TITLE 18. PROFESSIONAL AND OCCUPATIONAL LICENSING

BOARD OF LONG-TERM CARE ADMINISTRATORS

Proposed Regulation

Titles of Regulations: 18VAC95-20. Regulations Governing the Practice of Nursing Home Administrators (amending 18VAC95-20-80, 18VAC95-20-130, 18VAC95-20-175, 18VAC95-20-180, 18VAC95-20-220, 18VAC95-20-230, 18VAC95-20-300, 18VAC95-20-440; adding 18VAC95-20-201).

18VAC95-30. Regulations Governing the Practice of Assisted Living Facility Administrators (amending 18VAC95-30-40, 18VAC95-30-70, 18VAC95-30-80, 18VAC95-30-130, 18VAC95-30-140, 18VAC95-30-200; adding 18VAC95-30-91).

Statutory Authority: § 54.1-2400 of the Code of Virginia.

Public Hearing Information:

September 25, 2024 - 10 a.m. - Department of Health Professions, Hearing Room Five, 9960 Mayland Drive, Henrico, Virginia 23238.

Public Comment Deadline: November 22, 2024.

Agency Contact: Corie Tillman Wolf, Executive Director, Board of Long-Term Care Administrators, 9960 Mayland Drive, Suite 300, Henrico, VA 23233-1463, telephone (804) 367-4595, FAX (804) 527-4413, or email corie.wolf@dhp.virginia.gov.

Basis: Section 54.1-2400 of the Code of Virginia establishes the general powers and duties of health regulatory boards, including the responsibility to promulgate regulations that are reasonable and necessary.

Purpose: The proposed amendments are necessary to public health, safety, and welfare because they ensure that an adequate number of available nursing home administrators and assisted living facility administrators maintain licensure status with the Commonwealth.

Substance: This proposed action was initiated to implement changes targeted toward regulatory reduction as specified in Executive Order 19 (2022). Amendments include (i) creating a pathway for inactive licensure for nursing home administrators and assisted living facility administrators in new sections 18VAC95-20-201 and 18VAC95-30-91; (ii) eliminating requirements for attestations of compliance with existing laws from application and renewal requirements throughout both chapters; (iii) removing requirements for all documents in an application for licensure to be submitted at the same time throughout both chapters; and (iv) removing requirements to obtain new preceptors within 60 days upon interruption of a preceptor program in 18VAC95-20-440 and 18VAC95-30-200.

Issues: The primary advantage to the public is that this action reduces regulatory burden by eliminating needless attestations and requirements, and there are no disadvantages to the public. There are no primary advantages or disadvantages to the agency or the Commonwealth.

Department of Planning and Budget's Economic Impact Analysis:

The Department of Planning and Budget (DPB) has analyzed the economic impact of this proposed regulation in accordance with § 2.2-4007.04 of the Code of Virginia and Executive Order 19. The analysis presented represents DPB's best estimate of the potential economic impacts as of the date of this analysis.¹

Summary of the Proposed Amendments to Regulation. In response to Executive Order 19 (2022) and Executive Directive 1 (2022), the Board of Long-Term Care Administrators (board) proposes to remove some discretionary requirements and add an option for licensees to maintain an inactive license in the regulations governing nursing home and assisted living facility (ALF) administrators.

Background. Executive Directive Number One (2022) directs Executive Branch entities under the authority of the Governor "to initiate regulatory processes to reduce by at least 25% the number of regulations not mandated by federal or state statute, in consultation with the Office of the Attorney General, and in a manner consistent with the laws of the Commonwealth."² Accordingly, the board seeks to make a number of amendments that would increase flexibility and reduce burdens for the regulated community. Most of the proposed changes are identical in the two chapters, Regulations Governing the Practice of Nursing Home Administrators (18VAC95-20) and Regulations Governing the Practice of Assisted Living Facility Administrators (18VAC95-30). The most significant changes are summarized.

