Texas Department of Aging and Disability Services
Nursing Facility Administrators Handbook
Revision: 09-1

Subchapter A

§18.1  Purpose

This chapter implements the provisions of the Texas Health and Safety Code, Chapter 242, Subchapter I, Nursing Facility Administration, for the purpose of licensing nursing facility administrators in the state of Texas.

§18.2  Definitions

The words and terms in this chapter have the following meanings, unless the context clearly indicates otherwise:

(1)
Abuse —  Any act, failure to act, or incitement to act done willfully, knowingly, or recklessly through words or physical action that causes or could cause mental or physical injury or harm or death to a nursing facility resident. Abuse includes verbal, sexual, mental, psychological, or physical abuse; corporal punishment; involuntary seclusion; or any other actions within this definition.
(2)
Administrative law judge (ALJ) —  A State Office of Administrative Hearings (SOAH) attorney who conducts formal hearings for the Department of Aging and Disability Services.
(3)
Administrator —  A licensed nursing facility administrator.
(4)
Administrator-in-training (AIT) —  A person undergoing a minimum 1,000-hour internship under a DADS-approved certified preceptor.
(5)
Administrator of Record —  The individual who is listed as the facilityís licensed nursing facility administrator with the DADSí Licensing and Credentialing Section.
(6)
Applicant —  A person applying for a Texas nursing facility administrator license.
(7)
Application —  The notarized DADS application for licensure as a nursing facility administrator, as well as all required forms, fees, and supporting documentation.
(8)
Complaint —  An allegation that a licensed nursing facility administrator violated one or more of the licensure rules or statutory requirements.
(9)
DADS —  The Department of Aging and Disability Services.
(10)
Deficiency —  Violation of a federal participation requirement in a nursing facility.
(11)
Domains of the NAB —  The five categories for education and continuing education of the National Association of Long Term Care Administrator Boards, which are resident care and quality of life; human resources; finance; physical environment and atmosphere; and leadership and management.
(12)
Equivalent —  A level of achievement that is equal in amount and quality to completion of an educational or training program.
(13)
Formal hearing —  A hearing held by SOAH to adjudicate a sanction taken by DADS against a licensed nursing facility administrator.
(14)
Good standing —  The licensure status of a nursing facility administrator who is in compliance with the rules in this chapter and, if applicable, the terms of any sanction imposed by DADS.
(15)
Informal review —  The opportunity for a licensee to dispute the allegations made by DADS. The informal review includes the opportunity to show compliance.
(16)
Internship —  The 1,000-hour training period in a nursing facility for an AIT.
(17)
License —  A nursing facility administrator license or provisional license.
(18)
Licensee —  A person licensed by DADS as a nursing facility administrator.
(19)
Misappropriation of resident property —  The deliberate misplacement, exploitation, or wrongful temporary or permanent use of a nursing facility residentís belongings or money without the residentís consent.
(20)
NAB —  The National Association of Long Term Care Administrator Boards, which is composed of state boards or agencies responsible for the licensure of nursing facility administrators.
(21)
NAB examination —  The national examination developed by NAB that applicants must pass in combination with the state licensure examination to be issued a license to practice nursing facility administration in Texas.
(22)
NCERS —  The National Continuing Education Review Service, which is the part of NAB that approves and monitors continuing education activities for nursing facility administrators.
(23)
Neglect —  A deprivation of life's necessities of food, water, or shelter; or a failure of an individual to provide services, treatment, or care to a nursing facility resident that causes or could cause mental or physical injury, harm, or death to the nursing facility resident.
(24)
Nursing facility —  An institution or facility licensed by DADS as a nursing home, nursing facility, or skilled nursing facility.
(25)
Nursing facility administrator —  A person who is licensed to engage in the practice of nursing facility administration, regardless of whether the person has ownership interest in the facility.
(26)
Nursing Facility Administrators Advisory Committee (NFAAC) —  The nine-member governor-appointed advisory committee that makes recommendations to DADS about the practice and regulation of nursing facility administration.
(27)
Opportunity to show compliance —  An informal meeting between DADS and a licensee that allows the licensee an opportunity to show compliance with the requirements of law for the retention of the license. The opportunity to show compliance is part of an informal review.
(28)
Preceptor —  A licensed nursing facility administrator certified by DADS to provide supervision to an AIT.
(29)
PES —  Professional examination services. The testing agency that administers the NAB and state examinations to applicants seeking licensure as nursing facility administrators.
(30)
Referral —  A recommendation made by Regulatory Services Division staff to investigate an administratorís compliance with licensure requirements when deficiencies or substandard quality of care deficiencies are found in a nursing facility, as required by Title 42 Code of Federal Regulations.
(31)
Regulatory Services Division —  The division of DADS responsible for long term care regulation, including determining nursing facility compliance with licensure and certification requirements and licensing nursing facility administrators.
(32)
Sanctions —  Any adverse licensure actions DADS imposes against a licensee, including letter of reprimand, suspension, revocation, denial of license, and monetary penalties.
(33)
Self-study course —  A NAB-approved education course that an individual pursues independently to meet continuing education requirements for license renewal.
(34)
State examination —  The state licensure examination that applicants must pass, in combination with the NAB examination, to be issued a license to practice nursing facility administration in Texas. This examination covers the nursing facility requirements found in Chapter 19 of this title (relating to Nursing Facility Requirements for Licensure and Medicaid Certification).
(35)
State of Texas Administrator-In-Training Internship Manual —  The DADS program guide used by an AIT and preceptor during the AITís internship for nursing facility administrator licensure.
(36)
Substandard quality of care —  Any deficiency in Resident Behavior and Facility Practices, Quality of Life, or Quality of Care that is immediate jeopardy to nursing facility resident health or safety; or a pattern of widespread actual harm that is not immediate jeopardy; or a widespread potential for more than minimal harm that is not immediate jeopardy, with no actual harm.
(37)
Survey —  A resident-focused complaint/incident investigation or annual licensure or certification inspection of a nursing facility by DADS.
(38)
Traditional business hours —  Monday through Friday from 8:00 a.m. until 5:00 p.m.

§18.3  Nursing Facility Administrators Advisory Committee

(a)
The governor-appointed NFAAC advises DADS on:
(1)
the licensing process of nursing facility administrators;
(2)
minimum standards of conduct for the practice of nursing facility administration;
(3)
proposed rule changes;
(4)
complaints and referrals against administrators; and
(5)
sanctions for rule violations.
(b)
NFAAC members serve staggered terms of six years.
(c)
The nine-member advisory committee is made up of:
(1)
three licensed nursing facility administrators, at least one of whom represents a not-for-profit nursing facility;
(2)
three licensed healthcare professionals with geriatric experience and not employed by a nursing facility, consisting of:
(A)
a licensed physician;
(B)
a registered nurse; and
(C)
a licensed social worker; and
(3)
three public members who have working experience with the chronically ill and infirm.

§18.4  Schedule of Fees

DADS charges the following administrative and licensure fees:

(1)
application fee — $100;
(2)
state examination fee — $155;
(3)
state reexamination fee — $155;
(4)
NAB examination fee — $285;
(5)
NAB reexamination fee — $285;
(6)
initial licensure fee — $250;
(7)
renewal fee — $250 every two years when the license is renewed on or before the date the license expires;
(8)
late renewal fees for license renewals made after the license expires:
(A)
$375 for an expired license renewed during the first 90 days after the license expires; and
(B)
$500 for an expired license renewed between 91 and 365 days after the license expires;
(9)
formal inactive status fee — $250;
(10)
reinstatement of licensure fee — $500; and
(11)
duplicate license fee — $25.