GENERAL AUTHORITY C.R.S. 12-39-101 EFFECTIVE NOVEMBER, 2000 RULE 1. LICENSING EXAMINATION 1. All applicants who have met the education requirements and have otherwise complied with the rules of the Board must successfully pass a licensing examination, consisting of two parts. 2. Part I of the examination shall consist of questions determined by the Board to establish an applicant's knowledge specifically related to the practice of nursing home administration in this state. Part II shall consist of those questions constituting an examination formulated by a national association, approved by the Board.

3. Part I of the examination may include questions in the following areas: a. Principles of administration including budgeting, accounting, records management, organization, personnel, and business management.

b. Medical, sociological, psychological, environmental and therapeutic aspects of patient/resident care.

c. Federal, state and local laws, rules and regulation in relation to the administration of a nursing home.

4. Candidates shall be informed by mail regarding examination performance. 5. Candidates seeking licensure pursuant to 12-39-106, C.R.S. must complete both licensing examinations within the immediately preceding 3 years.

RULE 2 GENERAL LICENSING PROVISIONS 1. Change of name and address a. The licensee shall supply legal evidence of name change by court record or marriage certificate in order for such change to be made on Board records. b. Notice of change of address shall be submitted in writing to the Board by the licensee within 30 days of such change.

c. Any notification by the Board to licensees, required or permitted, under CRS 12-39-101 et seq., or the Colorado Administrative Procedures Act shall be addressed to the last address provided formally to the Board by the licensee and any such mailing shall be deemed proper service on said licensee.

2. An applicant for a license or permit who does not complete the licensing process within one year of the date of the original application shall complete the application process again including payment of the application fee.

3. Applications that have not been completed within one year of the date of the original application will be purged and destroyed.

RULE 3. STANDARDS FOR LICENSURE 1. The following must be met by any individual who receives and retains a license as a nursing home administrator. The licensee must:

a. Comply with provisions of the law, code, rules or regulation of any licensing or supervising authority or any federal, state, or local government entity having jurisdiction over the operation or reimbursement of nursing homes and/or nursing home administrators. The licensed nursing home administrator shall cooperate with any investigation of these government entities.

b. Exercise reasonable supervision over the activities of nursing home personnel. c. Maintain a clean, safe environment to ensure the health, safety, and welfare of residents and staff in the licensee's facility.

d. Ensure a quality of care and quality of life that is consistent with the health and safety of the residents in the licensee's facility.

e. Protect resident rights as required by state and federal laws. f. Participate with the Governing Body to plan, implement, and evaluate written policies and procedures to ensure compliance with law and regulation. g. Provide an environment which fosters effective communication and problem solving between management, staff, residents, and the community.

h. Plan, implement, and evaluate an integrated financial program for the facility which ensures compliance with applicable laws and regulations, quality of care, and appropriate and accurate billing for services.

i. Possess and maintain the competencies necessary to effectively perform his/her responsibilities as a nursing home administrator.

j. Take appropriate steps to avoid discrimination on basis of race, color, sex, religion, age, national origin, handicap, marital status, ancestry, or any other factor that is illegally discriminatory or not related to bona fide requirements of quality care. k. Participate with others in the community to plan for and provide a full range of health care services.

l. Provide appropriate systems to account for and to protect residents' personal funds and property within the facility.

m. Disclose to the governing body or other authority as may be appropriate, any actual or potential circumstance concerning the nursing home administrator that might reasonably be thought to create a conflict of interest or have a substantial adverse impact on the facility or its residents.

2. Any failure to meet these standards may result in disciplinary proceedings as set forth in 12-39-111 & 12-39-114, C.R.S..

RULE 4 ADMINISTRATOR-IN-TRAINING (AIT) PROGRAM 1. The Administrator - In - Training program is the way whereby a person seeking initial licensure as a nursing home administrator may obtain practical training and experience in nursing home administration under the direct supervision of a licensed nursing home administrator (preceptor) who is in full-time practice in the facility.

2. EDUCATION AND EXPERIENCE CRITERIA FOR ADMISSION INTO THE AIT PROGRAM. a. The applicant must have 2 years college level study in areas relating to health care OR 2 years of experience in nursing home administration or in a comparable health care management experience for each year of required education. i. College level study A. One year college level study is at least 30 semester hours or 45 quarter hours.

