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Licensure  Board Proposed qualification Changes

05/18/2017

License, qualifications, fee, examination, term–reciprocity–emergency license.

344.030. 1. An applicant for an initial license shall file a completed application with the board on a form provided by the board, accompanied by an application fee as provided by rule payable to the department of health and senior services. Information provided in the application must be attested by signature to be true and correct to the best of the applicant’s knowledge and belief.

  1. No initial license shall be issued to a person as a nursing home administrator unless:

(1) The applicant provides the board satisfactory proof that the applicant is twenty-one years of age or over and of good moral character; and

(2) The applicant applying for nursing home administrator licensure provides the board satisfactory proof that he or she has an associate degree or higher from an accredited academic institution and has met criteria established by the board. (criteria established by the board is very broad)

(3) The applicant passes the examinations administered by the board. If an applicant fails to make a passing grade on either of the examinations such applicant may make application for reexamination on a form furnished by the board and may be retested. If an applicant fails either of the examinations a third time, the applicant shall be allowed to reexamine after reapplying for licensure one year from the third time fail. be required to complete a course of instruction prescribed and approved by the board. After completion of the board-prescribed course of instruction, the applicant may reapply for examination. With regard to the national examination required for licensure, no examination scores from other states shall be recognized by the board after the applicant has failed his or her third attempt at the national examination. There shall be a separate, nonrefundable fee for each examination. The board shall set the amount of the fee for examination by rules and regulations promulgated pursuant to section 536.021. The fee shall be set at a level to produce revenue which shall not substantially exceed the cost and expense of administering the examination.

  1. The board may issue a license through reciprocity to any person who is regularly licensed as a nursing home administrator in any other state, territory, or the District of Columbia, if the regulations for securing such license are equivalent to those required in the state of Missouri. However, no license by reciprocity shall be issued until the applicant passes a special examination (what is special exam) approved by the board, which will examine the applicant’s knowledge of specific provisions of Missouri statutes and regulations pertaining to nursing homes. The applicant shall furnish satisfactory evidence that such applicant is of good moral character and has acted in the capacity of a nursing home administrator in such state, territory, or the District of Columbia at least one year after the securing of the license. The board, in its discretion, may enter into written reciprocal agreements pursuant to this section with other states which have equivalent laws and regulations. 05/18/2017
  2. Nothing in sections 344.010 to 344.108, or the rules or regulations thereunder shall be construed to require an applicant for a license as a nursing home administrator, who is employed by an institution listed and certified by the Commission for Accreditation of Christian Science Nursing Organizations/Facilities, Inc., to administer institutions certified by such commission for the care and treatment of the sick in accordance with the creed or tenets of a recognized church or religious denomination, to demonstrate proficiency in any techniques or to meet any educational qualifications or standards not in accord with the remedial care and treatment provided in such institutions. The applicant’s license shall be endorsed to confine the applicant’s practice to such institutions.
  3. The board may issue a temporary emergency license for a period not to exceed ninety days to a person twenty-one years of age or over, of good moral character and a high school graduate or equivalent that meets the criteria outlined in section 344.030.2

(1) and (2) to serve as an acting nursing home administrator, provided such person is replacing a licensed nursing home administrator who has died, has been removed or has vacated the nursing home administrator’s position. No temporary emergency license may be issued to a person who has had a nursing home administrator’s license denied, suspended or revoked. A temporary emergency license may be renewed for one additional ninety-day period upon a showing that the person seeking the renewal of a temporary emergency license meets the qualifications for licensure and has filed an application for a regular license, accompanied by the application fee, and the applicant has taken the examination or examinations but the results have not been received by the board. No temporary emergency license may be renewed more than one time. Temporary license candidates will also have to meet new qualifiers.  Won’t be many temporary licenses issued because not many individuals will qualify without completed mandatory 640 clock hour internship/AIT.  How many temporary license candidates will have baccalaureate or masters degree? Remember experience has been taken out. How will this effect owners wanting to advance from within?

19 CSR 73-2.020 Procedures and Requirements for Licensure of Nursing Home Administrators

PURPOSE: This rule specifies the minimum requirements for licensure as a nursing home administrator in Missouri.

PUBLISHER’S NOTE: The secretary of state has determined that the publication of the entire text of the material which is incorporated by reference as a portion of this rule would be unduly cumbersome or expensive. This material as incorporated by reference in this rule shall be maintained by the agency at its headquarters and shall be made available to the public for inspection and copying at no more than the actual cost of reproduction. This note applies only to the reference material. The entire text of the rule is printed here.

(1) An applicant interested in becoming a licensed nursing home administrator shall obtain an application form from the board. The application form, MO 580-2518 (03-11  add new revised form date), Application for Licensure NHA, is incorporated by reference in this rule and is available on the web at www.health.mo.gov/information/boards/bnha or by contacting the board at PO Box 570, Jefferson City, MO 65102, (573) 751-3511. This rule does not incorporate any subsequent amendments or additions. The application shall be completed and returned to the board with the fee referenced in 19 CSR 73-2.015. Information provided in the application shall be attested by signature to be true and correct to the best of the applicant’s knowledge and belief.

(2) The completed application form shall provide satisfactory proof that the applicant has met the following minimum requirements for Missouri nursing home administrator licensure:

(A) Twenty-one (21) years of age or over;

(B) A high school diploma or equivalent;

(B)(C) Of good moral character;

(C) United States citizen or qualified alien under the Federal Immigration and Naturalization Act and lawfully residing in the United States;

(D) In compliance with Missouri state income tax requirements, pursuant to section 324.010, RSMo;

(D) (E) Has not been charged with, arrested for, or convicted (including a nolo contendere plea or guilty plea) in any state or in federal court whether or not sentence was imposed or suspended. (whether or not sentence was imposed or suspended of any crime – I believe this needs to be more specific of conviction of crimes.  Anything could cause denial to qualify!)

