The steps to becoming licensed as a nursing home administrator in Maryland are:
Licensure Through the Administrator-In-Training (AIT) Program:
1. Have a baccalaureate or masters degree from an accredited college or university, plus 100 hours in a course of study in health care administration approved by the Board. The 100 hours may be waived if the baccalaureate or masters degree is in health care administration. The 100 hours may be taken while the applicant for licensure is in a registered AIT program. (The Board may waive the baccalaureate degree requirement for an individual who was licensed and practiced as a nursing home administrators for at least 3 years in another state, or if the individual is a registered nurse who has an associates in arts degree in nursing or is a diplomate nurse and has been working as a nursing home director of nursing for a period of at least 5 years, with at least 3 years experience at the same facility, prior to the date the applicant submits an application to the Board for a license.) The 100 hours in a course of study in health care administration can be completed online through the University of North Carolina at Chapel Hill (www.longtermcareeducation.com) or the St. Joseph’s College of Maine (www.sjcme.edu).
2. Download the Application for the AIT program and AIT Guidelines forms (Application for Administrator-in-Training Administrator-in-Training Guidelines), or contact the Board’s office and request a copy (410-764-4750).
3. Contact the nursing home administrator (NHA) of a facility and ask if they would be willing to accept you as an AIT. The AIT program is a supervised 12-month full-time (40 hours per week) or 18-month part-time (30 hours per week) internship during which you will work under the guidance and supervision of a preceptor, a licensed NHA meeting the qualifications set forth in 10.33.01.14. The AIT program is a required phase of education consisting of both the supervised practice of nursing home administration in the environment of the nursing facility, performing and participating in the day-to-day duties of each position, when legally permissible, in each of the following service areas: Administration, Business office, Nursing, Resident activities, Social services, Medical records, Dietary, Maintenance, Environmental, Rehabilitation services, and Quality assurance. To assist you in locating a site to complete the training, the Office of Health Care Quality offers a directory of comprehensive care nursing facilities licensed in Maryland. This directory is set up by county, and you can call the facilities closest to you geographically, and expand your search as needed. The link to this directory is http://www.dhmh.maryland.gov/ohcq/docs/Provider-Listings/PDF/WEB_LTC.pdf. If you train in a nursing facility with less than 60 beds, you will have to spend half of the program in a larger facility.
4. Complete the application and AIT outline. In addition to the application, you will need to submit two character reference letters, a current certificate of health, college transcripts, a passport type photo, and documentation of prior experience within the past five years. If you are currently a department head or assistant administrator, you must also send a letter stating who the acting department head or assistant will be while you are in the program.
If you believe you qualify for credit toward the one year of training, review section 10.33.01.13H. If you meet all the qualifying criteria for a particular category eligible for credit, the Board may award from 3 to 6 months credit toward the one year of training.
5. Appear before the Credentials Committee. After your application and AIT program outline are received in the Board’s office, you will be scheduled to appear before a credentials committee from the Board. They will review any relevant prior experience and explain what the Board’s expectations are for the AIT and preceptor during the training program. The Committee will present your AIT program to the full Board for its review and official approval. The Credentials Committee meets the first Tuesday of every month except January, July and August (If the first Tuesday is the day before the second Wednesday, the meeting will be held the last Tuesday of the month). The application and supporting documentation must be received in the office by the 15th of the month preceding your appearance. There is a $100 nonrefundable application fee due at the time the application is submitted.
6. Examinations - After completing a minimum of eight months of the AIT program, or the equivalent (if credit is awarded), and completing the 100-hour course (if required), you can sit for the National (NAB) and the State’s Standards examinations. Both the NAB exam and the State's Standards exam are administered online, and you can visit the NAB website for more information at www.nabweb.org. The State exam is 100 questions with 55 questions coming from the 10.07.02 Code of Maryland Regulations, 20 questions from 10.07.09, 10 questions from 10.09.10, 5 questions from 10.09.24, and 10 questions from 10.15.03. All fees for the exams are charged by, and payable to, the Professional Examination Service (PES). No additional fees for the exams are charged by the Board.
7. Final Approval. After completing the required training and 100-hour course, and passing both examinations, your file will be taken back before the Board for final approval. Once you are approved for licensure, there will be one last payment of $200 for the license itself.
Licensure Through Endorsement:
1. Have a baccalaureate or masters degree from an accredited college or university, plus 100 hours in a course of study in health care administration approved by the Board. The 100 hours may be waived if the baccalaureate or masters degree is in health care administration. The Board may waive the baccalaureate degree requirement for an individual who was licensed and practiced as a nursing home administrator for at least 3 years in another state.
2. Download the Application for Endorsement and Verification of Licensure forms. Along with the application, please submit documentation of having worked as the administrator of record at a nursing facility for at least one year within the past five years. Along with your application, you must also submit two character reference letters, a current certificate of health, passport type photo, answer the character and fitness questions on the application, and submit verification of licensure from all states where you hold or have held a license as a nursing home administrator. Documentation of successful completion of the national examination must also be submitted, either from the Professional Examination Service, or from the State that administered the examination. The nonrefundable application fee is $100.
3. Pass the Maryland State’s Standards examination. The State’s Standards exam is a computer-based test available online through the National Association of Long Term Care Administrator Boards (NAB). The exam consists of 100 questions with 55 questions coming from the 10.07.02 Code of Maryland Regulations, 20 questions from 10.07.09, 10 questions from 10.09.10, 5 questions from 10.09.24, and 10 questions from 10.15.03. The regulations can be e-mailed to you by our office, or we can mail you a compact disk containing all six Code of Maryland Regulations that are covered on the exam. The State’s Standards exam fee is charged by, and payable to, the Professional Examination Service (PES). After you have passed the State's Standards exam and have been approved by the Board, the final payment to the Board will be a $200 license fee.
How to be a Preceptor
A preceptor is a licensed Nursing Home Administrator who has met the qualifications listed below, and is certified by the Board to train candidates in the Administrator-In-Training (AIT) program.
How to become certified as a preceptor in Maryland
A preceptor must have three years of experience as a nursing home administrator, be licensed in Maryland for a minimum of one year, and complete the preceptor certification course. A preceptor must have been employed full time as a nursing home administrator for a minimum of 2 of the past 3 years immediately before application to preceptor. If the proposed preceptor has not precepted an AIT program within the past 5 years, the proposed preceptor shall recertify as a preceptor by completing a Board-approved training program.
The preceptor shall perform direct on-site communication/conferences and/or supervision of the AIT as required by the specific program.
Regular personal contact between the preceptor and the AIT is necessary, and every effort should be made to guide the AIT toward the ethics, philosophies and practices that should be required to promote the formation of a professional Nursing Home Administrator.
Joint conferences may be planned with other nursing home administrative personnel for instructive purposes (e.g. utilization review, staff meetings, fire drills, etc.) with the preceptor in attendance.
Delegation of instructive learning experiences to other nursing home personnel shall not replace the preceptor's prime responsibility for direct on-site conference. The preceptor must spend a minimum of 16 hours per week providing direct, on-site supervision to the AIT.
If specific areas of concern are not available in the designated nursing home (e.g. Medicare certification, department cost analysis, purchasing supplies, unionization, etc.), plans for provision of these topics should be designated elsewhere.
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