Virginia Law

Chapter 20. Regulations Governing the Practice of Nursing Home Administrators

Part I
General Provisions

18VAC95-20-10. Definitions.

A. The following words and terms when used in this chapter shall have the definitions ascribed to them in § 54.1-3100 of the Code of Virginia:

"Board"

"Nursing home"

"Nursing home administrator"

B. The following words and terms when used in this chapter shall have the following meanings unless the context indicates otherwise:

"Accredited institution" means any degree-granting college or university accredited by an accrediting body approved by the U.S. Department of Education.

"Active practice" means a minimum of 1,000 hours of practice as a licensed nursing home administrator within the preceding 24 months.

"AIT" means a person enrolled in the administrator-in-training program in nursing home administration in a licensed nursing home.

"Administrator-of-record" means the licensed nursing home administrator designated in charge of the general administration of the facility and identified as such to the facility's licensing agency.

"Approved sponsor" means an individual, business, or organization approved by NAB or by an accredited institution to offer continuing education programs in accordance with this chapter.

"Continuing education" means the educational activities that serve to maintain, develop, or increase the knowledge, skills, performance, and competence recognized as relevant to the nursing home administrator's professional responsibilities.

"Domains of Practice" means the content areas of tasks, knowledge, and skills necessary for administration of a nursing home as approved by NAB.

"Full time" means employment of at least 35 hours per week.

"Hour" means 50 minutes of participation in a program for obtaining continuing education.

"Internship" means a practicum or course of study as part of a degree or post-degree program designed especially for the preparation of candidates for licensure as nursing home administrators that involves supervision by an accredited college or university of the practical application of previously studied theory.

"NAB" means the National Association of Long Term Care Administrator Boards.

"National examination" means a test used by the board to determine the competence of candidates for licensure as administered by NAB or any other examination approved by the board.

"Preceptor" means a nursing home administrator currently licensed and registered or recognized by a nursing home administrator licensing board to conduct an administrator-in-training (AIT) program.

Statutory Authority

§ 54.1-2400 of the Code of Virginia.

Historical Notes

Derived from VR500-01-2:1 § 1.1, eff. August 15, 1990; amended, Virginia Register Volume 7, Issue 25, eff. October 9, 1991; Volume 8, Issue 24, eff. September 24, 1992; Volume 10, Issue 17, eff. June 15, 1994; Volume 15, Issue 4, eff. December 9, 1998; Volume 19, Issue 19, eff. July 2, 2003; Volume 21, Issue 18, eff. July 1, 2005; Volume 25, Issue 19, eff. June 24, 2009; Volume 29, Issue 20, eff. July 18, 2013; Volume 35, Issue 12, eff. March 6, 2019.

18VAC95-20-20. (Repealed.)

Historical Notes

Derived from VR500-01-2:1 §§ 1.2 to 2.1, eff. August 15, 1990; amended, Virginia Register Volume 7, Issue 25, eff. October 9, 1991; Volume 8, Issue 24, eff. September 24, 1992; Volume 10, Issue 17, eff. June 15, 1994; repealed, Virginia Register Volume 15, Issue 4, eff. December 9, 1998.

18VAC95-20-60. Posting of license.

Each licensee shall post his license in a main entrance or place conspicuous to the public in the facility in which the licensee is administrator-of-record.

Statutory Authority

§§ 54.1-2400 and 54.1-3101 of the Code of Virginia.

Historical Notes

Derived from VR500-01-2:1 § 2.2, eff. August 15, 1990; amended, Virginia Register Volume 7, Issue 25, eff. October 9, 1991; Volume 8, Issue 24, eff. September 24, 1992; Volume 10, Issue 17, eff. June 15, 1994.

18VAC95-20-70. Accuracy of information.

A. All changes in the address of record or the public address, if different from the address of record, or the name of a licensee, trainee, or preceptor shall be furnished to the board within 30 days after the change occurs.

B. All notices required by law and by this chapter to be mailed by the board to any registrant or licensee shall be validly given when mailed to the latest address of record on file with the board and shall not relieve the licensee, trainee, or preceptor of the obligation to comply.

Statutory Authority

§ 54.1-2400 of the Code of Virginia.

Historical Notes

Derived from VR500-01-2:1 § 2.3, eff. August 15, 1990; amended, Virginia Register Volume 7, Issue 25, eff. October 9, 1991; Volume 8, Issue 24, eff. September 24, 1992; Volume 10, Issue 17, eff. June 15, 1994; Volume 15, Issue 4, eff. December 9, 1998; Volume 25, Issue 19, eff. July 1, 2009; Errata, 25:22 VA.R. 4172 July 6, 2009.

18VAC95-20-80. Required fees.

