DAR File No. 43249

Commerce, Occupational and Professional Licensing

Rule R156-15

Health Facility Administrator Act Rule

Notice of Proposed Rule

(Amendment)

DAR File No.: 43249
Filed: 10/11/2018 10:23:45 AM

RULE ANALYSIS

Purpose of the rule or reason for the change:

The Health Facility Administrators Licensing Board (Board) proposes these amendments to: 1) update terms and provisions to conform to current industry practices and procedures; 2) allow applicants to meet certain education or experience requirements as optional pathways to licensure in lieu of completing an administrator-in-training (AIT) preceptorship; 3) provide easier practice re-entry through a reinstatement option for certain former Utah licensees; and 4) allow additional types of continuing professional education credit.

Summary of the rule or change:

In Sections R156-15-102 and R156-15-302d, these proposed amendments: 1) make minor formatting changes for clarity; and 2) update the rule regarding examination requirements to conform to changes made by the National Association of Long Term Care Administrator Boards to its National Nursing Home Administrator Line of Service Examination Program (NHA) exam, which included separating that exam into a two-part component exam. In Section R156-15-302a, these proposed amendments give applicants for licensure as a health facility administrator an additional option for meeting application requirements, by accepting the "Health Services Executive" (HSE) credential now offered by the National Association of Long Term Care Administrator Boards in lieu of completion of an approved AIT preceptorship. In Section R156-15-303, as allowed by Subsection 58-1-308(5)(a)(ii)(B), these proposed amendments will allow former Utah licensees whose licenses expired while active and in good standing, easier re-entry into practice by extending their reinstatement period from two years to five years. If these former licensees meet continuing education and certain other requirements, they may apply for reinstatement instead of being required to submit a new application for licensure complete with all supporting documents, as is required of an individual making an initial application for license and demonstrating they meet all current qualifications for licensure. In Section R156-15-308, these proposed amendments give applicants for licensure by endorsement additional options for meeting application requirements, by allowing them to meet one of the following additional experiences or education requirements: 1) have three years of experience; 2) have two consecutive years of employment at the same facility; or 3) hold the "Health Services Executive" (HSE) credential now offered by the National Association of Long Term Care Administrator Boards. In Section R156-15-309, these proposed amendments make nonsubstantive formatting changes for clarity, and also: 1) increase the 10-hour maximum continuing professional education (CPE) credit allowed for distance learning courses to a 20-hour maximum; and 2) allow licensees CPE credit for volunteer service on committees or in leadership roles in organizations for the development and improvement of the profession, up to a maximum of 10 CPE hours.

Statutory or constitutional authorization for this rule:

• Subsection 58-1-202(1)(a)
• Subsection 58-1-106(1)(a)
• Subsection 58-15-3(3)

Anticipated cost or savings to:

the state budget:

In Section R156-15-102 and Section R156-15-302d, these proposed amendments are not expected to impact state government revenue or expenditures because they only clarify existing licensure requirements in accordance with current industry standards and practices. In Sections R156-15-302a, R156-15-303, and R156-15-308, none of these proposed amendments are expected to impact state government revenues or expenditures because they simply allow various applicants for licensure additional options for meeting application requirements, and these options will not affect the Division of Occupational and Professional Licensing's (Division) existing licensing procedures or processes. Additionally, any additional increase in staff workload that may be caused by additional applications and additional individuals becoming licensed will be balanced by the additional revenue generated by those applications, and absorbed within the Division's existing budget. In Section R156-15-309, these proposed amendments are not expected to impact state government revenues or expenditures because they only increase the accepted types of CPE credit for health facility administrator licensees, and will not affect the Division's licensing or CPE audit procedures. No other fiscal impact to the state is expected, beyond a minimal cost to the Division of approximately $75 to print and distribute this rule once the proposed amendments are made effective.

local governments:

None of these proposed amendments are expected to have any impact on local governments' revenues or expenditures because they only clarify and add options to licensing and CPE requirements for individuals licensed as health facility administrators, and there are no known local governmental entities acting as businesses in this industry who might be impacted through employment of these licensees.

small businesses:

