TITLE XI
HOSPITALS AND SANITARIA
CHAPTER 151-A
NURSING HOME ADMINISTRATORS
Section 151-A:1
151-A:1 Definitions. –
As used in this chapter, unless otherwise stated, the following terms shall have the respective meanings hereinafter set forth:
I. ""Board'' means the board of examiners of nursing home administrators of the state of New Hampshire.
II. ""Secretary'' means the secretary of the board of examiners of nursing home administrators of the state of New Hampshire.
III. ""Nursing home administrator'' means any individual who is charged with the general administration of a nursing home whether or not such individual has an ownership interest in such home and whether or not such individual's functions and duties are shared with one or more other individuals.
IV. ""Nursing home'' means any institution or facility, whether proprietary or non-proprietary, defined as a nursing home for licensing purposes pursuant to RSA 151, or the equivalent facility or facilities as defined by the secretary of the United States Department of Health, Education and Welfare.
Source. 1969, 459:1. 1977, 477:1. 1998, 137:1, eff. Aug. 7, 1998.
Section 151-A:2
151-A:2 Nursing Home Administrator License Required. –
No nursing home in the state may operate unless it is under the supervision of an administrator who holds a currently valid nursing home administrator's license and registration issued pursuant to this chapter. No person shall practice or offer to practice nursing home administration in this state or use any title, sign, card or device to indicate that such person is a nursing home administrator unless such person is duly licensed and registered as a nursing home administrator as required by this chapter. However, nothing in this chapter or the rules adopted under this chapter shall be construed to require an applicant for a license as a nursing home administrator who is certified by a recognized church or religious denomination which teaches reliance on spiritual means alone for healing as having been approved to administer institutions certified by such church or denomination for the care and treatment of the sick in accordance with its teachings, to demonstrate proficiency in any medical techniques or to meet any medical educational qualifications or medical standards not in accord with the remedial care and treatment provided in such institutions.
Source. 1969, 459:1. 1977, 477:2. 1998, 137:2, eff. Aug. 7, 1998.
Section 151-A:3
151-A:3 Board of Examiners of Nursing Home Administrators. –
I. There shall be a board of examiners of nursing home administrators, which board shall be composed of 9 members, as follows: Four members shall be nursing home administrators duly licensed and registered under this chapter; four members shall be selected from other professions and institutions concerned with the care of chronically ill and infirm aged patients; and one member representative of the public at large; provided, however, that no more than 2 of the members of the board shall be officials or full time employees of state or local governments; and, provided further, that less than a majority of the board shall be representatives of a single profession or institutional category. All members of the board shall be citizens of the United States or shall have declared their intent to become citizens of the United States, and shall be residents of this state. The noninstitutional members shall have no direct financial interest in any nursing home.
II. Terms of Office. Three members of the initial board shall be appointed for a one-year term of office; 3 members of the initial board shall be appointed for a 2-year term of office; and 3 members of the initial board shall be appointed for a 3-year term of office. Thereafter, the term of office for each member of the board shall be 3 years. No member shall serve more than 2 consecutive full terms.
III. Nominations and Appointments.
(a) Appointments to the board shall be made by the governor after consultation with the associations and societies appropriate to the disciplines and professions representative of the vacancies to be filled.
(b) Each member of the board, before beginning the member's term of office, shall receive a certificate of appointment, and shall file the constitutional oath of office.
(c) The governor may remove any examiner for misconduct, incapacity, incompetence, or neglect of duty after the examiner so charged has been served with a written statement of charges and has been given an opportunity to be heard.
(d) Each member of the board shall receive $50 for each day actually engaged in the duties of the office, plus reasonable expenses incurred in the discharge of official duties.
IV. (a) The board shall elect annually from its membership a chairperson and vice-chairperson.
(b) The board shall hold 2 or more meetings each year. At any meeting a majority shall constitute a quorum.
V. The secretary of the board shall be elected by a majority vote of the members of the board. The secretary shall be the executive officer of the board but shall not be a member of the board. The secretary shall have such powers and perform such duties as are prescribed by law and the rules of the board.
VI. The board shall be an administratively attached agency, under RSA 21-G:10, to the department of health and human services.
Source. 1969, 459:1. 1973, 83:1. 1977, 477:3, 4. 1985, 416:11. 1989, 337:1. 1998, 137:3, 4, eff. Aug. 7, 1998.
