A4762

An Act concerning licensure of nursing home administrators, and amending and supplementing P.L.1968, c.356.

Be It Enacted by the Senate and General Assembly of the State of New Jersey:

1. Section 2 of P.L.1968, c.356 (C.30:11-12) is amended to read as follows:

2. a. Application for license required by [this act] P.L.1968, c.356 (C.30:11-11 et seq.) and P.L. , c. (C. ) (pending before the Legislature as this bill) shall be made upon forms furnished by the [Commissioner of the Department of Institutions and Agencies] Nursing Home Administrator’s Licensing Board. The applicant shall be required to furnish evidence of his or her ability to comply with the minimum standards for administrators to successfully supervise the institution for which the license is sought. An applicant for licensure as a nursing home administrator shall submit the following to the board:

(1) a completed application in the form developed by the board which must, within six months of the effective date of P.L. , c. (C. ) (pending before the Legislature as this bill), be accepted in an electronic format as specified in section 4 of P.L. , c. (C. ) (pending before the Legislature as this bill); and that provides transparency for the applicant to view the date and time of submission, date and time of board staff review, any requested revisions, the date and time of supplemental submissions, and the date and time of approval of denial determinations;

(2) declaration of intent to become a citizen, if applicable;

(3) a non-refundable licensure application fee as set by the board;

(4) an official transcript from an accredited college or university, which shall be accepted by the board in either electronic form or in printed form;

(5) a letter of reference from the preceptor of the applicant;

(6) documentation of administrative experience identified in subsection b. of this section;

(7) documentation of successful completion of 100 course hours identified in subsection b. of this section;

(8) documentation of involvement on the part of the applicant in disciplinary proceedings with a licensure board or governmental agency in any jurisdiction the applicant is, or has been, licensed as an administrator, and where, as a result of that proceeding, a sanction of at least the level of a written warning was imposed on the administrator, if applicable;

(9) documentation of any offense in violation of State or federal law; and

(10) a signed, notarized statement on the application by the applicant indicating that the statements and documents are true and correct.

An application submitted to the board shall remain active for a period of two years, by the end of which period, an applicant shall meet all eligibility requirements to take the licensing examination. At the expiration of the two-year period, the board shall deem the application for licensure to be inactive and, at the board’s discretion, may require the applicant to submit a new application. An applicant may request an extension of the two-year period with documentation of the progress made toward meeting the license requirements to the board prior to the expiration of the initial two-year period. The board, or its designee, may grant an extension pursuant to regulations established by the board.

b. Notwithstanding any law, rule, or regulation to the contrary, an applicant for a license as a nursing home administrator shall:

(1) be at least 21 years of age;

(2) be a citizen of the United States or have declared the intent to become a citizen;

(3) have, at a minimum, a baccalaureate degree from an institution of higher learning;

(4) have served either:

(a) as an administrative intern in one or more New Jersey licensed nursing homes for at least 1,750 hours at a rate of no more than 50 hours per week, performed on a part-time or full-time basis and completed not more than two years prior to the submission of the application for examination;

(b) as an assistant administrator, having served a minimum of 1,750 working hours as an assistant administrator in a licensed New Jersey nursing home within the two-year period immediately prior to the submission of an application; and the administrator submits documentation to the board, which shall be accepted electronically through the applicant’s portal, verifying the applicant’s completion of the requirement for 1,750 experience hours and recommending approval of the applicant’s license application; or

(c) with a combination of educational accomplishment and work experience as shall be set forth in regulations by the Commissioner of Health that establish qualifications equivalent to the training requirements set forth above;

(5) have successfully completed 100 seminar or course hours in areas relevant to long-term care administration as determined by the board;

(6) be of good moral character as required by section 3 of P.L.1968, c.356 (C.30:11-13); and

(7) have, within two years of completing the administrative intern requirement of paragraph 4 of this subsection and within three years of completing the course hours of paragraph 5 of this subsection, passed an examination approved by the board for the licensing of nursing home administrators.

c. A baccalaureate degree shall not be required for an individual to serve as an administrative intern but shall be required before the issuance of a license.

d. An applicant for licensure shall undergo a criminal history record background check with fingerprints pursuant to section 13 of P.L.1968, c.356 and bear all costs of administering and processing the background check.

e. An applicant shall have three opportunities to pass the written examination without being subject to additional approvals, reporting, training, or educational requirements from the board. The board may impose additional requirements upon any applicant who fails the written examination three times before permitting the applicant to re-take the written examination.

f. As used in this section, “board” means the Nursing Home Administrator’s Licensing Board.

