Titles of Regulations: 18VAC95-20. Regulations Governing the Practice of Nursing Home Administrators (amending 18VAC95-20-230).

18VAC95-30. Regulations Governing the Practice of Assisted Living Facility Administrators (amending 18VAC95-30-130).

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

Public Hearing Information: No public hearings are scheduled.

Public Comment Deadline: July 1, 2015.

Effective Date: July 16, 2015.

Agency Contact: Lisa Russell Hahn, Executive Director, Board of Long-Term Care Administrators, 9960 Mayland Drive, Suite 300, Richmond, VA 23233-1463, telephone (804) 367-4595, FAX (804) 527-4413, or email ltc@dhp.virginia.gov.

Basis: 18VAC95-20 and 18VAC95-30 are promulgated by the Board of Long-Term Care Administrators under the general authority of § 54.1-2400 of the Code of Virginia, which includes the responsibility to promulgate regulations that are reasonable and necessary for the administration of a regulatory program.

Purpose: The purpose of the amended regulation is protection of the health and safety of the elderly and often vulnerable population of residents and patients in assisted living facilities and nursing homes. Applicants are usually honest in their responses to questions about the status of licensure in other states and malpractice history. A report from the U.S. Department of Health and Human Services Data Bank ensures that Virginia will not license a person who has had disciplinary action based on unprofessional conduct or a criminal conviction that would provide grounds for denial of licensure and avoids exposing Virginians to practice by a person who could present a risk to the public.

Rationale for Using Fast-Track Process: The fast-track rulemaking process is being used because the amendment is essential for public protection and therefore will not be controversial.

Substance: The amendments require applicants for licensure to provide a current report from the U.S. Department of Health and Human Services Data Bank.

Issues: The advantage to the public is greater assurance that persons licensed as assisted living administrators and nursing home administrators have no history of convictions of unprofessional conduct that could present a risk of harm. There are no disadvantages to the public. The advantage to the board is the availability of a third-party confirmation of the possible disciplinary history of applicants. There are no disadvantages to the Commonwealth.

Department of Planning and Budget's Economic Impact Analysis:

Summary of the Proposed Amendments to Regulation. The Board of Long-Term Care Administrators (Board) proposes to require applicants for licensure to provide a current report from the U.S. Department of Health and Human Services National Practitioners Data Bank (NPDB).

Result of Analysis. Benefits likely outweigh costs for this proposed regulatory change.

Estimated Economic Impact. Current regulation requires applicants for licensure to attest on their applications that they have not been subject to any disciplinary actions while licensed in another state and also requires that they disclose any history of malpractice claims. The Board now proposes to also require applicants to provide a current report from the NPDB along with their applications. This report will allow Board staff to verify that the applicants have not been subject to any disciplinary action based on unprofessional conduct and that they do not have any criminal convictions that would be grounds to deny licensure.

Board staff reports that applicants will pay for the NPDB report, which currently costs $8, but also report that the cost of this report will be reduced to $5 on October 1, 2014. Since it is highly unlikely that this regulatory change will be effective before that date, applicants are likely to only incur costs equal to the $5 report fee plus any nominal mailing costs if they mail their application materials to the Board (rather than submitting them online). These costs are likely outweighed by the benefits that will accrue to residents of long-term care facilities who will be better protected from being subject to the care of licensed long-term care administrators who would have been disqualified from licensure if the Board had full information on them.

Businesses and Entities Affected. All applicants for licensure as long-term care administrators will likely be affected by this regulatory change. Board staff reports that they received 430 applications for licensure in the year period ending on June 30, 2014.

Localities Particularly Affected. No locality will be particularly affected by this proposed regulatory action.

Projected Impact on Employment. This proposed regulation is unlikely to affect employment in the Commonwealth.

Effects on the Use and Value of Private Property. This proposed regulation is unlikely to affect the use or value of private property in the Commonwealth.

Small Businesses: Costs and Other Effects. No small business is likely to incur any costs on account of the proposed regulation.

Small Businesses: Alternative Method that Minimizes Adverse Impact. No small business is likely to incur any costs on account of the proposed regulation.

Real Estate Development Costs. This proposed regulation is unlikely to affect real estate development costs.

Legal Mandate. General: 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 Number 17 (2014). Section 2.2-4007.04 requires that such economic impact analyses determine the public benefits and costs of the proposed amendments. Further the report should include but not be limited to:

• the projected number of businesses or other entities to whom the proposed regulation would apply,

• the identity of any localities and types of businesses or other entities particularly affected,

• the projected number of persons and employment positions to be affected,

• the projected costs to affected businesses or entities to implement or comply with the regulation, and

• the impact on the use and value of private property.

Small Businesses: If the proposed regulation will have an adverse effect on small businesses, § 2.2-4007.04 requires that such economic impact analyses include:

• an identification and estimate of the number of small businesses subject to the proposed regulation,

• 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,

• a statement of the probable effect of the proposed regulation on affected small businesses, and

• 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, if there is a finding that a proposed regulation may have an adverse impact on small business, the Joint Commission on Administrative Rules is notified at the time the proposed regulation is submitted to the Virginia Register of Regulations for publication. This analysis shall represent DPB's best estimate for the purposes of public review and comment on the proposed regulation.

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

Summary:

The amendments require applicants for licensure to provide a current report from the U.S. Department of Health and Human Services National Practitioner Data Bank.

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, 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.

18VAC95-30-130. 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;

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, 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.