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TITLE 22EXAMINING BOARDS
PART 11TEXAS BOARD OF NURSING
CHAPTER 214VOCATIONAL NURSING EDUCATION
RULE §214.4Approval

(a) The progressive designation of approval status is not implied by the order of the following listing. Approval status is based upon each program's performance and demonstrated compliance to the Board's requirements and responses to the Board's recommendations. Change from one status to another is based on NCLEX-PN® examination pass rates, compliance audits, survey visits, and other factors listed under subsection (b) of this section. Types of approval include:

  (1) Initial Approval.

    (A) Initial approval is written authorization by the Board for a new program to enroll students, is granted if the program meets the requirements and addresses the recommendations issued by the Board, and begins with the date of the first student enrollment.

    (B) The number of students to be enrolled while the program is on initial approval is determined by the Board and the requirements are included in the Board's initial approval letter.

    (C) Change from initial approval status to full approval status cannot occur until the program has met requirements and responded to all recommendations issued by the Board and the NCLEX-PN® examination pass rate is 80% after a full examination year. In order to ensure the continuing success of the program, the Board may, in its discretion, impose any restrictions or conditions it deems appropriate and necessary.

  (2) Full Approval.

    (A) Full Approval is granted by the Board to a vocational nursing education program that is in compliance with all Board requirements and has responded to all Board recommendations.

    (B) Only programs with full approval status may initiate extension programs and grant faculty waivers.

  (3) Full or initial approval with warning is issued by the Board to a vocational nursing education program that is not meeting the Board's requirements.

    (A) A program issued a warning will receive written notification from the Board of the warning and a survey visit will be conducted.

    (B) Following the survey visit, the program will be given a list of identified deficiencies and a specified time in which to correct the deficiencies. Further, in order to ensure the continuing success of the program, the Board may, in its discretion, impose any restrictions or conditions it deems appropriate and necessary.

  (4) Conditional Approval. Conditional approval is issued by the Board for a specified time to provide the program opportunity to correct deficiencies.

    (A) The program shall not enroll students while on conditional status.

    (B) The Board may establish specific criteria to be met in order for the program's conditional approval status to be changed.

    (C) Depending upon the degree to which the Board's requirements are currently being or have been met, the Board may change the approval status from conditional approval to full approval or to full approval with warning, or may withdraw approval. In order to ensure the continuing success of the program, the Board may, in its discretion, impose any restrictions or conditions it deems appropriate and necessary.

  (5) Withdrawal of Approval. The Board may withdraw approval from a program which fails to meet the Board's requirements within the specified time. The program shall be removed from the list of Board approved vocational nursing education programs.

(b) Factors Jeopardizing Program Approval Status.

  (1) When a program demonstrates non-compliance with Board requirements, approval may be changed to full with warning or conditional status, may be withdrawn, or the Board, in its discretion, may impose restrictions or conditions it deems appropriate and necessary. In addition to imposing restrictions or conditions, the Board may also require monitoring of the program. Board monitoring may include the review and analysis of program reports; extended communication with program directors; and additional survey visits. A monitoring plan may require the submission of quarterly reports of students' performance in courses and clinical learning experiences; remediation strategies and attrition rates; and reports from an assigned mentor to the program director. Additional survey visits by a Board representative may be conducted at appropriate intervals to evaluate the status of the program. The Board may alter a monitoring plan as necessary to address the specific needs of a particular program. When the Board requires monitoring activities to evaluate and assist the program, monitoring fees will apply.

  (2) A change in approval status, requirements for restrictions or conditions, or a monitoring plan may be issued by the Board for any of the following reasons:

    (A) deficiencies in compliance with the rule;

    (B) utilization of students to meet staffing needs in health care facilities;

    (C) noncompliance with school's stated philosophy/mission, program design, objectives/outcomes, and/or policies;

    (D) failure to submit records and reports to the Board office within designated time frames;

    (E) failure to provide sufficient variety and number of clinical learning opportunities for students to achieve stated objectives/outcomes;

    (F) failure to comply with Board requirements or to respond to Board recommendations within the specified time;

    (G) student enrollments without resources to support the program, including sufficient qualified faculty, adequate educational facilities, and appropriate clinical affiliating agencies;

    (H) failure to maintain an 80% passing rate on the licensing examination by first-time candidates;

    (I) failure of program director/coordinator to verify the currency of faculty licenses; or

    (J) other activities or situations that demonstrate to the Board that a program is not meeting Board requirements.

(c) Ongoing Approval Procedures. Ongoing approval status is determined biennially by the Board on the basis of information reported or provided in the program's NEPIS and CANEP, NCLEX-PN® examination pass rates, and other pertinent data.

  (1) Compliance Audit. Each approved vocational nursing education program shall submit a biennial CANEP regarding its compliance with the Board's requirements.

  (2) NCLEX-PN® Pass Rates. The annual NCLEX-PN® examination pass rate for each vocational nursing education program is determined by the percentage of first time test-takers who pass the examination during the examination year.

    (A) Eighty percent (80%) of first-time NCLEX-PN® candidates are required to achieve a passing score on the NCLEX-PN® examination during the examination year.