Adding inactive licensure status: Both chapters currently require licensees to renew a license or preceptor registration by March 31 of each year. New sections 18VAC95-20-201 and 18VAC95-30-91 would be added in each chapter, respectively, to allow current licensees to convert a license to inactive status when renewing the license. Both proposed sections contain identical stipulations that would (i) prohibit inactive licensees from performing any act requiring a license or registering to serve as a preceptor and (ii) exempt inactive licensees from meeting continuing education requirements, unless they choose to reactivate their license. Both proposed sections would allow inactive licensees to reactivate a license by (i) paying the difference between the inactive license fee and the active license fee for the year that the license is being reactivated and (ii) completing the continuing competency hours required for the period in which the license has been inactive, not to exceed three years.³ The proposed continuing competency requirement for reactivating the license is identical to the current requirement for license reinstatement. However, the board reports that other requirements for license reinstatement, such as an investigation by the Enforcement division, would not apply for license reactivation. Thus, the option to hold an inactive license for any period of time would provide greater flexibility to licensees who may want to temporarily step away from active professional practice or who are employed in roles that do not require an active license.

The sections on required fees in both chapters (18VAC95-20-80 and 18VAC95-30-40, respectively) would also be identically amended to add a $150 fee for inactive license renewal and a $35 fee for inactive license late renewal. For comparison, the current license renewal fee is $315 and the late renewal fee is $110. The board reports that these fees were set by comparing inactive license renewal fees among other boards and determining a comparable amount.⁴

Removing discretionary requirements: The board proposes to make the following changes to reduce the regulatory burden on licensees: Remove a requirement that licensees provide the "signature of an authorized representative of the approved sponsor" for evidence of attendance for continuing education. The board reports that virtual continuing education offerings have made this requirement outdated and onerous. Add "as documented in the NAB [National Association of Long-Term Care Administrator Boards] continuing education registry" as an option for licensees to demonstrate completion of continuing education requirements if they are contacted for an audit. The board notes that this information can be easily verified in the online registry, which removes the burden of providing this documentation from licensees. Remove a requirement that applicants for licensure as nursing home administrators who have completed an "administrator-in-training" program complete the board's Domains of Practice form. This requirement is duplicative as the applicants for complete the form during training. Remove a requirement for "an attestation that he has read and understands and will remain current with the applicable Virginia laws and regulations" for each profession in each chapter, respectively. The board reports that this attestation is now a standard part of the application form. Remove a requirement that all parts of the application package be submitted at the same time. Board staff cannot act on a license until all parts of the package are received, so the timing of each component does not matter. Remove a requirement that an administrator-in-training whose program is interrupted because the registered preceptor is unable to serve must obtain a new registered preceptor within 60 days. The board deems this timeline to be arbitrary and unnecessarily burdensome.

Estimated Benefits and Costs. The proposed amendments would benefit currently licensed nursing home administrators and ALF administrators, as well as those seeking to pursue licensure in those professions, by allowing for inactive licensure, thereby increasing flexibility, and by removing a number of requirements, mainly relating to the application process and the continuing education requirements. As mentioned previously, the process to reactivate an inactive license would be less rigorous than the process to reinstate a license that had expired, which could include an investigation by the Enforcement division. Although new fees would be added for renewing a license under inactive status, those fees would only apply if licensees chose to renew a license under that status and would be lower than the normal license renewal fee.

Businesses and Other Entities Affected. The Department of Health Professions reports that as of December 2023, the board had 2,159 licensees. As mentioned previously, currently licensed professionals as well as those seeking licensure in the future, would benefit from the increased flexibility and reduced requirements.

The Code of Virginia requires DPB to assess whether an adverse impact may result from the proposed regulation.⁵ An adverse impact is indicated if there is any increase in net cost or reduction in net benefit for any entity, even if the benefits exceed the costs for all entities combined.⁶ As noted, the proposal serves to reduce the regulatory burden on licensees. Thus, no adverse impact is indicated.

Small Businesses⁷ Affected.⁸ The proposed amendments would not adversely affect small businesses.

Localities⁹ Affected.¹⁰ The proposed amendments would neither affect any locality in particular nor create new costs for any local governments.

Projected Impact on Employment. The proposed amendments would not affect total employment.

Effects on the Use and Value of Private Property. The proposed amendments would not affect the value of private property. Real estate development costs would not be affected.

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¹ Section 2.2-4007.04 of the Code of Virginia requires that such economic impact analyses determine the public benefits and costs of the proposed amendments. Further the analysis should include but not be limited to: (1) the projected number of businesses or other entities to whom the proposed regulatory action would apply, (2) the identity of any localities and types of businesses or other entities particularly affected, (3) the projected number of persons and employment positions to be affected, (4) the projected costs to affected businesses or entities to implement or comply with the regulation, and (5) the impact on the use and value of private property.

