Policies

Policy: Administrator Investigation Following Substandard Quality Care Finding

Policy Statement
The North Dakota Board of Examiners for Nursing Home Administrators (NDBOENHA) may initiate an investigation to determine whether disciplinary action is warranted against a licensed administrator when notified by the North Dakota Department of Health of a facility’s finding of substandard quality care.

Procedure

1. The Executive Director will receive the CMS-2567 report from the Department of Health.

2. The Executive Director will consult with the Department to clarify the nature and severity of the cited deficiencies.

3. A formal report will be presented to the Board for review.

4. The Board will assess whether the situation constitutes grounds for disciplinary action under Administrative Rule 55-02-01-17. If so, appropriate steps will be taken under Rule 55-02-01-18.

5. The administrator and any relevant parties will be notified of the Board’s determination.

6. The Board will consult with legal counsel to ensure compliance with legal and procedural standards.

Policy History
Adopted: October 13, 1994
Revised: July 13, 1995; July 13, 2000; December 4, 2014; January 28, 2016; January 12, 2018; January 13, 2023

Policy: Complaint Review Process

Policy Statement
The North Dakota Board of Examiners for Nursing Home Administrators (NDBOENHA) is committed to reviewing all written complaints submitted against licensed administrators in a fair, timely, and consistent manner.

Procedure

1. Upon receiving a written complaint, the Board Chair will send an acknowledgment letter to the complainant.

2. A copy of the complaint will be forwarded to the administrator named in the complaint.

3. The complaint will be distributed to all members of the Board for review.

4. The Board will evaluate the complaint in accordance with North Dakota Administrative Code 55-02-01-18 and determine whether further action is warranted.

5. Legal counsel will be consulted as necessary to ensure proper handling and compliance with all applicable laws and regulations.

Policy History
Adopted: October 13, 1994
Revised: July 13, 2000; December 4, 2014

Policy: Nursing Home Administrators National Examination

Policy Statement
The North Dakota Board of Examiners for Nursing Home Administrators (NDBOENHA) utilizes the National Association of Long Term Care Administrator Boards (NAB) Computer-Based Testing system for the national licensure exam. All exam fees are paid directly to NAB.

Procedure

1. The NAB exam is administered via computer-based testing.

2. Exam scores are retained by the Board for 24 months to support future initial licensure in North Dakota.

3. Upon request, the Board may also report an individual’s test score to another state licensing board.

4. For more information or to register for the NAB exam, visit www.nabweb.org.

Legal and Procedural Compliance
The Board will consult with legal counsel as needed to ensure adherence to applicable laws and standards.

Policy History
Adopted: October 13, 1994
Revised: July 13, 2000; December 4, 2014; January 13, 2023

Policy: Nominating Committee and Board Officer Elections

Policy Statement
The North Dakota Board of Examiners for Nursing Home Administrators (NDBOENHA) maintains a structured nomination and election process to ensure effective leadership within the Board. A nominating committee, appointed by the Board Chair, is responsible for presenting officer nominations.

Procedure

1. Nominations:

   • A nominating committee is appointed by the Chair prior to the second Board meeting of even-numbered years.

   • The committee presents nominations for Board officer positions at that meeting.

2. Elections & Terms:

   • Officer elections are held at the second meeting of even-numbered years.

   • Elected officers assume their roles at the first meeting of the following year.

   • Officers serve a two-year term and may be re-elected once for a consecutive term (maximum of two two-year terms).

3. Board Officer Roles:

   • Chairperson: Presides over all Board meetings.

   • Vice Chairperson: Assumes the duties of the Chair when absent.

   • Secretary/Treasurer:

     • Records meeting minutes

     • Notifies members of meetings

     • Maintains administrator records

     • Handles correspondence and financial records

     • May delegate duties to the Executive Director with Board approval

Legal and Procedural Compliance
The Board will consult legal counsel as needed to ensure the nomination and election process aligns with statutory and regulatory requirements.

Policy History
Adopted: October 13, 1994
Revised: July 13, 2000; December 4, 2014; January 28, 2016

Policy: Professional Courtesy Regarding File Requests

Policy Statement
In the interest of transparency and fairness, the North Dakota Board of Examiners for Nursing Home Administrators (NDBOENHA) will notify licensees when a request is made to access the contents of their licensure file. All requests are handled in accordance with North Dakota public records laws.

Procedure

1. When a person or organization requests information from the file of a licensed administrator, a copy of the request will be sent to the administrator involved.

2. The Board will respond to the request in compliance with North Dakota’s public records statutes, ensuring that protected personal information is not disclosed unlawfully.

Legal and Procedural Compliance
All requests and disclosures will be reviewed as needed with legal counsel to ensure compliance with applicable state law.

Policy History
Adopted: October 13, 1994
Revised: July 13, 2000; December 4, 2014

Policy: Public Access and Release of Information

Policy Statement
The North Dakota Board of Examiners for Nursing Home Administrators (NDBOENHA) complies with North Dakota’s Open Meetings and Open Records Laws by providing public access to records while protecting personal information as defined by law.

Procedure

1. Public Records Requests:

   • Upon request, the Board will provide access to public records or furnish one copy of the requested documents.

   • Fees may be assessed in accordance with North Dakota public records law.

2. In-Office Review:

   • Individuals wishing to review records in person must schedule an appointment during regular business hours.

   • Appointments should be made by contacting the Executive Director at (701) 222-4867.

3. Protected Information:

   • The Board will not disclose personal information as defined under N.D.C.C. § 44-04-18.1(4), except for a licensee’s home address if it is the address of record.

