Approval

PURPOSE: This rule defines the approval status and process for programs of practical nursing. (1) Programs of practical nursing shall obtain approval from the board. (2) Purposes of Approval— (A) To promote the safe practice of practical nursing by setting minimum standards for programs preparing entry-level practical nurses; (B) To assure that educational requirements for admission to the licensure examination have been met and to facilitate endorsement in other states, territories, countries, or any combination of these; (C) To encourage continuing program improvement through assessment, evaluation, and consultation; and (D) To assist programs of practical nursing in developing and maintaining academic standards (theory and clinical) that are congruent with current educational and nursing practice standards. (3) Classification of Approval. (A) Initial approval is the status granted a program of practical nursing until full approval is granted or approval is withdrawn. (B) Full approval is the status granted a program of practical nursing after the program has met and continues to meet regulations or requirements. (C) Conditional approval is the status of a program that has failed to meet or maintain the regulations or requirements set by the board. (4) Initial Approval Status. (A) Process for Obtaining Initial Approval— 1. An accredited institution of education desiring to establish a program of practical nursing shall submit a proposal; 2. Prior to submission of the proposal, nursing programs operating under the institution’s sponsorship shall meet requirements for full program approval; 3. Each sponsoring institution shall have only one (1) program proposal under consideration for initial approval at any one time; 4. The program proposal shall be written and presented to the board by the program administrator of the proposed program. The proposal shall comply with the Minimum Standards for Program of Practical Nursing as prescribed in 20 CSR 2200-3.050 through 20 CSR 2200-3.130 and bear the signature of the administrator who meets the criteria in 20 CSR 2200-3.060(1)(B) and has been active in the position on a full-time basis for at least nine (9) months prior to the entry of the first class; 5. The required application fee of three thousand dollars ($3,000) shall be submitted with the proposal; 6. The proposal shall include each component as indicated in paragraph (4)(A)8. of this rule. The proposal shall remain active for no more than one (1) calendar year from the date of review by the board. Members designated by the board will review the proposal and make recommendations prior to presentation of the proposal to the board; 7. Board approval of the proposal shall be obtained no later than six (6) months prior to the anticipated opening date; 8. The proposal shall contain the following information: A. Sponsoring institution— (I) Name and location of the sponsoring institution; (II) Evidence of accreditation by an agency recognized by the United States Department of Education; (III) Evidence of authorization to conduct the program of professional nursing by the governing body of the sponsoring institution; (IV) Proposed program location (and satellites) in relation to the administrative offices of the sponsoring institution; (V) Current organizational chart(s) illustrating the relationship of the program to the sponsoring institution and the faculty structure within the proposed program; (VI) Mission statement of the sponsoring institution and philosophy and/or mission statements of the proposed program; (VII) Type and length of the nursing program proposed; and (VIII) Evidence of financial stability and resources of the sponsoring institution and the program of nursing to include a sustainability plan for the purchase, replacement, and maintenance of skills lab supplies, furnishings, and equipment to meet program outcomes; B. Curriculum. (I) Philosophy and/or mission. (II) Graduate competencies. (III) Curriculum sequence. (IV) Course descriptions and objectives with number of credit hours or clock hours for all courses. Credit or clock hour allocations specific to theory, lab, and clinical portions shall be included. If utilized, credit hours allocated to theory, lab, and clinical instruction shall be included. (V) Systematic evaluation plan. (VI) Evidence of eligibility for articulation of credits related to completion of a program of professional nursing; C. Students. (I) Maximum number of students per class. (II) Number of classes admitted per year. (III) Number of students anticipated in initial class. (IV) Plan for increase to maximum enrollment, if applicable. (V) Admission criteria. (VI) Plans for progression and retention of students. (VII) Appeal policies and procedures. (VIII) Availability and accessibility of student services; D. Faculty. (I) Plan for hiring full-time and part-time theory and clinical faculty. This plan shall include full-time equivalents, student to faculty ratios, and full-time to part-time faculty ratios to meet initial and increasing enrollment. (II) Position descriptions; E. Support services personnel. (I) Number of full-time and part-time ancillary support services personnel. (II) Position descriptions; and F. Facilities. (I) Description of educational facilities to be used by the practical nursing program such as classrooms, library, offices, clinical skills and simulation laboratories, and other facilities. (II) Description of planned or available learning resources to include such items as equipment, supplies, library services, computers, simulation technology, and online educational resources to be utilized for instructional purposes. (III) Letter(s) of intent from potential clinical sites stating ability to provide appropriate educational experiences to meet objectives and outcomes of the proposed program. A description of each potential clinical site, average daily patient census, and the ability to provide clinical placements to potential students in addition to those of existing nursing programs shall be included; 9. The board will electronically notify existing nursing programs approved by this board that a proposal for establishment of a new nursing program is under review; 10. Site survey. Representatives from the board will make an on-site survey to verify implementation of the proposal and compliance with 20 CSR 2200-3.050 through 20 CSR 2200-3.130; and 11. The board’s decision to grant initial approval is contingent upon evidence from the site survey that the program is being implemented in compliance with 20 CSR 2200-3.050 through 20 CSR 2200-3.130. (B) Initial program approval contingent on the site survey shall remain active for no more than one (1) calendar