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Virginia Administrative Code
Title 18. Professional And Occupational Licensing
Agency 95. Board of Long-Term Care Administrators
Chapter 20. Regulations Governing the Practice of Nursing Home Administrators
11/21/2024

FORMS (18VAC95-20).

Checklist and Instructions for Nursing Home Administrator Application for Initial Licensure (rev. 3/2023)

Checklist and Instructions for Nursing Home Administrator Application by Endorsement (rev. 3/2023)

Nursing Home Administrator Reinstatement Application (rev. 8/2024)

Checklist and Instructions for Nursing Home Administrator-in-Training (rev. 3/2023)

Nursing Home Administrator-in-Training Notice of Change of Status or Discontinuance (rev. 7/2020)

Nursing Home Administrator Preceptor Application (rev. 1/2024)

Preceptor Reinstatement Application (rev. 8/2024)

Monthly Report of Nursing Home Administrator-in-Training (rev. 12/2022)

Nursing Home Administrator-in-Training Documentation of Completion Form (rev. 12/2022)

Proposed Administrator-in-Training Program Training Plan Domains of Practice (rev. 12/2022)

Continuing Education Affidavit of Completion for Nursing Home Administrators (rev. 12/2022)

Continuing Education (CE) Credit Form for Volunteer Practice (rev. 7/2020)

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