TITLE 24

Professions and Occupations

CHAPTER 52. NURSING HOME ADMINISTRATORS

Subchapter II. License


(a) No person shall engage in the practice of nursing home administration or hold himself or herself out to the public in this State as being qualified to act as nursing home administrator; or use in connection with that person's own name, or otherwise assume or use, any title or description conveying or tending to convey the impression that the person is qualified to act as nursing home administrator, unless such person has been duly licensed under this chapter.

(b) Whenever a license to practice as a nursing home administrator in this State has expired or been suspended or revoked, it shall be unlawful for the person to act as a nursing home administrator in this State.

(c) No person shall act as a nursing home administrator-in-training, or hold out that that person is a nursing home administrator-in-training, unless such person has been duly registered by the Board under this chapter.

76 Del. Laws, c. 89, § 1; 70 Del. Laws, c. 186, § 1.;

(a) Applicants for original licensure, licensure by reciprocity, temporary licensure, registration, or licensure renewal shall submit, at the applicant's expense, fingerprints and other necessary information in order to obtain the following:

(1) A report of the applicant's entire criminal history record from the State Bureau of Identification or a statement from the State Bureau of Identification that the State Central Repository contains no such information relating to that person; and

(2) A report of the applicant's entire federal criminal history record pursuant to the Federal Bureau of Investigation appropriation of Title II of Public Law 92-544 (28 U.S.C. § 534).

(b) The State Bureau of Identification shall be the intermediary for purposes of this section and the Board of Examiners of Nursing Home Administrators shall be the screening point for the receipt of said federal criminal history records.

76 Del. Laws, c. 89, § 1.;

(a) An applicant applying for original licensure as a nursing home administrator under this chapter shall submit evidence, verified by oath and satisfactory to the Board, that such person:

(1) Has completed a Board-approved course of study in nursing home administration at an accredited educational institution and meets the educational and experience requirements of the Board, including:

a. Having received a baccalaureate or graduate degree from an accredited college or university with a major in health and human services, hospital administration, nursing or business administration; has been registered by the Board; and successfully completed a 6-month, pre-approved nursing home AIT program under the direct supervision of a Board-approved preceptor; or

b. Having received a baccalaureate or graduate degree in a field other than health and human services, hospital administration, nursing or business administration; has been registered by the Board; and successfully completed a 9-month, pre-approved nursing home AIT program under the direct supervision of a Board-approved preceptor; or

c. Having received an associate degree in any field from an accredited college or university, or holding a current Delaware license as a registered nurse; has been registered by the Board; and successfully completed a 12-month, pre-approved nursing home AIT program under the direct supervision of a Board-approved preceptor;

(2) Has achieved a passing score on all examinations prescribed by the Board;

(3) Has not received any administrative penalties regarding that applicant's own practice as a nursing home administrator, including but not limited to fines, formal reprimands, license suspensions or revocation (other than for nonpayment of renewal fees), probationary limitations, and/or has not entered into any "consent agreements" which contain conditions placed by a licensing board on that applicant's professional conduct and practice, including any voluntary surrender of a license. The Board may determine after a hearing whether an administrative penalty is grounds to deny licensure;

(4) Does not have any impairment related to drugs or alcohol that would limit the applicant's ability to act as a nursing home administrator in a manner consistent with the safety of the public;

(5) Has not been adjudicated mentally incompetent by any court or administrative entity under any circumstances that would limit the applicant's ability to act as a nursing home administrator in a manner consistent with the safety of the public. The Board may determine after a hearing whether such mental incompetence is grounds to deny licensure; and

(6) Has complied with the provisions of § 5208 of this title regarding criminal background records and does not have a criminal conviction record nor pending criminal charge which is substantially related to nursing home administration. However, after a hearing or review of documentation demonstrating that the applicant meets the specified criteria for a waiver, the Board, by an affirmative vote of a majority of the quorum, may waive this paragraph (a)(6), if it finds all of the following:

a. For waiver of a felony conviction, more than 5 years have elapsed since the date of the conviction. At the time of the application the applicant may not be incarcerated, on work release, on probation, on parole or serving any part of a suspended sentence and must be in substantial compliance with all court orders pertaining to fines, restitution and community service.

