator residency program shall begin on the first day of the first month of the calendar quarter, namely: January 1, April 1, July 1, or October 1.

(C) Registration:

(1) How to register: To register for internship residency in the AIT administrator residency program, an applicant shall submit all of the following items to the board:

(a) The fee invoice, preliminary data for a board-approved AIT administrator residency program form, the AIT administrator resident application, the a board-approved employment status form, and the a board-approved facility survey form having complete and accurate entries of information.

(b) Certified transcript(s) of college credits and proof of degree(s), in accordance with paragraph (A)(4) of rule 4751-1-05 of the Administrative Code; said transcripts to be sent by the institution directly to the office of the board.

(c) Certificate or other specific and adequate documentation of completion of approved course of study or program of instruction meeting the special academic requirements in the subject areas specific to health care administration in accordance with paragraph (A)(5) of rule 4751-1-05 of the Administrative Code.

(d) Any additional or supplemental documentation to support data entries on the application form and to establish any qualifying administrative experience.

(e) The professional development plan, with its supporting documentation.

(2) Deadline: The applicant shall submit all parts of the application to the board so that the application is on file with the board at least twenty-one days before the regular board meeting that precedes the requested beginning date of an internship residency with the AIT administrator residency program.

(3) Board approval: The board shall only approve an applicant's registration for internship residency in the AIT administrator residency program if the board is satisfied that the applicant meets, or has arranged to meet, each of the following requirements:

(a) The applicant is at least twenty-one years of age.

(b) The applicant has good health and is otherwise suitable to the practice of nursing home administration according to paragraph (A)(3) of rule 4751-1-05 of the Administrative Code.

(c) The applicant meets general education requirements of paragraph (A)(4) of rule 4751-1-05 of the Administrative Code.

(d) The applicant has submitted records to the board to verify that he or she meets, or has arranged to meet, the special academic requirements of paragraph (A)(5) of rule 4751-1-05 of the Administrative Code.

(e) The applicant has arranged for an internship a residency at an internship a residency site(s) of which the board approves, pursuant to paragraph (A)(6) of rule 4751-1-05 of the Administrative Code.

(f) The internship residency site(s) will not employ the applicant in any capacity other than that of an AIT administrator resident during the internship residency hours.

(g) The applicant does not have a substantial financial interest in any nursing home that will be the internship residency site at which he or she would serve a major portion of his or her internship residency.

(h) The applicant successfully completed a background check (BCI and FBI) with the results sent directly to the board office.

(i) The applicant completed the report of a board-approved conviction report form, as applicable.

(j) The board, in accordance with section 9.79 of the Revised Code, has determined that the results of the background check do not make the individual ineligible for the license.

(D) Training Residency site:

(1) The training residency site shall comply with all the following:

(a) The training residency site shall be under the full-time supervision of a licensed nursing home administrator who qualifies as a preceptor. Full-time is defined as a minimum of thirty-five hours per week in the nursing facility. If the licensed nursing home administration splits time between multiple buildings, the AIT administrator resident shall follow the preceptor to those sites, and those additional sites shall also be approved.

(b) The training residency site shall provide professional nursing care under the full-time supervision of a director of nursing who is a registered nurse. The director of nursing shall have at least two years' full-time experience as an RN in a nursing home or hospital.

(c) The training residency site shall be staffed and operated in accordance with all applicable local, state, and federal laws and rules and be deemed by the board to provide quality care in a safe environment. The administrator shall be required to submit copies of all current survey reports.

(d) Out-of-state training residency sites in contiguous states may be approved at the discretion of the board. The preceptor and AIT administrator resident remain under the board's jurisdiction. All Ohio requirements must be met in order to successfully complete the program.

(2) The internship residency shall only be served at the training residency site(s) approved by the board prior to the beginning of the program. An alternate training residency site is allowed on a temporary basis only for specific purposes (e.g., when such training residency cannot be provided at the approved site).