The applicant or licensee shall submit all fees in this section that apply:

Statutory Authority

§ 54.1-2400 of the Code of Virginia.

Historical Notes

Derived from VR500-01-2:1 § 3.1, eff. August 15, 1990; amended, Virginia Register Volume 7, Issue 25, eff. October 9, 1991; Volume 8, Issue 24, eff. September 24, 1992; Volume 10, Issue 17, eff. June 15, 1994; Volume 15, Issue 4, eff. December 9, 1998; Volume 19, Issue 7, eff. January 15, 2003; Volume 24, Issue 16, eff. May 14, 2008; Volume 31, Issue 2, eff. October 22, 2014; Volume 35, Issue 12, eff. March 6, 2019.

18VAC95-20-90. (Repealed.)

Historical Notes

Derived from VR500-01-2:1, eff. August 15, 1990; amended, Virginia Register Volume 7, Issue 25, eff. October 9, 1991; Volume 8, Issue 24, eff. September 24, 1992; Volume 10, Issue 17, eff. June 15, 1994; repealed, Virginia Register Volume 15, Issue 4, eff. December 9, 1998.

18VAC95-20-130. Additional fee information.

A. There shall be a fee of $50 for a returned check or a dishonored credit card or debit card.

B. Fees shall not be refunded once submitted.

C. Examination fees are to be paid directly to the service contracted by the board to administer the examinations.

Statutory Authority

§ 54.1-2400 of the Code of Virginia.

Historical Notes

Derived from VR500-01-2:1 § 3.6, eff. August 15, 1990; amended, Virginia Register Volume 7, Issue 25, eff. October 9, 1991; Volume 8, Issue 24, eff. September 24, 1992; Volume 10, Issue 17, eff. June 15, 1994; Volume 15, Issue 4, eff. December 9, 1998; Volume 22, Issue 13, eff. April 5, 2006; Volume 36, Issue 9, eff. February 6, 2020.

18VAC95-20-140. (Repealed.)

Historical Notes

Derived from VR500-01-2:1, eff. August 15, 1990; amended, Virginia Register Volume 7, Issue 25, eff. October 9, 1991; Volume 8, Issue 24, eff. September 24, 1992; Volume 10, Issue 17, eff. June 15, 1994; repealed, Virginia Register Volume 15, Issue 4, eff. December 9, 1998.

Part II
Renewals and Reinstatements

18VAC95-20-170. Renewal requirements.

A. A person who desires to renew his license or preceptor registration for the next year shall, not later than the expiration date of March 31 of each year, submit a completed renewal form and fee.

B. The renewal form and fee shall be received no later than the expiration date. Postmarks shall not be considered.

C. A nursing home administrator license or preceptor registration not renewed by the expiration date shall be invalid.

Statutory Authority

§ 54.1-2400 of the Code of Virginia.

Historical Notes

Derived from VR500-01-2:1 § 4.4, eff. August 15, 1990; amended, Virginia Register Volume 7, Issue 25, eff. October 9, 1991; Volume 8, Issue 24, eff. September 24, 1992; Volume 10, Issue 17, eff. June 15, 1994; Volume 15, Issue 4, eff. December 9, 1998; Volume 26, Issue 8, eff. January 20, 2010.

18VAC95-20-175. Continuing education requirements.

A. In order to renew a nursing home administrator license, an applicant shall attest on his renewal application to completion of 20 hours of approved continuing education for each renewal year.

1. Up to 10 of the 20 hours may be obtained through Internet or self-study courses and up to 10 continuing education hours in excess of the number required may be transferred or credited to the next renewal year.

2. Up to two hours of the 20 hours required for annual renewal may be satisfied through delivery of services, without compensation, to low-income individuals receiving health services through a local health department or a free clinic organized in whole or primarily for the delivery of those services. One hour of continuing education may be credited for one hour of providing such volunteer services, as documented by the health department or free clinic.

3. At least two hours of continuing education for each renewal year shall relate to the care of residents with mental or cognitive impairments, including Alzheimer's disease and dementia.

4. A licensee who serves as the registered preceptor in an approved AIT or Assisted Living Facility AIT program may receive one hour of continuing education credit for each week of training up to a maximum of 10 hours of self-study course credit for each renewal year.

5. A licensee is exempt from completing continuing education requirements and considered in compliance on the first renewal date following initial licensure.

B. In order for continuing education to be approved by the board, it shall (i) be related to health care administration and shall be approved or offered by NAB, an accredited institution, or a government agency or (ii) as provided in subdivision A 2 of this section.

C. Documentation of continuing education.

1. The licensee shall retain in the licensee's personal files for a period of three renewal years complete documentation of continuing education including evidence of attendance or participation as provided by the approved sponsor for each course taken.