b. For waiver of a misdemeanor conviction or violation, at the time of the application the applicant may not be incarcerated, on work release, on probation, on parole or serving any part of a suspended sentence and must be in substantial compliance with all court orders pertaining to fines, restitution and community service.

c. The applicant is capable of practicing nursing home administration in a competent and professional manner.

d. The granting of the waiver will not endanger the public health, safety, or welfare.

(b) If the Board has found to its satisfaction that an applicant has been intentionally fraudulent, or that false information has been intentionally supplied, it shall report its findings to the Attorney General for further action.

(c) If the application of a person has been refused or rejected, and such applicant has reason to believe the Board acted without justification; has imposed higher or different standards for that applicant than for other applicants or licensees; or has in some other manner contributed to or caused the failure of such application, the applicant may appeal to the Superior Court.

64 Del. Laws, c. 159, § 2; 70 Del. Laws, c. 186, § 1; 76 Del. Laws, c. 89, § 1; 77 Del. Laws, c. 199, § 39; 78 Del. Laws, c. 44, §§ 76, 77.;

(a) The Board may, upon the written request of a nursing home administrator who wishes to act as a preceptor, register an individual as a nursing home administrator-in-training under the following circumstances:

(1) The preceptor has submitted that preceptor's own request in a form approved by the Board;

(2) The preceptor has been licensed in this State or in any other jurisdiction for at least the 2 years immediately prior to date of the written request;

(3) The written request includes a clear statement by the preceptor agreeing to act as preceptor for the individual for whom that preceptor is seeking registration;

(4) The written request includes a clear statement by the preceptor of the specific functions and responsibilities that the individual for whom the preceptor is seeking registration will perform;

(5) The written request includes a clear statement by both the preceptor and the individual for whom that preceptor is seeking registration indicating that the individual has met the requirements of §§ 5208 and 5209(a)(4) through (a)(6) of this title; and

(6) The written request includes, as attachments when necessary, evidence satisfactory to the Board supporting the veracity of the statement required by paragraph (a)(5) of this section.

(b) Persons presented to the Board by a preceptor shall provide a notarized statement to the Board that they will:

(1) Only perform those specific functions which have been delineated in the preceptor's statement;

(2) Only practice under the direct supervision of a preceptor; and

(3) Not represent themselves to the public, residents, or patients as licensed nursing home administrators.

(c) The preceptor shall be responsible and available to provide direction, observation, aid, training, and instruction to the administrator-in-training, including the submission of progress reports. This is an interactive process between the preceptor and the administrator-in-training intended to ensure the extent, quality, and scope of experience of the duties performed as a nursing home administrator.

(d) The Board, in its regulations, shall determine the number of nursing home administrators-in-training that a preceptor may supervise and the requirements of their supervision.

76 Del. Laws, c. 89, § 1; 70 Del. Laws, c. 186, § 1.;

(a) Immediately upon receipt of an application therefore, the Board may issue a temporary license to an individual who wishes to serve as a temporary nursing home administrator in the event that a facility's licensed nursing home administrator is removed from the position by death or other unexpected cause. The owner, governing body, or other appropriate authority of the nursing home suffering such removal may designate an individual to serve as a temporary nursing home administrator subject to such regulations set forth and approved by the Board. The owner, governing body, or other appropriate authority of the nursing home, not the individual serving as the temporary nursing home administrator, must submit:

(1) A written application for temporary licensure to the Board, in a form approved by the Board, immediately after the individual begins undertaking the functions of a nursing home administrator;

(2) A clear statement that the individual has not held a temporary license issued pursuant to this section within the preceding 12 months;

(3) A clear statement that the individual understands that the temporary license will expire 90 days after the date of its issuance, that the temporary license may only be renewed once, for an additional 90 days, at the Board's discretion, and that the individual is not eligible for a subsequent temporary license within the 12 months immediately following its expiration;

(4) An affidavit from the individual that the individual has 3 years of health care management experience acceptable to the Board; and

(5) Verification that the individual holds either a degree in any field from an accredited college or university or holds a current Delaware license as a registered nurse.