(cf: P.L.1968, c.356, s.2)

2. (New section) a. An Administrative Intern Training (AIT) program may begin upon the submission of an application that contains the items set forth herein to the board. All training hours completed in accordance with the training program after the submission of the application shall count toward the 1,750 hours, or less as approved by the board, required regardless of if the hours are completed before the board’s approval of the application. Within 45 days of the submission of the application, the board shall review an AIT program and shall approve the program if the program complies with the following and is:

(1) conducted in licensed New Jersey nursing homes;

(2) under a preceptor who meets the qualifications set forth in P.L. , . (C. ) (pending before the Legislature as this bill);

(3) for a period of not more than 1,750 hours, or less as required by the board after evaluation of an applicant’s education and experience based upon the requirements contained in this chapter; and

(4) with a minimum of 875 hours, or half of the total hours required by the board, served while the preceptor is on the premises of a nursing home concurrently with the applicant.

b. An AIT program shall include at least 70 hours each of administrative experience in the following required areas:

(1) administration management;

(2) business office management;

(3) nursing management;

(4) management of resident activities;

(5) social service management;

(6) medical records management;

(7) dietary management;

(8) maintenance management; and

(9) environmental management, including housekeeping and laundry.

Additional hours in non-required service areas shall be at the discretion of the preceptor but shall be set forth in the training program submitted to the board. The board may waive, after review of an individual’s application, some or all of the hours required to meet the administrative experience requirements set forth in subsection b. of this section. An AIT program of 1,750 hours shall be completed within two years. If the board requires 875 or fewer total hours pursuant to paragraph (3) of subsection a. of this section, the program shall be completed within one year.

c. As used in this section, “board” means the Nursing Home Administrator’s Licensing Board.

3. (New section) a. A preceptor shall be responsible for supervising and for scheduling hours and activities for an administrative intern. A preceptor shall:

(1) hold a current New Jersey nursing home administrator license and shall have held such license for at least five years;

(2) have practiced as a licensed nursing home administrator of record in a nursing home for at least three years; and

(3) have unlimited access to the nursing home or homes at which the training program will occur through employment, oversight, or ownership, including, but not limited to:

(a) as an employed, full-time administrator; or

(b) as a regional administrator who supports more than one affiliated nursing home within a multi-facility chain; or

(c) as a management executive, such as a chief operating officer or director of operations or director of administrator education, or such other title as may apply to a management position that supports a nursing home or affiliated nursing home or homes within a multi-facility chain; or

(d) as an individual with ownership interest in the nursing homes where the training program will occur.

b. The preceptor shall notify the board in writing if an administrative intern leaves the program, there is a change of preceptor, or there is a change in an approved training program.

c. The preceptor shall submit any change in an approved training plan to the board in writing for reapproval, but any training hours that occur pending the board’s review and approval of the revised training program shall count towards the trainee’s hours.

d. The board shall not refuse to approve a preceptor for training administrative interns if the preceptor meets the requirements of P.L. , c. (C. ) (pending before the Legislature as this bill) and maintains a license in good standing.

e. A licensed nursing home administrator shall not be a preceptor for more than two administrative interns at any one time.

f. As used in this section, “board” means the Nursing Home Administrator’s Licensing Board.

4. (New section) a. Within six months of the effective date of P.L. , c. (C. ) (pending before the Legislature as this bill), the board shall accept all required applications, plans, and reports in an electronic format within an AIT-specific portal that provides transparency for the applicant to view the date and time of submission, date and time of review by staff of the board, any requested revisions, the date and time of supplemental submissions, and the date and time of approval or denial determinations.

b. All training hours completed at any time when the board is reviewing any application, plan, or report submitted by an applicant or preceptor shall count toward a trainee’s required training hours.

c. Repeated and habitual failure to submit written plans and reports of the training process by the trainee or the preceptor, as required by the board, shall constitute grounds for the denial of a nursing home administrator license.

d. As used in this section, “board” means the Nursing Home Administrator’s Licensing Board.