year prior to program start. (C) Throughout the period of initial approval, the program shall submit an annual report, an annual registration, and the annual registration fee as set by the board. (D) Upon graduation of the program’s first class and receipt of results of the first official National Council Licensure Examination for Practical Nurses (NCLEX-PN®) program pass rate, as reported after completion of the fourth quarter of the respective calendar year, the board will review the following: 1. The program’s compliance with minimum standards during initial approval including the program’s adherence to the approved proposal and changes authorized by the board; 2. Report of an on-site survey; 3. Report of the National Council Licensure Examination for Practical Nurses (NCLEX-PN®) results (as per 20 CSR 22003.180(1)); 4. Identification and analysis of class graduation rate; and 5. Submission of program’s ongoing systematic evaluation plan with available data. (E) After its review, the board shall decide to continue initial approval for a specific period of time determined by the board, withdraw approval, or grant full approval. (F) On-Site Surveys. At least two (2) representatives of the board will make on-site surveys. On-site surveys will be made on a regular basis throughout the initial approval period. A program may request additional visits. Programs retained on initial approval status will have on-site surveys on an annual basis and as directed by the board. (G) A program’s approval may be withdrawn pursuant to section 335.071.3, RSMo, for noncompliance with minimum standards. A program which fails to correct identified deficiencies to the satisfaction of the board will, after notice and hearing, be removed from the board’s listing of approved programs. (5) Full Approval Status. (A) Annual Report. Each program and each campus of each program shall complete and submit the board’s annual report by the established deadline. Following review by the board, each program will be notified of the board’s action(s). (B) A program’s approval status is subject to review by the board if the required annual report, annual registration, or annual registration fee is not received by the established deadline. (C) On-Site Surveys. On-site surveys will be made on a scheduled basis, at the direction of the board, or upon request of the nursing program. Each nursing program will be surveyed typically at five- (5-) year intervals. If the program is accredited by a national nursing accreditation agency, the nursing program may request that the on-site survey be scheduled in coordination with a national nursing accreditation agency visit. Representatives of the board will form a survey team to conduct each on-site survey. Each survey team shall consist of two (2) or more persons qualified to conduct on-site surveys. The program shall solicit public comments in preparation for each routine on-site survey. Evidence of solicitation of public comments shall be available for review during the on-site survey. (D) Additional Visits/Surveys. At least two (2) representatives of the board will make additional visits/surveys as deemed necessary by the board. A program may request additional visits. (6) Conditional Approval Status. (A) Should circumstances warrant, the board will notify the program administrator of concerns regarding the program and the administrator will be requested to respond to those AND INSURANCE concerns. (B) A program may be placed on conditional approval status if it has failed to meet or maintain the rules/regulations or requirements, or both, set by the board. The program will remain on conditional approval status until such time as the deficiencies are corrected to the satisfaction of the board. (C) On-Site Surveys. At least two (2) representatives of the board will make on-site surveys. On-site surveys are conducted on a regular basis throughout the conditional approval period as directed by the board. A program may request additional visits. (D) Throughout the period of conditional approval, the program shall submit an annual report, an annual registration, and the annual registration fee as set by the board. (E) A program’s approval may be withdrawn pursuant to section 335.071.3., RSMo, for noncompliance with minimum standards. A program which fails to correct identified deficiencies to the satisfaction of the board shall, after notice and hearing, be removed from the board’s listing of approved programs. (7) Moratorium on Student Admissions. (A) Should circumstances be such that instructional quality and integrity for the program is jeopardized as determined by the board, the board may impose a moratorium on student admissions. A moratorium on student admissions may be imposed by the board during initial, full, and conditional approval status of the program. The moratorium may be lifted by the board upon proof submitted to the board that the program has cured any deficiencies in the instructional quality and integrity of the program. (8) Annual Registration Requirements. (A) The board will send an application for annual registration to each approved program. Failure to receive the annual registration form does not relieve the program of its obligation to register. (B) A separate annual registration form and designated fee as established in 20 CSR 2200-4.010(1)(F) shall be submitted to the board for each approved program prior to June 1 of each year. Satellite locations do not qualify as a campus of an approved program. (C) A program’s approval status is subject to review by the board if the required registration fee is not received by the June 1 deadline. AUTHORITY: section 335.036, RSMo Supp. 2022, and section 335.071, RSMo 2016.* This rule originally filed as 4 CSR 200-3.010. Original rule filed Jan. 29, 1974, effective Feb. 8, 1974. Amended: Filed Dec. 12, 1975, effective Dec. 22, 1975. Rescinded and readopted: Filed Oct. 14, 1981, effective Jan. 14, 1982. Amended: Filed Oct. 14, 1987, effective Jan. 29, 1988. Rescinded and readopted: Filed March 25, 1993, effective Dec. 9, 1993. Amended: Filed Dec. 14, 1994, effective May 28, 1995. Amended: Filed Aug. 6, 1998, effective Feb. 28, 1999. Amended: Filed Dec. 1, 2000, effective May 30, 2001. Moved to 20 CSR 2200-3.010, effective Aug. 28, 2006. Rescinded and readopted: Filed April 17, 2007, effective Dec. 30, 2007. Amended: Filed Jan. 11, 2013, effective July 30, 2013. Amended: Filed Feb. 9, 2018, effective Aug. 30, 2018. Amended: Filed Feb. 14, 2022, effective Aug. 30, 2022. Amended: Filed March 23, 2023, effective Sept. 30, 2023. *Original authority: 335.036, RSMo 1975, amended 1981, 1985, 1993, 1995, 1999, 2007, 2008, 2011, 2018, and 335.071, RSMo 1975, amended 1981, 1999.