(b) A temporary license issued pursuant to this section shall expire 90 days after the date of its issuance and may only be renewed once, for an additional 90 days, at the Board's discretion. No person having previously been issued a temporary license may, within 12 months following its expiration, be granted a subsequent temporary license pursuant to this section.

(c) The Board shall not grant more than 1 temporary license to be used at a single facility at any 1 time.

(d) The Board shall not grant consecutive temporary licenses for use at a single facility.

(e) No person serving as a nursing home administrator pursuant to this section shall be permitted to concurrently serve as a registered nursing home administrator-in-training.

(f) A temporary license is only valid for the individual named in the license to work as a temporary nursing home administrator in the facility that submitted the temporary licensure application.

(g) The Board shall designate 1 of its members to review temporary licensure applications received between regular Board meetings. The designated Board member will have the authority to approve or deny such applications on behalf of the Board between regular Board meetings. At the subsequent regular Board meeting, the Board will review the temporary licensure application and either ratify or overturn the individual Board member's decision.

76 Del. Laws, c. 89, § 1; 70 Del. Laws, c. 186, § 1.;

The Board shall approve an Administrator-In-Training Program that complies with the guidelines of the National Association of Boards of Long-Term Care Administrators (NAB), and contains at a minimum the following:

(1) Introduction and orientation;

(2) Admission procedures;

(3) Medical records requirements;

(4) Resident rights;

(5) Administration;

(6) Food service;

(7) Nursing;

(8) Housekeeping/maintenance/janitorial;

(9) Medical and allied health;

(10) Recreation;

(11) Rehabilitation services;

(12) Social services;

(13) Disaster/emergency services;

(14) Medicare/Medicaid;

(15) Professional ethics; and

(16) Applicable state and federal laws and regulations.

76 Del. Laws, c. 89, § 1.;

Upon payment of the appropriate fee and submission and acceptance of a written application on forms provided by the Board:

(1) The Board shall grant a license to each applicant who presents proof of current licensure in "good standing" in another state, the District of Columbia, or territory of the United States, whose standards for licensure are substantially similar to those of this State; and

(2) The Board may grant a license to an applicant who presents proof of current licensure in "good standing" in another state, the District of Columbia, or territory of the United States, whose standards are not substantially similar to those of this state, provided that the applicant shall have practiced in that state for a minimum of 3 years after licensure; and provided further that the applicant would not be prohibited from being licensed pursuant to this chapter because of that applicant's criminal or administrative record, any impairment related to drugs or alcohol, or mental incompetence.

64 Del. Laws, c. 159, § 2; 70 Del. Laws, c. 186, § 1; 76 Del. Laws, c. 89, § 1.;

The amount to be charged for each fee imposed under this chapter shall approximate and reasonably reflect all costs necessary to defray the expenses of the Board, as well as the proportional expenses incurred by the Division of Professional Regulation in its service on behalf of the Board. At the beginning of each licensure biennium, the Division of Professional Regulation, or any other state agency acting in its behalf, shall compute, for each separate service or activity, the appropriate Board fees for the licensure biennium.

64 Del. Laws, c. 159, § 2; 76 Del. Laws, c. 89, § 1.;

(a) The Board shall issue a license to each applicant, who meets the requirements of this chapter for licensure as a nursing home administrator and who pays the fee established under § 5214 of this title.

(b) Each license shall be renewed biennially, in such manner as is determined by the Division of Professional Regulation, and upon payment of the appropriate fee and submission of a renewal form provided by the Division of Professional Regulation, and proof that the licensee has met the continuing education requirements established by the Board.