In Sections R156-15-102, R156-15-302d, and R156-15-309, these proposed amendments are not expected to have any impact on small businesses revenues or expenditures because they merely clarify existing licensure requirements in accordance with current industry standards and practices, and apply only to individuals licensed as health facility administrators, or who are applying for licensure as health facility administrators. In Sections R156-15-302a, R156-15-303, and R156-15-308, these proposed amendments are expected to indirectly benefit small businesses that employ licensed health facility administrators, due to an increase in licensure of qualified applicants and a corresponding increase in both new and experienced licensees available for employment. In addition to being able to more easily hire new employees, these businesses also may be able to transfer existing employees from another state to a Utah location. The Division currently processes on average approximately 40 new applications for licensure each year, and there are an estimated 80 small business facilities offering skilled nursing or similar services in Utah who employ licensed health facility administrators, such as nursing care facilities (including skilled nursing facilities, retirement homes or rest homes with nursing care, and group homes for the disabled or aged with nursing care) (NAICS 623110), and general or specialty hospitals and centers (NAICS 622110, 622310). However, the full fiscal and non-fiscal benefits to these small businesses cannot be estimated because the benefits obtained from being able to more easily hire qualified licensed health facility administrators, especially administrators with years of experience in their profession, will vary substantially depending on the requirements of each small business and on the individual characteristics and unique choices of each individual licensee.

persons other than small businesses, businesses, or local governmental entities:

In Section R156-15-102 and Section R156-15-302d, these proposed amendments only clarify existing licensure requirements, so none of these proposed changes are expected to impact other persons. In Sections R156-15-302a and R156-15-308, because these proposed amendments allow qualified applicants for licensure as a health facility administrator additional options for meeting the application requirements, they are expected to benefit these applicants by increasing their ability to become licensed and enter into practice. However, the full fiscal impact to such applicants cannot be estimated because the data regarding the qualifications of applicants is unavailable. Additionally, it cannot be determined how many of these applicants will choose to take advantage of these new options -- such as, for example, how many might decide to pursue an HSE credential from NAB instead of completing an AIT preceptorship. In Section R156-15-303, these proposed amendments will allow easier re-entry into practice for Utah health facility administrators whose license expired while active and in good standing. There are currently 41 licensees whose licenses have expired in this manner. These amendments will benefit these and future experienced health facility administrators who choose to re-enter into practice. However, the full fiscal and non-fiscal benefits to these persons cannot be estimated because any resulting employment will vary substantially depending on the choices and characteristics of each individual person. In Section R156-15-309, because these proposed amendments increase the types of CPE credit available to licensees, the Division estimates that they will cause a fiscal benefit to these persons. First, allowing an additional 10 hours of real-time, interactive distance learning to fulfill CPE requirements will save some licensees the cost of traveling to a central location to obtain their required CPE hours. This will be especially beneficial to licensees in remote, rural locations. However, the full impact of the savings is inestimable because it cannot be determined how many of these licensees will take advantage of distance learning, and because any benefits actually received will vary substantially from licensee to licensee depending on their location and individual choices. Similarly, although the Division estimates a resulting fiscal benefit to licensees who donate hours of their time in service on committees or in leadership roles and receive a corresponding savings on the cost of CPE courses they would have otherwise been required to purchase to obtain those credit hours, the full impact to these other persons is inestimable because the credit hours and corresponding savings will vary widely depending on the number of hours each licensee chooses to serve, if any, and the types of CPE courses that they choose.

Compliance costs for affected persons:

These proposed amendments are not expected to impose any additional compliance cost on any affected person because these amendments only clarify existing requirements for licensure, or are expected to result in positive fiscal impacts.

Comments by the department head on the fiscal impact the rule may have on businesses:

In Sections R156-15-102 and R156-15-302d, these proposed amendments: 1) make minor formatting changes for clarity; and 2) update the rule regarding examination requirements to conform to changes made by the National Association of Long Term Care Administrator Boards to its NHA exam, which included separating that exam into a two-part component exam. In Section R156-15-302a, these proposed amendments give applicants for licensure as a health facility administrator an additional option for meeting application requirements, by accepting the HSE credential now offered by the National Association of Long Term Care Administrator Boards in lieu of completion of an approved AIT preceptorship. In Section R156-15-303, as allowed by Subsection 58-1-308(5)(a)(ii)(B), these proposed amendments will allow former Utah licensees, whose licenses expired while active and in good standing, easier re-entry into practice by extending their reinstatement period from two years to five years. In Section R156-15-308, these proposed amendments give applicants for licensure by endorsement additional options for meeting application requirements by allowing them to meet one of the following additional experiences or education requirements: 1) have three years of experience; 2) have two consecutive years of employment at the same facility; or 3) hold the HSE credential now offered by the National Association of Long Term Care Administrator Boards. In Section R156-15-309, these proposed amendments make nonsubstantive formatting changes for clarity, and also: 1) increase the 10-hour maximum CPE credit allowed for distance learning courses to a 20-hour maximum; and 2) allow licensees CPE credit for volunteer service on committees or in leadership roles in organizations for the development and improvement of the profession, up to a maximum of 10 CPE hours. In Sections R156-15-102, R156-15-302d, and R156-15-309, these proposed amendments are not expected to have any impact on small businesses or non-small businesses revenues or expenditures because they merely clarify existing licensure requirements in accordance with current industry standards and practices, and apply only to individuals licensed as health facility administrators or who are applying for licensure as health facility administrators. In Sections R156-15-302a, R156-15-303, and R156-15-308, these proposed amendments are expected to indirectly benefit small businesses and non-small businesses that employ licensed health facility administrators, due to an increase in licensure of qualified applicants and a corresponding increase in both new and experienced licensees available for employment. In addition to being able to more easily hire new employees, these businesses also may be able to transfer existing employees from another state to a Utah location. The Division currently processes on average approximately 40 new applications for licensure each year, and there are an estimated 80 small business facilities and an estimated 144 non-small business facilities offering skilled nursing or similar services in Utah who employ licensed health facility administrators, such as nursing care facilities (including skilled nursing facilities, retirement homes or rest homes with nursing care, and group homes for the disabled or aged with nursing care) (NAICS 623110), and general or specialty hospitals and centers (NAICS 622110, 622310). However, the full fiscal and non-fiscal benefits to these businesses cannot be estimated because the benefits obtained from being able to more easily hire qualified licensed health facility administrators, especially administrators with years of experience in their profession, will vary substantially depending on the requirements of each business and on the individual characteristics and unique choices of each individual licensee.

Francine A. Giani, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Office of Administrative Rules, or at:

Commerce
Occupational and Professional Licensing
HEBER M WELLS BLDG
160 E 300 S
SALT LAKE CITY, UT 84111-2316

Direct questions regarding this rule to:

• Allyson Pettley at the above address, by phone at 801-530-6179, by FAX at 801-530-6511, or by Internet E-mail at apettley@utah.gov

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

12/03/2018

Interested persons may attend a public hearing regarding this rule:

• 11/07/2018 10:00 AM, Heber Wells Bldg, 160 E 300 S, Hearing Room 250 (second floor), Salt Lake City, UT

This rule may become effective on:

12/10/2018

Authorized by:

Mark Steinagel, Director

Appendix 1: Regulatory Impact Summary Table*

Fiscal Costs	FY 2019	FY 2020	FY 2021
State Government	$0	$0	$0
Local Government	$0	$0	$0
Small Businesses	$0	$0	$0
Non-Small Businesses	$0	$0	$0
Other Person	$0	$0	$0
Total Fiscal Costs:	$0	$0	$0
Fiscal Benefits
State Government	$0	$0	$0
Local Government	$0	$0	$0
Small Businesses	$0	$0	$0
Non-Small Businesses	$0	$0	$0
Other Persons	$0	$0	$0
Total Fiscal Benefits:	$0	$0	$0
Net Fiscal Benefits:	$0	$0	$0

 

*This table only includes fiscal impacts that could be measured. If there are inestimable fiscal impacts, they will not be included in this table. Inestimable impacts for State Government, Local Government, Small Businesses and Other Persons are described above. Inestimable impacts for Non - Small Businesses are described below.

 

Appendix 2: Regulatory Impact to Non - Small Businesses (50 or more employees)

Sections R156-15-102, R156-15-302d, and R156-15-309: These proposed amendments are not expected to have any impact on non-small business revenues or expenditures because they merely clarify existing licensure requirements in accordance with current industry standards and practices, and apply only to individuals licensed as health facility administrators or who are applying for licensure as health facility administrators.

 

Sections R156-15-302a, R156-15-303, and R156-15-308: These proposed amendments are expected to indirectly benefit non-small businesses that employ licensed health facility administrators, due to an increase in licensure of qualified applicants and a corresponding increase in both new and experienced licensees available for employment. In addition to being able to more easily hire new employees, these businesses also may be able to transfer existing employees from another state to a Utah location. The Division currently processes on average approximately 40 new applications for licensure each year, and there are an estimated 144 non-small business facilities offering skilled nursing or similar services in Utah who might hire licensed health facility administrators, such as Nursing Care Facilities (including skilled nursing facilities, retirement homes or rest homes with nursing care, and group homes for the disabled or aged with nursing care) (NAICS 623110), and general or specialty hospitals and centers (NAICS 622110, 622310. However, the full fiscal and non-fiscal benefits to these non-small businesses cannot be estimated because the benefits obtained from being able to more easily hire qualified licensed health facility administrators, especially administrators with years of experience in their profession, will vary substantially depending on the requirements of each non-small business and on the individual characteristics and unique choices of each individual licensee.

