NURSING HOME ADMINISTRATORS

chapter 141	licensure of nursing home administrators	
chapter 142	reserved	
chapter 143	continuing education for nursing home administration	
chapter 144	discipline for nursing home administrators	
CHAPTER 141
LICENSURE OF NURSING HOME ADMINISTRATORS
[Prior to 8/24/88, see Nursing Home Administrators Board of Examiners[600], Ch 2]
645—141.1(155) Definitions. For purposes of these rules, the following definitions shall apply:
“Active license” means a license that is current and has not expired.
“Administrator” means a licensed nursing home administrator.
“Board” means the board of nursing home administrators.
“Grace period” means the 30-day period following expiration of a license when the license is still considered to be active.
“HSE” means a Health Services Executive as designated by the National Association of Boards of Examiners of Long Term Care Administrators.
“Inactive license” means a license that has expired because it was not renewed by the end of the grace period.
“Licensee” means any person licensed to practice as a nursing home administrator in the state of Iowa.
“License expiration date” means December 31 of odd-numbered years.
“Licensure by endorsement” means the issuance of an Iowa license to practice nursing home administration to an applicant who is or has been licensed in another state.
“NAB” means National Association of Boards of Examiners of Long Term Care Administrators.
“Preceptor” means a person who is currently licensed as a nursing home administrator and is approved by the department to supervise a person in a mentoring or administrator training program.
“Provisional license” means a license issued to an administrator appointed on a temporary basis to perform the duties of a nursing home administrator.
“Reactivate” or “reactivation” means the process as outlined in rule 645—141.15(17A,147,272C) by which an inactive license is restored to active status.
“Reinstatement” means the process as outlined in rule 645—11.31(272C) by which a licensee who has had a license suspended or revoked or who has voluntarily surrendered a license may apply to have the license reinstated, with or without conditions.
[ARC 7971C, IAB 5/15/24, effective 6/19/24]
645—141.2(155) Requirements for licensure. The following criteria shall apply to licensure:
	141.2(1) Submit a completed online application and pay the nonrefundable licensure fee specified in rule 645—5.10(147,155);
	141.2(2) Provide verification of certification as an HSE through NAB; or
	141.2(3) Provide verification of the following:
	a. 	Transcripts verifying a baccalaureate or postbaccalaureate degree sent directly from an accredited college or university;
	b. 	Passing score on all required national NAB examinations and meeting all other licensure requirements to be approved to take all required national NAB examinations;
	c. 	Completion of one of the following:
	(1)	Administrator training program;
	(2)	Practicum in long-term health care completed through an accredited college or university; or
	(3)	2,080 hours of long-term health care administration or health-care-related experience in a nursing home may be approved by the board.
	141.2(4) An applicant who has been licensed in another state will provide verification of license from the jurisdiction in which the applicant has most recently been licensed, sent directly from the jurisdiction to the board office. The applicant must also disclose any public or pending complaints against the applicant in any other jurisdiction. Web-based verification may be substituted for verification direct from the jurisdiction’s board office if it provides:
	a. 	Licensee’s name;
	b. 	Date of initial licensure;
	c. 	Current licensure status; and
	d. 	Any disciplinary action taken against the licensee.
[ARC 7971C, IAB 5/15/24, effective 6/19/24]
645—141.3(147,155) Foreign-trained applicants. Foreign-trained nursing home administrators will:
	141.3(1) Provide an equivalency evaluation of their educational credentials by International Educational Research Foundation, Inc., Credentials Evaluation Service. A candidate will be responsible for the expense of the curriculum evaluation.
	141.3(2) Provide a copy of the certificate or diploma awarded to the applicant from a nursing home administration program in the country in which the applicant was educated.
	141.3(3) Provide satisfactory evidence of completion of administrator training program, practicum or 2,080 hours of work experience in long-term health care administration.
[ARC 7971C, IAB 5/15/24, effective 6/19/24]
645—141.4(155) Preceptor qualifications. Preceptor qualifications are as follows:
	141.4(1) Current licensure and at least two years of experience as a nursing home administrator.