(E) Professional development plan: The professional development plan for internship residency in the AIT administrator residency program shall provide documentation that the following requirements have been, or will be, met:

(1) A pre-training assessment of the applicant's background in terms of educational level, pertinent experience, maturity, motivation, and initiative has been made jointly by the applicant and the preceptor.

(2) Based on the pre-training assessment, the applicant and the preceptor have jointly developed a detailed goal-oriented professional development plan with adequate supporting documentation that relates educational objectives, subject areas of the core of knowledge in nursing home administration, training residency sites and/or agencies involved, estimated number of hours needed for mastering each objective, and total number of hours in the professional development plan. The NAB professional development plan form shall be used. This form is located within the "National Administrator-in-Training Administrator Residency Program Manual, Module 3 - NHA" (2021) at https://www.nabweb.org.

(3) Supporting documentation for the professional development plan shall include preceptor's qualifications, the qualifications of the nursing director at the internship residency site(s), and a description of each internship residency site and the staff that is necessary to determine the site's adequacy to meet specific goals in the professional development plan.

(4) Use of the AIT administrator residency self-assessment is mandatory. This is necessary to give the AIT administrator resident and preceptor an accurate assessment for the AIT's administrator resident's strengths and weaknesses, and a guide to the hours needed to be spent instructing each domain of practice.

(F) Waiver requests:

(1) It is the responsibility of the AIT administrator resident and/or preceptor to document any waiver request which is submitted. Reduction in hour requests must be applied for prior to the AIT administrator residency program approval.

(2) Requests for reduction in internship residency hours are granted for two reasons: education and experience. Significant experience in a nursing facility is required in order to qualify for a three-month/five-hundred-hour reduction based upon experience. The AIT administrator resident shall be able to demonstrate mastery of at least five-hundred-hours' worth of training plan knowledge specific to a nursing facility setting.

(3) The board-supplied required training plan must be used.

(4) The plan must list in the margin the number of hours needed for mastering each subject area and objective, and must indicate the total number of hours in the plan.

(5) An AIT administrator resident requesting a reduction of the internship residency hours must still submit a training plan for the maximum number of hours required at his/her education level (in the margin) in addition to the second column of hours showing the requested reduction.

(6) The board's decision on waiver requests is final.

(G) Training Residency hours:

(1) An internship A residency is approved for a set number of months and hours. Both the months and the hours apply, i.e., a nine-month, one-thousand-five-hundred-hour internship residency shall be completed over nine months and a total of one thousand five hundred hours. This applies to internships residencies of all lengths.

(2) Time spent at the core of knowledge course does not count towards the hours required for the internship residency.

(3) The AIT administrator resident is expected to serve the internship residency primarily between the hours of six a.m and six p.m, Monday to Friday, and serve a minimum of thirty-five hours per week. This does not preclude the AIT administrator resident from training residency on weekends and second and third shifts. The preceptor is expected to be available to the AIT administrator resident by phone but is not expected to work the varying shifts with the AIT administrator resident.

(4) An AIT administrator resident may be granted internship residency credit for up to ten days of jury duty, but if the days of jury duty exceed that number, the AIT administrator resident shall request a leave of absence for the additional days and be required to make up the time. The board shall not unreasonably deny such request.

(5) Normally a monthly schedule of internship residency should not exceed one hundred eighty hours. Some allowance is made for extra hours which are served to make up time spent at the core of knowledge course during the internship residency.

(6) Vacations/leaves of absence: request for vacations or leaves of absence in excess of two weeks must be made to the board office, countersigned by the preceptor and the time must be made up.

(7) Continuing education programs attended during the internship residency will be reported to the board on the monthly report form.

(8) Continuing education courses taken prior to licensing will not count for licensure renewal.

(9) The AIT administrator resident shall attend the board's virtual AIT administrator resident training course.

(10) The AIT administrator resident must be at the facility at the specified times. In case of illness or other problems, the AIT residency must contact the administrator and explain the absence or tardiness as soon as possible.

(11) The AIT administrator resident must comply with facility policy relative to the treatment of the persons served and communications, dress code, grooming, etc.

