Addressing Substandard Care Issues

Administrator Investigation Resulting from Facility Receiving Finding of Substandard Quality Care.

Policy Statement: It is the policy of the North Dakota Board of Examiners for Nursing Home Administrators to determine if disciplinary action needs to be taken on an administrator’s license if the Board has been notified by the State Department of Health of a finding of substandard quality care.

Procedure: The Executive Director of the North Dakota Board of Examiners for Nursing Home Administrators will receive a copy of the CMS-2567 from the Department of Health.  The Executive Director will communicate with the Department of Health to clarify the nature of the deficiencies and report the notice of substandard care to the Board.

After the Board completes their review, they will determine whether grounds for disciplinary action pursuant to administrative rule 55-02-01-17 exist and if so, proceed according to administrative rule 55-02-01-18. The administrator and any appropriate authorities will be informed of the determination.

The North Dakota Board of Examiners for Nursing Home Administrators will consult with legal counsel on procedures.

Policy and procedure acted upon at the October 13, 1994, Board Meeting; Revised upon Board action at the July 13, 1995 Board Meeting; Revised upon Board action at the July 13, 2000 Board Meeting; Revised upon Board action at the December 4, 2014 Board Meeting; Revised upon Board Action at the January 28, 2016 Board Meeting. Revised upon Board action at the January 12, 2018 Board Meeting. Revised upon Board action at the January 13, 2023 Board Meeting.

Complaints

Policy Statement: It is the policy of the North Dakota Board of Examiners for Nursing home Administrators to review all complaints presented in writing to the Board.

Procedure: A written acknowledgment of the complaint will be sent to the complainant from the Board Chair and a copy of the complaint will be forwarded to the Administrator. Any written complaint against an administrator presented to the North Dakota Board of Examiners for Nursing Home Administrators, will be distributed to all members of the Board. The Board will proceed according to the requirements of administrative rule 55-02-01-18.

The North Dakota Board of Examiners for Nursing Home Administrators will consult with legal counsel on procedures.

Policy and Procedure acted upon at the October 13, 1994, Board Meeting; Revised upon Board action at the July 13, 2000, Board Meeting; Revised upon Board action at the December 4, 2014 Board Meeting.

Nursing Home Administrators National Examination Policy

Policy Statement: It is the policy of the North Dakota Board of Examiners for Nursing Home Administrators to offer the NAB Nursing Home Administrators test through Computer Based Testing. The fee is to be paid directly to NAB.

A record of the test score will be kept for purposes of initial licensure at a later date in North Dakota for a period of twenty-four months. A record of the test score may also be reported to another nursing home administrator licensing board upon request from the individual.

As of January 2000, the NAB Nursing Home Administrators Exam is computerized. Visit www.nabweb.org for more information on the exam.

The North Dakota Board of Examiners for Nursing Home Administrators will consult with legal counsel on procedures.

Policy and Procedure acted upon at the October 13, 1994, Board Meeting; Revised upon Board action at the July 13, 2000, Board Meeting; Revised upon Board action at the December 4, 2014 Board Meeting. Revised upon Board action at the January 13, 2023 Board Meeting..

Nominating Committee

Policy Statement: A nominating committee, appointed by the Chairperson, shall make nominations for these offices prior to the second meeting of the Board in even numbered years. Elections take place at the second meeting and the duties are assumed at the first meeting of the following year.

The officers of the Board shall be the Chair and Vice Chair, and the Secretary/Treasurer, each of whom shall be elected for a two-year term. Officers may be elected to a consecutive term, not to exceed 2 two-year terms.

Procedure: Duties of the Board are:

1. The Chairperson presides at all meetings of the Board.
2. In the absence of the Chairperson, the Vice-Chairperson presides at meetings, and performs all the duties usually performed by the Chairperson.
3. The Secretary/Treasurer, with assistance as may be required, keeps a record of the minutes of the meetings, notifies the members of the Board meetings and maintains the files of all administrators in North Dakota (the Board may employ an employee to assist with the performance of its duties). The Secretary/Treasurer conducts all routine correspondence for the Board, receives all money payable to the Board and keeps such financial records as are approved by the Board. Any functions of the secretary-treasurer may be delegated by the board to the Executive Director.

The North Dakota Board of Examiners for Nursing Home Administrators will consult with legal counsel on procedures.

Policy and Procedure acted upon at the October 13, 1994, Board Meeting; Revised upon Board action at the July 13, 2000, Board Meeting; Revised upon Board action at the December 4, 2014 Board Meeting; Revised upon Board Action at the January 28, 2016 Board Meeting.