	141.4(2) Completion of a preceptor training course prior to the preceptorship.
	141.4(3) Preceptor has not had the preceptor’s nursing home administrator license disciplined, limited, suspended, or placed on probation during the one year immediately prior to the approval to act as a preceptor.
	141.4(4) Is not related to the training administrator.
[ARC 7971C, IAB 5/15/24, effective 6/19/24]
645—141.5(155) Provisional license. A provisional license may be issued to an administrator appointed on a temporary basis to perform the duties of a nursing home administrator. A provisional license is considered a temporary appointment, and the person appointed may serve as an administrator for a period of time not to exceed 12 months in an entire career. The 12 months in service are not required to be consecutive; however, a new application is required for each appointment period. It is the responsibility of the approved provisional administrator to maintain documentation of the actual dates the administrator serves in that capacity.
	141.5(1) The limited circumstances under which the request for a provisional appointment will be granted include the inability of the licensed administrator to perform the administrator’s duties, the death of the licensed administrator, or circumstances that prevent the immediate transfer of the licensed administrator’s duties to another licensed administrator. A provisional license will not be issued to a licensed nursing home administrator.
	141.5(2) Application for a provisional license shall be in writing on forms prescribed by the board. Applicants will meet the following minimum qualifications:
	a. 	Be at least 18 years of age.
	b. 	Be employed on a full-time basis of no less than 40 hours per week to perform the duties of the nursing home administrator.
	c. 	Be knowledgeable about the nursing home administrator’s domains of practice, including resident care, human resources, finance, physical environment, and leadership and management.
	d. 	Be without a history of unprofessional conduct or denial of or disciplinary action against a license to practice nursing home administration or any other profession by any lawful licensing authority for reasons outlined in 645—Chapter 144.
	e. 	Provide evidence to establish that the provisional appointment will not exceed the lifetime maximum period of 12 calendar months in duration. For any period in which the applicant previously served as a provisional administrator, written employment verification or a written attestation of the facility owner, chief operating officer, or board officer will satisfy this requirement.
	f. 	Provide evidence that the provisional appointment complies with the requirements in 481—subrule 58.8(4). A written attestation of the facility owner, chief operating officer, or board officer will satisfy this requirement.
	141.5(3) Applications for an extension of the time period for the provisional appointment within the same facility do not require the payment of an additional fee, as long as all other requirements stated in this rule are met.
	141.5(4) The board expressly reserves the right to withdraw approval of a provisional appointment. Withdrawal of approval will be based on information or circumstances warranting such action. The provisional administrator will be notified of the withdrawal of approval in writing by certified mail.
[ARC 7971C, IAB 5/15/24, effective 6/19/24]
645—141.6(155) Licensure by endorsement.
	141.6(1) An applicant who has been a licensed nursing home administrator under the laws of another jurisdiction will file an application for licensure by endorsement with the board office. The board may receive by endorsement any applicant from the District of Columbia or another state, territory, province or foreign country who:
	a. 	Meets the requirements of rule 645—141.2(155).
	b. 	Provides evidence of an active license as a nursing home administrator for at least two years just prior to application, or meets the qualifications outlined in rule 645—141.4(155).
	141.6(2) Licensure by verification. A person who is licensed in another jurisdiction but who is unable to satisfy the requirements for licensure by endorsement may apply for licensure by verification, if eligible, in accordance with rule 645—19.1(272C).
[ARC 7971C, IAB 5/15/24, effective 6/19/24]
645—141.7(147,155) License renewal.
	141.7(1) The biennial license renewal period for a license to practice nursing home administration will begin on January 1 of each even-numbered year and end on December 31 of the next odd-numbered year. All licensees will renew on a biennial basis. The licensee is responsible for renewing the license prior to its expiration.
	141.7(2) An individual who was issued a license within six months of the license renewal date does not need to renew the license until the subsequent renewal two years later.
	141.7(3) A licensee applying for renewal shall:
	a. 	Meet the continuing education requirements of rule 645—143.2(272C) and the mandatory reporting requirements of subrule 141.9(8). A licensee whose license was reactivated during the current renewal compliance period may use continuing education credit earned during the compliance period for the first renewal following reactivation; and
	b. 	Submit the completed renewal application and renewal fee before the license expiration date.