(c) The Board, in its rules and regulations, shall determine the period of time within which a licensed nursing home administrator may still renew that administrator's own license, notwithstanding the fact that such licensee has failed to renew on or before the renewal date.

(d) A licensee, upon written request, may be placed in an inactive status in accordance with the Board's rules and regulations. Such person may reenter practice upon written notification to the Board of the intent to do so and completion of continuing education as required in the Board's rules and regulations. The renewal fee of such person shall be prorated according to the amount of time such person was inactive.

64 Del. Laws, c. 159, § 2; 70 Del. Laws, c. 186, § 1; 76 Del. Laws, c. 89, § 1.;

(a) A practitioner licensed under this chapter shall be subject to disciplinary actions set forth in § 5218 of this title, if, after a hearing, the Board finds that the nursing home administrator:

(1) Has employed or knowingly cooperated in fraud or material deception in order to acquire a license as a nursing home administrator; has impersonated another person holding a license, or allowed another person to use that practitioner's own license, or aided or abetted a person not licensed as a nursing home administrator to represent himself or herself as a nursing home administrator;

(2) Has illegally, incompetently or negligently practiced nursing home administration;

(3) Has been convicted of any offense, which is substantially related to the practice of nursing home administration. A copy of the record of conviction certified by the clerk of the court entering the conviction shall be conclusive evidence therefore;

(4) Has excessively used or abused drugs either in the past 2 years or currently;

(5) Has engaged in an act of abuse, neglect, mistreatment or financial exploitation of a nursing home resident or patient;

(6) Has violated a lawful provision of this chapter, or any lawful regulation established thereunder;

(7) Has had that practitioner's own license as a nursing home administrator suspended or revoked, or other disciplinary action taken by the appropriate licensing authority in another jurisdiction; provided, however, that the underlying grounds for such action in another jurisdiction have been presented to the Board by certified record; and the Board has determined that the facts found by the appropriate authority in the other jurisdiction constitute 1 or more of the acts defined in this chapter. Every person licensed as a nursing home administrator in this State shall be deemed to have given consent to the release of this information by the Board of Examiners of Nursing Home Administrators or other comparable agencies in another jurisdiction and to waive all objections to the admissibility of previously adjudicated evidence of such acts or offenses;

(8) Has failed to notify the Board that the practitioner's own license as a nursing home administrator in another state has been subject to discipline, or has been surrendered, suspended or revoked. A certified copy of the record of disciplinary action, surrender, suspension or revocation shall be conclusive evidence thereof; or

(9) Has a physical condition such that the performance of nursing home administration is or may be injurious or prejudicial to the public.

(b) Subject to the provisions of subchapter IV of Chapter 101 of Title 29, no license shall be restricted, suspended or revoked by the Board, and no practitioner's right to practice nursing home administration shall be limited by the Board until such practitioner has been given notice, and an opportunity to be heard, in accordance with the Administrative Procedures Act [Chapter 101 of Title 29].

64 Del. Laws, c. 159, § 2; 70 Del. Laws, c. 186, § 1; 76 Del. Laws, c. 89, § 1.;

(a) All complaints shall be received and investigated by the Division of Professional Regulation in accordance with § 8735 of Title 29, and the Division shall be responsible for issuing a final written report at the conclusion of its investigation.

(b) When it is determined that an individual is engaging, or has engaged, in the practice of nursing home administration, or is using the title "nursing home administrator" or other title implying that the individual is competent to act as a "nursing home administrator" and is not licensed under the laws of this State, the Board shall apply to the Office of the Attorney General to issue a cease and desist order.