B. Study must be successfully completed in college or university approved by: 1. Middle States Association of Colleges and Schools 2. New England Association of Colleges and Schools 3. North Central Association of Colleges and Schools 4. North West Association of Colleges and Schools 5. Southern Association of Colleges and Schools 6. Western Associations of Colleges and Schools C. The types of courses which will be considered “relating to health care” will be courses such as social services if related to health care (not welfare), recreational therapy (not physical education), dietary, psychology, sociology, physiology, anatomy, biology, speech, health care management and administration, These courses are representative of the type of courses that the Board will accept and are not intended as an exclusive list. No more than 6 semester or 9 quarter hours may be in the “humanities” (i.e., art, music, foreign language, literature.) ii. Experience in nursing home administration or in a comparable health care management experience.

A. Experience must be obtained in a nursing home administration or in a comparable health care management experience.

B. Experience in comparable health care management must include experiences in the following areas.

1. Direct health care which includes nursing, clinical social work, physical therapy, dietitian, and persons with experience in such areas as medical records, social services, or other related experiences.

2. Planning, organizing and controlling events toward a goal such as involvement in finance, budget, and policy making decisions. 3. It should be noted that supervisory experience is not a requirement for placement in the AIT Program. Supervisory exposure will be gained during the A.I.T. Program.

b. The Board may approve substitution of two years of board approved experience for a year of education, or may approve proportional experience for various amounts of education. 3. APPLYING FOR THE AIT PROGRAM a. An applicant for the nursing home administrator in training program shall meet the statutory requirements of 12-39-106 and 12-39-107, C.R.S. and shall submit an application in the manner and on the forms prescribed by the board, which consists of: i. The application form having complete and accurate entries of information; ii. If applicable, transcripts sent directly by the institution to the office of the board; iii. Any additional or supplemental documentation to support data entries on the application form and to establish any qualifying administrative experience. iv. An application for approval of a preceptor, signed by the applicant and the preceptor. It shall be the responsibility of the AIT applicant to enter into an agreement with a licensed administrator who meets the qualifications to be a preceptor and who is willing to accept and supervise the applicant as an AIT in accordance with the rules set forth hereinafter.

v. The AIT program plan, with supporting documentation. The program plan must include a detailed timetable of planned learning experiences and a description of objectives. The full AIT program must be for a period of 2000 hours. The program plan must include the methods of instruction and describe in detail the program of study addressing the following areas:

A. Principles of administration including budgeting, accounting, records management, organization, personnel, and business management. B. Medical, sociological, psychological, environmental and therapeutic aspects of patient/resident care.

C. Federal, state and local laws, rules and regulation in relation to the administration of a nursing home.

b. The AIT shall work under the personal on-site supervision of the preceptor for the duration of the approved program. It is the responsibility of the preceptor and of the AIT to insure that the AIT is primarily engaged in the AIT program.

c. The application and all required information shall be on file with the board at least two weeks prior to the regular meeting of the board preceding the requested beginning date of the AIT program:

d. Before approving the applicant for the AIT program, the board must be satisfied that the applicant does not have a substantial financial interest in the nursing home which is to be the site wherein the major portion of the training time will be served. 4. PRECEPTORS a. “Preceptor” - a nursing home administrator who:

i. Is licensed and actively practicing nursing home administration the preceding twelve (12) months in the State of Colorado; and ii. Agrees to abide by the terms of the administrator-in-training agreement set forth by the Board for any administrator-in-training under his supervision. iii. Is the administrator of record in a facility eligible by federal and state law to offer a nurse aide training and competency evaluation program or competency evaluation program.

b. No preceptor shall have more than two (2) AIT's under supervision at any one time. c. No preceptor shall receive any financial remuneration from or on behalf of an AIT for his services as a preceptor under his program.

d. Each preceptor shall serve at the discretion of the Board. e. All preceptors shall comply with the rules and regulations regarding the AIT program and may be disciplined for failure to comply.

f. All preceptors shall abide by the terms of any agreement entered into with the board to act as a preceptor.

g. It is the responsibility of the preceptor to assist the AIT applicant in developing this detailed program of training. Such program may include classroom experience received while in the AIT program if Board approval is sought prior to obtaining same. 5. WAIVERS a. The Board may consider requests for waivers of a portion of the AIT period provided the applicant has had responsibility for performing administrative or supervisory tasks in a nursing home in the following categories:

i. Budgeting, accounting, records management, organization, personnel and business management.

ii. Physical, sociological, psychological, environmental, and therapeutic aspects of patient/client care.

b. For consideration of request for a waiver of 500 hours, the applicant is required to have had one years' responsibility for performing administrative or supervisory tasks in a nursing home in one of the above categories.

c. For consideration of request for a waiver of 1000 hours, the applicant is required to have had 2 years' responsibility for performing administrative or supervisory tasks, one in each of the above categories.