 

The head of the Department of Commerce, Francine A. Giani, has reviewed and approved this fiscal analysis.

 

 

R156. Commerce, Occupational and Professional Licensing.

R156-15. Health Facility Administrator Act Rule.

R156-15-101. Title.

This rule is known as the "Health Facility Administrator Act Rule".

 

R156-15-102. Definitions.

In addition to the definitions in Title 58, Chapters 1 and 15, as used in this rule:

(1) "Administrator in training (AIT)" means an individual who is participating in a preceptorship with a licensed health facility administrator.

(2) "Board" means the Health Care Administrators Board.

(3) "Distance learning" means acquiring [qualified]continuing professional education (CPE) as referenced in S[ubs]ection R156-15-309[(4)] using technologies and other forms of learning, including internet, audio/visual recordings, mail, or other correspondence.

(4) "General administration" as used in the definition of "administrator", Subsection 58-15-2(1), means that the administrator is responsible for operation of the health facility in accordance with all applicable laws regardless of whether the administrator is present full or part time in the facility or whether the administrator maintains an office inside or outside of the facility, but may not exceed responsibility for more than the number of licensed facilities in accordance with Utah Administrative Code R432-150 or R432-200.

(5) "General supervision" means general supervision as defined in Subsection R156-1-102a(4)(c).

(6) "NAB" means the National Association of Long Term Care Administrators Boards.

([6]7) "Nursing home administrator" means a health facility administrator.

([7]8) "Preceptor" means a licensed health facility administrator meeting the qualifications of Subsection R156-15-307(2), who is responsible for the supervision and training of an AIT.

([8]9) "Preceptorship" means a formal training program for an administrator in training (AIT), that is:

(a) conducted in a licensed health facility;

(b) under the supervision of an approved licensed health facility administrator; and

(c) approved by the Division in collaboration with the Board[for an administrator in training (AIT), under the supervision of an approved licensed health facility administrator. The program is conducted in a licensed health facility].

([9]10) "Qualifying experience" means at least 8,000 hours of employment in a licensed health facility including hours in a supervisory role as referenced in Section R156-15-302c.

 

R156-15-302a. Qualifications for Licensure - Application Requirements.

In accordance with Subsections 58-1-203(1)(b) and 58-1-301(3), the application requirements for licensure in Section 58-15-4 are defined, clarified, or established as follows:

(1) (a) [C]complete an approved AIT preceptorship consisting of a minimum of 1,000 hours[.]; or

(b) hold a NAB Health Services Executive (HSE) credential; and

(2) [M]meet:

(a) [either ]the education requirement in Section R156-15-302b ; or

(b) the experience requirement in Section R156-15-302c.

 

R156-15-302d. Qualifications for Licensure - Examination Requirements.

In accordance with Subsections 58-1-203(1)(b) and 58-1-301(3), the examination requirement for licensure in Subsection 58-15-4(4) is defined, clarified, or established as follows:

(1) [The National Association of Boards of Examiners for Nursing Home Administrators (NAB) examination is the qualifying examination required]An applicant for licensure as a health facility administrator[.] shall pass NAB's two-part component examination for nursing home administrators:

(a) the National Core of Knowledge Examination for Long Term Care Administrators (CORE); and

(b) the National Nursing Home Administrator Line of Service Examination Program (NHA).

(2) The passing score [on the]for each NAB exam[ination]component shall be a minimum scaled score of 113.

(3) An applicant may take both NAB exam components at once, or take each component individually.

(4) An applicant who fails a NAB exam component shall retake that component in accordance with NAB policies and procedures.

(5) An applicant who took the NAB exam prior to July 5, 2017, shall have passed the NAB National Nursing Home Administrator Licensing Examination (NHA) with a minimum scaled score of 113.

 

R156-15-303. Expiration, Renewal , and Reinstatement of License [ Cycle - Procedures ].

[(1) ]In accordance with S[ubs]ection 58-1-308[(1),]:

(1) The [the ]renewal date for the two-year renewal cycle applicable to licensees under Title 58, Chapter 15 is established by rule in Section R156-1-308a(1).