64 Del. Laws, c. 159, § 2; 65 Del. Laws, c. 355, § 1; 70 Del. Laws, c. 186, § 1; 76 Del. Laws, c. 89, § 1.;

(a) The Board may impose any of the following sanctions, singly or in combination, when it finds that 1 of the conditions or violations set forth in § 5216 of this title applies to a practitioner regulated by this chapter:

(1) Issue a letter of reprimand;

(2) Censure a practitioner;

(3) Place a practitioner on probationary status, and require the practitioner to:

a. Report regularly to the Board upon the matters, which are the basis of the probation;

b. Limit all practice and professional activities to those areas prescribed by the Board;

(4) Suspend any practitioner's license;

(5) Revoke any practitioner's license;

(6) Impose a monetary penalty not to exceed $500 for each violation.

(b) The Board may withdraw or reduce conditions of probation when it finds that the deficiencies, which required such action, have been remedied.

(c) In the event of a formal or informal complaint concerning the activity of a licensee that presents a clear and immediate danger to the public health, safety or welfare, the Board may temporarily suspend the person's license, pending a hearing, upon the written order of the Secretary of State or the Secretary's designee, with the concurrence of the Board chair or the Board chair's designee. An order temporarily suspending a license may not be issued unless the person or the person's attorney received at least 24 hours' written or oral notice before the temporary suspension so that the person or the person's attorney may file a written response to the proposed suspension. The decision as to whether to issue the temporary order of suspension will be decided on the written submissions. An order of temporary suspension pending a hearing may remain in effect for no longer than 60 days from the date of the issuance of the order unless the temporarily suspended person requests a continuance of the hearing date. If the temporarily suspended person requests a continuance, the order of temporary suspension remains in effect until the hearing is convened and a decision is rendered by the Board. A person whose license has been temporarily suspended pursuant to this section may request an expedited hearing. The Board shall schedule the hearing on an expedited basis, provided that the Board receives the request within 5 calendar days from the date on which the person received notification of the decision to temporarily suspend the person's license.

(d) When a license has been suspended due to a disability of the licensee, the Board may reinstate such license if, after a hearing, the Board is satisfied that the licensee is able to practice with reasonable skill and safety.

64 Del. Laws, c. 159, § 2; 70 Del. Laws, c. 186, § 1; 74 Del. Laws, c. 262, § 96; 75 Del. Laws, c. 436, § 51; 76 Del. Laws, c. 89, § 1; 79 Del. Laws, c. 213, § 2.;

(a) If a complaint is filed with the Board pursuant to § 8735 of Title 29, alleging violation of § 5216 of this title, the Board shall set a time and place to conduct a hearing on the complaint. Notice of the hearing shall be given and the hearing shall be conducted in accordance with the Administrative Procedures Act, Chapter 101 of Title 29.

(b) All hearings shall be informal without use of rules of evidence. If the Board finds, by a majority vote of all members, that action or actions constituting grounds for discipline have been proven, the Board shall take such action permitted under this chapter, as it deems necessary. The Board's decision shall be in writing and shall include its reasons for such decision. The Board's decision shall be mailed immediately to the practitioner.

(c) If the practitioner is in disagreement with the action of the Board, that practitioner may appeal the Board's decision to the Superior Court within 30 days of service, or of the postmarked date of the copy of the decision mailed to the practitioner whichever is greater. Stays shall be granted in accordance with § 10144 of Title 29.

64 Del. Laws, c. 159, § 2; 70 Del. Laws, c. 186, § 1; 76 Del. Laws, c. 89, § 1.;

(a) As a condition to reinstatement of a suspended license, or removal from probationary status, the Board may reinstate such license if, after a hearing, the Board is satisfied that the licensee has taken the prescribed corrective actions and otherwise satisfied all of the conditions of the suspension and/or the probation.

(b) Applicants for reinstatement must pay the appropriate fees and submit documentation required by the Board as evidence that all the conditions of a suspension and/or probation have been met. Proof that the applicant has met the continuing education requirements of this chapter may also be required, as appropriate.

(c) A new license to replace any license lost, destroyed or mutilated may be issued subject to the rules of the Board. A charge shall be made for such issuance.

64 Del. Laws, c. 159, § 2; 74 Del. Laws, c. 262, § 97[1]; 76 Del. Laws, c. 89, § 1.;