1,000 Hour Program:
- Holds a baccalaureate degree from an accredited college or university and majored in health care administration, health services administration, or an equivalent major, or has credit for at least 60 semester hours in subjects, as prescribed by rule of the board, which prepare the applicant for total management of a nursing home.
2,000 Hour Program:
- Holds a baccalaureate degree from an accredited college or university.
Applicants with Health History
If you answer “yes” to any of the health history questions on the application, please submit supporting documentation including the relevant dates and circumstances of such treatment and/or addiction along with the names and addresses of the medical practitioners or hospitals who performed such treatment.
Applicants with Discipline History
Applicants with prior disciplinary actions are required to submit the following:
Board Actions – Certified copies of document(s) relative to any disciplinary action taken against any license. The documents must come from the agency that took the disciplinary action and must be certified by that agency.
Self-Explanation – A detailed description of the circumstances surrounding your disciplinary action and a thorough description of the rehabilitative changes in your lifestyle since the time of the disciplinary action which would enable you to avoid future occurrences. It would be helpful to include factors in your life, which you feel may have contributed to your disciplinary action, what you have learned about yourself since that time, and the changes you have made that support your rehabilitation.
Applicants with Criminal History
Applicants with prior criminal convictions are required to submit the following:
Final Dispositions/Arrest Records – Final disposition records for offenses can be obtained at the clerk of the court in the arresting jurisdiction. If the records are not available, you must have a letter on court letterhead sent from the clerk of the court attesting to their unavailability.
Completion of Probation/Parole/Sanctions – Probation and financial sanction records for offenses can be obtained at the clerk of the court in the arresting jurisdiction. Parole records for offenses can be obtained from the Department of Corrections or at the clerk of the court in the arresting jurisdiction. If the records are not available, you must have a letter on court letterhead sent from the clerk of the court attesting to their unavailability.
Self-Explanation – Applicants who have listed offenses on the application must submit a letter in their own words describing the circumstances of the offense. Include in your letter the date of the original offense, the charge, and the jurisdiction where it occurred.
Health Care Fraud; Disqualifications for License, Certificate, or Registration
Effective July 1, 2012, Section 456.0635, Florida Statutes (F.S.), provides that health care boards or the department shall refuse to issue a license, certificate or registration and shall refuse to admit a candidate for examination if the applicant:
- Has been convicted of, or entered a plea of guilty or nolo contendere to, regardless of adjudication, a felony under Chapter 409, F.S., (relating to social and economic assistance), Chapter 817, F.S., (relating to fraudulent practices), Chapter 893, F.S., (relating to drug abuse prevention and control) or a similar felony offense(s) in another state or jurisdiction unless the candidate or applicant has successfully completed a drug court program for that felony and provides proof that the plea has been withdrawn or the charges have been dismissed. Any such conviction or plea shall exclude the applicant or candidate from licensure, examination, certification, or registration, unless the sentence and any subsequent period of probation for such conviction or plea ended:
- For the felonies of the first or second degree, more than 15 years from the date of the plea, sentence and completion of any subsequent probation;
- For the felonies of the third degree, more than 10 years from the date of the plea, sentence and completion of any subsequent probation;
- For the felonies of the third degree under section 893.13(6)(a), F.S., more than five years from the date of the plea, sentence and completion of any subsequent probation;
- Has been convicted of, or entered a plea of guilty or nolo contendere to, regardless of adjudication, a felony under 21 U.S.C. ss. 801-970 (relating to controlled substances) or 42 U.S.C. ss. 1395-1396 (relating to public health, welfare, Medicare and Medicaid issues), unless the sentence and any subsequent period of probation for such conviction or pleas ended more than 15 years prior to the date of the application;
- Has been terminated for cause from the Florida Medicaid program pursuant to section 409.913, F.S., unless the candidate or applicant has been in good standing with the Florida Medicaid program for the most recent five years;
- Has been terminated for cause, pursuant to the appeals procedures established by the state or Federal Government, from any other state Medicaid program, unless the candidate or applicant has been in good standing with a state Medicaid program for the most recent five years and the termination occurred at least 20 years before the date of the application;
- Is currently listed on the United States Department of Health and Human Services Office of Inspector General’s List of Excluded Individuals and Entities.
A Preceptor must be located prior to starting the program. As a courtesy, the board generates an updated list of all Florida Certified Preceptors. This list can be located under Resources, then Forms and Requests.
Please download, print and complete the paper application and submit along with your fees to the address listed below:
Florida Board of Nursing Home Administrators
P. O. Box 6330
Tallahassee, FL 32314-6330
The following documents are required in order to complete your application:
- An official copy of your transcript(s) submitted directly to the board office.
- Latest AHCA Survey Report, including statement indicating the facility is currently in compliance with AHCA standards.
Within 7-14 days of receipt of your application, the board office will notify you of the status of your application and any remaining required documents that need to be submitted.
1,000 Hour AIT Program:
|Unlicensed Activity Fee||$5.00|
2,000 Hour AIT Program:
|Unlicensed Activity Fee||$5.00|
Make certified checks or money orders payable to the “Department of Health.”
Chapter 468, Part II: Nursing Home Administrators
Chapter 456: Health Professions and Occupations: General Provisions
Chapter 400, Part II: Nursing Homes and Related Health Care Facilities
Chapter 415, Parts: Adult Protective Services
Chapter 765, Parts I, II, III and IV: Health Care Advance Directives
Chapter 120: Administrative Procedure Act
Florida Administrative Code (F.A.C.)
Rules: Chapter 64B10: (Board of Nursing Home Administrators Rules)
Rules: Chapter 64E11: (Division of Environmental Health – Food Hygiene)
Rules: Chapter 64E16: (Division of Environmental Health – Biomedical Waste)
Rules: Chapter 59A4: (Agency for Health Care Administration – Minimum Standards for Nursing Homes)