2. Evidence of attendance shall be an original document provided by the approved sponsor and shall include:

a. Date the course was taken;

b. Hours of attendance or participation;

c. Participant's name; and

d. Signature of an authorized representative of the approved sponsor.

3. If contacted for an audit, the licensee shall forward to the board by the date requested a signed affidavit of completion on forms provided by the board and evidence of attendance or participation as provided by the approved sponsor.

D. The board may grant an extension of up to one year or an exemption for all or part of the continuing education requirements due to circumstances beyond the control of the administrator, such as a certified illness, a temporary disability, mandatory military service, or officially declared disasters. The request for an extension shall be received in writing and granted by the board prior to the renewal date.

Statutory Authority

§§ 54.1-2400 and 54.1-3102 of the Code of Virginia.

Historical Notes

Derived from Virginia Register Volume 15, Issue 4, eff. December 9, 1998; amended, Virginia Register Volume 19, Issue 19, eff. July 2, 2003; Volume 24, Issue 20, eff. July 24, 2008; Volume 25, Issue 19, eff. June 24, 2009; Volume 29, Issue 20, eff. July 18, 2013; Volume 33, Issue 11, eff. March 9, 2017; Volume 35, Issue 12, eff. March 6, 2019; Volume 39, Issue 7, eff. December 21, 2022.

18VAC95-20-180. Late renewal.

A. A person who fails to renew his license or preceptor registration by the expiration date shall within one year of the initial expiration date:

1. Return the renewal notice or request renewal in writing to the board; and

2. Submit the applicable renewal fee and late fee.

B. The documents required in subsection A of this section shall be received in the board office within one year of the initial expiration date. Postmarks shall not be considered.

Statutory Authority

§ 54.1-2400 of the Code of Virginia.

Historical Notes

Derived from VR500-01-2:1 § 4.5, eff. August 15, 1990; amended, Virginia Register Volume 7, Issue 25, eff. October 9, 1991; Volume 8, Issue 24, eff. September 24, 1992; Volume 10, Issue 17, eff. June 15, 1994; Volume 15, Issue 4, eff. December 9, 1998; Volume 35, Issue 12, eff. March 6, 2019.

18VAC95-20-190. (Repealed.)

Historical Notes

Derived from VR500-01-2:1 § 4.6, eff. August 15, 1990; amended, Virginia Register Volume 7, Issue 25, eff. October 9, 1991; Volume 8, Issue 24, eff. September 24, 1992; Volume 10, Issue 17, eff. June 15, 1994; repealed, Virginia Register Volume 15, Issue 4, eff. December 9, 1998.

18VAC95-20-200. Reinstatement for nursing home administrator license or preceptor registration.

A. The board may reinstate a nursing home administrator license or preceptor registration that was not renewed within one year of the initial expiration date.

B. An applicant for nursing home administrator license reinstatement shall apply on a reinstatement form provided by the board, submit the reinstatement fee, and provide one of the following:

1. Evidence of the equivalent of 20 hours of continuing education for each year since the last renewal, not to exceed a total of 60 hours.

2. Evidence of active practice in another state or United States jurisdiction or in the United States armed services during the period licensure in Virginia was lapsed.

3. Evidence of requalifying for licensure by meeting the requirements prescribed in 18VAC95-20-220 or 18VAC95-20-225.

C. An applicant for preceptor reinstatement shall apply on a reinstatement form provided by the board, submit the reinstatement fee, and meet the current requirements for a preceptor in effect at the time of application for reinstatement.

D. Any person whose license or registration has been suspended, revoked, or denied renewal by the board under the provisions of 18VAC95-20-470 shall, in order to be eligible for reinstatement, (i) submit a reinstatement application to the board for a license, (ii) pay the appropriate reinstatement fee, and (iii) submit any other credentials as prescribed by the board. After a hearing, the board may, at its discretion, grant the reinstatement.

Statutory Authority

§ 54.1-2400 of the Code of Virginia.

Historical Notes

Derived from VR500-01-2:1 § 4.7, eff. August 15, 1990; amended, Virginia Register Volume 7, Issue 25, eff. October 9, 1991; Volume 8, Issue 24, eff. September 24, 1992; Volume 10, Issue 17, eff. June 15, 1994; Volume 15, Issue 4, eff. December 9, 1998; Volume 19, Issue 19, eff. July 2, 2003; Volume 35, Issue 12, eff. March 6, 2019.

18VAC95-20-210. (Repealed.)

Historical Notes

Derived from VR500-01-2:1 § 4.8, eff. August 15, 1990; amended, Virginia Register Volume 7, Issue 25, eff. October 9, 1991; Volume 8, Issue 24, eff. September 24, 1992; Volume 10, Issue 17, eff. June 15, 1994; repealed, Virginia Register Volume 15, Issue 4, eff. December 9, 1998.

