NC Nursing Home Administrator Exam

Cards · 50

NC Board of Examiners for Nursing Home Administrators (NCBENHA)

Established under NCGS Chapter 90, Article 20 to set qualifications, administer examinations, issue licenses, and discipline nursing home administrators.

AIT Program Duration in North Carolina

21 NCAC 37D .0402 requires an Administrator-in-Training program of up to 26 weeks (or minimum 12 weeks for applicants with advanced health care degrees).

AIT Preceptor Eligibility Requirements

Must be a licensed NC administrator in good standing with at least 3 years of active continuous practice as a licensed NHA immediately prior to precepting.

Continuing Education Units (CEU) Requirement for NC NHA Renewal

21 NCAC 37G .0101 requires 30 approved continuing education hours every two-year licensing cycle to maintain an active NHA license.

License Renewal Deadline for NC NHAs

All NC nursing home administrator licenses expire biennially on September 30 of even-numbered years and must be renewed on or before that date.

Grace Period for NC NHA License Renewal

A licensee has until December 31 following the expiration date to renew with a late fee before the license becomes expired and subject to reinstatement.

Mandatory Notification of Change of Address or Employment

Per 21 NCAC 37B .0203, an NHA must notify the NCBENHA in writing within 15 calendar days of any change of residence or place of employment.

Temporary Administrator Permit in North Carolina

NCGS 90-278 allows issuance of a temporary license for up to 6 months in emergencies when a facility loses its administrator unexpectedly.

Grounds for Disciplinary Action under NCGS 90-285.1

Includes fraud, deceit, felony convictions, gross negligence, incompetence, and violation of board rules or patient care standards.

NC Division of Health Service Regulation (DHSR)

The state licensing and regulatory oversight agency responsible for surveying nursing homes and enforcing NC rules and CMS certification mandates.

Full-Time Administrator Mandate (10A NCAC 13D .2201)

Every licensed nursing home in NC must employ a full-time, licensed nursing home administrator responsible for overall facility management.

Director of Nursing (DON) Qualification in NC

Under 10A NCAC 13D .2202, the DON must be a registered nurse licensed in NC with clinical experience and supervisory authority over all nursing services.

DON Absence and Replacement Coverage

When the DON is absent for more than 30 consecutive days, a qualified RN must be designated in writing to assume the DON duties and notify DHSR.

Minimum Direct Nursing Care Hours in North Carolina

10A NCAC 13D .2303 requires a minimum of 2.1 nursing hours per patient day (NHPPD) distributed across licensed and unlicensed nursing staff.

RN Coverage Requirement (10A NCAC 13D .2303 / 42 CFR 483.35)

A facility must have a licensed registered nurse on duty at least 8 consecutive hours a day, 7 days a week, plus 24-hour licensed nurse coverage.

Medical Director Responsibilities (10A NCAC 13D .2203)

Responsible for overall medical direction, clinical policy development, resident medical care coordination, and physician peer review.

Quality Assessment and Assurance (QAA) Committee Composition

Under 42 CFR 483.75, must include the DON, Medical Director or designee, at least three other staff members, and an infection preventionist.

Infection Preventionist Specialized Training Mandate

42 CFR 483.80 requires a designated infection preventionist with specialized post-secondary training working at least part-time on-site.

Mandatory Abuse Reporting Timeframe (42 CFR 483.12)

Must report alleged abuse involving serious bodily injury within 2 hours; other suspected abuse or neglect must be reported within 24 hours.

North Carolina Adult Protective Services (APS) Reporting Mandate

NCGS Chapter 108A mandates any person with reasonable cause to believe a disabled adult needs protective services to report immediately to county DSS.

Comprehensive Resident Assessment Timeline (RAI/MDS)

Under 42 CFR 483.20, an MDS assessment must be completed no later than 14 calendar days after admission and annually, plus significant changes.

Comprehensive Care Plan Completion Deadline

Must be developed within 7 calendar days after the completion of the comprehensive MDS assessment under 42 CFR 483.21.

Baseline Care Plan Deadline

Under federal rules, a baseline care plan meeting initial medical and safety needs must be completed within 48 hours of admission.

Monthly Pharmaceutical Regimen Review (PRR)

42 CFR 483.45 mandates a licensed pharmacist conduct a monthly medication regimen review for every resident and report irregularities.

Medication Error Rate Threshold

Under federal and state survey guidelines, facilities must maintain a medication administration error rate of less than 5 percent.