5. Section 16 of P.L.1968, c.356 (C.30:11-26) is amended to read as follows:

16. Any person, firm, partnership, corporation or association who shall operate or conduct a convalescent home or private nursing home without first obtaining an administrator licensed pursuant to the provisions of [this act] P.L.1968, c.356 (C.30:11-11 et seq.), or who shall operate such convalescent home or private nursing home after denial, revocation or suspension of its administrator's license shall be liable to a penalty of [$50.00] $50 for each day of operation in violation hereof for the first offense, and for any subsequent offense shall be liable to a penalty of [$100.00] $100 for each day in violation hereof. Any such penalty shall be sued for and collected in a summary proceeding instituted by the Attorney General, at the request and in the name of the State [Board of Control] Department of Health, pursuant to the Penalty Enforcement law (N.J.S. 2A:58-1, et seq.). The State [Board of Control] Department of Health, with the approval of the Attorney General, is hereby authorized and empowered to compromise and settle claims for money penalties in appropriate circumstances where it appears to the satisfaction of the board that payment of the full penalty will work severe hardship on any individual not having sufficient financial ability to pay the full penalty, but in no case shall the penalty be compromised for a sum less than [$200.00] $200 for the first offense and [$500.00] $500 for the second and each subsequent offense; provided, however, that any penalty of less than [$200.00] $200 or [$500.00] $500 as the case may be, may be compromised for a lesser sum. Money penalties when required shall be payable to the General State Fund. No money penalties provided for herein shall be required to be paid until the appellate procedures provided for in the courts shall have been exhausted and then only if on appeal, it is determined that the licensee was in violation of the provisions hereof or the rules and regulations of the State [Board of Control] Department of Health establishing minimum standards for license. Money penalties assessed prior to the filing of an appeal to the appellate court or courts shall be recoverable only to the extent that the appellate court or courts affirms the decision of the department in the first instance. Other than as specifically set forth above, the Department of Health shall not have the authority to issue monetary penalties against either an applicant for a nursing home administrator license or a licensee for any reason.

(cf: P.L.1968, c.356, s.16)

6. The Commissioner of Health, in consultation with the Nursing Home Administrator’s Licensing Board, shall promulgate rules and regulations in advance and consistent with P.L. , c. (C. ) (pending before the Legislature as this bill) as shall be necessary to effectuate the purposes of P.L. , c. (C. ) (pending before the Legislature as this bill).

7. This act shall take effect immediately.

STATEMENT

This bill revises the law related to licensure of nursing home administrators.

This bill incorporates regulations regarding licensure of nursing home administrators promulgated by the Department of Health (department) into State law. The bill requires the department to establish a portal specific for nursing home administrators and administrators in training and incorporates the application requirements for licensure as a nursing home administrator from chapter 34 of Title 8 of the New Jersey Annotated Code.

The bill also establishes the Administrative Intern Training (AIT) program and provides that the Nursing Home Administrator’s Licensing Board (board) to approve training programs in accordance with section 3 of this bill. Section 4 of this bill sets requirements for the preceptor of the AIT program. The preceptor will be responsible for supervising and for scheduling hours and activities for the administrative intern. The preceptor is required to:

· hold a current New Jersey nursing home administrator license and have held such license for five years;

· have practiced as a licensed nursing home administrator of record in a nursing home for at least three years; and

· have unlimited access to the nursing home or homes where the training program will take place.

Additionally, the preceptor would be required to notify the board if an intern leaves the program, there is a change in the preceptor, or there is a change in the approved plan. The changes are to be submitted to the board in writing and the board is to approve any changes. A preceptor may not train more than two interns at any one time.

An applicant who qualifies to take the written examination for licensure as a nursing home administrator will have three opportunities to pass the written examination without being subject to additional approvals, reporting, training, or educational requirements from the board.

The bill also revises the penalty section at N.J.S.A.30:11-26 to clarify that only the monetary penalties specifically authorized by N.J.S.A.30:11-26 may be imposed.