² https://www.governor.virginia.gov/media/governorvirginiagov/governor-of-virginia/pdf/ed/ED-1-Regulatory-Reduction.pdf.

³ The current continuing education requirement is 20 hours per year, so inactive licensees seeking to reactivate would have to complete a maximum of 60 hours of continuing education.

⁴ See Agency Background Document (ABD), pages 8 and 10: https://townhall.virginia.gov/ l/GetFile.cfm?File=28\6189\10113\AgencyStatement_DHP_10113_v1.pdf.

⁵ Pursuant to § 2.2-4007.04 D: In the event this economic impact analysis reveals that the proposed regulation would have an adverse economic impact on businesses or would impose a significant adverse economic impact on a locality, business, or entity particularly affected, the Department of Planning and Budget shall advise the Joint Commission on Administrative Rules, the House Committee on Appropriations, and the Senate Committee on Finance. Statute does not define "adverse impact," state whether only Virginia entities should be considered, nor indicate whether an adverse impact results from regulatory requirements mandated by legislation.

⁶ Statute does not define "adverse impact," state whether only Virginia entities should be considered, nor indicate whether an adverse impact results from regulatory requirements mandated by legislation. As a result, DPB has adopted a definition of adverse impact that assesses changes in net costs and benefits for each affected Virginia entity that directly results from discretionary changes to the regulation.

⁷ Pursuant to § 2.2-4007.04, small business is defined as "a business entity, including its affiliates, that (i) is independently owned and operated and (ii) employs fewer than 500 full-time employees or has gross annual sales of less than $6 million."

⁸ If the proposed regulatory action may have an adverse effect on small businesses, § 2.2-4007.04 requires that such economic impact analyses include: (1) an identification and estimate of the number of small businesses subject to the proposed regulation, (2) the projected reporting, recordkeeping, and other administrative costs required for small businesses to comply with the proposed regulation, including the type of professional skills necessary for preparing required reports and other documents, (3) a statement of the probable effect of the proposed regulation on affected small businesses, and (4) a description of any less intrusive or less costly alternative methods of achieving the purpose of the proposed regulation. Additionally, pursuant to § 2.2-4007.1 of the Code of Virginia, if there is a finding that a proposed regulation may have an adverse impact on small business, the Joint Commission on Administrative Rules shall be notified.

⁹ "Locality" can refer to either local governments or the locations in the Commonwealth where the activities relevant to the regulatory change are most likely to occur.

¹⁰ Section 2.2-4007.04 defines "particularly affected" as bearing disproportionate material impact.

Agency's Response to Economic Impact Analysis: The Board of Long-Term Care Administrators concurs with the economic impact analysis prepared by the Department of Planning and Budget.

Summary:

The proposed amendments (i) create a pathway for inactive licensure for nursing home administrators and assisted living facility administrators; (ii) eliminate requirements for attestations of compliance with existing laws from application and renewal requirements; (iii) remove requirements for all documents in an application for licensure to be submitted at the same time; and (iv) remove requirements to obtain new preceptors within 60 days upon interruption of a preceptor program.

18VAC95-20-80. Required fees.

The applicant or licensee shall submit all fees in this section that apply:

1. AIT program application	$215
2. Preceptor application	$65
3. Licensure application	$315
4. Verification of licensure requests from other states	$35
5. Nursing home administrator license renewal	$315
6. Inactive nursing home administrator license renewal	$150
7. Preceptor renewal	$65
7. Penalty 8. Fee for nursing home administrator late renewal	$110
8. Penalty 9. Fee for preceptor late renewal	$25
9. 10. Fee for late inactive licensure renewal	$35
11. Nursing home administrator reinstatement	$435
10. 12. Preceptor reinstatement	$105
11. 13. Duplicate license	$25
12. 14. Duplicate wall certificates	$40
13. 15. Reinstatement after disciplinary action	$1,000

18VAC95-20-130. Additional fee information.

A. There shall be a fee of $50 for a returned check or a dishonored credit card or debit card.

B. Fees shall not be refunded once submitted.

C. Examination fees are to be paid directly to the service contracted by the board to administer or entity that administers the examinations.

Part II

Renewals and, Reinstatements, and Inactive Licenses

18VAC95-20-175. Continuing education requirements.

A. In order to renew a nursing home administrator license, an applicant shall attest on his the renewal application to completion of 20 hours of approved continuing education for each renewal year.