Section 151-A:4
151-A:4 Functions and Duties of the Board. –
I. It shall be the function and duty of the board to:
(a) Develop, impose, and enforce standards which must be met by individuals in order to receive a license as a nursing home administrator, which standards shall be designed to insure that nursing home administrators will be individuals who are of good character and are otherwise suitable, and who, by training or experience in the field of institutional administration, are qualified to serve as nursing home administrators;
(b) Develop and apply appropriate techniques, including examinations and investigations, for determining whether an individual meets such standards;
(c) Issue licenses and registrations to qualified individuals and invoke disciplinary actions for violations of the provisions of licensure or practice under this chapter. The disciplinary actions may include revocation or suspension of a license or registration, imposition of a fine, or reprimand or censure of the licensee. All disciplinary proceedings by the board shall meet due process requirements for notice and hearings as provided in RSA 541-A.
(d) Establish and carry out procedures designed to insure that individuals licensed as nursing home administrators will, during any period that they serve as such, comply with the requirements of such standards;
(e) Receive, investigate, and take appropriate action with respect to, any charge or complaint filed with the board to the effect that any individual licensed as a nursing home administrator has failed to comply with the requirements of such standards;
(f) Conduct a continuing study and investigation of nursing homes and administrators of nursing homes within the state with a view to the improvement of the standards imposed for the licensing of such administrators and of procedures and methods for the enforcement of such standards with respect to administrators of nursing homes who have been licensed as such.
II. The board or any committee thereof designated by the board acting in an official capacity, shall have the authority to issue subpoenas, compel the attendance of witnesses, administer oaths and take testimony of all matters within the jurisdiction of the board. The board shall not be bound by the strict rules of evidence in the conduct of its proceedings but any determinations made shall be founded upon sufficient legal evidence to sustain them.
III. [Repealed.]
Source. 1969, 459:1. 1989, 337:2, 11, eff. Aug. 1, 1989.
Section 151-A:4-a
151-A:4-a Rulemaking. –
The board shall adopt rules pursuant to RSA 541-A as may be necessary for the proper performance of its duties, and to take such other actions as may be necessary to enable the state:
I. To meet the requirements set forth in section 1908 of the Social Security Act and other federal requirements.
II. To establish and collect fees for examination of applicants, for licenses and renewal of licenses to practice under this chapter, for temporary and emergency permits, and for transcribing and transferring records and other services. The fees established by the board shall recover revenues equal to 125 percent of the direct operating expenses of the board for the previous year or the full cost of the board, including the cost of support and administrative services provided by other agencies, whichever is greater.
III. To establish a schedule of fines.
IV. To establish procedures and requirements for disciplinary proceedings and criteria for disciplinary actions, including suspending, revoking or placing conditions on a license.
V. To establish standards and criteria for licensing, application and examination of applicants, and criteria for granting waivers of experience pursuant to RSA 151-A:5, II.
VI. To establish criteria for review and approval of educational requirements, including formal educational requirements for licensure or renewal and practical training requirements.
VII. To establish procedures for accepting and processing reports of violations of this chapter.
Source. 1989, 337:3, eff. Aug. 1, 1989.
Section 151-A:5
151-A:5 Qualifications for Admission to Examination. –
The board shall admit to examination for licensure as a nursing home administrator any candidate who pays a reasonable fee as established by the board and submits evidence of good moral character and suitability prescribed by the board and evidence that the candidate is at least 21 years old and has completed preliminary education satisfactory to the board; provided:
I. That no applicant for licensure as a nursing home administrator shall be admitted to such licensing examination, nor shall such applicant be entitled to or be granted a license as a nursing home administrator unless such applicant shall submit written evidence, on forms provided for such purpose by the board, that the applicant has successfully completed a bachelor of science or bachelor of arts degree from an accredited school.
II. That no applicant for licensure as a nursing home administrator shall be admitted to such licensing examination, nor shall such applicant be entitled to or be granted a license as a nursing home administrator unless the applicant submits evidence satisfactory to the board that such applicant possesses such training or experience in the field of institutional administration as is required by the rules of the board, or has been granted a waiver by the board based on conditions established by rule.
Source. 1969, 459:1. 1977, 477:5. 1989, 337:4. 1998, 137:5, eff. Aug. 7, 1998.
Section 151-A:6
151-A:6 Examinations. –
I. The board shall determine the subjects of examination for applicants for licensure as nursing home administrators, and the scope, content and format of such examinations which in any examination shall be the same for all candidates; provided, however, that such examinations shall include examination of the applicant to demonstrate the applicant's proficiency in the rules of the department of health and human services pertaining to health and safety.
