Section 172-106-009 - PROVISIONAL LICENSE AS A NURSING HOME ADMINISTRATORTo obtain a provisional license, an individual must submit a complete application provided by the Department and provide documentation demonstrating that the applicant meets the credentialing requirements of Neb. Rev. Stat. § 38-2423, 172 NAC 10, and this chapter.
009.01APPLICATION. The applicant must provide the following: (A) Name of facility to be employed;(C) Name of previous administrator of facility; and(D) Signed affidavit of designation of a provisional license, completed by the owner, governing body, or other appropriate authority of the nursing home or home for the aged or infirm which includes: (i) Name of chairperson, governing body, or similar authority of the nursing home; (ii) Name of applicant requesting a provisional license;(iii) Name of previous administrator;(iv) Proposed starting date; and(v) Reason for request, such as death of previous administrator, medical emergency, unexpected resignation of the licensed administrator.009.02PROVISIONAL LICENSE RE-ISSUED. A provisional license issued to an individual may be re-issued one time for an additional 6-month period for the same facility, upon approval and submission of a new application under this section.009.03MENTORING TRAINEE AND PROVISIONAL LICENSEE. A person in a mentoring program may serve as the provisional licensee while completing the mentoring training program.172 Neb. Admin. Code, ch. 106, § 009
Amended effective 9/21/2020