1. Up to 10 of the 20 hours may be obtained through Internet or self-study courses and up to 10 continuing education hours in excess of the number required may be transferred or credited to the next renewal year.

2. Up to two hours of the 20 hours required for annual renewal may be satisfied through delivery of services, without compensation, to low-income individuals receiving health services through a local health department or a free clinic organized in whole or primarily for the delivery of those services. One hour of continuing education may be credited for one hour of providing such volunteer services, as documented by the health department or free clinic.

3. At least two hours of continuing education for each renewal year shall relate to the care of residents with mental or cognitive impairments, including Alzheimer's disease and dementia.

4. A licensee who serves as the registered preceptor in an approved AIT or Assisted Living Facility AIT program may receive one hour of continuing education credit for each week of training up to a maximum of 10 hours of self-study course credit for each renewal year.

5. A licensee is exempt from completing continuing education requirements and considered in compliance on the first renewal date following initial licensure.

B. In order for continuing education to be approved by the board, it shall (i) be related to health care administration and shall be approved or offered by NAB, an accredited institution, or a government agency or (ii) as provided in subdivision A 2 of this section.

C. Documentation of continuing education.

1. The licensee shall retain in the licensee's personal files for a period of three renewal years complete documentation of continuing education, including evidence of attendance or participation as provided by the approved sponsor for each course taken.

2. Evidence of attendance shall be an original document provided by the approved sponsor and shall include:

a. Date the course was taken;

b. Hours of attendance or participation; and

c. Participant's name; and

d. Signature of an authorized representative of the approved sponsor.

3. If contacted for an audit, the licensee shall forward to the board by the date requested a signed affidavit of completion on forms provided by the board and evidence of attendance or participation as provided by the approved sponsor or as documented in the NAB continuing education registry.

D. The board may grant an extension of up to one year or an exemption for all or part of the continuing education requirements due to circumstances beyond the control of the administrator, such as a certified illness, a temporary disability, mandatory military service, or officially declared disasters. The request for an extension shall be received in writing and granted by the board prior to the renewal date.

18VAC95-20-180. Late renewal.

A. A person who fails to renew his a license or preceptor registration by the expiration date shall may, within one year of the initial expiration date:

1. Return the renewal notice or request renewal in writing to the board; and

2. Submit the applicable renewal fee and late fee.

B. The documents required in subsection A of this section shall be received in the board office within one year of the initial expiration date. Postmarks shall not be considered.

18VAC95-20-201. Inactive licensure.

A. A nursing home administrator who holds a current, unrestricted license in Virginia shall, upon a request for inactive status on the renewal application and submission of the required renewal fee, be issued an inactive license.

1. An inactive licensee shall not be entitled to perform any act requiring a license to practice nursing home administration or registration to serve as a preceptor in Virginia.

2. The holder of an inactive license shall not be required to meet continuing education requirements, except as may be required for reactivation in subsection B of this section.

B. A nursing home administrator who holds an inactive license may reactivate a license by:

1. Paying the difference between the renewal fee for an inactive license and that of an active license for the year in which the license is being reactivated; and

2. Providing proof of completion of the number of continuing competency hours required for the period in which the license has been inactive, not to exceed three years.

18VAC95-20-220. Qualifications for initial licensure.

One of the following sets of qualifications is required for licensure as a nursing home administrator:

1. Degree and practical experience. The applicant shall (i) hold a baccalaureate or higher degree in a health care-related field that meets the requirements of 18VAC95-20-221 from an accredited institution;, (ii) have completed not less than a 320-hour internship that addresses the Domains of Practice as specified in 18VAC95-20-390 in a licensed nursing home as part of the degree program under the supervision of a preceptor;, and (iii) have received a passing grade on the national examination;

2. Certificate program. The applicant shall (i) hold a baccalaureate or higher degree from an accredited college or university, (ii) successfully complete a program with a minimum of 21 semester hours study in a health care-related field that meets the requirements of 18VAC95-20-221 from an accredited institution, (iii) successfully complete not less than a 400-hour internship that addresses the Domains of Practice as specified in 18VAC95-20-390 in a licensed nursing home as part of the certificate program under the supervision of a preceptor, and (iv) have received a passing grade on the national examination;

3. Administrator-in-training program. The applicant shall have (i) successfully completed an AIT program that meets the requirements of Part IV (18VAC95-20-300 et seq.) of this chapter, and (ii) received a passing grade on the national examination, and (iii) completed the Domains of Practice form required by the board; or

4. Health Services Executive (HSE) credential. The applicant shall provide evidence that he the applicant has met the minimum education, experience, and examination standards established by NAB for qualification as a Health Services Executive.