II. Examinations shall be held at least 2 times each year, at such times and places as the board shall designate.
Source. 1969, 459:1. 1989, 337:5. 1995, 310:181. 1998, 137:6, eff. Aug. 7, 1998.
Section 151-A:7
151-A:7 Licenses. –
I. An applicant for a license as a nursing home administrator who has:
(a) Successfully complied with the requirements of RSA 151-A:5 and the standards provided for therein; and
(b) Passed the examination provided for in RSA 151-A:6 shall be issued a license on a form provided for that purpose by the board, certifying that such applicant has met the requirements of the laws and rules entitling the applicant to serve, act, practice and otherwise hold such applicant out as a duly licensed nursing home administrator.
II. Under emergency conditions the secretary of the board in the secretary's discretion subject to the confirmation of the board may issue a non-renewable temporary emergency permit to a person of good character and suitability to act in the capacity of an administrator under the supervision of a licensed administrator pending action by the board until the next examination or not to exceed 6 months.
II-a. If the board is satisfied that a candidate for licensure under the reciprocity provisions of RSA 151-A:9 meets all the requirements and needs only sit for the state examination, the board may, if an urgent need is demonstrated, provide the candidate with a temporary permit to work as an administrator in a nursing home within the state of New Hampshire. This temporary permit shall only be valid for a period of 6 months and shall not be renewable or reissued to the same candidate.
III. Any license issued by the board under or pursuant to the provisions of this section shall be under the hand and seal of the secretary of the board.
IV. If the board finds that programs of training and instruction conducted within the state are not sufficient in number or content to enable nursing home administrators to meet requirements established pursuant to this chapter, the board may request the department of health and human services to institute and conduct or arrange with others to conduct one or more such programs, and shall make provision for their accessibility to residents of this state. The department of health and human services may approve programs conducted within and without this state as sufficient to meet education and training requirements established pursuant to this chapter. For purposes of this paragraph, the department of health and human services shall have the authority to receive and disburse state funds allocated for this purpose and federal funds received pursuant to section 1908(e)(1) of the Social Security Act.
Source. 1969, 459:1. 1971, 350:1. 1977, 477:6. 1989, 337:6, 7. 1995, 310:181. 1998, 137:7, eff. Aug. 7, 1998.
Section 151-A:8
151-A:8 Registration. –
I. Every individual who holds a valid license as a nursing home administrator issued by the board under RSA 151-A:7 shall immediately upon issuance thereof be deemed registered with the board and be issued a certificate of registration. Thereafter, such individual shall biennially be required to apply to the board for a new certificate of registration and report any facts requested by the board on forms provided for such purpose.
II. Upon making an application for a new certificate of registration such individual shall pay a reasonable biennial registration fee as established by the board.
III. Upon receipt of such application for registration, the registration fee and the evidence required with respect to the rules and regulations of the board, the board shall issue a certificate of registration to such nursing home administrator.
IV. Upon complaint or other knowledge of a nursing home administrator's violation of any provision of this chapter and for the health, safety, and protection of the public, the board is granted emergency license suspension authority. The secretary of the board may, upon recommendation of the board, immediately suspend an administrator's license to practice, pending notice and hearing as provided under RSA 541-A. For any license so suspended, the secretary shall also notify the bureau of health facilities administration.
V. A nursing home administrator who has been duly licensed and registered in this state whose license shall not have been revoked or suspended, and whose registration has expired because such nursing home administrator shall have temporarily abandoned the practice of nursing home administration, or shall have removed from the state, or for such other reason, may register within the state upon complying with the provisions of this section for registration, and also filing with the board an affidavit of such facts.
VI. Only an individual who has qualified as a licensed and registered nursing home administrator under the provisions of this chapter, and who holds a valid current registration certificate pursuant to the provisions of this section for the current biennial registration period, shall have the right and the privilege of using the title ""Nursing Home Administrator'', and have the right and the privilege of using the abbreviation ""N.H.A.'' after such individual's name. No other person shall use or shall be designated by such title or such abbreviation or any other words, letters, sign, card, or device tending to, or intended to, indicate that such person is a licensed and registered nursing home administrator.
VII. The board shall maintain a register of all applications for licensing and registration of nursing home administrators, which register shall show:
(a) The place of residence, name and age of each applicant;
(b) The name and address of employer or business connection of each applicant;
(c) The date of application; complete information of educational and experience qualifications;
(d) The action taken by the board;
(e) The serial number of the license and of registration certificates issued to the applicant;
(f) The date on which the board reviewed and acted upon the application;
(g) And such other pertinent information as may be deemed necessary.
