MINNESOTA STATE EXAM INFORMATION

Applicant State Exam Steps Checklist

1. Read the entire packet.

2. Familiarize yourself with the following documents:

a. Minnesota MDH Nursing Home Rules 4605, 4658, 4638, 6800.

b. Minnesota MDH Nursing Home Statutes (Vulnerable Adult)

a. 626.557

b. 626.5571

c. 626.5572

d. 626.5573

e. 145B

f. 145C

c. Minnesota MDH Statutes 144, specifically the Clean Indoor Air Act, Admission Contracts,

Bill of Rights, Nursing Homes and Home Care General.

d. Minnesota Statutes 144A BELTSS

e. Minnesota Rules 6400.5000 to .7095 BELTSS Rules (Both LNHA and LALD)

3. Submit pages 3-6 with fee to register. The fee for the MN state exam is $100.00 USD and must be paid as a check or money order mailed to the BELTSS office.

4. An email be sent to you to confirm your application for examination has been accepted and

attached will be the State Exam Confidentiality & Attestation form. You will need to bring a

printed copy of the form and a government issued picture ID with you to your exam.

5. A username and password with access instructions will be sent via email to the proctor. You will

use this information to log in and complete your state exam online under the supervision of

your chosen proctor.

6. Print and sign the Confidentiality and Attestation form the day of the exam and return the

document to the board office via scan and email or US Mail.

7. Complete exam. Your scores will be available on your account after we receive your completed

Confidentiality and Attestation form.

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Technical Requirements for State Exam

1. You cannot use Internet Explorer to take this exam. You must use an alternate browser such as

Chrome or Firefox.

2. The exam is designed to be access on laptops or desktop computers. Mobile or tablet devices

such as cell phones and iPads can be used to access the exam, however this is not

recommended. If you are using a mobile or tablet device such as an iPad, be aware that you

must use the exam’s navigation options. Swiping, double tapping, or otherwise attempting to

navigate the exam using the device will break the exam, and your exam will be interrupted or

marked incomplete.

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STATE EXAM INFORMATION

STATE EXAM APPLICATION

Minnesota requires all applicants for licensure to pass a 1 hour 25-minute, 35 multiple choice questions using an open book exam method testing the candidate’s ability to research and interpret Minnesota Statutes and Rules pertaining to operation of a Minnesota nursing home. All items are found in the bibliography resources unless a notation is written in the question.

1. You must have an active application with BELTSS to reserve a state examination slot. Pleasekeep this state exam application and then submit when you are ready to complete the exam.

2. This state examination application should be submitted 21 days prior to reserving an exam testslot. The reserved test slot will be in the range of days 7-21 of your request. Candidates may sitfor this exam remotely with oversight from another licensed individual or proctor, selected bythe candidate, who verifies a secured test environment. See Proctor requirements below.

3. A pass rate of 75% is required.

FEE: $100.00 PER EXAM 1. Submit the completed state exam application form with the fee to secure a reservation for the

state examination. This must be completed via US MAIL only. If the application is complete andapproved, you will receive an “Authorization to Test” email notification from BELTSS along withinstructions for completing the exam. Examinations must be completed within a 14-dayapproved window from the date of receiving the Authorization to Test email. The link withsupporting documents and the exam will be sent to the Proctor via email only.

Minnesota Approved Bibliography: 1. Minnesota MDH Nursing Home Rules: NURSING HOME RULES 4605, 4658, 4638, 6800

2. Minnesota MDH Nursing Home Statutes (Vulnerable Adult) 626.557-626.5573, 145B,145C

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3. Minnesota MDH Statutes 144 (Clean Indoor Air Act, Admission Contracts, Bill of Rights,Nursing Homes and Home Care General.

4. Minnesota Statutes 144A BELTSS

5. Minnesota Rules 6400.5000 to .7095 BELTSS Rules (Both LNHA and LALD)

Applicant: Please complete to register for the state examination: Please print the information requested below and sign the candidate statement.

Full Legal Name:

MN Applicant/ Reference Number:

I am applying to take the Minnesota

Date of Birth:

Last 4 Digits of Social Security:

Phone Number:

Email Address:

Proctor: Please complete:

Licensed Proctor Full Legal Name:

City & State:

Phone Number:

Email Address:

ALD State Exam HSE State Exam NHA State Exam

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Currently Licensed as one of the following:

License Number:

OFFICE USE ONLY

Attempt Number:

Deposit:

Check Number:

Received Date:

Emailed Date:

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Exam Proctor reads the following: • Only items found on the Educare link are used for this examination. You may use multiple

monitors connected to the Educare link, but no personal phones or additional laptops ordevices are allowed in the test area or in addition to the secured link.

• The link will control the time allotted for the examination. We’ll attempt to keep the area asquiet as possible. All other electronic devices are stored away from the test taker.

• As the proctor I may occasionally check the environment to assure it is controlled.

• The time starts when the first question is presented.

• You may begin and watch the brief introduction and orientation.

Thank you to the Proctor for your assistance!

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