10.33.01.13

.13 Administrator-in-Training.

A. An Administrator-in-training (AIT) is a supervised 12-month full-time or 18-month part-time internship during which the AIT works under the guidance and supervision of a preceptor, a licensed administrator meeting the qualifications set forth in Regulation .14 of this chapter. 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:

(1) Administration;

(2) Business office;

(3) Nursing;

(4) Resident activities;

(5) Social services;

(6) Medical records;

(7) Dietary;

(8) Maintenance;

(9) Environmental, including housekeeping and laundry;

(10) Rehabilitation services; and

(11) Quality assurance.

B. An AIT may not, during the normal working hours of the program, fill a specific, specialized position in the nursing facility.

C. If the AIT is a department head, notice shall be conspicuously posted in the nursing facility stating who the acting department head will be while the AIT is performing training duties.

D. If a candidate does not meet all of the requirements for licensure after having completed 12 months in the full-time or 18 months in the part-time AIT program, preceptor and candidate have the option to work out a plan satisfactory to the Board to continue studying in the AIT program beyond the 12 or 18 months until all the requirements are met.

E. The Board shall interview each applicant and proposed preceptor, or preceptors, before the approval of an AIT program. The Board shall satisfy itself that the background and circumstances of the applicant and preceptor, or preceptors, qualify them for the AIT program.

F. Application Requirements.

(1) The Board may approve an application for a nursing facility AIT program only if it determines that the application contains satisfactory evidence that:

(a) The applicant is at least 21 years old;

(b) The applicant is of good moral character;

(c) The applicant's training will be supervised by a preceptor approved by the Board; and

(d) The AIT program meets the other requirements of this section.

(2) The training shall be satisfactory to the Board.

(3) The applicant shall participate in training provided in a nursing facility licensed in Maryland, as defined in Regulation .02B of this chapter, with at least 60 beds.

(4) If there are subject areas as specified in the list of subjects provided in Regulation .09 of this chapter that are not available in the nursing facility approved by the Board for training, the Board may require training in other facilities.

(5) The applicant shall participate in training provided in not more than two duly Maryland licensed nursing facilities approved by the Board for training. One of the licensed nursing facilities shall have at least 60 beds.

(6) The preceptor is currently certified by the Board.

(7) The preceptor may not be responsible for more than two AITs at any one time. The preceptor shall devote a minimum of 16 hours per week of direct, on-site supervision for each AIT, which may be on an individual or combined basis in the case of two trainees.

(8) The preceptor may or may not be the administrator of record of the facility in which the training is to take place, but the preceptor may not be the administrator of record of a facility other than the one designated for training.If the preceptor is the administrator of record of the facility where the training is to take place, the preceptor shall have had a minimum of 30 days of oversight in the facility in which the training is to take place immediately prior to beginning the AIT program.

(9) A minimum of 80 percent of the training shall occur during 8 consecutive hours for full-time programs or 6 consecutive hours for part-time programs each day (except for regular days off) between the hours of 7 a.m. and 7 p.m. A minimum of 40 hours per week for full-time or 30 hours per week for part-time shall be devoted to continuous, bona fide training activities which include observing and performing the day-to-day duties of each position, when legally permissible, in the service areas referred to in žA of this regulation. The trainee shall be exposed to all shifts during the AIT program.

(10) The applicant may spend a maximum of 50 percent of the training in a family-owned or family-operated nursing facility, and the remainder of the time shall be spent in another Board-approved facility, under a Board-approved preceptor.

(11) An employee may not be a preceptor for his employer.

G. Required AIT Reports.

(1) The AIT and preceptor shall maintain a progress report for the training program on forms prescribed by the Board for every 3 months of the training program.

(2) The report shall:

(a) Be submitted to the Board's office on the dates specified by the Board; and

(b) Include the following:

(i) A brief description of activity or area covered, or both, and dates of rotation;

(ii) A brief analysis of any problems observed, new experiences, insights gained, and the AIT's role in problem solutions; and

(iii) A checklist including signatures from preceptor, AIT, and department managers to verify that the AIT trained in those departments.

(3) At the conclusion of the training program, the AIT shall complete a brief survey and return it to the Board's office providing feedback with suggestions for continuing improvements.

(4) If the reports are not submitted to the Board's office on the date specified by the Board, the AIT shall be considered to have violated the terms of the AIT contract.

H. Credit for Prior Experience.

(1) The AIT program is a minimum of 12 months for full-time programs or 18 months for part-time programs unless the Board awards credit for prior experience within the last 5 years. The amount of credit awarded is at the discretion of the Board, based on exposure to the core of knowledge set forth in Regulation .09 of this chapter, but may not exceed;

(a) 6 months for a hospital assistant administrator;

(b) 8 months for a hospital administrator;

(c) 6 months for a nursing facility assistant administrator;

(d) 6 months for a department head;

(e) 3 months for an executive director of a continuing care retirement community;

(f) 3 months for an assisted living manager;

(g) 3 months for a health-care-related senior management official;

(h) 3 months for a non-health-care-related senior management official.

(2) Qualifying Experience for Healthcare Related Professions in §H(1)(a)—(f) of this regulation. The following requirements set the minimum experience required for receiving credit:

(a) Minimum of 18 months as a full-time employee, with line responsibility for hiring, firing, budget, and supervision of at least one department comprised of ten or more employees;

(b) Reporting directly to the facility administrator or chief executive officer;

(3) Qualifying Experience for Healthcare Related or Non-Healthcare Related Senior Management Official in §H(1)(g) and (h) of this regulation. The following requirements set the minimum experience required for receiving credit:

(a) Minimum of 18 months as a full-time senior management official of a single facility or entity; and

(b) Administrative responsibility for the total operation of the facility or entity and its multiple departments, as applicable.

(4) Experience credit can be awarded on a month-to-month basis totaling 12 months for:

(a) An individual who has worked as a licensed nursing home administrator in another state;

(b) A resident or intern in a program offered by an accredited college or university for the purpose of satisfying the requirements for a baccalaureate or master's degree in health care administration; or

(c) An individual who has successfully completed an AIT program in another state, if the program is substantially comparable to the AIT program in Maryland, as determined by the Board.

I. Discontinuance of AIT Status in a Nursing Facility in Which the Trainee is Registered.

(1) The AIT and the preceptor shall report discontinuance within 10 days.

(2) Within 10 days of the date of discontinuance, the preceptor shall file a report detailing the trainee's experience and abilities.

(3) The trainee may fulfill the training requirement in not more than two licensed nursing facilities, with not more than 90 days lapse between the two periods of training.

J. A change of preceptor may be authorized by the Board upon submission of:

(1) Application by the proposed new preceptor;

(2) A report by the Credentials Committee resulting from a personal interview with the trainee and proposed preceptor;

(3) Evidence satisfactory to the Board that the proposed preceptor is certified by the Board; and

(4) A new signed contract by the trainee, preceptor, and the Board.

K. If a preceptor is found by the Board to have failed to provide adequate training, the Board may cancel the preceptor's authorization to serve as a preceptor for a period of time prescribed by the Board. If an AIT fails to live up to the terms of the contract, the Board may cancel the contract.

L. A person duly registered as an AIT whose internship is interrupted by service in the armed forces of the United States shall be permitted to resume the internship without loss of credit at any time within 1 year after the date of the AIT's separation from active service.