(2) Renewal and reinstatement procedures shall be in accordance with Sections R156-1-308[c]a through R156-1-308l, except as provided in Subsection (3).

(3) If an application for reinstatement of licensure is received by the Division between two years and five years after the date the license expired, and the license was active and in good standing at the time of expiration, the applicant shall:

(a) submit a completed renewal form as furnished by the Division demonstrating compliance with all requirements and conditions of license renewal;

(b) pay the established license renewal fee and reinstatement fee for the current renewal period;

(c) submit evidence of completion of continuing professional education (CPE) for each preceding renewal period in which the license was expired; and

(d) provide information requested by the Division and Board to clearly demonstrate the applicant is currently competent to engage in the profession.

 

R156-15-308. License By Endorsement.

[A license may be granted to an applicant in]In accordance with Section 58-1-302 and Subsection 58-15-4(6), the Division may grant a license by endorsement to an applicant who[ is]:

(1) is currently a licensed health facility administrator in good standing in another state; and

(2) meets the examination requirement [as stated ]in Section R156-15-302d[.]; and

(3) meets one or more of the following equivalent education or experience requirements:

(a) has been employed as a health facility administrator in another state for three years;

(b) has been employed as a health facility administrator at the same facility in another state for two consecutive years; or

(c) holds a Health Services Executive (HSE) credential from the National Association of Long Term Care Administrator Boards (NAB).

 

R156-15-309. Continuing Education.

[(1) ]In accordance with Subsections 58-1-203(1)(g) and 58-1-308(3)(b), [there is created a]the following continuing professional education requirements ("CPE") are established as a condition for renewal or reinstatement of licenses under Title 58, Chapter 15[.]:

([2]1) During each two-[ ]year period commencing on June 1 of each odd -[ ]numbered year, a licensee shall [be required to ]complete [not less than]at least 40 hours of [qualified professional education]CPE directly related to the licensee's professional practice[, of which no more than 10 hours shall be distance learning].

([3]2) [The required number of hours of qualified professional education for an individual who]If a licensee first becomes licensed during the two-[ ]year renewal period , the licensee's required number of CPE hours shall be decreased [in a pro-rata amount equal to any part of that two year period preceding the date on which that individual first became licensed]proportionately according to the date of licensure.

([4]3) [Qualified professional education under this section]All CPE shall:

(a) have an identifiable clear statement of purpose and defined objective for the educational program directly related to the practice of a health facility administrator;

(b) be relevant to the licensee's professional practice;

(c) be presented in a competent, well organized, and sequential manner consistent with the stated purpose and objective of the program;

(d) be prepared and presented by individuals who are qualified by education, training, and experience; and

(e) have [associated with it ]a competent method of registration of individuals who actually completed the professional education program, with [and] records of that registration and completion [are ]available for review.

([5]4) The following may qualify as CPE:

(a) e[E]ducation obtained from an accredited university or college in pursuit of an advanced degree[may qualify as continuing education.];

(b) lecturing or instructing a CPE course or teaching in a college or university in the licensee's profession;

([6]c) [Continuing professional ]education under the sponsorship of or approved by [the]a licensing agency of Utah or another state;[may qualify as continuing education.]

([7]d) real-time, interactive distance learning courses that are clearly documented as real-time and interactive;

(e) distance learning courses that are not real-time and interactive, up to a maximum of 20 CPE hours;

(f) volunteer service on boards, committees, or in leadership roles in any state, national, or international organization for the development and improvement of the licensee's profession, up to a maximum of 10 CPE hours.

(5) A licensee shall [be responsible for maintaining competent records of completed qualified professional education for a period of four years after close of the two year period to which the records pertain. It is the responsibility of the licensee to maintain such information with respect to qualified professional education to demonstrate it meets the requirements under this section]maintain adequate documentation as proof of the licensee's compliance with this section, for a period of four years after the end of the renewal cycle for which the CPE is due.

([8]6) [Waiver from or an extension of time to complete continuing education shall be]The Division may defer or waive CPE requirements in accordance with Section R156-1-308d , [. A licensee who receives a waiver or extension may be excused from the requirement ]for a period of up to three years.

 

KEY: licensing, health facility administrators

Date of Enactment or Last Substantive Amendment: [May 8, 2014]2018

Notice of Continuation: August 25, 2016

Authorizing, and Implemented or Interpreted Law: 58-1-106(1)(a); 58-1-202(1)(a); 58-15-3(3)