Controlled Substances Destruction in NC Nursing Facilities

10A NCAC 13D .2604 requires destruction of controlled substances by a licensed pharmacist and RN, maintaining detailed witness documentation.

Emergency Drug Kit (Stat Box) Oversight

Must be sealed, regularly inspected, maintained by a consulting pharmacy, and used only upon a valid prescriber order.

Initial Dietary and Nutritional Assessment Timing

Per 10A NCAC 13D .2501, nutritional screening must be conducted upon admission, with formal dietetic plans overseen by a registered dietitian.

Maximum Meal Interval Rule

There must be no more than 14 hours between a substantial evening meal and breakfast, extendable to 16 hours if a nourishing bedtime snack is served.

Disaster and Emergency Preparedness Plan (10A NCAC 13D .2208)

Facility must establish a comprehensive written emergency plan addressing fire, severe weather, evacuation, power loss, and annual drills.

Emergency Generator Monthly Inspection and Testing

Requires monthly 30-minute load tests of the emergency generator and 24-hour fuel reserve capacity under NFPA 99 and NFPA 101 standards.

Fire Drills Frequency in NC Nursing Homes

Under Life Safety Code and NC rules, fire safety drills must be conducted unannounced at least quarterly per shift across all three operating shifts.

NC Health Care Personnel Registry (HCPR) Check

NCGS 131E-256 requires verification of prospective unlicensed direct care employees against the HCPR prior to employment to bar substantiated abusers.

Nurse Aide Certification and Competency Evaluation

Non-certified aides must complete an approved state training program and pass state competency tests within 4 months of hire (42 CFR 483.35).

Nurse Aide Annual In-Service Hours

Under 42 CFR 483.95, certified nurse aides must receive at least 12 hours of qualified in-service education every 12-month period.

Physician Visit Frequency for Long-Stay Residents

42 CFR 483.30 mandates residents be seen at least once every 30 days for the first 90 days, and at least once every 60 days thereafter.

Residents' Bill of Rights (NCGS 131E-115 et seq.)

Guarantees rights to privacy, dignified treatment, financial autonomy, freedom from chemical/physical restraint, and choice of personal physician.

Physical Restraint Medical Order Limitations

Restraints may only be used upon a physician order with specific clinical indication, time-limited duration, and documented trial of alternatives.

Psychotropic Medication Gradual Dose Reduction (GDR)

Federal rules require regular GDR attempts and behavioral interventions unless clinically contraindicated to prevent unnecessary chemical restraint.

Resident Council Rights in North Carolina

Facilities must provide private meeting space and staff support for resident councils, responding in writing to grievances raised during meetings.

Notice of Transfer or Discharge Timeframe

Except for emergency or rapid clinical change, written notice must be given to resident and representative at least 30 days prior to transfer.

Facility Plan of Correction (POC) Submission Deadline

Following receipt of a CMS-2567 Statement of Deficiencies, the facility must submit an acceptable Plan of Correction within 10 calendar days.

Immediate Jeopardy (IJ) Survey Finding

A crisis-level deficiency where noncompliance has caused or is likely to cause serious injury, harm, impairment, or death to a resident.

Medical Record Retention Period in North Carolina

10A NCAC 13D .2105 requires adult medical records to be retained for at least 5 years following the date of discharge (longer for minors).

Clinical Record Access Request Timeframe

Under 42 CFR 483.10, residents have the right to inspect records within 24 hours of request and obtain copies within two working days.

Tuberculosis (TB) Screening Protocol for Personnel

10A NCAC 13D .2209 mandates initial two-step tuberculin skin test or IGRA screening for new healthcare personnel prior to resident contact.

Water Temperature Control Standards in Resident Areas

10A NCAC 13D .3404 mandates that hot water delivered to resident bathtubs, showers, and handwashing lavatories stay between 100°F and 116°F.

Bedrails Assessment and Safety Requirements

42 CFR 483.25 requires facilities to assess residents for entrapment risk and obtain informed consent before installing or utilizing bedrails.

Preadmission Screening and Resident Review (PASRR)

Federal mandate ensuring individuals with serious mental illness or intellectual disability are screened prior to admission to determine appropriate care.

Resident Personal Funds Surety Bond

Per 42 CFR 483.10, facilities managing resident personal funds must hold a surety bond ensuring full financial protection of residents' trust money.