Apply to be a nursing home administrator in training (AIT)

• Completed application
• Application fee amount of $150.00
• 2x2 passport style color photo
  • White or off-white background
• A written request from you for the proposed AIT internship. Include:
  • The name of the preceptor
  • The facility at which the training will take place
  • The name of the facility’s owner
  • The number of beds
  • Any requests for credit for academic and/or professional experience
• A letter from the proposed preceptor to the Board requesting that they be approved as the preceptor. The preceptor must be a Massachusetts licensed administrator in good standing with at least 5 years of Nursing Home Administration experience.
• A detailed outline of the proposed Internship
  • Note A: the Preceptor Guidelines can't be submitted as the internship outline
  • Note B: Once approved, the preceptor must submit a 3 and 6 months progress reports with completed hours directly to the Board of Registration of Nursing Home Administrators
• A signed agreement between the preceptor and the candidate. The agreement must state where the training will be held, the number of beds in the facility, and if it's a multi-level or skilled facility.
• Your current resume
• Official transcripts of a bachelor’s program or equivalent Transcripts must be complete and state the degree and date conferred.
• The educational institution must send transcripts directly to the Board.
• A National Practitioner Data Bank-Healthcare Integrity and Protection Data Bank Self-Query. To request a Self-Query, please contact the National Practitioner Data Bank. The Self-Query must be submitted to the Board without any modifications.
• Signed and notarized Criminal Offender Record Information (CORI) Acknowledgement Form (PDF) | (DOCX)

If applicable

• Official verification of licensure from any state or jurisdiction in which you now or have previously held any professional license, including expired license(s)
  • The state or other jurisdictions must send verifications directly to the Board.
• If you answer "yes" to any of the Professional and Criminal History Questions:
  • Submit a personal statement explaining the circumstances.
  • Submit all supporting documentation (police reports, court documents, disciplinary consent agreements, etc.)