1. A. General Provisions.

   1. (1) An AIT program is a supervised 12-month full-time, or 18-month part-time, internship during which the AIT works under the guidance and supervision of a preceptor who is a licensed administrator that meets the qualifications set forth in Regulations .05 and .06 of this chapter.

   2. (2) The AIT program is a required phase of education consisting of both the supervised practice of nursing home administration in the environment of the nursing home, performing and participating in the day-to-day duties of each position, when legally permissible, in each of the following service areas:

      1. (a) Administration;
      2. (b) Business office;
      3. (c) Nursing;
      4. (d) Resident activities;
      5. (e) Social services;
      6. (f) Medical records;
      7. (g) Dietary services;
      8. (h) Maintenance;
      9. (i) Environmental services, including housekeeping and laundry;
      10. (j) Rehabilitation services; and
      11. (k) Quality assurance.

   3. (3) Prior to Board approval of the AIT program, the AIT applicant and preceptor shall develop an outline for the written course of instruction and dates of rotation schedule for the provision of practical training, experience, and learning situations that includes:

      1. (a) The 11 basic service areas set forth in §A(2) of this regulation;
      2. (b) The AIT's past experience and allocation of clinical experiences in the nursing home; and
      3. (c) Approval by the Board.
   4. (4) An AIT may not, during the normal working hours of the program, fill a specific, specialized position in the nursing home.
   5. (5) The AIT shall be exposed to all shifts during the AIT program.
   6. (6) If the AIT is a department head, notice shall be conspicuously posted in the nursing home stating who the acting department head will be while the AIT is performing training duties.
   7. (7) If an applicant does not meet all of the requirements for licensure after having completed 12 months in the full-time or 18 months in the part-time AIT program, the preceptor and applicant have the option to work out a plan satisfactory to the Board to continue studying in the AIT program beyond the 12 or 18 months until all the requirements are met.
   8. (8) The Board or Board committee shall interview each applicant and proposed preceptor, or preceptors, before the approval of an AIT program.
   9. (9) After the interview, the AIT and preceptor shall sign an AIT contract and submit it to the Board for consideration of approval.
   10. (10) The Board may approve the AIT program if it is satisfied that the background and circumstances of the applicant and preceptor, or preceptors, qualify them for the AIT program.

   11. (11) A change of preceptor may be authorized by the Board upon submission of:

       1. (a) Application by the proposed new preceptor;
       2. (b) Evidence satisfactory to the Board that the proposed preceptor is certified by the Board; and
       3. (c) A new signed AIT contract by the AIT and preceptor.
   12. (12) If a preceptor is found by the Board to have failed to provide adequate training, the Board may cancel the preceptor's authorization to serve as a preceptor for a period of time prescribed by the Board.
   13. (13) The AIT and preceptor shall comply with the AIT contract.
   14. (14) An individual duly registered as an AIT whose internship is interrupted by service in the armed forces of the United States shall be permitted to resume the internship without loss of credit at any time within 1 year after the date of the AIT's separation from active service.

2. B. Application Requirements.

   1. (1) The Board may approve an application for a nursing home AIT program only if it determines that the application contains satisfactory evidence that:

      1. (a) The applicant is at least 21 years old;
      2. (b) The applicant is of good moral character;
      3. (c) The applicant's training will be supervised by a Board-certified preceptor; and
      4. (d) The AIT program meets the other requirements set forth in this regulation.
   2. (2) The training proposed to be provided to the applicant shall be satisfactory to the Board.

   3. (3) The applicant shall participate in training provided in:

      1. (a) A nursing home licensed in the State, as defined in COMAR 10.33.01.02B; and
      2. (b) Not more than two licensed nursing homes in the State approved by the Board for training. If two nursing homes are utilized for training, one shall have at least 60 beds.
   4. (4) If there are subject areas as specified in the list of subjects provided in §A(2) of this regulation that are not available in the nursing home approved by the Board for training, the Board may require training in other facilities.

3. C. Credit for Prior Experience.

   1. (1) The AIT program is a minimum of 12 months for full-time programs or 18 months for part-time programs unless, upon request from the applicant to review prior work experience, the Board awards credit for prior experience within the last 5 years. The amount of credit awarded is at the discretion of the Board, based on an applicant’s work experience demonstrating exposure to the core of knowledge set forth in Regulation .04A(2) of this chapter, but may not exceed;

      1. (a) Six months for a hospital assistant administrator;
      2. (b) Eight months for a hospital administrator;
      3. (c) Six months for a nursing home assistant administrator;
      4. (d) Six months for a department head;
      5. (e) Three months for an Executive Director of a continuing care retirement community;
      6. (f) Three months for an assisted living manager;
      7. (g) Three months for a healthcare-related senior management official; or
      8. (h) Three months for a non-healthcare-related senior management official.

   2. (2) Qualifying Experience for Healthcare Related Professions in §C(1)(a)—(f) of this regulation. The minimum experience required for receiving credit towards the AIT program includes:

      1. (a) A minimum of 18 months as a full-time employee, with line responsibility for hiring, firing, budget, and supervision of at least one department comprised of ten or more employees; and
      2. (b) Reporting directly to the nursing home administrator or chief executive officer.

   3. (3) Qualifying Experience for Healthcare Related or Non-Healthcare Related Senior Management Official in §C(1)(g) and (h) of this regulation. The following requirements set the minimum experience required for receiving credit:

      1. (a) Minimum of 18 months as a full-time senior management official of a single nursing home or entity; and
      2. (b) Administrative responsibility for the total operation of the nursing home or entity and its multiple departments, as applicable.

   4. (4) Experience credit can be awarded on a month-to-month basis totaling 12 months for:

      1. (a) An individual who has worked as a licensed nursing home administrator in another state;
      2. (b) A resident or intern in a program offered by an accredited college or university for the purpose of satisfying the requirements for a baccalaureate or master's degree in healthcare administration; or
      3. (c) An individual who has successfully completed an AIT program in another state, if the program is substantially comparable to the AIT program in the State, as determined by the Board.

Authority: Health Occupations Article, §§9-205, 9-301—9-316.1, and 9-401—9-501, Annotated Code of Maryland

Effective date: January 19, 2026 (53:1 Md. R 22)