Source. 1969, 459:1. 1977, 477:7. 1989, 337:8. 1998, 137:8, eff. Aug. 7, 1998.
Section 151-A:9
151-A:9 Reciprocity. –
The board, subject to the provisions of this chapter and the rules and regulations of the board promulgated thereunder prescribing the qualifications for nursing home administrator license, may endorse a nursing home administrator license issued by the proper authorities of any other state upon payment of a reasonable fee as established by the board and upon submission of evidence satisfactory to the board that:
I. Such other state maintained a system and standard of qualifications and examinations for a nursing home administrator license which were substantially equivalent to those required in this state at the time such other license was issued by such other state; and,
II. Such other state gives similar recognition and endorsement to nursing home administrator licenses of this state.
Source. 1969, 459:1. 1977, 477:8, eff. Sept. 10, 1977.
Section 151-A:10
151-A:10 Injunction. –
The board may in accordance with the laws of the state governing injunctions and other process maintain an action in the name of the state against any nursing home or against any individual who is in violation of this chapter.
Source. 1969, 459:1, eff. July 3, 1969.
Section 151-A:11
151-A:11 Disciplinary Proceedings. –
I. The license or registration or both of any person practicing or offering to practice nursing home administration may be revoked or suspended, or such licensee may be reprimanded, censured, or fined or may have conditions placed on the license or may otherwise be disciplined in accordance with the provisions of this section upon decision and after due hearing as provided by RSA 541-A in any of the following cases:
(a) Upon proof that such licensee is unfit or incompetent by reason of negligence, habits or other causes;
(b) Upon proof that such licensee has willfully or repeatedly violated any of the provisions of this chapter or the rules adopted under this chapter; or willfully or repeatedly acted in a manner inconsistent with the health and safety of the patients of the home in which the licensee is the administrator;
(c) Upon proof that such licensee is guilty of fraud or deceit in the practice of nursing home administration or in his or her admission to such practice;
(d) Upon proof that such licensee has been convicted in a court of competent jurisdiction, either within or without this state, of a felony. Due consideration shall be given to the nature of the offense in determining whether the license shall be revoked or suspended.
II. The members of the board or a hearing committee of 3 or more members of the board shall have jurisdiction to hear all charges brought under the provisions of this section against persons licensed and registered as nursing home administrators and upon such hearings shall determine such charges upon their merits. If the board determines that such person is guilty of the charges, the board may revoke his or her license or registration, suspend him or her from practice, or reprimand, censure, fine, place conditions on his or her license, or otherwise discipline such licensee.
III. Proceedings under this section shall be begun by filing with the board charges in writing and under oath. Such charges shall be filed by any person, corporation, association or by the board. Every individual, agency, facility, institution, or organization which employs nursing home administrators within the state shall report any action which violates this chapter to the board within 30 days of such action. The chairperson of the board may designate 3 or more members of the board as a hearing committee to conduct a hearing on the charges and to report to the board on the charges.
IV. At such hearing the licensee shall have the right to appear either personally or by counsel or both, to produce witnesses and evidence on the licensee's own behalf, to cross-examine witnesses and to have subpoenas issued in the licensee's behalf by the hearing committee. The hearing committee shall make a written report to the board of the findings and recommendations which shall be considered by the board in arriving at its determination.
V. The board or the hearing committee shall exercise any of the powers set forth in RSA 151-A:4, II as may be necessary for the proper conduct of the hearing.
Source. 1969, 459:1. 1977, 477:9, 10. 1989, 337:9, 10. 1998, 137:9-11, eff. Aug. 7, 1998.
Section 151-A:12
151-A:12 Restoration of Licenses and/or Registrations. –
I. The board may, in its discretion, reissue a license and/or registration to any person whose license and/or registration has been revoked.
II. If a person convicted of a felony or crime deemed to be a felony is subsequently pardoned by the governor of the state where such conviction was had or by the president of the United States, or shall receive a certificate of good conduct granted by the board of parole, the board shall, on application of such person and on the submission of evidence satisfactory to the board, restore to such person the nursing home administrator's license and/or registration.
Source. 1969, 459:1, eff. July 3, 1969.
Section 151-A:13
151-A:13 Separability Clause. –
If any action or provision of this chapter shall be declared unconstitutional or void by any court of competent jurisdiction, or the applicability thereof to any person or circumstances shall be held invalid, the constitutionality and validity of the remainder of the chapter and the applicability thereof to other persons and circumstances shall not be affected thereby, and to this end the sections and provisions of this chapter are declared to be severable.