18VAC95-20-230. Application package.

A. An application for licensure shall be submitted after the applicant completes the qualifications for licensure.

B. An individual seeking licensure as a nursing home administrator or registration as a preceptor shall submit:

1. A completed application as provided by the board;

2. Additional documentation as may be required by the board to determine eligibility of the applicant;

3. The applicable fee; and

4. An attestation that he has read and understands and will remain current with the applicable Virginia laws and regulations relating to the administration of nursing homes; and 5. A current report from the U.S. Department of Health and Human Services National Practitioner Data Bank (NPDB).

C. With the exception of school transcripts, examination scores, the NPDB report, employer verifications, and verifications from other state boards, all parts of the application package shall be submitted at the same time. An incomplete package shall be retained by the board for one year, after which time the application shall be destroyed and a new application and fee shall be required.

18VAC95-20-300. Administrator-in-training qualifications.

A. To be approved as an administrator-in-training, a person shall:

1. Have received a passing grade on a total of 60 semester hours of education from an accredited institution;

2. Obtain a registered preceptor to provide training;

3. Submit the fee prescribed in 18VAC95-20-80;

4. Submit the application and Domains of Practice form provided by the board; and

5. Submit additional documentation as may be necessary to determine eligibility of the applicant and the number of hours required for the AIT program.

B. With the exception of school transcripts, all required parts of the application package shall be submitted at the same time. An incomplete package shall be retained by the board for one year after which time the application shall be destroyed and a new application and fee shall be required.

18VAC95-20-440. Interruption of program.

A. If the program is interrupted because the registered preceptor is unable to serve, the AIT shall notify the board within five working days and shall obtain a new preceptor who is registered with the board within 60 days.

B. Credit for training shall resume when a new preceptor is obtained and approved by the board.

C. If an alternate training plan is developed, it shall be submitted to the board for approval before the AIT resumes training.

18VAC95-30-40. Required fees.

A. The applicant or licensee shall submit all fees in this subsection that apply:

1. ALF AIT program application	$215
2. Preceptor application	$65
3. Licensure application	$315
4. Verification of licensure requests from other states	$35
5. Assisted living facility administrator license renewal	$315
6. Inactive license renewal	$150
7. Preceptor renewal	$65
7. Penalty 8. Fee for assisted living facility administrator late renewal	$110
8. Penalty 9. Fee for preceptor late renewal	$25
10. Fee for inactive license late renewal	$35
9. 11. Assisted living facility administrator reinstatement	$435
10. 12. Preceptor reinstatement	$105
11. 13. Duplicate license	$25
12. 14. Duplicate wall certificates	$40
13. 15. Returned check or dishonored credit card or debit card	$50
14. 16. Reinstatement after disciplinary action	$1,000

B. Fees shall not be refunded once submitted.

C. Examination fees are to be paid directly to the service contracted by the board to administer or entity that administers the examination.

Part II

Renewals and, Reinstatements, and Inactive Licenses

18VAC95-30-70. Continuing education requirements.

A. In order to renew an assisted living administrator license, an applicant shall attest on the applicant's renewal application to completion of 20 hours of approved continuing education for each renewal year.

1. Up to 10 of the 20 hours may be obtained through Internet or self-study courses and up to 10 continuing education hours in excess of the number required may be transferred or credited to the next renewal year.

2. Up to two hours of the 20 hours required for annual renewal may be satisfied through delivery of services, without compensation, to low-income individuals receiving health services through a local health department or a free clinic organized in whole or primarily for the delivery of those services. One hour of continuing education may be credited for one hour of providing such volunteer services, as documented by the health department or free clinic.

3. At least two hours of continuing education for each renewal year shall relate to the care of residents with mental or cognitive impairments, including Alzheimer's disease and dementia.

4. A licensee who serves as the registered preceptor in an approved ALF AIT program may receive one hour of continuing education credit for each week of training up to a maximum of 10 hours of self-study course credit for each renewal year.

5. A licensee is exempt from completing continuing education requirements for the first renewal following initial licensure in Virginia.

B. In order for continuing education to be approved by the board, it shall (i) be related to the Domains of Practice for residential care/assisted care or assisted living and approved or offered by NAB, an accredited educational institution, or a governmental agency or (ii) be as provided in subdivision A 2 of this section.

