Ohio Admin. Code 4751-1-09

Current through all regulations passed and filed through October 14, 2024
Section 4751-1-09 - Administrator-in-training program
(A) Introduction: The board has established the administrator-in-training ("AIT") 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") 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 training agency ("internship site").
(B) Dates: All internships in the AIT 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 in the AIT program, an applicant shall submit all of the following items to the board:
(a) The fee invoice, preliminary data for AIT program form, the AIT application, the employment status form, and the 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 with the AIT program.
(3) Board approval: The board shall only approve an applicant's registration for internship in the AIT 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 at an internship site(s) of which the board approves, pursuant to paragraph (A)(6) of rule 4751-1-05 of the Administrative Code.
(f) The internship site(s) will not employ the applicant in any capacity other than that of an AIT during the internship hours.
(g) The applicant does not have a substantial financial interest in any nursing home that will be the internship site at which he or she would serve a major portion of his or her internship.
(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 conviction 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 site:
(1) The training site shall comply with all the following:
(a) The training 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 shall follow the preceptor to those sites, and those additional sites shall also be approved.
(b) The training 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 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 sites in contiguous states may be approved at the discretion of the board. The preceptor and AIT remain under the board's jurisdiction. All Ohio requirements must be met in order to successfully complete the program.
(2) The internship shall only be served at the training site(s) approved by the board prior to the beginning of the program. An alternate training site is allowed on a temporary basis only for specific purposes (e.g., when such training cannot be provided at the approved site).
(E) Professional development plan: The professional development plan for internship in the AIT 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 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 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 site(s), and a description of each internship 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 self-assessment is mandatory. This is necessary to give the AIT and preceptor an accurate assessment for the AIT'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 and/or preceptor to document any waiver request which is submitted. Reduction in hour requests must be applied for prior to the AIT program approval.
(2) Requests for reduction in internship 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 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 requesting a reduction of the internship 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 hours:
(1) An internship 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 shall be completed over nine months and a total of one thousand five hundred hours. This applies to internships of all lengths.
(2) Time spent at the core of knowledge course does not count towards the hours required for the internship.
(3) The AIT is expected to serve the internship 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 from training on weekends and second and third shifts. The preceptor is expected to be available to the AIT by phone but is not expected to work the varying shifts with the AIT.
(4) An AIT may be granted internship credit for up to ten days of jury duty, but if the days of jury duty exceed that number, the AIT 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 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.
(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 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 shall attend the board's virtual AIT training course.
(10) The AIT must be at the facility at the specified times. In case of illness or other problems, the AIT must contact the administrator and explain the absence or tardiness as soon as possible.
(11) The AIT must comply with facility policy relative to the treatment of the persons served and communications, dress code, grooming, etc.
(12) If the AIT experiences problems at the facility which cannot be resolved in cooperation with the assigned supervisor, it is the AIT's responsibility to contact first the preceptor, and if necessary, the board office.
(H) Evaluation:
(1) Monitoring: During an internship, the board may monitor the internship and may call for the AIT and preceptor into a conference with the board.
(2) AIT reporting:
(a) Each AIT shall file such periodic and summary reports as required by and in the format prescribed by the board.
(b) The AIT 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 fails to file reports promptly, such trainee may be deemed to have abandoned the administrator-in-training program.
(c) If an AIT fails to report to the board before the deadline in paragraph (E)(2) of this rule, the board may determine that the AIT abandoned the AIT program.
(d) The AIT is required to keep an accurate daily log of all training hours and subject areas covered during the internship. 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. It must be available for review by the board representative at the training site at all times.
(3) Board determination: After the AIT completes an internship, the board shall determine if the AIT received training that complies with this rule before the board admits the AIT to licensure examination.
(I) Reciprocity: The board may grant credit towards the AIT program for an AIT's internship in another state's internship program if the AIT registers with the board no later than ninety days after he or she leaves the other state's training program.
(J) Preceptors:
(1) No preceptor shall be related by blood or marriage to the AIT.
(2) No preceptor shall have a personal financial interest in the licensure of an AIT.
(3) A preceptor shall not train his or her employer or supervisor.
(4) The AIT program is not responsible for any financial arrangements between an AIT and the preceptor/facility.
(5) The AIT cannot serve as the director of nursing while in the administrator-intraining 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 program.
(7) Approval is temporary and shall be re-applied for prior to the start of each training 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 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.
(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) 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.
(10) The preceptor shall request permission from the board to train more than one AIT concurrently. There is a limit of two AITs 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) The preceptor should provide adequate orientation to the trainee before assigning responsibilities. Orientation should include knowledge of physical layout, personnel policies, goals, objectives, programs, etc.
(12) The preceptor should spell out the AIT's responsibilities, authority and limitations in the student role.
(13) The preceptor should provide physical facilities and equipment needed by the AIT to perform the required tasks.
(14) The preceptor shall contact the board if problems arise that preclude the successful completion of the program by the AIT.
(15) The preceptor shall notify the board of any employment status changes potentially affecting the AIT's internship program.
(16) If a preceptor fails to provide the AIT an opportunity to follow and complete the board-approved professional development plan while the AIT 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 experiences problems at the facility which cannot be resolved in cooperation with the assigned supervisor, it is the AIT's responsibility to contact first the preceptor, and if necessary, the board office.
(2) If an AIT discontinues his or her internship in the approved internship site(s), the AIT and the preceptor shall report the AIT'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 period if the board determines that an AIT fails to serve an internship that complies with this rule.
(4) The board may terminate or rearrange all or part of the internship if, during an AIT's internship, the board determines that the internship is unsatisfactory.
(5) An AIT shall not serve in the capacity of a licensed nursing home administrator or assistant administrator. The board may disqualify the entire internship period of an AIT who serves in the capacity of a licensed nursing home administrator.
(6) If a preceptor fails to provide the AIT an opportunity for an adequate internship while the AIT is under his or her supervision, the board may disqualify the preceptor from further service in the AIT program.
(7) The board may deny an AIT admission for examination to become a licensed nursing home administrator if the AIT falsified or misrepresented facts on an application, documents that support an application, or in any periodic or summary reports on an internship.
(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.
(L) Non-party: Any financial arrangements between preceptor/facility and administrator-in-training 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-intraining (AIT) 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 to attend every day of the core of knowledge course. You 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)."

Ohio Admin. Code 4751-1-09

Effective: 10/1/2023
Five Year Review (FYR) Dates: 7/12/2023 and 10/01/2028
Promulgated Under: 119.03
Statutory Authority: 4751.04; 42 U.S.C. 1396g; 42 C.F.R. 431.707, 431.708
Rule Amplifies: 4751.20, 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