Source. 1969, 459:1, eff. July 3, 1969.
Section 151-A:14
151-A:14 Authorization. –
In order to provide necessary funds for training courses for nursing home administrators, the state treasurer is authorized to establish a revolving fund within the department of health and human services in sums sufficient to carry out this provision, such funds to be reimbursed in full by federal matching funds and by tuition charges to the nursing home administrators taking such training courses.
Source. 1969, 459:1. 1983, 291:1, I. 1995, 310:181, eff. Nov. 1, 1995.
Section 151-A:15
151-A:15 Patient Accounts; Disposition Upon Death; Testate or Intestate. –
I. If within 180 days after the date of a testate or intestate patient's death in any nursing home no petition for probate has been filed under any section of RSA 553 and the gross value of the personal property remaining at the nursing home belonging to the deceased, including any amount left in a patient account, is no more than $2,500, the nursing home administrator shall file in the probate court in the county where the nursing home is located an affidavit for the purpose of disposing of such deceased patient's estate. The form of the affidavit, and the rules governing proceedings under this section, shall be provided by the probate court pursuant to RSA 547:33 and RSA 548:8. The nursing home administrator shall not file a death certificate with the probate court, but shall attest to the death in the affidavit. If the nursing home patient died testate and if the nursing home administrator has the will or a copy of the will, the nursing home administrator shall file the same in the probate court in the county where the nursing home is located. The probate court shall waive all filing fees.
II. Notwithstanding the provisions of RSA 561, if all known debts of the deceased have been paid and a balance remains in the deceased's estate after the filing required under paragraph I, the probate court shall order the administrator to pay the balance into the treasury of the county where the deceased was domiciled, where it shall be subject to the claims of persons entitled to it, through application to the county commissioners.
Source. 1981, 249:1. 1991, 85:1. 1998, 137:12, eff. Aug. 7, 1998. 2005, 252:6, eff. Jan. 1, 2006. 2006, 180:1, eff. May 25, 2006.
Quality Assurance in Nursing Homes
Section 151-A:16
151-A:16 Proceedings of Quality Assurance Program; Confidentiality. –
I. In this subdivision:
(a) ""Records'' means records of interviews, internal reviews and investigations, and all reports, statements, minutes, memoranda, charts, statistics, and other documentation generated during the activities of a quality assurance program. ""Records'' shall not mean original medical records or other records kept relative to any patient in the course of the business of operating a nursing home.
(b) ""Quality assurance program'' means a comprehensive, ongoing, organization-wide system of mechanisms for monitoring and evaluating the quality and appropriateness of the care provided, so that important problems and trends in the delivery of care are identified and that steps are taken to correct problems and to take advantage of opportunities to improve care.
II. Records of a nursing home's quality assurance program, including those of its functional components and committees as defined by the nursing home's quality assurance plans, organized to evaluate matters relating to the care and treatment of patients and to improve the quality of care provided and testimony by members on the board of directors of the nursing home, medical and clinical staff, employees, or the committee attendees relating to activities of the quality assurance program shall be confidential and privileged and shall be protected from direct or indirect means of discovery, subpoena, or admission into evidence in any judicial or administrative proceeding. However, information, documents, or records otherwise available from original sources are not to be construed as immune from discovery or use in any such civil or administrative action merely because they were presented to a quality assurance program, and any person who supplies information or testifies as part of a quality assurance program, or who is a member of a quality assurance program committee, may not be prevented from testifying as to matters within his or her knowledge, but such witness may not be asked about his or her testimony before such program, or opinions formed by him or her, as a result of committee participation. Further, a program's records shall be discoverable in either of the following cases:
(a) A judicial or administrative proceeding brought by a nursing home, its quality assurance program, or its board of directors, to revoke or restrict the license or certification of a staff member; or
(b) A proceeding alleging repetitive malicious action and personal injury brought against a staff member.
III. A nursing home, board of directors, or trustees may waive privileges under this subdivision and release information or present records of the quality assurance program by discovery, subpoena, or admission into evidence in any judicial or administrative proceeding.
IV. No owner, directors, trustees, medical or clinical staff, employees, or other attendees of the quality assurance program shall be held liable in any action for damages or other relief arising from the providing of information to a quality assurance program or in any judicial or administrative proceeding.
Source. 1992, 41:1. 2002, 221:3, eff. Jan. 1, 2003.