1. (a) Except as provided in subsection (b) of this section, an applicant seeking a license as a nursing facility administrator (NFA) from the Texas Health and Human Services Commission (HHSC) must pass the following examinations:

   1. (1) the state examination on nursing facility requirements in Texas; and
   2. (2) the NAB examinations.
2. (b) An applicant who meets the academic and internship requirements by presenting evidence of a health services executive (HSE) qualification must pass the state examination.

3. (c) An applicant registers for examination at the designated NAB website by:

   1. (1) submitting an application for approval to take the examination; and
   2. (2) paying the applicable state examination and NAB examination fees online.
4. (d) HHSC sends an e-mail notifying an applicant of the applicant's eligibility to take the examinations.
5. (e) An applicant must not take any examination without HHSC approval.
6. (f) An applicant with a disability, including an applicant with dyslexia as defined in Texas Education Code §51.970 (relating to Instructional Material for Blind and Visually Impaired Students and Students with Dyslexia), may request a reasonable accommodation for the examination under the Americans with Disabilities Act.
7. (g) An applicant completes the online state and NAB examinations.
8. (h) HHSC notifies an applicant of examination scores after receiving examination results.
9. (i) An applicant who fails an examination and wants to retake the examination must pay the appropriate state or NAB examination fee for each exam.
10. (j) An applicant who fails the state or NAB examination three consecutive times must complete an additional 1,000-hour administrator-in-training internship before retaking the examination.
11. (k) An applicant previously licensed as an NFA and whose license expired 365 or more days before the applicant reapplies for a license or who voluntarily surrendered the license must retake the state examination to obtain a new license.
12. (l) An applicant previously licensed as an NFA and whose license expired 365 or more days before the applicant reapplies for a license, or who voluntarily surrendered the license, must retake the NAB examination to obtain a new license if more than five years have passed since the applicant passed the NAB examination.

Source Note:The provisions of this §555.18 adopted to be effective November 14, 2021, 46 TexReg 7791; amended to be effective December 6, 2023, 48 TexReg 7078; amended to be effective September 18, 2024, 49 TexReg 7339.