Current through Register Vol. 49, No. 18, September 16, 2024
PURPOSE: This rule describes the course of
instruction and training that may be prescribed by the board under the
authority as set forth in section 344.030.1., RSMo.
(1) Applicants who do not otherwise qualify
for examination shall complete one (1) of the following courses of instruction
and training. The formal instruction shall be coursework qualifying for
academic credit, completed with a grade of not less than "C." A portion of the
formal instruction may be from an intensive and comprehensive seminar of at
least forty (40) clock hours specific to longterm care administration which has
been approved by the board. An applicant who has completed-
(A) A high school education or the
equivalent, must complete three hundred fifteen (315) clock hours of formal
instruction and a minimum of two thousand (2,000) clock hours of
internship;
(B) A licensed
practical nurse program, must complete two hundred twenty-five (225) clock
hours of formal instruction and a minimum of eight hundred (800) clock hours of
internship;
(C) An associate
degree, must complete six hundred forty (640) clock hours of
internship;
(D) A three (3) year
diploma program or a baccalaureate of science (BS)/baccalaureate of arts (BA),
must complete five hundred (500) clock hours of internship; or
(E) A masters or beyond, must complete five
hundred (500) clock hours of internship.
(2) The course of instruction and training
shall follow the core of knowledge areas and other subject matter as deemed
necessary by the board to properly prepare an applicant for health care
administration. The core of knowledge shall include, but shall not be limited
to, the following subject areas:
(A) Nursing
and Physician Services:
1. Restorative
nursing;
2.
Rehabilitation;
3. Definition,
concept, and procedures of nursing;
4. Skin and wound care;
5. Infection control procedures;
6. Drug administration and drug
effects;
7. Disease recognition and
process;
8. Quality
assurance;
9. Physician's role in
the facility; and
10.
Physician/resident relationships;
(B) Social Services:
1. Resident rights;
2. Living wills and advance
directives;
3. Social, emotional,
religious, and financial needs of the resident;
4. Family counsel and consultation;
5. Grieving process;
6. Death and dying;
7. Communication with the resident;
and
8. Ombudsman program;
(C) Food Services:
1. Proper nutrition;
2. Therapeutic diets; and
3. Resident satisfaction;
(D) Social and Therapeutic
Recreational Activities:
1. Needs of the
resident;
2. Community
resources;
3. Rehabilitation
services;
4. Volunteers and
auxiliaries; and
5. Chemical
dependency of the resident;
(E) Medical Record Keeping:
1. Medical records systems;
2. Appropriate charting and documentation;
and
3. Evaluation and revision of
care plans;
(F)
Pharmaceutical Services:
1. Proper drug
handling and control;
2. Proper
drug dispensing; and
3. Drug
interactions;
(G)
Personnel Management:
1. Maintaining a
positive atmosphere;
2. Grievance
procedures;
3. Effective
communication;
4. Evaluation
procedures;
5. Recruitment of
staff;
6. Interviewing
candidates;
7. Selecting future
employees;
8. Staff development and
training;
9. Personnel policies and
procedures;
10. Health and safety;
11. Departmental organization and
management;
12. Professional
ethics and conduct;
13. Total
quality management; and
14. Health
care reform;
(H)
Financial Management:
1. Budgeting;
2. Marketing principles;
3. Asset management; and
4. Accounting;
(I) Marketing and Public Relations:
1. Public relation principles;
2. Marketing principles;
3. Newsletters;
4. Community and social organizations;
and
5. Working with the
media;
(J) Physical
Resource Management:
1. Building and grounds
management;
2. Environmental
services and sanitation;
3. Safety
procedures and programs; and
4.
Fire and disaster plans; and
(K) Laws, Regulatory Codes, and Governing
Boards:
1. Medicare and Medicaid;
2. Omnibus Budget Reconciliation Act
(OBRA);
3. Occupational Safety and
Health Administration (OSHA);
4.
