Administrator In Training (AIT) Course

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Administrator In Training (AIT) Course May 9-10, June 13-14, July 18-19, and September 11-13, 2018 8:30 a.m. 4:30 p.m. $900 Lunch and Materials Included Who should take this course? People who are currently working in a long-term care facility who plan to take the Arkansas State exam and the National Association of Long Term Care Administrator Boards (NAB) exam but need further education. You must meet the eligibility criteria listed on the AIT check list. Will this course or the AHCF help me find a job? After passing this course, you must take the state exam and the NAB exam to be qualified as an administrator. Completing this course is not a guarantee of a job as an administrator, nor is it a substitution for the Arkansas State exam or the National Association of Long Term Care Administrator Boards (NAB) exam. The foundation does not provide or assist candidates with employment. Is this course required if I wish to sit for the NAB or Arkansas State exam? No, this course is designed for individuals who do not have the education or work experience to be eligible for licensure exams but is not required. How is the class structured? The course is offered once a year and students will come to our Little Rock training center four times, beginning in May. Each class session will be two days long. AIT students will work with their preceptor for the days and times of their facility based instruction. What will I do in this course? The AIT class is composed of two components- class room instruction and a facility-based internship with a preceptor. Trainees will be required to serve their internship at a local skilled nursing facility which employs a certified preceptor who has agreed to work with the trainee. The preceptor will determine the trainees specific schedule, but each trainee will be expected to serve their internship for 40 hours per over 16 weeks. How long is this course? This course is 16 weeks total and is comprised of classroom instruction and facility-based instruction. training, the trainee will be expected to work with their preceptor 40 hours per week on a Monday through nursing facility. What is the attendance policy? The attendance policy for classroom instruction is extremely rigorous and strict. If a student must leave a course due to unpreventable circumstances, the student will be required to drop the course and reenroll in the program at a later date. Each trainee must complete both sections of the program in its entirety without interruptions before a certificate of completion can be issued.

Can I audit this course? Yes, if you already qualify for state and NAB licensure examinations you may audit this course. When classroom training but the facility-based instruction is omitted. Class dates and cost will be the same as the full AIT course. What is the cost of the course? The cost of the entire course is $900. This includes classroom instruction, materials and lunch during class days. What is the cost for application? There is a $100 application fee that, if accepted into the program, is applied to the total cost of the course. If an applicant is not accepted into the AIT course, they forfeit the application fee. What happens after I complete the course? After the course is concluded, the trainee and department manager will complete a performance evaluation which will then be reviewed by the preceptor. At the end of the internship, the candidate and the preceptor will complete an overall performance evaluation that will indicate whether or not the trainee has satisfactorily completed the facilitybased instruction component. This evaluation will be reviewed during the course instruction period and also sent to ACHF to be placed in the trainee s file. Once the trainee has completed the entire AIT program, the Office of Long Term care will approve him/her for State and NAB exams. Exams must be attempted within 6 months of completion of the AIT program. If a candidate scores below passing he/she will be required to complete an additional course of study determined by AHCF. AIT Application Check List You must meet ALL of the following requirements before applying for admission to the program. Submit to a background check Complete AIT application and include all requested documentation fee totaling $900 Have a certified preceptor who has agreed to the mentorship Plan to take the state NAB exam within 6 months of AIT course completion You must meet at least ONE of the following requirements: I have an associate s degree (or above) from an accredited college supervisory experience in a long term care facility I am a licensed practical nurse with care facility semester hours of college level in instruction (only hours for accounting, management, human resources, writing skills or resident care are applicable) For more information, please contact the Association at 501-374-4422 or AIT@arhealthcare.com. 1401 W. Capitol Avenue, Suite 180, Little Rock, AR 72201 Phone 501-374-4422 Fax 501-374-1077

Administrator In Training (AIT) Course May 9-10, June 13-14, July 18-19, and September 11-13, 2018 8:30 a.m. 4:30 p.m., AHCA Training Room, Suite 175 $900 Lunch and Materials Included To register, send this completed form and $100 application fee to: Mail: 1401 W. Capitol Ave., Suite 180, Little Rock, AR 72201 Fax: 501-374-1077 Email: registration@arhealthcare.com. The information contained herein, together with all attached documents, will be regarded as property of AHCA. Section I Personal Information Mailing Address City State Zip Cell Phone Email Address (Confirmation and class materials will be sent to this address) Last 4 digits of SSN Employer Current Title Employer s Address City State Zip Section II A. Have you been employed by a nursing facility? Yes No B. If so, please provide this additional information regarding your employment. Add additional sheets if necessary. If not, continue on to the next page. City State Zip nt Position City State Zip Position

C. Employment History Please begin with your present or most recent position and work back. Additional sheets may be attached if necessary. City State City State Zip City State Zip City State Zip Administrator In Training (AIT) Course Page 2

Section III Educational Record A. A complete and original transcript of your college credits must be provided with this application. This information will become part of the application. Name High School College Graduate School Other Location Grades, Years or Hours Completed List Field(s) of Study: Major Minor B. Regulations require that all applicants have basic education or experience in the following areas. Please specify how you meet these core requirements in the grid below. List the course name, workshop, seminar, or experience in each area. Accounting/Bookkeeping Management/Supervision Personnel Writing Skills Resident Care Section IV 1. On a separate sheet of paper, please explain why you feel that you are capable or qualified to function as a nursing home administrator. Attach the explanation to the application. If so, please indicate the state and license number: State License Number Administrator In Training (AIT) Course Page 3

3. Have you ever been convicted of a felony? Yes No If so, attach a separate statement showing offense, charge, date and disposition of the case. Yes No Yes No 6. Attach three professional reference letters from those who have knowledge of your character, work experience and ability. Not including relatives. Name Address How long reference has known you Phone Number 1. 3. I HEREBY CERTIFY: Section V Certification promulgated there under entitled Rules and Regulations for the Licensure of Nursing Home Administrators. willful misrepresentation or falsification, and the information given by me is true and complete to the best of my knowledge and belief. I am aware that should an investigation by the Arkansas Health Care Foundation reveal any such misrepresentation or falsification, it may prevent me from becoming licensed or, if I am already licensed, cause my license as a nursing home administrator to be revoked. Sworn to and subscribed before me by the above this Notary Public Signature County State Notary Public Seal Administrator In Training (AIT) Course Page 4 For more information, please contact the Association at 501-374-4422 or AIT@arhealthcare.com. 1401 W. Capitol Avenue, Suite 180, Little Rock, AR 72201 Phone 501-374-4422 Fax 501-374-1077