	141.7(4) A two-year license will be issued after the requirements of this rule are met. If the board receives adverse information on the renewal application, the board shall issue the renewal license but may refer the adverse information for further consideration or disciplinary investigation.
	141.7(5) Late renewal. The license will become late when the license has not been renewed by the expiration date on the renewal. The licensee will be assessed a late fee as specified in 645—subrule 5.10(3). To renew a late license, the licensee will complete the renewal requirements and submit the late fee within the grace period.
	141.7(6) Inactive license. A licensee whose license is inactive continues to hold the privilege of licensure in Iowa, but may not practice as a nursing home administrator in Iowa until the license is reactivated.
	141.7(7) Licensees will display their license certificate and proof of active licensure will be in a conspicuous public place at the primary site of practice.
	141.7(8) Mandatory reporter training requirements.
	a. 	A licensee who examines, attends, counsels, or treats children, dependent adults, or both in the scope of the licensee’s professional practice will complete the applicable department of health and human services training relating to the identification and reporting of child abuse, dependent adult abuse, or both. Written documentation of training completion should be maintained for three years. The training is not required if the licensee is engaged in active duty military service or holds a waiver demonstrating a hardship in complying with these training requirements.
	b. 	The board may select licensees for audit of compliance with the requirements in subrule 141.7(8).
[ARC 7971C, IAB 5/15/24, effective 6/19/24]
645—141.8(17A,147,272C) License reactivation. To apply for reactivation of an inactive license, a licensee shall:
	141.8(1) Submit a completed online reactivation application and pay the nonrefundable application fee.
	141.8(2) Provide verification of current competence to practice as a nursing home administrator by satisfying the following criteria:
	a. 	Verification of the license from the jurisdiction in which the applicant has most recently been practicing during the time period the Iowa license was inactive, sent directly from the jurisdiction to the board office. The applicant must also disclose any public or pending complaints against the applicant in any other jurisdiction. Web-based verification may be substituted for verification from a jurisdiction’s board office if the verification includes:
	(1)	Licensee’s name;
	(2)	Date of initial licensure;
	(3)	Current licensure status; and
	(4)	Any disciplinary action taken against the license; and
	b. 	Verification of completion of 40 hours of continuing education within two years of the application for reactivation or verification of active practice, consisting of a minimum of 2,080 hours, in another state or jurisdiction during the two years preceding an application for reactivation.
[ARC 7971C, IAB 5/15/24, effective 6/19/24]
645—141.9(17A,147,272C) License reinstatement. A licensee whose license has been revoked, suspended, or voluntarily surrendered must apply for and receive board-approved reinstatement of the license and must apply for and be granted reactivation of the license prior to practicing as a nursing home administrator in this state.
[ARC 7971C, IAB 5/15/24, effective 6/19/24]
These rules are intended to implement Iowa Code chapters 17A, 147, 155, and 272C.