Legal and Procedural Compliance
The Board consults legal counsel as needed to ensure all procedures are conducted in accordance with state laws governing public access and confidentiality.

Policy History
Adopted: October 13, 1994
Revised: July 13, 2000; December 4, 2014

Policy: Application Review Committee

Policy Statement
The Executive Director of the North Dakota Board of Examiners for Nursing Home Administrators (NDBOENHA) is authorized to review all license applications to ensure compliance with licensure requirements.

Procedure

1. The Executive Director will review applications for completeness and verify that all licensure requirements are met.

2. If the applicant has no history of disciplinary action or criminal conduct and the application is complete, the Executive Director may issue the license without further Board review.

3. Any applications with concerns or questions will be referred to the full Board for review and decision.

Legal and Procedural Compliance
The Board will consult legal counsel as necessary to ensure adherence to applicable laws and regulations.

Policy History
Adopted: October 13, 1994
Revised: July 13, 2000; December 4, 2014; January 28, 2016; January 12, 2018

Policy: Investment of Board Funds

Policy Statement
The North Dakota Board of Examiners for Nursing Home Administrators (NDBOENHA) aims to achieve an optimal rate of return on funds not required for immediate operations, while maintaining liquidity and minimizing risk.

Procedure

1. Board members shall exercise responsible judgment when investing assets, prioritizing capital safety and reasonable income.

2. Investments will be limited to Certificates of Deposit (CDs) with amounts not exceeding FDIC insurance limits at any financial institution.

3. The maximum maturity for any investment will be six years.

4. Financial institutions selected as depositories must have a physical presence in North Dakota and be evaluated on financial stability, community involvement, and other economic criteria.

5. Investments will be reviewed at least annually for continuation.

6. The Executive Secretary will approve investments and provide regular updates to the Board, in coordination with the Treasurer and Chair.

7. No Board member or employee shall receive personal financial gain from investment decisions.

Legal and Procedural Compliance
The Board will consult legal counsel as needed to ensure investment practices comply with applicable regulations.

Policy History
Adopted: January 11, 2008

Policy: Renewal Application Review

Policy Statement
Following initial licensure, the North Dakota Board of Examiners for Nursing Home Administrators (NDBOENHA) requires periodic review of publicly available criminal history information in conjunction with license renewal applications. This process helps maintain professional standards and public trust.

Procedure

• In even-numbered years, the Board will review renewal applications for licensees with last names beginning with letters “A” through “M.”

• In odd-numbered years, the Board will review renewal applications for licensees with last names beginning with letters “N” through “Z.”

• Reviews will focus primarily on criminal history information available in North Dakota.

• The Executive Director will conduct these reviews as directed by the Board.

Legal and Procedural Compliance
The Board will consult legal counsel as necessary to ensure that reviews comply with applicable laws and respect licensees’ rights.

Policy History
Adopted: December 4, 2014

Policy: License Application Process

Policy Statement
To meet licensure requirements under North Dakota Administrative Code § 55-02-01-10, applicants must pass two examinations: the NAB Nursing Home Administrators exam and the state exam. The NAB exam is administered by NAB, and the state exam is administered by the Board.

Procedure

• Applicants may take either exam any time after submitting a license application and paying the application fee.

• License applications are valid for 24 months from the date received.

• All required documentation must be submitted within this 24-month period.

• Applicants who do not complete licensure within this timeframe must reapply.

Legal and Procedural Compliance
The Board will consult with legal counsel to ensure procedures meet regulatory standards.

Policy History
Adopted: August 13, 2015
Revised: January 13, 2023

Policy: Administrator Residency (AIT) Program

History and Purpose
The Administrator Residency (AIT) Program, established January 1, 1997, provides aspiring nursing facility administrators with practical experience to effectively serve residents, families, and staff, and to prepare for state and national licensure exams. The Board may delegate program administration.

Program Description

• Length: Minimum of 1,000 hours, to be completed within 24 months. Applicants must submit a licensure application within one year of completing the program unless an extension is approved by the Board for good cause.

• Content: The program utilizes the NAB National Interactive AIT Program Manual, which includes four modules covering program design, knowledge and skills, lines of service, and reference materials. The program is flexible to allow customized learning experiences aligned with required domains. Alternative programs may be accepted if they meet the 1,000-hour requirement and cover all domains.

• Validation: Written verification of AIT experience is required.

Preceptors

• Must hold a current, unrestricted nursing home administrator license.

• Must have at least three years of administrative experience in any state.

• Must complete the NAB Preceptor Course and fulfill program requirements.

• Financial arrangements are made between preceptor/facility and trainee and may involve pay, volunteer work, or credit.

Trainee Prerequisites

• Must hold or be enrolled in a BS/BA program or be within one year of graduation.

Waiver of Hours
Applicants with relevant experience may qualify for reduced practicum hours based on full-time equivalency (35 hours/week), as follows:

• 750 hours: For those with 2+ years managerial/administrative experience with supervision of 25+ employees and budget responsibility over $1,000,000, or with 2+ years employment in a hospital or nursing facility in professional or direct care roles.

• 500 hours: For those with 2+ years as department managers with supervisory and budget responsibilities, or who have held equivalent administrative roles meeting specific criteria.

• 250 hours: For those with 2+ years as a full-time director of nurses, 1+ year as hospital administrator/assistant administrator, or 1+ year as assistant administrator or equivalent role in a nursing home.

Completion
Verification of program completion is required prior to licensure.

Legal and Procedural Compliance
The Board consults legal counsel to ensure compliance with relevant laws and regulations.

Policy History
Adopted: January 28, 2016
Revised: January 13, 2023