(12) If the AIT administrator resident experiences problems at the facility which cannot be resolved in cooperation with the assigned supervisor, it is the AIT's administrator resident's responsibility to contact first the preceptor, and if necessary, the board office.

(H) Evaluation:

(1) Monitoring: During an internship a residency, the board may monitor the internship residency and may call for the AIT administrator resident and preceptor into a conference with the board.

(2) AIT Administrator resident reporting:

(a) Each AIT administrator resident shall file such periodic and summary reports as required by and in the format prescribed by the board.

(b) The AIT administrator resident and the preceptor shall both sign, then file, each report required in paragraph (E)(1) of this rule with the board no more than ten days after the end of each reporting period. If the AIT administrator resident fails to file reports promptly, such trainee the administrator resident may be deemed to have abandoned the administrator-in-training administrator residency program.

(c) If an AIT administrator resident fails to report to the board before the deadline in paragraph (E)(2) of this rule, the board may determine that the AIT administrator resident abandoned the AIT administrator residency program.

(d) The AIT administrator resident is required to keep an accurate daily log of all training hours and subject areas covered during the internship residency. This is necessary not only to provide an accurate tally of hours on the monthly reports to the board, but also as documentation of day by day activity. This daily log is to be kept throughout the internship residency. It must be available for review by the board representative at the training residency site at all times.

(3) Board determination: After the AIT administrator resident completes an internship a residency, the board shall determine if the AIT administrator resident received training that complies with this rule before the board admits the AIT administrator resident to licensure examination.

(I) Reciprocity: The board may grant credit towards the AIT administrator residency program for an AIT's internship administrator resident's residency in another state's internship residency program if the AIT administrator resident registers with the board no later than ninety days after he or she leaves the other state's training residency program.

(J) Preceptors:

(1) No preceptor shall be related by blood or marriage to the AIT administrator resident.

(2) No preceptor shall have a personal financial interest in the licensure of an AIT administrator resident.

(3) A preceptor shall not train his or her employer or supervisor.

(4) The AIT administrator residency program is not responsible for any financial arrangements between an AIT administrator resident and the preceptor/facility.

(5) The AIT administrator resident cannot serve as the director of nursing while in the administrator-in-training administrator residency program.

(6) At the discretion of the board, a licensed nursing home administrator may be approved by the board to supervise the practical training and experience of future nursing home administrators in the board-approved AIT administrator residency program.

(7) Approval is temporary and shall be re-applied for prior to the start of each training residency program. If the board should determine that a nursing home administrator is unsatisfactory to serve as a preceptor, the board may withdraw its approval and deny future approval.

(8) Preceptors shall attend the board's virtual preceptor training course for each AIT administrator resident unless they have attended one in the past year.

(9) The board shall base its approval on the following:

(a) Whether the administrator is in good standing with the board: has an active license, and any recent disciplinary action on record.

(b) Whether the administrator has successfully completed NAB's online preceptor training course.

(c) Whether the administrator has successfully mentored other AITs administrator residents.

(d) The manner in which the administrator has administered the facility as documented by state inspections and certifications and any recent substandard care citations.

(e)(10) A preceptor shall be a full-time nursing home administrator who has been licensed in and has practiced full-time in Ohio for a minimum of two years and shall have a current certificate of registration. Out-of-state preceptors must have been licensed and practiced full-time for a minimum of two years and have a current certificate of registration.

(10)(11) The preceptor shall request permission from the board to train more than one AIT administrator resident concurrently. There is a limit of two AITs administrator residents per preceptor at any one time. Out-of-state preceptors must have been licensed and practiced full-time for a minimum of two years and have a current certificate of registration.

(11)(12) The preceptor should provide adequate orientation to the trainee administrator resident before assigning responsibilities. Orientation should include knowledge of physical layout, personnel policies, goals, objectives, programs, etc.

(12)(13) The preceptor should spell out the AIT's administrator resident's responsibilities, authority and limitations in the student role.

(13)(14) The preceptor should provide physical facilities and equipment needed by the AIT administrator resident to perform the required tasks.

