National Association of Boards of Examiners of Long Term Care Administrators

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National Association of Boards of Examiners of
Long Term Care Administrators

• American Public Health Association
• October 23, 2001

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Nursing Home Administrators A Vanishing
Profession

• Third Year Decline
• And Increasing Need
• May Signal a Crisis-in-the-Making
• Introduction
• History of Licensure
• Current Profile of NHAs
• Current Situation
• How We Are Responding

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IntroductionRandy Lindner, MHSA, CAE

• Executive Director
• National Association of Boards of Examiner of
• Long Term Care Administrators (NAB)
• Member - Board of Directors (FARB)
• Federation of Associations of Regulatory Boards
• Member- Board of Directors (CLEAR)
• Council on Licensure, Enforcement and Regulation
• Member
• Interprofessional Workgroup on Health Care
  Regulatory Reform
• Member - Advisory Committee
• Wertlieb Educational Institute for Long Term Care
  Management, George Washington University
• Member (ACHCA)
• American College of Healthcare Administrators

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Introduction

• National Association of Boards of Examiners of
  Long Term Care Administrators (NAB)
• Mission Public Protection
• Members

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History

• National Legislation for Licensure
• Amendment to the 1965 Social Security Act in 1967
• States obligated to have licensure program in
  effect by July 1, 1970
• NAB Formed 1970
• Responsible for nationally recognized Long-Term
  Care Administrators exams
• Nursing Home Administrator
• Assisted Living Managers

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Other Support Programs

• Academic accreditation
• Continuing educational approvals
• Disciplinary reporting
• Standards of practice
• Reciprocity development
• Model regulations and standards

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OBRA 86 Raised the Bar

• CMS (a.k.a. HCFA) released proposed administrator
  standards in 1987
• Baccalaureate Degree
• All but 14 states currently meet standard
• 12 week (480 hour) internship program
• All but 7 states require 250 2000 hours
• Standardized Examination
• Full compliance
• 20 Hours of CE annually
• All but 4 states require 15-30 hours
• Regulation still pending

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Demographics for NHA Candidates (2000)

• 65 Female
• Age Cohort 25 to 35
• College graduate Emphasis on long term care
• 50 Baccalaureate, 27 Masters
• Completed AIT Program
• Experienced in long term care

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Number of NHA Candidates

• Average 1988 to 1997 3778
• Range 3351 to 4572
• 1998 3324 lt-12gt
• 1999 2975 lt-11gt
• 2000 2423 lt-19gt
• 2001 (Projected) 2000
• Revised Projection as of August 2001 (2,400)

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NHA Exam Candidates 1988-2000 36.5 Decline --
1997-2000  
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Reports of College Programs

• Decline in enrollments
• Decline in graduations
• Decline in candidates sitting for exam

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Reasons Given for Enrollment Declines

• Unpaid internships (AIT)
• Lower salaries than other sectors
• Increased competition from Assisted Living
• Negative image of profession
• Perception of high stress job
• Lack of knowledge of career options

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Anecdotal Reports of Declines in Renewals

• States are reporting a decline in the renewal
  rate of currently licensed NHAs
• Recruiters report increased demand and supply
  shortage in some areas of the country
• NAB desires to further quantify these reports and
  the reasons for the decline

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Possible Reasons for Decline

• Punitive Regulatory Environment
• Labor/staffing shortages
• Compensation
• Alternate attractive career options
• Litigious environment
• Industry Financial distress
• Negative image of industry

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How Have States Responded?

• NAB conducted survey to quantify decline and
  response on the state level
• Experiencing a decline (58 new, 38 endorsement)
• Relaxed educational requirements (17)
• Relaxed AIT requirements (32)
• Relaxed requirements for reciprocity (29)

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58 of Reporting States, Reported a Decline in
New NHA Applicants
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NABs Response

• Partnership efforts with Academia, Industry,
  Government, Professional Trade Assns
• Summit on the Decline in Recruitment and
  Retention of LTC Administrators
• Establishment of Marketing Task Force
• Career Brochure Development
• PR Campaign
• National Practice Act
• Registry of Profession
• Research

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Closing Remarks

• Recommendations to NAB State Licensure Boards
  and/or Agencies, Academia, Government and
  Associations
• Raise Awareness of the Profession
• Improve the image of the Profession
• Elevate Visibility of the Problems
• Eliminate Unnecessary Barriers to Licensure
• Work as Coalitions to Address Problems

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Contact Information