Part III
Requirements for Licensure

18VAC95-20-220. Qualifications for initial licensure.

One of the following sets of qualifications is required for licensure as a nursing home administrator:

1. Degree and practical experience. The applicant shall (i) hold a baccalaureate or higher degree in a health care-related field that meets the requirements of 18VAC95-20-221 from an accredited institution; (ii) have completed not less than a 320-hour internship that addresses the Domains of Practice as specified in 18VAC95-20-390 in a licensed nursing home as part of the degree program under the supervision of a preceptor; and (iii) have received a passing grade on the national examination;

2. Certificate program. The applicant shall (i) hold a baccalaureate or higher degree from an accredited college or university, (ii) successfully complete a program with a minimum of 21 semester hours study in a health care-related field that meets the requirements of 18VAC95-20-221 from an accredited institution, (iii) successfully complete not less than a 400-hour internship that addresses the Domains of Practice as specified in 18VAC95-20-390 in a licensed nursing home as part of the certificate program under the supervision of a preceptor, and (iv) have received a passing grade on the national examination;

3. Administrator-in-training program. The applicant shall have (i) successfully completed an AIT program that meets the requirements of Part IV (18VAC95-20-300 et seq.) of this chapter, (ii) received a passing grade on the national examination, and (iii) completed the Domains of Practice form required by the board; or

4. Health Services Executive (HSE) credential. The applicant shall provide evidence that he has met the minimum education, experience, and examination standards established by NAB for qualification as a Health Services Executive.

Statutory Authority

§ 54.1-2400 of the Code of Virginia.

Historical Notes

Derived from VR500-01-2:1 § 5.1, eff. August 15, 1990; amended, Virginia Register Volume 7, Issue 25, eff. October 9, 1991; Volume 8, Issue 24, eff. September 24, 1992; Volume 10, Issue 17, eff. June 15, 1994; Volume 15, Issue 4, eff. December 9, 1998; Volume 19, Issue 19, eff. July 2, 2003; Volume 22, Issue 26, eff. October 4, 2006; Volume 24, Issue 20, eff. July 24, 2008; Volume 29, Issue 20, eff. July 18, 2013; Volume 35, Issue 12, eff. March 6, 2019.

18VAC95-20-221. Required content for coursework.

To meet the educational requirements for a degree in a health care-related field, an applicant must provide an official transcript from an accredited college or university that documents successful completion of a minimum of 21 semester hours of coursework concentrated on the administration and management of health care services to include a minimum of three semester hours in each of the content areas in subdivisions 1 through 4 of this section, six semester hours in the content area set out in subdivision 5 of this section, and three semester hours for an internship.

1. Customer care, supports, services: Course content shall address program and service planning, supervision, and evaluation to meet the needs of patients, such as (i) nursing, medical and pharmaceutical care; (ii) rehabilitative, social, psychosocial, and recreational services; (iii) nutritional services; (iv) safety and rights protections; (v) quality assurance; and (vi) infection control.

2. Human resources: Course content shall focus on personnel leadership in a health care management role and must address organizational behavior and personnel management skills such as (i) staff organization, supervision, communication, and evaluation; (ii) staff recruitment, retention, and training; (iii) personnel policy development and implementation; and (iv) employee health and safety.

3. Finance: Course content shall address financial management of health care programs and facilities such as (i) an overview of financial practices and problems in the delivery of health care services; (ii) financial planning, accounting, analysis, and auditing; (iii) budgeting; (iv) health care cost issues; and (v) reimbursement systems and structures.

4. Environment: Course content shall address facility and equipment management such as (i) maintenance, (ii) housekeeping, (iii) safety, (iv) inspections and compliance with laws and regulations, and (v) emergency preparedness.

5. Leadership and management: Course content shall address the leadership roles in health delivery systems such as (i) government oversight and interaction, (ii) organizational policies and procedures, (iii) principles of ethics and law, (iv) community coordination and cooperation, (v) risk management, and (vi) governance and decision making.

Statutory Authority

§ 54.1-2400 of the Code of Virginia.

Historical Notes

Derived from Virginia Register Volume 22, Issue 26, eff. October 4, 2006; amended, Virginia Register Volume 35, Issue 12, eff. March 6, 2019.

18VAC95-20-225. Qualifications for licensure by endorsement.

The board may issue a license to any person who:

1. Holds a current, unrestricted license from any state or the District of Columbia; and

2. Meets one of the following conditions:

a. Has been engaged in active practice as a licensed nursing home administrator; or

b. Has education and experience equivalent to qualifications required by this chapter and has provided written evidence of those qualifications at the time of application for licensure.

Statutory Authority

§ 54.1-2400 of the Code of Virginia.