Professional Courtesy

Policy Statement: When a person/company requests a copy of the contents of a file of a licensed administrator, it is the policy of the North Dakota Board of Examiners for Nursing Home Administrators to send a copy of the request to the administrator of whom the request was made. The North Dakota Board of Examiners for Nursing Home Administrators will comply with North Dakota public records law in responding to any requests for information

The North Dakota Board of Examiners for Nursing Home Administrators will consult with legal counsel on procedures.

Policy and Procedure acted upon at the October 13, 1994, Board Meeting; Revised upon Board action at the July 13, 2000, Board Meeting; Revised upon Board action at the December 4, 2014 Board Meeting.

Policy for Releasing Information

Policy Statement: The North Dakota Board of Examiners for Nursing Home Administrators policy for releasing information in accordance with North Dakota Open Meetings, Open Records Laws is as follows:

Upon request of public records, the North Dakota Board of Examiners for Nursing Home Administrators will furnish the request, or one copy of the public records requested. Permitted charges under the North Dakota public records law will be assessed.

A person requesting to review information within the office of the North Dakota Board of Examiners for Nursing Home Administrators must first schedule an appointment to do so during normal business hours. An appointment must be scheduled with the Executive Director of the North Dakota Board of Examiners for Nursing Home Administrators at 701-222-4867.

The Board shall not disclose any applicant or licensee personal information as defined in N.D.C.C. § 44-04-18.1(4) except for a person's home address if the home address is the address of record.

The North Dakota Board of Examiners for Nursing Home Administrators will consult with legal counsel on procedures.

Policy and Procedure acted upon at the October 13, 1994, Board Meeting; Revised upon Board action at the July 13, 2000, Board Meeting; Revised upon Board action at the December 4, 2014 Board Meeting.

Application Review Committee

Policy Statement: The Executive Director shall review all applications for licensure.

Procedure: If applications for licensure are complete, meet all requirements for licensure, the applicant has no history of disciplinary action or criminal conduct, the Executive Director may issue a license without further review of the Board. The Executive Director will bring any questionable applications to the full Board for its review.

The North Dakota Board of Examiners for Nursing Home Administrators will consult with legal counsel on procedures.

Policy and Procedure acted upon at the October 13, 1994, Board Meeting; Revised upon Board action at the July 13, 2000, Board Meeting; Revised upon Board action at the December 4, 2014 Board Meeting; Revised upon Board Action at the January 28, 2016 Board Meeting. Revised upon Board action at the January 12, 2018 Board Meeting.

Investment Policy

Policy Statement: The policy of the ND Board of Examiners for Nursing Home Administrators is to achieve an optimum rate of return on available assets not required for current operating needs, in a manner that retains liquidity and minimizes risk.

Procedure:

1. Participants of the Board shall act responsibly when investing assets, considering the safety of the capital invested as well as the probable income to be derived.
2. Investments shall be limited to Certificates of Deposit, not to exceed FDIC/insurance limits at any bank/savings institution.
3. The maximum maturity of a deposit will be 6 years.
4. Financial institutions with a physical location in the State of North Dakota will be selected as depositories based on but not limited to the following: financial stability, community involvement and other relevant economic criteria.
5. The Board will review all investments for continuation a minimum of once each year.
6. The Executive Secretary shall approve each investment and keep the Board regularly informed with the concurrence of the Treasurer and President.
7. No employee or Board member shall receive personal gain as a result of investment decisions made by the ND Board of Examines for Nursing Home Administrators.

The North Dakota Board of Examiners for Nursing Home Administrators will consult with legal counsel on procedures.

Policy and Procedure acted upon at the January 11, 2008, Board Meeting.

Proposed Policy on Renewal Application Review

Policy Statement: It will be the policy of the Board that subsequent to initial licensure, the Board will direct the Executive Director to conduct a review of any publicly available criminal history information, primarily in North Dakota, in conjunction with a licensees request for renewal of a license. In even numbered years, the Board will review information related to renewal applications of licensees whose last name begins with “a” through “m”; and in odd numbered years, the Board will review information related to renewal applications of licensees whose last name begins with “n” through “z”

The North Dakota Board of Examiners for Nursing Home Administrators will consult with legal counsel on procedures.

Policy and Procedure adopted at the December 4, 2014 Board Meeting.

License Application Process Policy

Policy Statement: Two examinations are required to meet the license requirements of North Dakota Administrative Code § 55-02-01-10. NAB requests information from the Board on exam participants prior to taking the exam; and the state exam is administered through the Board. License applicants may take either exam any time after the submission of their license application to the Board and payment of the appropriate license application fee. A license application will be valid for twenty-four months upon receipt of the application. An applicant for licensure must submit all documentation necessary for licensure during the twenty-four month application period. An applicant failing to obtain licensure during the twenty-four month application period will need to reapply for licensure.