    (B) When the passing score of first-time NCLEX-PN® candidates is less than 80% on the examination during the examination year, the nursing program shall submit a Self-Study Report that evaluates factors that may have contributed to the graduates' performance on the examination and a description of the corrective measures to be implemented. The report shall comply with Board Education Guideline 3.2.1.a. Writing a Self-Study Report on Evaluation of Factors that Contributed to the Graduates' Performance on the NCLEX-PN® or NCLEX-RN® Examination.

  (3) Change in Approval Status. The progressive designation of a change in approval status is not implied by the order of the following listing. A change in approval status is based upon each program's performance and demonstrated compliance to the Board's requirements and responses to the Board's recommendations. A change from one approval status to another may be determined by NCLEX-PN® examination pass rates, compliance audits, survey visits, and other factors listed under subsection (b) of this section.

    (A) A warning may be issued to a program when:

      (i) the pass rate of first-time NCLEX-PN®, candidates, as described in paragraph (2)(A) of this subsection, is less than 80% for two (2) consecutive examination years; and

      (ii) the program has been in violation of Board requirements.

    (B) A program may be placed on conditional approval status if:

      (i) the pass rate of first-time NCLEX-PN® candidates, as described in paragraph (2)(A) of this subsection, is less than 80% for three (3) consecutive examination years;

      (ii) the faculty fails to implement appropriate corrective measures identified in the Self-Study Report or survey visit;

      (iii) the program has continued to engage in activities or situations that demonstrate to the Board that the program is not meeting Board requirements and standards; or

      (iv) the program persists despite the existence of multiple deficiencies set forth in subsection (b) of this section.

    (C) Approval may be withdrawn if:

      (i) the performance of first-time NCLEX-PN® candidates fails to be at least 80% during the examination year following the date the program is placed on conditional approval;

      (ii) the program is consistently unable to meet requirements of the Board; or

      (iii) the program persists in engaging in activities or situations that demonstrate to the Board that the program is not meeting Board requirements and standards.

    (D) A program issued a warning or placed on conditional approval status may request a review of the program's approval status by the Board at a regularly scheduled meeting following the end of the examination year if:

      (i) the program's pass rate for first-time NCLEX-PN® candidates during the examination year is at least 80%; and

      (ii) the program has met all Board requirements.

    (E) The Board may, in its discretion, change the approval status of a program on full approval with warning to full approval, to full approval with restrictions or conditions, or impose a monitoring plan. The Board may restrict enrollments.

    (F) The Board may change the approval status of a program on conditional approval to full approval, full approval with restrictions or conditions, full approval with warning, or impose a monitoring plan. The Board may restrict enrollments.

  (4) Survey Visit. Each vocational nursing education program shall be visited at least every six (6) years after full approval has been granted, unless accredited by a Board-recognized national nursing accrediting agency.

    (A) Board Staff may conduct a survey visit at any time based upon Board Education Guideline 3.2.3.a. Criteria for Conducting Survey Visits.

    (B) After a program is fully approved by the Board, a report from a Board-recognized national nursing accrediting agency regarding a program's accreditation status may be accepted in lieu of a Board survey visit.

    (C) A written report of the survey visit, information from the program's NEPIS and CANEP, and NCLEX-PN® examination pass rates shall be reviewed by the Board at a regularly scheduled meeting.

  (5) The Board will select one (1) or more national nursing accrediting agencies, recognized by the United States Department of Education, and determined by the Board to have standards equivalent to the Board's ongoing approval standards. Identified areas that are not equivalent to the Board's ongoing approval standards will be monitored by the Board on an ongoing basis.

  (6) The Board will periodically review the standards of the national nursing accrediting agencies following revisions of accreditation standards or revisions in Board requirements for validation of continuing equivalency.

  (7) The Board will deny or withdraw approval from a vocational nursing education program that fails to:

    (A) meet the prescribed program of study or other Board requirements;

    (B) maintain voluntary accreditation with the national nursing accrediting agency selected by the Board; or

    (C) maintain the approval of the state board of nursing of another state that the Board has determined has standards that are substantially equivalent to the Board's standards under which it was approved.

  (8) A vocational nursing education program is considered approved by the Board and exempt from Board rules that require ongoing approval as described in Board Education Guideline 3.2.4.a. Nursing Education Programs Accredited by the National League for Nursing Accrediting Commission and/or the Commission on Collegiate Nursing Education - Specific Exemptions from Education Rule Requirements if the program:

    (A) is accredited and maintains voluntary accreditation through an approved national nursing accrediting agency that has been determined by the Board to have standards equivalent to the Board's ongoing approval standards; and

    (B) maintains an acceptable NCLEX-PN® pass rate, as determined by the Board, on the NCLEX-PN® examination.

  (9) A vocational nursing education program that fails to meet or maintain an acceptable pass rate, as determined by the Board, on NCLEX-PN® examinations is subject to review by the Board.

  (10) A vocational nursing education program that qualifies for exemption pursuant to paragraph (8) of this subsection, but does not maintain voluntary accreditation through an approved national nursing accrediting agency that has been determined by the Board to have standards equivalent to the Board's ongoing approval standards, is subject to review by the Board.

Cont'd...

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