Historical Notes

Derived from Virginia Register Volume 15, Issue 4, eff. December 9, 1998; amended, Virginia Register Volume 25, Issue 6, eff. December 24, 2008; Volume 35, Issue 12, eff. March 6, 2019.

18VAC95-20-230. Application package.

A. An application for licensure shall be submitted after the applicant completes the qualifications for licensure.

B. An individual seeking licensure as a nursing home administrator or registration as a preceptor shall submit:

1. A completed application as provided by the board;

2. Additional documentation as may be required by the board to determine eligibility of the applicant;

3. The applicable fee;

4. An attestation that he has read and understands and will remain current with the applicable Virginia laws and regulations relating to the administration of nursing homes; and

5. A current report from the U.S. Department of Health and Human Services National Practitioner Data Bank (NPDB).

C. With the exception of school transcripts, examination scores, the NPDB report, employer verifications, and verifications from other state boards, all parts of the application package shall be submitted at the same time. An incomplete package shall be retained by the board for one year, after which time the application shall be destroyed and a new application and fee shall be required.

Statutory Authority

§ 54.1-2400 of the Code of Virginia.

Historical Notes

Derived from VR500-01-2:1 § 5.2, eff. August 15, 1990; amended, Virginia Register Volume 7, Issue 25, eff. October 9, 1991; Volume 8, Issue 24, eff. September 24, 1992; Volume 10, Issue 17, eff. June 15, 1994; Volume 15, Issue 4, eff. December 9, 1998; Volume 19, Issue 19, eff. July 2, 2003; Volume 24, Issue 20, eff. July 24, 2008; Volume 26, Issue 8, eff. January 20, 2010; Volume 31, Issue 20, eff. July 16, 2015; Volume 35, Issue 12, eff. March 6, 2019.

18VAC95-20-240. (Repealed.)

Historical Notes

Derived from VR500-01-2:1 §§ 5.3 to 5.7, eff. August 15, 1990; amended, Virginia Register Volume 7, Issue 25, eff. October 9, 1991; Volume 8, Issue 24, eff. September 24, 1992; Volume 10, Issue 17, eff. June 15, 1994; repealed, Virginia Register Volume 15, Issue 4, eff. December 9, 1998.

18VAC95-20-290. (Repealed.)

Historical Notes

Derived from VR500-01-2:1 § 5.8, eff. August 15, 1990; amended, Virginia Register Volume 7, Issue 25, eff. October 9, 1991; Volume 8, Issue 24, eff. September 24, 1992; Volume 10, Issue 17, eff. June 15, 1994; Volume 15, Issue 4, eff. December 9, 1998; repealed, Virginia Register Volume 19, Issue 19, eff. July 2, 2003.

Part IV
Administrator-In-Training Program

18VAC95-20-300. Administrator-in-training qualifications.

A. To be approved as an administrator-in-training, a person shall:

1. Have received a passing grade on a total of 60 semester hours of education from an accredited institution;

2. Obtain a registered preceptor to provide training;

3. Submit the fee prescribed in 18VAC95-20-80;

4. Submit the application and Domains of Practice form provided by the board; and

5. Submit additional documentation as may be necessary to determine eligibility of the applicant and the number of hours required for the AIT program.

B. With the exception of school transcripts, all required parts of the application package shall be submitted at the same time. An incomplete package shall be retained by the board for one year after which time the application shall be destroyed and a new application and fee shall be required.

Statutory Authority

§ 54.1-2400 of the Code of Virginia.

Historical Notes

Derived from VR500-01-2:1 § 6.1, eff. August 15, 1990; amended, Virginia Register Volume 7, Issue 25, eff. October 9, 1991; Volume 8, Issue 24, eff. September 24, 1992; Volume 10, Issue 17, eff. June 15, 1994; Volume 15, Issue 4, eff. December 9, 1998; Volume 19, Issue 19, eff. July 2, 2003; Volume 29, Issue 20, eff. July 18, 2013; Volume 35, Issue 12, eff. March 6, 2019.

18VAC95-20-310. Required hours of training.

A. The AIT program shall consist of 2,000 hours of continuous training in a facility as prescribed in 18VAC95-20-330 to be completed within 24 months. An extension may be granted by the board on an individual case basis. The board may reduce the required hours for applicants with certain qualifications as prescribed in subsections B and C of this section.

B. An AIT applicant with prior health care work experience may request approval to receive a maximum 1,000 hours of credit toward the total 2,000 hours as follows:

1. The applicant shall have been employed full time for four of the past five consecutive years immediately prior to application as an assistant administrator or director of nursing in a training facility as prescribed in 18VAC95-20-330, or as the licensed administrator of an assisted living facility;

2. The applicant with experience as a hospital administrator shall have been employed full time for three of the past five years immediately prior to application as a hospital administrator-of-record or an assistant hospital administrator in a hospital setting having responsibilities in all of the following areas:

a. Regulatory;

b. Fiscal;

c. Supervisory;

d. Personnel; and

e. Management; or

3. The applicant who holds a license as a registered nurse shall have held an administrative level supervisory position for at least four of the past five consecutive years, in a training facility as prescribed in 18VAC95-20-330.