C. Documentation of continuing education.

1. The licensee shall retain in his the licensee's personal files for a period of three renewal years complete documentation of continuing education including evidence of attendance or participation as provided by the approved sponsor for each course taken.

2. Evidence of attendance shall be an original document provided by the approved sponsor and shall include:

a. Date the course was taken;

b. Hours of attendance or participation; and

c. Participant's name; and

d. Signature of an authorized representative of the approved sponsor.

3. If contacted for an audit, the licensee shall forward to the board by the date requested a signed affidavit of completion on forms provided by the board and evidence of attendance or participation as provided by the approved sponsor or as documented in the NAB continuing education registry.

D. The board may grant an extension of up to one year or an exemption for all or part of the continuing education requirements due to circumstances beyond the control of the administrator, such as a certified illness, a temporary disability, mandatory military service, or officially declared disasters. The request for an extension shall be submitted in writing and granted by the board prior to the renewal date.

18VAC95-30-80. Late renewal.

A. A person who fails to renew his a license or preceptor registration by the expiration date shall may, within one year of the initial expiration date:

1. Submit the renewal notice or request renewal by mail to the board;

2. Submit the applicable renewal fee and penalty fee;

3. Provide evidence as may be necessary to establish eligibility for renewal.

B. The documents required in subsection A of this section shall be received in the board office within one year of the initial expiration date. Postmarks shall not be considered.

18VAC95-30-91. Inactive licensure.

A. An assisted living facility administrator who holds a current, unrestricted license in Virginia shall, upon a request for inactive status on the renewal application and submission of the required renewal fee, be issued an inactive license.

1. An inactive licensee shall not be entitled to perform any act requiring a license to practice assisted living facility administration or registration to serve as a preceptor in Virginia.

2. The holder of an inactive license shall not be required to meet continuing education requirements, except as may be required for reactivation in subsection B of this section.

B. An assisted living facility administrator who holds an inactive license may reactivate such license by:

1. Paying the difference between the renewal fee for an inactive license and that of an active license for the year in which the license is being reactivated; and

2. Providing proof of completion of the number of continuing competency hours required for the period in which the license has been inactive, not to exceed three years.

18VAC95-30-130. Application package.

A. An application for licensure shall be submitted after the applicant completes the qualifications for licensure.

B. An individual seeking licensure as an assisted living facility administrator or registration as a preceptor shall submit:

1. A completed application as provided by the board;

2. Additional documentation as may be required by the board to determine eligibility of the applicant, to include the most recent survey report if the applicant has been serving as an acting administrator of a facility;

3. The applicable fee; and

4. An attestation that he has read and understands and will remain current with the applicable Virginia laws and the regulations relating to assisted living facilities; and 5. A current report from the U.S. Department of Health and Human Services National Practitioner Data Bank (NPDB).

C. With the exception of school transcripts, examination scores, the NPDB report, employer verifications, and verifications from other state boards, all parts of the application package shall be submitted at the same time. An incomplete package shall be retained by the board for one year, after which time the application shall be destroyed and a new application and fee shall be required.

18VAC95-30-140. Training qualifications.

A. To be approved as an ALF administrator-in-training, a person shall:

1. Meet the requirements of 18VAC95-30-100 A 1;

2. Obtain a registered preceptor to provide training;

3. Submit the application and Domains of Practice form provided by the board and the fee prescribed in 18VAC95-30-40; and

4. Submit additional documentation as may be necessary to determine eligibility of the applicant and the number of hours required for the ALF AIT program.

B. With the exception of school transcripts, all required parts of the application package shall be submitted at the same time. An incomplete package shall be retained by the board for one year after which time the application shall be destroyed and a new application and fee shall be required.

18VAC95-30-200. Interruption or termination of program.

A. If the program is interrupted because the registered preceptor is unable to serve, the trainee shall notify the board within 10 working days and shall obtain a new preceptor who is registered with the board within 60 days.

1. Credit for training shall resume when a new preceptor is obtained and approved by the board.

2. If an alternate training plan is developed, it shall be submitted to the board for approval before the trainee resumes training.

B. If the training program is terminated prior to completion, the trainee and the preceptor shall each submit a written explanation of the causes of program termination to the board within 10 business days. The preceptor shall also submit all required monthly progress reports completed prior to termination within 10 business days.