6. MONITORING a. Each AIT shall file bi-monthly reports as required by and in the form prescribed by the board. b. All reports are to be co-signed by the AIT and the preceptor and filed with the board no more than then ten days following the end of the reporting period. c. If an AIT fails to file reports as prescribed above, the AIT may be deemed to have abandoned the AIT program.

d. Any falsification or misrepresentation contained in any report or document attesting the facts, conditions and activities of the AIT and submitted by the AIT, preceptor, or other licensees under the jurisdiction of the Board may be considered conduct which fails to meet generally accepted standards for nursing home administration practice and could subject the licensees to discipline pursuant to the statute.

e. The board or its designee shall have the right to monitor, call for conference any party or parties thereto, or visit the facility during the course of the AIT program to assure compliance with these rules.

7. INTERRUPTION, DISCONTINUANCE, OR DISQUALIFICATION a. Termination of the AIT/Preceptor agreement shall be reported by the AIT in writing to the board within seven days of such termination.

b. Discontinuance by the AIT of the program shall be reported by the AIT in writing to the board within seven (7) days after such discontinuance.

c. The AIT program in whole or in part may be disqualified or disallowed if it is determined by the board that the AIT has failed to serve as an AIT in conformity with these rules. d. Acceptance into the AIT program in no way implies authority for the AIT to serve in the capacity of a nursing home administrator; such action by the AIT may disqualify the entire period of the AIT program.

e. In the event the preceptor fails to provide the AIT an opportunity for adequate professional and occupational experience under supervision in the administrative and operational activities of a nursing home, the board may disqualify the preceptor from further service as such in the AIT program.

f. In the event that during the AIT program the training experience proves unsatisfactory, the board may terminate or rearrange all or part of the program. RULE 5. TEMPORARY LICENSES PURSUANT TO 12-39-108 (5) & 12-39-108 (6) 1. The Board may delegate its authority to review and approve applications for temporary licensure to the program administrator. The program administrator has discretion to deny a request for a temporary license. If the program administrator denies a request for a temporary license the application will be presented to the Board at its next regularly scheduled meeting. 2. Temporary License for Endorsement Applicants a. Upon completion of all requirements of licensure by endorsement an applicant may be granted a temporary license. The applicant must request a temporary license, complete an application, and pay the appropriate fee.

b. The temporary license shall be effective for six months or until the Board grants or denies the applicant's request for licensure by endorsement pursuant to 12-39-110. 3. Temporary License for Emergency Situations a. A temporary license not to exceed ninety (90) days may be issued to a qualified applicant in the case of death of the administrator, termination of the administrator, resignation of the administrator without notice, or other similar circumstances. Promotion or transfer made at the discretion of the ownership or management company does not qualify as an emergency.

b. The program administrator is authorized to issue only one ninety (90) day emergency temporary license per occurrence.

c. A qualified applicant may include the following:

i. An individual who has completed the AIT program;

ii. The Director of Nursing;

iii. An individual who qualifies for licensure by exam or endorsement and is either working in the facility or has made application for licensure. d. An applicant for an emergency temporary license must submit an application setting forth the emergency and payment of the appropriate fee.

4. Temporary License for a Hospital Administrator a. The applicant under this section must submit the following: i. A completed application;

ii. The appropriate fee; and iii. A letter from the general hospital board of directors or similar authority indicating that the applicant is, in fact, employed as the hospital administrator and that the hospital does need to have this person serve as the nursing home administrator. b. The program administrator has the authority to grant the temporary license for a period up to twelve months.

c. The program administrator may grant the temporary license for a period of less than twelve months. If a temporary license under this section is granted for less than twelve months, the program administrator must present the application to the Board at its next regularly scheduled board meeting.

RULE 6. REINSTATEMENT OF EXPIRED LICENSE 1. A licensee who fails to renew his/her license shall cease and desist from acting as a nursing home administrator. A licensee may not practice with an expired license. 2. To be considered for licensure reinstatement if the license has been expired for more than 3 months, the applicant must submit the following:

a. completed application for reinstatement with the appropriate fee; b. verification from each state in which applicant holds or has ever held a professional license that the license is in good standing; and c. proof in a form determined by the Board that the applicant has not violated the statute, rules and regulations.

3. The Board may deny an applicant for reinstatement upon a finding that the applicant has violated any provisions of this statute, rules and regulations. Such denial would be pursuant to 12-39-112 and 12-39-114, C.R.S 4. The fee for reinstatement for nursing home administrators shall be as follows: a. The renewal fee established pursuant to 24-34-105, C.R.S.; and b. The reinstatement fee which shall be determined and collected pursuant to 24-35-105, C.R.S.