C. An AIT applicant with the following educational qualifications shall meet these requirements:

1. An applicant with a master's or a baccalaureate degree in a health care-related field that meets the requirements of 18VAC95-20-221 with no internship shall complete 320 hours in an AIT program;

2. An applicant with a master's degree in a field other than health care shall complete 1,000 hours in an AIT program;

3. An applicant with a baccalaureate degree in a field other than health care shall complete 1,500 hours in an AIT program; or

4. An applicant with 60 semester hours of education in an accredited college or university shall complete 2,000 hours in an AIT program.

D. An AIT shall be required to serve weekday, evening, night and weekend shifts and to receive training in all areas of nursing home operation. An AIT shall receive credit for no more than 40 hours of training per week.

E. An AIT shall complete training on the care of residents with cognitive or mental impairments, including Alzheimer's disease and dementia.

Statutory Authority

§§ 54.1-2400 and 54.1-3102 of the Code of Virginia.

Historical Notes

Derived from VR500-01-2:1 § 6.2, eff. August 15, 1990; amended, Virginia Register Volume 7, Issue 25, eff. October 9, 1991; Volume 8, Issue 24, eff. September 24, 1992; Volume 10, Issue 17, eff. June 15, 1994; Volume 15, Issue 4, eff. December 9, 1998; Volume 19, Issue 19, eff. July 2, 2003; Volume 22, Issue 26, eff. October 4, 2006; Volume 29, Issue 20, eff. July 18, 2013; Volume 39, Issue 7, eff. December 21, 2022.

18VAC95-20-320. (Repealed.)

Historical Notes

Derived from VR500-01-2:1 § 6.3, eff. August 15, 1990; amended, Virginia Register Volume 7, Issue 25, eff. October 9, 1991; Volume 8, Issue 24, eff. September 24, 1992; Volume 10, Issue 17, eff. June 15, 1994; repealed, Virginia Register Volume 15, Issue 4, eff. December 9, 1998.

18VAC95-20-330. Training facilities.

Training in an AIT program shall be conducted only in:

1. A nursing home licensed by the Virginia Board of Health or by a similar licensing body in another jurisdiction;

2. An institution operated by the Virginia Department of Behavioral Health and Developmental Services in which long-term care is provided;

3. A certified nursing home owned or operated by an agency of any city, county, or the Commonwealth or of the United States government; or

4. A certified nursing home unit that is located in and operated by a licensed hospital as defined in § 32.1-123 of the Code of Virginia, a state-operated hospital, or a hospital licensed in another jurisdiction.

Statutory Authority

§ 54.1-2400 of the Code of Virginia.

Historical Notes

Derived from VR500-01-2:1 § 6.4, eff. August 15, 1990; amended, Virginia Register Volume 7, Issue 25, eff. October 9, 1991; Volume 8, Issue 24, eff. September 24, 1992; Volume 10, Issue 17, eff. June 15, 1994; Volume 15, Issue 4, eff. December 9, 1998; Volume 19, Issue 19, eff. July 2, 2003; Volume 22, Issue 26, eff. October 4, 2006; Volume 28, Issue 24, eff. August 29, 2012.

18VAC95-20-340. Supervision of trainees.

A. Training shall be under the supervision of a preceptor who is registered or recognized by a licensing board.

B. A preceptor may supervise no more than two AIT's at any one time.

C. A preceptor shall:

1. Provide direct instruction, planning, and evaluation in the training facility;

2. Shall be routinely present with the trainee for on-site supervision in the training facility as appropriate to the experience and training of the AIT and the needs of the residents in the facility; and

3. Shall continually evaluate the development and experience of the AIT to determine specific areas in the Domains of Practice that need to be addressed.

Statutory Authority

§§ 54.1-2400 and 54.1-3102 of the Code of Virginia.

Historical Notes

Derived from VR500-01-2:1 § 6.5, eff. August 15, 1990; amended, Virginia Register Volume 7, Issue 25, eff. October 9, 1991; Volume 8, Issue 24, eff. September 24, 1992; Volume 10, Issue 17, eff. June 15, 1994; Volume 15, Issue 4, eff. December 9, 1998; Volume 19, Issue 19, eff. July 2, 2003; Volume 22, Issue 26, eff. October 4, 2006; Volume 35, Issue 12, eff. March 6, 2019; Volume 39, Issue 7, eff. December 21, 2022.

