The opinion
September 17, 1974
The Honorable T. M. Lawrence, Jr. Opinion No. H- 401
Executive Secretary, Texas Board
of Licensure for Nursing Home Re: Does the Board of Licensure
Administrators for Nursing Home Administrators
P. 0. Box 4246 have authority to issue different
Austin, Texas 78765 license to administrators of group
homes.
Dear Mr. Lawrence:
On behalf of the Texas Board of Licensure for Nursing Home
Administrators (hereafter The Board) you have asked our opinion as
to whether the Board has authority to establish criteria and issue licenses
for nursing home administrators who would function only as administrators
and houseparents of facilities you describe as “group homes. ”
A group home (also known as a “transitional resident facility” or
“halfway house”) is a home designed to assist persons released from
mental institutions to face the problems inherent in assimilation into
society. The home resembles an ordinary home except that there are
eight to twelve residents and a couple acting as houseparents.
You advise that a group home built to certain specifications is
eligible to be licensed by the State Health Department as an “Intermediate
Care Facility-II, ” and that, if it is administered by a person who is
himself licensed as a nursing home administrator, a group home is entitled
to receive certain federally financed benefits through the Texas Department
of Public Welfare. Title XIX of the Social Security Act, provides for grants
to states for medical assistance programs. Section 1908 of the Social
Security Act, referred to in $8 of Article 4442d, infra, and codified as
42 U. S. C. $1396g, defines a ” ‘State program for the licensing of administra-
tors of nursing homes’ ” as one which provides that no nursing home may
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The Honorable T. M. Lawrence, Jr. page 2 (H-401)
operate within the state except under supervision of a licensed administra-
tor.
However, as you additionally point out, the houseparents who
operate group homes do not require the same skills as those who administer
traditional nursing homes. Therefore, if authorized to do so, your Board
has considered issuing a second type of nursing home administrators license
for the houseparents.
Article 4442d, V. T. C. S., in $ Z(3) defines “nursing home” as any
institution licensed as a nursing home by the Department of Health under
Article 4442c, V. T. C. S. Although the definition of “institutions” contained
in 5 2 of Article 4442~ does not specifically mention a group home or
halfway house, it is sufficiently broad to cover them.
The jurisdiction of your Board over licensing of nursing home
administrators is extremely comprehensive. Article 4442d, in part,
provides:
. . .
Sec. 5. The Board shall have exclusive authority
to determine the qualifications, skill and fitness of any
person to serve as an administrator of a nursing home
under the provisions of this Act and the holder of a
license under the provisions of this Act shall be deemed
to be qualified to serve as the administrator of any
nursing home for all purposes.
Sec. 6. It shall be the function and duty of the
board to:
(1) develop, impose, and enforce standards which
must be met by individuals in order to receive a license
as a nursing home administrator, which standards shall
be designed to insure that nursing home administrators
p. 1873
The Honorable T. M. Lawrence page 3 (H-401)
will be individuals who are of good character and
are otherwise suitable, and who, by training or
experience in the field of institutional administration,
are qualified to serve as nursing home administrators:
(2) develop and apply appropriate techniques,
including examinations and investigations, for determin-
ing whether an individual meets such standards;
(3) issue licenses to individuals determined, after
application of such techniques, to meet such standards,
and revoke or suspend licenses previously issued by
the board in any case where the individual holding any
such license is determined substantially to have failed to
conform to the requirements of such standards;
. . .
Sec. 8. The Board shall have the authority to make
rules and regulations not inconsistent with law as may
be necessary or proper for the performance of its duties,
and to take such other actions as may be necessary to
enable the State to meet the requirements set forth in
Section 1908 of the Social Security Act, the Federal rules
and regulations promulgated thereunder, and other per-
tinent Federal authority: provided, however, that no rule
shall be promulgated, altered or abolished without the
approval of a two-thirds majority of the,Board.
Sec. 9. The Board shall have authority to issue
licenses to qualified persons as nursing home administra-
tors, and shall establish qualification criteria for such
nursing home administrators. No license shall be issued
to a person as a nursing home administrator unless:
(1) he is at least 21 years of age, of good moral
p. 1874
The Honorable T. M. Lawrence page 4 (H-401)
character, sound in mental and physical health, and
is a citizen of the United States or has duly declared
his intention of becoming a citizen of the United States:
(2) he has satisfactorily completed a course of
instruction and training prescribed by the board, which
course shall be so designed as to content and so adminis-
tered as to present sufficient knowledge of the proper
needs to be served by nursing homes; laws governing
the operation of nursing homes and the protection of the
interests of patients therein; and the elements of good
nursing home administration; or has presented evidence
satisfactory to the board of sufficient education, training
or experience in the foregoing fields to enable him to
administer, supervise and manage a nursing home;
(3) he has passed an examination administered by the
board and designed to test for competence in the subject
matters referred to in subsection (2) hereof:
(4) that applicant submit written evidence, on forms
provided for such purpose by the board, that he has
successfully completed a course of study and has been
graduated from a high school or secondary school
approved and recognized by the educational authorities
of the State in which such school is located, or a political
ditisibn thereof, or has submitted a certificate indicating
that he has obtained high school or secondary school
equivalency, such certificate being certified by a State
educational authority or a political division thereof; and
(5) tha,t applicant has complied with all other qualifica-
tions and requirements as may have been established by
rule and regulation of the board.
. . .
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. . .
The Honorable T. M. Lawrence page 5 (H-401)
Although it is our conclusion that Articles 4442~ and 4442d are
sufficiently broad to permit licensure of directors of group homes which
meet the statutory definition of institution in Article 4442c, $ 2, as
nursing home administrators, we do not believe the statute permits the
Board to establish a second type of license. Section 5 of Article 4442d
clearly provides that the holder of a license “shall be deemed to be
qualified to serve as the administrator ofany nursing home for all
purposes. ” (emphasis added) In our opinion this language requires a
single type of license. See Attorney General Opinion H-147 (1973).
SUMMARY
The Texas Board of Licensure for Nursing Home
Administrators may license directors of group homes
as nursing home administrators, but it may not
establish a separate type of license for them.
Very truly yours,
JOHN L. HILL
Attorney General of Texas
DAVID M. KENDALL, Chairman
Opinion Committee
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