(14)(15) The preceptor shall contact the board if problems arise that preclude the successful completion of the program by the AIT administrator resident.

(15)(16) The preceptor shall notify the board of any employment status changes potentially affecting the AIT's administrator resident's internship residency program.

(16)(17) If a preceptor fails to provide the AIT administrator resident an opportunity to follow and complete the board-approved professional development plan while the AIT administrator resident is under the preceptor's supervision, the board may disqualify the preceptor from further service in the preceptor program.

(K) Adverse actions:

(1) If the AIT administrator resident experiences problems at the facility which cannot be resolved in cooperation with the assigned supervisor, it is the AIT's administrator resident's responsibility to contact first the preceptor, and if necessary, the board office.

(2) If an AIT administrator resident discontinues his or her internship residency in the approved internship residency site(s), the AIT administrator resident and the preceptor shall report the AIT's administrator resident's discontinuance to the board before the tenth day after the discontinuance.

(3) The board may disqualify or disallow all (or part) of an internship a residency period if the board determines that an AIT administrator resident fails to serve an internship a residency that complies with this rule.

(4) The board may terminate or rearrange all or part of the internship residency if, during an AIT's internship administrator resident's residency, the board determines that the internship residency is unsatisfactory.

(5) An AIT administrator resident shall not serve in the capacity of a licensed nursing home administrator or assistant administrator. The board may disqualify the entire internship residency period of an AIT administrator resident who serves in the capacity of a licensed nursing home administrator.

(6) If a preceptor fails to provide the AIT administrator resident an opportunity for an adequate internship residency while the AIT administrator resident is under his or her supervision, the board may disqualify the preceptor from further service in the AIT administrator residency program.

(7) The board may deny an AIT administrator resident admission for examination to become a licensed nursing home administrator if the AIT administrator resident falsified or misrepresented facts on an application, documents that support an application, or in any periodic or summary reports on an internship a residency.

(8) According to rule 4751-1-12 of the Administrative Code, the board may suspend or revoke a license if the administrator falsified or misrepresented facts on an application, documents that support an application, or in any periodic or summary reports on an internship a residency.

(L) Non-party: Any financial arrangements between preceptor/facility and administrator-in-training administrator resident are the joint responsibility of the parties involved and are not the responsibility of the board.

(M) Core of knowledge:

(1) The core of knowledge course is designed specifically for the administrator-in-training (AIT) administrator resident participant. This course meets the special academic requirement set by BELTSS for qualifying to take the state licensure board examination.

(2) The content of the course is designed to provide information and promote understanding that will lead to more effective performance in the administration of long-term care. The subject areas covered have been recommended by the national association of long-term care administrator boards and endorsed by BELTSS.

(3) BELTSS expects you the administrator resident to attend every day of the core of knowledge course. You The administrator resident may be required to make up time, which may incur an additional fee.

(4) All those satisfactorily completing the course will receive a certificate which satisfies the requirement of the board of executives of long-term services and supports (BELTSS).

(5) The BELTSS core code of conduct, available from the course provider, shall be followed.

(N) Definitions for this rule:

"AIT application" means "'Form AIT' (Rev., January 2023)."

"Employment status form" means "'Employment Status Form' (Rev., January 2023)."

"Facility survey form" means "'Facility Survey Form' (Rev., December 2016)."

"Preliminary data for AIT program" means "'Preliminary Data for AIT Program' (Rev., January 2023)."

"Report of conviction form" means "'Report of Conviction Form' (Rev., March 2020)."

Notes

Ohio Admin. Code 4751-1-09

Effective: 2/1/2025
Five Year Review (FYR) Dates: 10/31/2024 and 02/01/2030
Promulgated Under: 119.03
Statutory Authority: 4751.04; 42 U.S.C. 1396g; 42 C.F.R. 431.707
Rule Amplifies: 4751.38; 42 U.S.C. 1396g; 42 C.F.R. 431.707, 431.708
Prior Effective Dates: 09/29/1970, 10/01/1974, 06/01/2015, 04/16/2018, 02/01/2022, 10/01/2023