1. A. As an exception to the licensure requirements in this chapter, a nursing home shall immediately appoint an individual not licensed to practice as a nursing home administrator to act as the interim nursing home administrator if:

   1. (1) A licensed nursing home administrator in the State leaves or is removed from the position as a nursing home administrator by death or other unexpected cause; and
   2. (2) A licensed nursing home administrator in the State is unavailable to fill the position.

2. B. The departure of the licensed nursing home administrator specified under §A of this regulation is by unexpected cause if:

   1. (1) The departure occurred suddenly;
   2. (2) The departure was unforeseen; and
   3. (3) There was insufficient time for the nursing home to obtain the services of a nursing home administrator licensed in the State.
3. C. The appointed non-licensed individual may begin acting as the interim nursing home administrator upon appointment by the nursing home.

4. D. No later than 24 hours after the appointment of the non-licensed individual as interim nursing home administrator, under §A of this regulation, the nursing home shall:

   1. (1) File an application with the Board requesting a provisional license for the non-licensed individual;
   2. (2) Notify the Board of the circumstances involved in the departure of the licensed nursing home administrator;
   3. (3) Notify the Board of the credentials of the non-licensed individual; and
   4. (4) If requested, provide the Board with the acts the nursing home took, or is taking, to hire a nursing home administrator who is licensed in the State.

5. E. State and National Criminal History Records Check.

   1. (1) The appointed non-licensed individual shall immediately submit to a criminal history records check, in accordance with Health Occupations Article, §9-302.1, Annotated Code of Maryland.
   2. (2) A criminal history records check is not required if the appointed non-licensed individual is actively licensed by a health occupations board in the State who previously has completed a criminal history records check required for licensure, certification, or registration.
   3. (3) The Board may deny approval of an appointment based on the results of a criminal history records check after consideration of the factors listed in Health Occupations Article, §9–308(b)(1), Annotated Code of Maryland.

6. F. Provisional License. The Board may issue a provisional license to the applicant if the Board determines that:

   1. (1) The applicant is of good moral character;
   2. (2) The departure of the licensed nursing home administrator was by unexpected cause; and
   3. (3) The applicant is capable of adequately administering the nursing home for the provisional period.
7. G. If the Board grants the application for the provisional nursing home administrator license, the provisional license is in effect for 90 days from the date of the departure of the licensed nursing home administrator. For good cause shown, the Board may extend the provisional license period by 30 days.

8. H. Denial of Provisional License.

   1. (1) If the application for a provisional license is denied by the Board, the nursing home may request a meeting with the Board to contest the denial.
   2. (2) The nursing home shall provide the request for a meeting to the Board within 5 business days of the denial.
   3. (3) If the nursing home requests a meeting, the appointed non-licensed individual may remain acting as the interim nursing home administrator until the Board issues a decision.
   4. (4) If the Board denies the application for a provisional license after a meeting contesting the initial denial, the non-licensed individual shall immediately cease acting as the interim nursing home administrator upon receipt of the decision.
   5. (5) If the nursing home does not file a timely request for a meeting with the Board, the non-licensed individual shall cease acting as the interim nursing home administrator within 5 business days of the denial.
9. I. If the non-licensed individual is required to cease acting as the interim nursing home administrator under §H of this regulation, and a nursing home administrator licensed in the State remains unavailable to fill the nursing home administrator position, the nursing home may appoint another non-licensed individual as set forth in this regulation.
10. J. As a result of §I of this regulation, if the nursing home appoints another non-licensed individual, and a provisional license is granted, the provisional license is in effect for 90 days from the date of the departure of the nursing home administrator licensed in the State, unless the Board extends the provisional license, for good cause shown, for an additional 30 days.
11. K. Upon request by the nursing home, for reasonable cause, the Board may extend the 24-hour time period for meeting the requirements of §D of this regulation.

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)