Americans With Disabilities Act (ADA);
5. Life safety;
6. Legislative process;
7. Board responsibilities; and
8. By-laws.
(3) The course of instruction and training
shall include instruction in the services which must be provided in long-term
care facilities, the protection of the rights and interests of the residents,
and the elements of good long-term care administration, as well as other
subject matter as deemed necessary by the board to properly prepare that
applicant for long-term care administration.
(4) Instruction and training prescribed by
the board shall be recognized as meeting the requirements of this rule only if
it is offered by an accredited educational institution or affiliate which has
been duly registered with the Missouri Board of Nursing Home
Administrators.
(5) Internships as
required by section (1) shall be under the direct supervision of a licensed
administrator approved and designated as a preceptor by the Missouri Board of
Nursing Home Administrators. An administrator may be approved and designated as
a preceptor for a period of two (2) years, if s/he-
(A) Has been licensed for at least three (3)
years;
(B) Has been employed as a
Missouri administrator for at least one (1) year within the three (3) years
before applying to be a designated preceptor;
(C) Is currently serving as the administrator
of a duly licensed intermediate care facility (ICF), skilled nursing facility
(SNF), assisted living facility (ALF), or any Residential Care Facility (RCF)
that was licensed as a residential care II on or before August 27, 2006, that
continues to meet the licensure standards for a residential care facility II in
effect on August 27, 2006, with thirty (30) or more beds;
(D) Is an administrator of an ICF, SNF, ALF,
or RCF (as described above) with thirty (30) or more beds, which is in
substantial compliance with the rules governing long-term care facilities;
and
(E) Has not been the subject of
any action by any board of nursing home administrators or licensing authority
which resulted in discipline, including but not limited to, formal reprimand,
probation, suspension, or revocation of license or privileges as an
administrator; and
(F) Has
successfully completed a board-approved preceptor training program.
(6) Designated preceptors shall
request in writing board approval to conduct an internship for an applicant who
has been found not qualified for licensure by the board, based upon
19
CSR 73-2.020. Approval may be granted by the board if
the preceptor-
(A) Is not related to the
intern within the fourth degree of consanguinity;
(B) Agrees to give the intern an opportunity
to observe and take part in the managerial tasks of the preceptor;
(C) Will acquaint the intern with the
organization and operation of all the various departments of the facility by
permitting his/her observation and/or participation in department
activities;
(D) Will hold an exit
interview with the intern upon completion of an internship to point out noted
strengths and weaknesses; and
(E)
Upon satisfactory completion of the internship will prepare and return to the
board office the mandatory form certifying the completion of the required hours
of internship.
(7) The
board, for good cause, may refuse to approve or renew a preceptor designation
or may refuse to approve an assignment of an intern to a preceptor.
(8) A preceptor may supervise no more than
one (1) intern concurrently.
(9)
Internships shall be completed within eighteen (18) months of completion of
classroom or other formal instruction unless approved by the board.
(10) A portion of an internship for a nursing
home administrator applicant may be completed in a duly licensed ALF or RCF (as
described above) with thirty (30) or more beds if the intern desires such
experience. The residential care and assisted living administrator applicant
may complete its entire portion of an internship in a duly licensed ALF or RCF
(as described above) with thirty (30) or more beds. The maximum hours of
nursing home administrator internship that may be served in such an ALF or RCF
(as described above) are designated as follows. Nursing home administrator
applicants may complete up to-
(A) 667 clock
hours if 2,000 clock hours are required by the board;
(B) 267 clock hours if 800 clock hours are
required by the board;
(C) 214
clock hours if 640 clock hours are required by the board; or
(D) 167 clock hours if 500 clock hours are
required by the board.
(11) Each day of an internship experience
shall include at least one (1) four (4)-hour block of time within the primary
working hours of the administrator.
*Original authority: 344.070, RSMo 1969, amended 1979,
1993, 1995, 2007.