18VAC95-20-350. (Repealed.)

Historical Notes

Derived from VR500-01-2:1 §§ 6.6 to 6.8, eff. August 15, 1990; amended, Virginia Register Volume 7, Issue 25, eff. October 9, 1991; Volume 8, Issue 24, eff. September 24, 1992; Volume 10, Issue 17, eff. June 15, 1994; repealed, Virginia Register Volume 15, Issue 4, eff. December 9, 1998.

18VAC95-20-380. Qualifications of preceptors.

A. To be registered by the board as a preceptor, a person shall:

1. Hold a current, unrestricted Virginia nursing home administrator license and be employed full time as an administrator of record in a training facility for a minimum of two of the past three years immediately prior to registration;

2. Provide evidence that he has completed the online preceptor training course offered by NAB; and

3. Meet the application requirements in 18VAC95-20-230.

B. To renew registration as a preceptor, a person shall:

1. Hold a current, unrestricted Virginia nursing home administrator license and be employed by or have an agreement with a training facility for a preceptorship; and

2. Meet the renewal requirements of 18VAC95-20-170.

Statutory Authority

§ 54.1-2400 of the Code of Virginia.

Historical Notes

Derived from VR500-01-2:1 § 6.9, eff. August 15, 1990; amended, Virginia Register Volume 7, Issue 25, eff. October 9, 1991; Volume 8, Issue 24, eff. September 24, 1992; Volume 10, Issue 17, eff. June 15, 1994; Volume 15, Issue 4, eff. December 9, 1998; Volume 19, Issue 19, eff. July 2, 2003; Volume 22, Issue 26, eff. October 4, 2006; Volume 35, Issue 12, eff. March 6, 2019.

18VAC95-20-390. Training plan.

Prior to the beginning of the AIT program, the preceptor shall develop and submit for board approval a training plan that shall include and be designed around the specific training needs of the administrator-in-training. The training plan shall address the Domains of Practice approved by NAB that is in effect at the time the training program is submitted for approval. An AIT program shall include training in each of the learning areas as outlined in the NAB AIT Manual.

Statutory Authority

§§ 54.1-2400 and 54.1-3102 of the Code of Virginia.

Historical Notes

Derived from VR500-01-2:1 § 6.10, eff. August 15, 1990; amended, Virginia Register Volume 7, Issue 25, eff. October 9, 1991; Volume 8, Issue 24, eff. September 24, 1992; Volume 10, Issue 17, eff. June 15, 1994; Volume 15, Issue 4, eff. December 9, 1998; Volume 19, Issue 19, eff. July 2, 2003; Volume 22, Issue 26, eff. October 4, 2006; Volume 25, Issue 19, eff. June 24, 2009; Volume 35, Issue 12, eff. March 6, 2019; Volume 39, Issue 7, eff. December 21, 2022.

18VAC95-20-400. Reporting requirements.

A. The preceptor shall maintain progress reports on forms prescribed by the board for each month of training. The preceptor shall document in the progress report evidence of on-site supervision of the AIT training.

B. The AIT's final report of completion with the accumulated original monthly reports shall be submitted by the preceptor to the board within 30 days following the completion of the AIT program.

Statutory Authority

§§ 54.1-2400 and 54.1-3102 of the Code of Virginia.

Historical Notes

Derived from VR500-01-2:1 § 6.11, eff. August 15, 1990; amended, Virginia Register Volume 7, Issue 25, eff. October 9, 1991; Volume 8, Issue 24, eff. September 24, 1992; Volume 10, Issue 17, eff. June 15, 1994; Volume 15, Issue 4, eff. December 9, 1998; Volume 39, Issue 7, eff. December 21, 2022.

18VAC95-20-410. (Repealed.)

Historical Notes

Derived from VR500-01-2:1 §§ 6.12 and 6.13, eff. August 15, 1990; amended, Virginia Register Volume 7, Issue 25, eff. October 9, 1991; Volume 8, Issue 24, eff. September 24, 1992; Volume 10, Issue 17, eff. June 15, 1994; repealed, Virginia Register Volume 15, Issue 4, eff. December 9, 1998.

18VAC95-20-430. Termination of program.

A. If the AIT program is terminated prior to completion, the trainee and the preceptor shall each submit a written explanation of the causes of program termination to the board within 10 business days.

B. The preceptor shall also submit all required monthly progress reports completed prior to termination.

Statutory Authority

§ 54.1-2400 of the Code of Virginia.

Historical Notes

Derived from VR500-01-2:1 § 6.14, eff. August 15, 1990; amended, Virginia Register Volume 7, Issue 25, eff. October 9, 1991; Volume 8, Issue 24, eff. September 24, 1992; Volume 10, Issue 17, eff. June 15, 1994; Volume 15, Issue 4, eff. December 9, 1998; Volume 35, Issue 12, eff. March 6, 2019.