 Has not been convicted of any crime, an essential element of which is fraud, dishonesty or moral turpitude, or which involves the operation of a long-term care facility or other health-care facility, whether or not sentence is imposed. A copy of the record of conviction or plea of guilty or nolo contendere shall be conclusive evidence of the conviction; and

(E) Experience and/or education from an accredited educational institution in one (1) of the following areas:

(F) Education from an accredited educational institution and administrator-in-training programs in one (1) of the following areas:

  1. Experience: A minimum of three (3) years of experience in health-care administration, full-time equivalency; or
  2. Education:
  3. Associate degree in health-care administration, including a minimum of twenty-one (21) semester hours of course work directly in health-care administration; or
  4. Baccalaureate degree (Bachelor of Science or Bachelor of Arts) in one (1) of the following areas:

(I) Health-care administration;   

(II) Gerontology (including a long-term care practicum, internship, or both);

(III) Nursing (BSN or diploma nurse); or

  1. Master’s degree or beyond in one (1) of the following areas:

(I) Health-care administration;

(II) Gerontology (including a long-term care practicum, internship or both);

(III) Nursing; or

  1. Experience and education in one (1) of the following areas:
  2. Associate degree AND two (2) years experience in a health-care facility; or
  3. Baccalaureate degree (BS or BA) AND one (1) year experience in a health-care facility; or
  4. Master’s degree or beyond AND one (1) year experience in a health-care facility.
  5. Baccalaureate degree or higher in health care management or clinical field, or related areas; or (no experience required! How does a degree qualify?)
  6. Associate degree in health care management or clinical field, or related areas; and successful completion of administrator-in-training coursework; or (No experience? And mandated 640 clock hours of internship/AIT – who can afford this? Bring back experience. Someone who has worked their entire life in a facility and has a degree still has to complete internship/AIT)
  7. Associate degree or higher not related to health care management or clinical field, and successful completion of administrator-in-training coursework and internship; (No experience? And mandated 640 clock hours of internship/AIT – who can afford this? Bring back experience. Someone who has worked their entire life in a facility and has a degree still has to complete internship/AIT)

(3) An administrator-in-training coursework shall meet the following criteria:

  1. The curriculum is aligned with the National Association for Long Term Care Administrator Boards (NAB) domains of practice for nursing home administration;
  2. Approved by the board or by the National Association of Long Term Care Administrator Boards;
  3. May be offered in-seat or online; Does an online program give the applicant experience?
  4. Evaluation method to determine if the applicant successfully meets the objectives of the program of study; and
  5. Certification of completion to be issued to the applicant upon successful completion of the coursework.

(4) An administrator-in-training internship shall meet the following criteria:

  1. Applicant must complete 640 clock hours of internship under a licensed nursing home administrator in Missouri or any other state that licenses nursing home administrators. The licensed nursing home administrator shall:
  2. Be currently licensed in Missouri or any other state that licenses nursing home administrators;
  3. Be in good standing with the appropriate state nursing home administrator boards; and
  4. Have a minimum of five (5) years of nursing home administration experience.
  5. The internship is aligned with the National Association for Long Term Care Administrator Boards (NAB) domains of practice for nursing home administration;
  6. Evaluation method to determine if the applicant successfully meets the objectives of the internship; and
  7. Certification of completion to be issued to the applicant upon successful completion of the internship. This entire program is going to costly to the individual, Administrator in charge and facility in time to monitor applicant for 640 clock hours and evaluation process!

(3) (5) The applicant shall be eligible to take the examinations upon board approval and payment of the required examination fees.

(4) (6) If the board determines the applicant has failed to meet one (1) of the criteria outlined in 19 CSR 73-2.020(2)(E)1.–3. 19 CSR 73-2.020(2), the applicant may submit additional information for reevaluation if done so no later than two (2) weeks prior to the next board meeting. If the board determines the applicant has failed to meet the criteria after reevaluation, the person cannot reapply for licensure until one year after the date of the denial letter.

(A) Must complete the course of instruction and training approved by the board pursuant to 19 CSR 73-2.031. The planned curriculum, including a description of each planned course, must be submitted to the board in writing for PRIOR review and approval. Failure to do so within six (6) months following notification of the board’s decision will cause reapplication to become necessary for any future consideration.

(B) May submit additional information for reevaluation if done so no later than two (2) weeks prior to the next board meeting. The applicant will be given notice of the next board meeting date.

AUTHORITY: section 344.070, RSMo Supp. 2010.* This rule was previously filed as 13 CSR 73- 2.020. Original rule filed March 5, 1974, effective March 15, 1974. Rescinded and readopted: Filed May 13, 1980, effective Aug. 11, 1980. Amended: Filed April 14, 1983, effective July 11, 1983. Amended: Filed Oct. 16, 1985, effective March 14, 1986. Amended: Filed Oct. 1, 1987, effective Jan. 14, 1988. Amended: Filed Dec. 4, 1989, effective March 1, 1990. Emergency amendment filed Nov. 17, 1999, effective Dec. 11, 1999, expired June 7, 2000. Amended: Filed Nov. 1, 1999, effective April 30, 2000. Amended: Filed April 30, 2001, effective Jan. 1, 2002. Moved and amended: Filed Jan. 31, 2003, effective Aug. 30, 2003. Amended: Filed Dec. 28, 2007, effective Aug. 30, 2008. Emergency amendment filed May 5, 2011, effective May 15, 2011, expired Feb. 23, 2012. Amended: Filed June 15, 2011, effective Jan. 30, 2012.

*Original authority: 344.070, RSMo 1969, amended 1979, 1993, 1995, 2007.