Current through Reg. 49, No. 12; March 22, 2024
(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-RN®
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 will be included in the Board's Order approving the
program.
(C) Change from initial
approval status to full approval status cannot occur until the program has
demonstrated compliance with this chapter, has met requirements and responded
to all recommendations issued by the Board, and the
NCLEX-RN® examination pass rate is at least 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 for continued operation and/or as
a condition for changing the approval status.
(2) Full Approval.
(A) Full approval is granted by the Board to
a professional 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 with warning or initial approval
with warning is issued by the Board to a professional 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 areas of concern and a
specified time in which to respond with a set of corrective measures. 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 for continued operation and/or as a condition for changing the
approval status.
(4)
Conditional Approval. Conditional approval is issued by the Board for a
specified time to provide the program opportunity to correct any areas of
concern identified by the Board or from findings in the program's self-study
report.
(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 program's approval status 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 for continued operation and/or as a condition for changing the
approval status.
(5)
Withdrawal of Approval. The Board may withdraw approval from a program which
fails to meet the Board's requirements within the specified time. A program may
also elect to voluntarily close a program, as provided for in subsection
(c)(12) of this section. The dean/director shall submit a plan for closure
according to Board Education Guideline 3.1.7 available at
https://www.bon.texas.gov and
outlined in subsection (d) of this section.
(6) When a program closes by Board action or
voluntary decision, the program will be removed from the list of Board approved
professional nursing education programs, but students may complete the program
in teach-out.
(7) A diploma program
of study in Texas that leads to an initial license as a registered nurse under
this chapter must have a process in place to ensure that their graduates are
entitled to receive a degree from a public or private institution of higher
education accredited by an agency recognized by the THECB or the TWC, as
applicable. At a minimum, a graduate of a diploma program will be entitled to
receive an associate degree in nursing.
(b) Factors Jeopardizing Program Approval
Status.
(1) When a program demonstrates
non-compliance with Board requirements, approval status may be changed,
approval 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 additional
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.
(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) substantiated student
complaints;
(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/dean 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 or
lacks institutional control necessary for successful student
outcomes.
(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, program compliance with this chapter, and other program outcomes.
Certificates of Board approval will be sent to all Board-approved nursing
programs biennially in even-numbered years.
(1) Compliance Audit. Each approved
professional nursing education program shall submit a biennial CANEP regarding
its compliance with the Board's requirements.
(2) NCLEX-RN®
Pass Rates. The annual NCLEX-RN® examination
pass rate for each professional nursing education program is determined by the
percentage of first time test-takers who pass the examination during the
examination year.
(A) A minimum of eighty
percent (80%) of first-time NCLEX-RN® candidates is required to achieve a
passing score on the NCLEX-RN® examination during the examination
year.
(B) When the passing score of
first-time NCLEX-RN® 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 NCLEX-RN®
examination and a description of the corrective measures to be implemented. The
report shall comply with Board Education Guideline 3.2.1 available at
https://www.bon.texas.gov.
Within one year of the submission of the Self-Study Report to the Board, the
program shall provide to Board Staff evaluation data on the effectiveness of
corrective measures implemented.
(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 program outcomes, including the
NCLEX-RN® 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-RN® candidates, as described in paragraph
(2)(A) of this subsection, is less than 80% for two (2) consecutive examination
years; or
(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 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 lacks
institutional control necessary for successful student outcomes; or
(iv) the program persists despite the
existence of multiple deficiencies mentioned in subsection (b) of this
section.
(C) Approval may
be withdrawn if:
(i) the performance of
first-time NCLEX-RN 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 continues to engage in
activities or situations that demonstrate to the Board that the program is not
meeting Board requirements and standards or lacks institutional control
necessary for successful student outcomes.
(D) The Board may consider a change in
approval status at a regularly scheduled Board meeting for a program on
initial, full approval, full approval with warning, or conditional approval if:
(i) the program's pass rate for first-time
NCLEX-RN 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 or impose a monitoring plan. The Board may restrict
enrollment.
(F) The Board may, in
its discretion, change the approval status of a program on conditional approval
or impose a monitoring plan. The Board may restrict
enrollment.
(4) Survey
Visit. Each professional nursing education program shall be visited at least
once 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 3.2.2 available at
https://www.bon.texas.gov.
(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-RN 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
according to Board Education Guideline 3.2.3 available at
https://www.bon.texas.gov.
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)
Accredited Programs. The Board may review and/or change the approval status of
an accredited professional nursing education program that fails to:
(A) meet the prescribed program of study or
other Board requirement;
(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 professional nursing education program
is considered approved by the Board and exempt from Board rules that require
ongoing approval as described in Board Education Guideline 3.2.3 available at
https://www.bon.texas.gov 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;
(B) complies with Board rules from which it
is not exempt; and
(C) maintains an
acceptable NCLEX-RN® pass rate, as determined by the Board, on the
NCLEX-RN® examination.
(9) A professional nursing education program
that fails to meet or maintain an acceptable NCLEX-RN pass rate, as determined
by the Board, on NCLEX-RN examinations is subject to review by the
Board.
(10) A professional nursing
education program that qualified 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.
(11) A program that voluntarily closes or
from which approval has been withdrawn by the Board may submit a new proposal.
A new proposal may not be submitted to the Board until at least twelve (12)
calendar months have elapsed from the date the program's voluntary closure is
accepted by the Executive Director or from the date of the program's withdrawal
of approval by the Board.
(12) A
professional nursing education program accredited by a national nursing
accrediting agency recognized by the Board shall:
(A) provide the Board with copies of any
reports submitted to or received from the national nursing accrediting agency
selected by the Board within three (3) months of receipt of any official
reports;
(B) demonstrate
accountability of compliance with national nursing accreditation standards and
processes and provide copies of approvals for substantive changes from the
national nursing accreditation organizations after the program has followed the
approval process;
(C) notify the
Board of any change in accreditation status within two (2) weeks following
receipt of an official notification letter; and
(D) provide other information required by the
Board as necessary to evaluate and establish nursing education and workforce
policy in this state.
(d) Notice of a change in a program's
approval status shall be sent to the dean or director and others as determined
by the Board. The chief administrative officer of the governing entity shall be
notified when there is a change of approval status of the program.