18VAC95-20-440. Interruption of program.

A. If the program is interrupted because the registered preceptor is unable to serve, the AIT shall notify the board within five working days and shall obtain a new preceptor who is registered with the board within 60 days.

B. Credit for training shall resume when a new preceptor is obtained and approved by the board.

C. If an alternate training plan is developed, it shall be submitted to the board for approval before the AIT resumes training.

Statutory Authority

§ 54.1-2400 and Chapter 31 (§ 54.1-3100 et seq.) of Title 54.1 of the Code of Virginia.

Historical Notes

Derived from VR500-01-2:1 § 6.15, eff. August 15, 1990; amended, Virginia Register Volume 7, Issue 25, eff. October 9, 1991; Volume 8, Issue 24, eff. September 24, 1992; Volume 10, Issue 17, eff. June 15, 1994; Volume 15, Issue 4, eff. December 9, 1998.

18VAC95-20-450. (Repealed.)

Historical Notes

Derived from VR500-01-2:1 §§ 6.16 and 6.17, eff. August 15, 1990; amended, Virginia Register Volume 7, Issue 25, eff. October 9, 1991; Volume 8, Issue 24, eff. September 24, 1992; Volume 10, Issue 17, eff. June 15, 1994; repealed, Virginia Register Volume 15, Issue 4, eff. December 9, 1998.

Part V
Refusal, Suspension, Revocation, and Disciplinary Action

18VAC95-20-470. Unprofessional conduct.

The board may refuse to admit a candidate to an examination, refuse to issue or renew a license or registration or approval to any applicant, suspend a license for a stated period of time or indefinitely, reprimand a licensee or registrant, place his license or registration on probation with such terms and conditions and for such time as it may designate, impose a monetary penalty, or revoke a license or registration for any of the following causes:

1. Conducting the practice of nursing home administration in such a manner as to constitute a danger to the health, safety, and well-being of the residents, staff, or public;

2. Failure to comply with federal, state, or local laws and regulations governing the operation of a nursing home;

3. Conviction of a felony or any misdemeanor involving abuse, neglect, or moral turpitude;

4. Violating or cooperating with others in violating any of the provisions of Chapters 1 (§ 54.1-100 et seq.), 24 (§ 54.1-2400 et seq.), and 31 (§ 54.1-3100 et seq.) of the Code of Virginia or regulations of the board;

5. Inability to practice with reasonable skill or safety by reason of illness or substance abuse or as a result of any mental or physical condition;

6. Abuse, negligent practice, or misappropriation of a resident's property;

7. Entering into a relationship with a resident that constitutes a professional boundary violation in which the administrator uses his professional position to take advantage of the vulnerability of a resident or his family, to include actions that result in personal gain at the expense of the resident, an inappropriate personal involvement with a resident, or sexual conduct with a resident;

8. The denial, revocation, suspension, or restriction of a license to practice in another state, the District of Columbia, or a United States possession or territory;

9. Assuming duties and responsibilities within the practice of nursing home administration without adequate training or when competency has not been maintained;

10. Obtaining supplies, equipment, or drugs for personal or other unauthorized use;

11. Falsifying or otherwise altering resident or employer records, including falsely representing facts on a job application or other employment-related documents;

12. Fraud or deceit in procuring or attempting to procure a license or registration or seeking reinstatement of a license or registration; or

13. Employing or assigning unqualified persons to perform functions that require a license, certificate, or registration.

Statutory Authority

§ 54.1-2400 of the Code of Virginia.

Historical Notes

Derived from VR500-01-2:1 § 7.1, eff. August 15, 1990; amended, Virginia Register Volume 7, Issue 25, eff. October 9, 1991; Volume 8, Issue 24, eff. September 24, 1992; Volume 10, Issue 17, eff. June 15, 1994; Volume 15, Issue 4, eff. December 9, 1998; Volume 29, Issue 20, eff. July 18, 2013; Volume 35, Issue 12, eff. March 6, 2019.

18VAC95-20-471. (Repealed.)

Historical Notes

Derived from Virginia Register Volume 21, Issue 19, eff. June 29, 2005; repealed, Virginia Register Volume 35, Issue 12, eff. March 6, 2019.

18VAC95-20-480. (Repealed.)

Historical Notes

Derived from VR500-01-2:1, eff. August 15, 1990; amended, Virginia Register Volume 7, Issue 25, eff. October 9, 1991; Volume 8, Issue 24, eff. September 24, 1992; Volume 10, Issue 17, eff. June 15, 1994; repealed, Virginia Register Volume 15, Issue 4, eff. December 9, 1998.

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)