[Filed 2/23/71]
[Filed 3/19/76, Notice 2/9/76—published 4/5/76, effective 5/10/76]
[Filed 11/18/76, Notice 9/22/76—published 12/15/76, effective 1/19/77]
[Filed 8/28/78, Notice 3/8/78—published 9/20/78, effective 10/25/78]
[Filed 12/8/78, Notice 9/20/78—published 12/27/78, effective 1/31/79]
[Filed 10/19/79, Notice 8/22/79—published 11/14/79, effective 12/21/79]1
[Filed emergency 12/18/79—published 1/9/80, effective 12/18/79]
[Filed 5/7/80, Notice 4/2/80—published 5/28/80, effective 7/7/80]
[Filed emergency 6/9/80—published 7/9/80, effective 7/7/80]
[Filed 3/13/81, Notice 12/24/80—published 4/1/81, effective 5/7/81]
[Filed 8/14/81, Notice 6/10/81—published 9/2/81, effective 10/7/81]
[Filed 3/18/82, Notice 2/3/82—published 4/14/82, effective 5/19/82]
[Filed 10/6/83, Notice 7/20/83—published 10/26/83, effective 12/1/83]
[Filed emergency 11/30/83 after Notice 10/26/83—published 12/21/83, effective 11/30/83]
[Filed 5/11/84, Notice 3/14/84—published 6/6/84, effective 7/12/84]
[Filed 7/13/84, Notice 6/6/84—published 8/1/84, effective 9/5/84]◊
[Filed 11/8/84, Notice 9/12/84—published 12/5/84, effective 1/9/85]
[Filed 1/11/85, Notice 11/7/84—published 1/30/85, effective 3/6/85]
[Filed 4/4/85, Notice 12/5/84—published 4/24/85, effective 5/29/85]
[Filed 7/10/85, Notice 6/5/85—published 7/31/85, effective 9/4/85]
[Filed 1/17/86, Notice 8/14/85—published 2/12/86, effective 3/21/86]
[Filed 8/5/88, Notice 3/23/88—published 8/24/88, effective 9/28/88]
[Filed 2/17/89, Notice 12/14/88—published 3/8/89, effective 4/12/89]
[Filed 11/22/89, Notice 9/20/89—published 12/13/89, effective 1/17/90]
[Filed 4/13/90, Notice 2/21/90—published 5/2/90, effective 6/6/90]
[Filed 7/20/90, Notice 4/4/90—published 8/8/90, effective 9/12/90]◊
[Filed 3/15/91, Notice 12/26/90—published 4/3/91, effective 5/8/91]
[Filed emergency 8/16/91—published 9/4/91, effective 8/16/91]
[Filed 2/13/92, Notice 12/25/91—published 3/4/92, effective 4/8/92]
[Filed 8/25/95, Notice 3/15/95—published 9/13/95, effective 10/18/95]2
[Filed 9/4/98, Notice 7/15/98—published 9/23/98, effective 10/28/98]
[Filed 6/11/99, Notice 4/7/99—published 6/30/99, effective 8/4/99]
[Filed 10/29/99, Notice 9/8/99—published 11/17/99, effective 12/22/99]
[Filed 9/29/00, Notice 7/26/00—published 10/18/00, effective 11/22/00]
[Filed 5/11/01, Notice 3/21/01—published 5/30/01, effective 7/4/01]
[Filed 10/21/04, Notice 8/18/04—published 11/10/04, effective 12/15/04]
[Filed 7/21/05, Notice 4/27/05—published 8/17/05, effective 9/21/05]◊
[Filed 1/20/06, Notice 11/9/05—published 2/15/06, effective 3/22/06]
[Filed 10/19/06, Notice 8/2/06—published 11/8/06, effective 12/13/06]
[Filed ARC 7576B (Notice ARC 7285B, IAB 10/22/08), IAB 2/11/09, effective 3/18/09]
[Filed ARC 0024C (Notice ARC 9801B, IAB 10/5/11), IAB 2/22/12, effective 3/28/12]3
[Editorial change: IAC Supplement 3/21/12]
[Filed ARC 0797C (Notice ARC 0651C, IAB 3/20/13), IAB 6/26/13, effective 7/31/13]
[Filed ARC 5070C (Notice ARC 4936C, IAB 2/26/20), IAB 7/1/20, effective 8/5/20]
[Filed ARC 5775C (Notice ARC 5453C, IAB 2/24/21), IAB 7/14/21, effective 8/18/21]
[Filed ARC 6995C (Notice ARC 6657C, IAB 11/16/22), IAB 4/19/23, effective 5/24/23]
[Filed ARC 7971C (Notice ARC 7476C, IAB 1/10/24), IAB 5/15/24, effective 6/19/24]
◊	Two or more ARCs
1	Effective date of rule 600—2.7 delayed by the Administrative Rules Review Committee 70 days.
2	Effective date of 645—subrule 141.3(2), delayed until adjournment of the 1996 General Assembly by the Administrative Rules Review Committee at its meeting held October 10, 1995.
3	March 28, 2012, effective date of 141.9(1) delayed 70 days by the Administrative Rules Review Committee at its meeting held March 12, 2012.