The North Dakota Board of Examiners for Nursing Home Administrators will consult with legal counsel on procedures.

Policy and Procedure adopted at the August 13, 2015 Board Meeting. Revised upon Board action at the January 13, 2023 Board Meeting.

Administrator In Training (AIT) Program Policy

Statement of History and Purpose:

The AIT Program was implemented beginning January 1, 1997. The purpose of this program is to provide an opportunity for potential nursing facility administrators to:

• Optimally function as an administrator in providing service to respective residents, family, and staff, and
• Gain vital practical experience in a nursing facility thus better preparing them for writing state and national examinations.
• It is the intent of the Board that administration of the program may be delegated.

Description of AIT Program:

Length: Minimum of 1,000 hours to be completed within twenty-four months. Application for licensure must be submitted within one year of AIT Program completion, unless good cause is shown by the Applicant and determined by the Board for an extended period of time.

Program Content: The program will be required to use the NAB National Interactive AIT Program Manual as the course content. The NAB Program will guide both the Preceptor and the Administrator in Training (AIT) through the internship experience providing the AIT with a solid foundation in the exciting field of long term care and establish a consistent AIT experience for all future leaders. The AIT Program Manual consists of four modules. Module 1: Guidelines for designing an AIT program. Phases of AIT program. AIT model standards covering domains. Flashcard links. Module 2: Knowledge & skills. Domains of Practice. Sample learning activities. Module 3: One Module per Line of Service (NHA, RCAL, HCBS, HSE) including a LOS specific self-assessment and professional development plan. Section for customization to include state content is included. Module 4: Reference material: glossary, prefixes, suffixes, abbreviations, therapeutic actions, common diagnoses. Will be flexible to allow opportunity for individuals to create/design their own learning experiences. NOTE: Other AIT Programs may be substituted in lieu of the NDBOENHA’s AIT Program if all domains are included and 1,000 hours are met.

Written Validation of AIT Experiences: Will be required.

Preceptors: Administrators in North Dakota nursing facilities who meet the following requirements may be approved as preceptors:

• Holds a current, unencumbered nursing home administrator license;
• Has been licensed in any state as an administrator for a minimum of three years;
• Is willing to fulfill all requirements with AIT Trainee and Program reporting;
• Completes the NAB Preceptor Course;

Financial Considerations: Any financial considerations will be determined between each individual preceptor/facility and the Trainee. Work may be performed on a pay, volunteer, or credit basis.

Trainee Pre-Requisites: Holds a minimum of a BS/BA or is currently enrolled in a BS/BA Program or within 1 year of obtaining a BS/BA Degree.

Waiver of hours: Each applicant must complete a 1,000-hour practicum unless the applicant presents evidence to the board that the applicant has experience as described below for a reduction in the number of practicum hours. The board shall determine the minimum number of hours of practicum to be completed by an applicant by comparing the applicant’s experience to the requirements listed below. The amount of experience required to qualify for a practicum reduction under items 3 and 4 shall be measured in full-time equivalency at the rate of 35 hours per week.

1. 750 hours for an individual with two or more years of managerial or administrative employment experience, including supervision of at least 25 employees and responsibility for an annual budget of at least $1,000,000
2. 750 hours for an individual who has two or more years of employment in a hospital or nursing facility in any professional capacity or in any direct patient care capacity
3. 500 hours for an individual who has served two or more years as a department manager with supervisory and budgetary responsibility and meets one or more of the following criteria:
   a. the individual does not meet the requirements for assistant administrator under item 4 but has otherwise held that title in a nursing facility or hospital and has performed under the title for two or more years
   b. the individual has served, for two or more years, as director of nurses in a hospital or registered housing with services establishment that has an arranged comprehensive home care license; or
   c. the individual has served as a housing manager in a registered housing with services establishment that has an arranged comprehensive home care license
4. 250 hours for an individual who has served:
   a. two or more years as a full-time director of nurses in a nursing facility,
   b. one or more years as a full-time hospital administrator or hospital assistant administrator with responsibility for both resident care and administrative functions, or
   c. one or more years in a nursing home as the assistant administrator, chief executive officer, or equivalent role with responsibility for both resident care and administrative functions. Time working as an acting administrator under an acting license or permit in the same nursing facility where the individual also served as the assistant administrator, chief executive officer, or equivalent role meets this requirement.

Completion of Program:
Verification of successful AIT Program completion must be received prior to licensure.

The North Dakota Board of Examiners for Nursing Home Administrators will consult with legal counsel on procedures.

Policy and Procedure adopted at the January 28, 2016 Board Meeting. Revised upon Board action at the January 13, 2023 Board Meeting.