18VAC95-20 Regulations Governing the Practice of Nursing Home Administrators

REGULATIONS

Vol. 27 Iss. 25 - August 15, 2011

TITLE 18. PROFESSIONAL AND OCCUPATIONAL LICENSING

BOARD OF LONG-TERM CARE ADMINISTRATORS

Chapter 20

Forms

Titles of Regulations: 18VAC95-20. Regulations Governing the Practice of Nursing Home Administrators.

18VAC95-30. Regulations Governing the Practice of Assisted Living Facility Administrators.

Agency Contact: Elaine J. Yeatts, Agency Regulatory Coordinator, Department of Health Professions, 9960 Mayland Drive, Suite 300, Richmond, VA 23233, telephone [phone], FAX [phone], or email [e-mail].

NOTICE: The following forms used in administering the regulations were filed by the agency. The forms are not being published; however, online users of this issue of the Virginia Register of Regulations may click on the name to access a form. The forms are also available through the agency contact or at the Office of the Registrar of Regulations, General Assembly Building, 2nd Floor, Richmond, Virginia 23219.

FORMS (18VAC95-20)

Nursing Home Administrator Application General Information (rev. 7/08).

Nursing Home Administrator Application for Initial Licensure (rev. 7/08).

Endorsement Verification Form (rev. 3/08).

Nursing Home Administrator-in-Training Application (rev. 7/08).

Nursing Home Administrator-in-Training – Notice of Change of Status or Discontinuance (rev. 10/07).

Nursing Home Administrator Preceptor Application (rev. 7/08).

Nursing Home Administrator Application for Reinstatement of License (rev. 7/08).

Nursing Home Administrator Application for Licensure by Endorsement (rev. 7/08).

Nursing Home Administrator-in-Training Monthly Report (rev. 10/07).

Nursing Home Administrator-in-Training – Documentation of Completion Form (rev. 8/08).

Domains of Practice (rev. 10/07).

Nursing Home Administrator Application General Information (rev. 9/08).

Nursing Home Administrator Application for Initial Licensure (rev. 3/10).

License Verification Form (rev. 3/10).

Nursing Home Administrator-in-Training Application (rev. 3/10).

Nursing Home Administrator-in-Training – Notice of Change of Status or Discontinuance (rev. 3/10).

Nursing Home Administrator Preceptor Application (rev. 3/10).

Nursing Home Administrator Application for Reinstatement of License (rev. 3/10).

Nursing Home Administrator Application for Licensure by Endorsement (rev. 3/10).

Nursing Home Administrator-in-Training Monthly Report (rev. 4/10).

Nursing Home Administrator-in-Training Documentation of Completion Form (rev. 3/10).

Domains of Practice (rev. 3/10).

FORMS (18VAC95-30)

Checklist for Endorsement or Credentials Application to Practice as an Assisted Living Facility Administrator (rev. 1/08).

Checklist for Licensure by Experience (For Current Administrators only) to Practice as an Assisted Living Facility Administrator (rev. 1/08).

Checklist for Initial Licensure by Education to Practice as an Assisted Living Facility Administrator (rev. 1/08).

Checklist for Licensure by Examination to Practice as an Assisted Living Administrator (eff. 1/08).

Assisted Living Facility Administrator Application for Licensure (rev. 1/08).

Assisted Living Facility Administrator Administrator-in-Training Application (rev. 1/08).

Monthly Report of Assisted Living Facility Administrator-in-Training (rev. 12/07).

Completion of Assisted Living Facility Administrator-in-Training (rev. 12/07).

Assisted Living Facility Administrator Preceptor Application (rev. 1/08).

Domains of Practice (rev. 2/08).

Checklist for Endorsement or Credentials Application to Practice as an Assisted Living Facility Administrator (rev. 3/10).

Checklist for Initial Licensure by Education to Practice as an Assisted Living Facility Administrator (rev. 3/10).

Assisted Living Facility Administrator Application for Licensure (rev. 3/10).

Assisted Living Facility Administrator Administrator-in-Training Application (rev. 4/10).

Monthly Report of Assisted Living Facility Administrator-in-Training (rev. 3/10).

Completion of Assisted Living Facility Administrator-in-Training (rev. 3/10).

Endorsement Certification Form (rev. 8/07).

Assisted Living Facility Administrator Preceptor Application (rev. 4/10).

Domains of Practice (rev. 11/09).

VA.R. Doc. No. R11-2940; Filed July 25, 2011, 3:51 p.m.