Directions for Recording and Reporting Continuing Education Credits
- Each licensee must maintain an accurate record of his/her Continuing Education (CE) attendance at approved CE programs and/or completion of other approved CE activities. Other approved CE activities are: credit bearing college course work, preceptor service, teaching or publishing in the field of nursing home administration, or approved home study. Approved program and activity categories are described in the Nursing Home Administrator Continuing Education Program Guidelines.
- In order for credits to be used toward the licensee's fulfillment of NYS nursing home administrator CE requirements, sponsors will issue a certificate or other document to each licensee who attends their approved programs. Licensees are responsible for ensuring that they receive such a certificate from the sponsor for each program they attend and to provide copies of such certificates upon audit only when specifically instructed to do so by the Board. Each certificate should contain the following information:
- Program title;
- Licensee's name;
- New York State NHA license number;
- Date of CE program presentation or activity;
- Location (City and State) of CE program presentation or Home Study/Home-based/On-line designation;
- Name and signature of CE program sponsor;
- Program approval number issued by NAB/NCERS, a state board of nursing home administrators or state licensing agency; and
- The number of hours that the licensee was in attendance at the program/activity.
If any of the above do not appear on the certificate, add them in the upper right-hand corner of the certificate.
- Licensees must record CE attendance on the "New York State Nursing Home Administrator Continuing Education Credit Report," form DOH-4167, and submit the completed form with the registration renewal/reactivation application. For each CE program or activity attended, the following information must be recorded in the correct box on a "New York State Nursing Home Administrator Continuing Education Credit Report" Form DOH-4167 (the credit report form may be reproduced by the licensee as needed). Note that boxes are designated by reference numbers one (1) through eight (8) corresponding to the following required information. ALL boxes must be filled out for EACH reported CE program or activity.
- Title of CE Program or Activity – write the program's title in the box indicated with the reference number 1.
- Name of CE Program Sponsor – write the name of the program's sponsor in the box indicated with the reference number 2.
- Home Study/Internal Corporate Provider – you must designate whether or not the program is offered through home-study, self-study, on-line or correspondence or is a NAB/NCERS approved program offered internally by a corporate provider by inserting a "Y" (for yes) or an "N" (for no) in the box indicated with reference number 3.
- Program Date/s – write the date or dates of the CE program presentation or the date of completion of the activity/program in the box indicated with reference number 4.
- City/State – write the location (City and State) where the CE program presentation was held in the box indicated with reference number 5. If the program was home-based or on-line, write "home" in this box. If the program sponsor is your employing corporation, write "work" in this box.
- Approval # - write the complete program approval number issued by the National Continuing Education Review Service (NCERS)* or a state board of examiners of nursing home administrators, or a state nursing home administrator (NHA) licensing agency in the box indicated with reference number 6.
* NCERS is a service of the National Association of Boards of Examiners of Long Term Care Administrators (NAB).
- Approving Entity – write the name of the agency/entity/organization that approved the program or activity in the box marked with reference number 6. Only programs approved for nursing home administrator CE credit by NAB/NCERS, the NYS Department of Health or another state's nursing home administrator licensing body are acceptable for nursing home administrator CE credit in New York State.
- Approved CE Hours Attended – write the number of clock hours that the licensee attended approved programming (not to include time involving non-presentation activity, e.g., meal or break time, facility tours, program registration, etc.) or the number of credits awarded for the approved CE activity in the box marked with reference number 8.
All information submitted in support of an application for licensure or registration is subject to audit/verification; the making of false statements is subject to the penalties prescribed by law.
Do Not Submit Certificates Or Other Sponsor Supplied Documentation To The Board Unless Specifically Requested By The Board To Do So.
Each licensee will submit his or her CE Credit Report to the Board only in conjunction with, and at the same time as, submitting an application for registration renewal or reactivation, or if specifically requested to do so by the Board. All forms and documentation in support of Nursing Home Administrator License Registration Renewal or Reactivation are to be mailed to:NYS Department of Health
Board of Examiners of Nursing Home Administrators
875 Central Avenue
Albany, NY 12206
- All of the following must be on each page of the submitted CE Credit Report:
- Certification Statement signed and dated by the licensee (at the bottom of each page of the CE Credit Report) attesting that the reported programs were attended by the licensee for the number of hours reported (signatures must be original, not copies);
- Licensee's name, typed or printed legibly;
- Licensee's New York State NHA license number; and
- Page number and number of pages being submitted (at the bottom right corner of each page).
- For audit purposes, each licensee must retain his or her certificates of program attendance or other written documentation, as stated above, for at least two (2) years following his/her license registration renewal or reactivation. Upon request, the licensee must submit the certificates to the New York State Department of Health or the Board of Examiners of Nursing Home Administrators (the Board).