PROPOSED RULEMAKING
STATE BOARD OF NURSING
[49 PA. CODE CH. 21]
General Revisions of the Professional Nursing Provisions
[31 Pa.B. 809] The State Board of Nursing (Board) proposes general revisions to its regulations governing professional nurses (RNs) in Chapter 21 (relating to State Board of Nursing) to read as set forth in Annex A.
A. Effective Date
The amendments will be effective upon publication of final-form regulations in the Pennsylvania Bulletin.
B. Statutory Authority
The Board is authorized to adopt regulations necessary for the administration of its enabling statute under section 2.1(k) of the Professional Nursing Law (law) (63 P. S. § 212.1(k)). Section 6.1 of the law (63 P. S. § 216.1) requires the Board to establish standards for the operation and approval of nursing education programs for the preparation of registered professional nurses.
C. Background and Purpose
The proposed amendments represent the results of the Board's systematic review of its professional nursing regulations. The Board began the review in 1993. The Board held a public hearing in that year to receive public comments from the profession on an early draft of these proposed amendments. The Board continued its review in accordance with the principles and requirements of Executive Order 1996-1 of February 6, 1996. The Executive Order directs executive agencies to evaluate existing regulations and amend and delete regulations as necessary to comply with the order. In accordance with the Executive Order, a draft of this proposal was sent on August 10, 1998, to 27 agencies, associations, health care entities and individuals who have been identified as interested parties or who have expressed an interest in this proposed rulemaking. The Board reviewed these comments at its meeting of November 17, 1998.
The Board seeks in these revisions to eliminate outdated provisions, to standardize and simplify language in provisions that maintain their validity, and to reflect educational, testing and practice developments.
D. Description of Amendments
These revisions would make editorial changes to 31 sections, eliminate 20 sections, and add five new sections. These revisions would also consolidate separate provisions pertaining to baccalaureate, associate degree and diploma programs into one category, nursing education programs, the term used in section 6.1 of the law. Seven new definitions are proposed for § 21.1 (relating to definitions). The content of § 21.26 (relating to failing rate of a school in examination) would be moved to § 21.34(b) (relating to removal from approved list). A new standard for removing nursing education programs based on the failure rate of first-time examinees is proposed. Major substantive changes are also proposed for faculty and staff requirements for a nursing education program.
Major Changes
§ 21.34. Removal from approved list; percentage failure rate in examination.
The Board proposes to reserve § 21.26, move its contents to § 21.34, clarify the procedure for removing a nursing education program from the approved list, and establish a new standard for removal of a program based on the failure rate for the licensure examination.
One of the criteria used by the Board, as well as many other state boards of nursing, in approving a nursing education program is the passing rate of graduates of the program who take the licensure examination (NCLEX) for the first time. Under the current § 21.26, a nursing education program's status will be downgraded from fully approved to provisionally approved if less than 60% of its graduates pass the NCLEX when they take it the first time.
The amendments would reserve the current § 21.26 and move the criteria for establishing minimum pass rates to § 21.34, which deals with removal of a nursing education program from the Board's approved list. The amendments would cause a nursing education program, beginning 1 year after final rulemaking is implemented, to be downgraded from fully approved to provisionally approved if less than 80% of its graduates pass the NCLEX when they take it the first time. The Board proposes this change for the following reasons.
The Commonwealth's minimum passing rate is the least stringent standard in the Nation when compared with other states that use the NCLEX passing rate as a criterion for approving a nursing education program. Under current standards, a nursing education program will maintain full approval status if more than 60% of its graduates pass the NCLEX on their first attempt. Seven states have established 75% as the minimum passing rate, 13 states have established 80% as the minimum, and six states have established 85% as the minimum. (National Council of State Boards of Nursing, Inc., Profiles of Member Boards-1996)
For the examination year October 1, 1997, to September 30, 1998, only 10 of 56 jurisdictions had NCLEX performance rates below that of this Commonwealth. The 10 jurisdictions are American Samoa (four candidates), Delaware, District of Columbia, Guam, Illinois, New York, Northern Mariana Islands (10 candidates), Puerto Rico and Virgin Islands. The overall pass rate for first time examinees applying for licensure in this Commonwealth who were educated in programs in this Commonwealth during the examination year October 1, 1997, to September 30, 1998, was 80.6%. The overall pass rate for the United States in the same period was 85.3% When this Commonwealth's pass rate is broken down according to type of program, the pass rate for graduates of associate degree programs was 79% (1,075 of 1,355 examinees), baccalaureate degree programs, 80% (1,157 of 1,452), and diploma programs, 84% (717 of 853).
Under the current standards, the nursing education programs in this Commonwealth can maintain full approval status. If the amendments were in effect, 11 of 22 associate degree programs, 17 of 32 baccalaureate degree programs and six of 26 diploma programs would be on provisional status. These programs would have to improve the performance of their graduates on the NCLEX to return to full approval status.
The Board believes that the minimum passing rate for this Commonwealth's programs should be consistent with the rest of the Nation. Programs will be motivated to improve if the minimum passing rate required for maintaining full approval is increased. The Board believes that a number of programs are not providing sufficient support services for students which results in lower pass rates for their graduates. It is the Board's understanding that programs with higher pass rates do not have more resources available to them than programs with lower pass rates.
The proposed amendments to § 21.34(a) also clarify the procedure for removing a nursing education program from the approved list. Under the current § 21.34, the Board gives ''sufficient'' notice of its intent to remove a program. The proposed amendment will provide 90 days notice to the program.
§ 21.71. Faculty and staff requirements for baccalaureate and associate degree programs.
The current § 21.71(b)(1) requires the director of a baccalaureate degree program to hold a master's degree in nursing and either an earned doctorate or a specific plan for completing the doctorate, and to have experience in nursing practice, nursing education within an institution of higher education and educational administration. The amendment to § 21.71(b) would require the nurse administrator of a baccalaureate nursing education program who is employed for the first time 1 year after the implementation of final rulemaking to hold an earned doctorate with a nursing major at either the master's or doctoral level. The nurse administrator will also be required to have experience in the areas of administration (not necessarily educational administration), nursing practice and nursing education within an institution of higher education.
The proposed requirement that the nurse administrator of a baccalaureate nurse education program have a doctorate reflects the current standard in nursing education. The nurse administrators of 30 of this Commonwealth's 32 baccalaureate degree programs hold doctorates. The remaining two programs would not be required to comply with the doctoral standard until there is a change of nurse administrator. When the current regulation went into effect in 1983, few nurses held doctorates. Today nurses holding doctorates are available.
The current §§ 21.71(b)(2) and 21.74 (relating to faculty and staff requirements for diploma programs) require the director of an associate degree program or a diploma program to hold a master's degree in nursing and have experience in the areas of nursing practice, nursing education and educational administration. Additionally, a candidate without a master's degree who has made outstanding contributions to nursing education may, at the discretion of the Board, serve as the director of a diploma program.
Under the proposed amendments, the nurse administrator of an associate degree or diploma program will still be required to hold a master's degree in nursing and have experience in the areas of nursing practice, nursing education and administration (although not necessarily educational administration). The Board will no longer require that a candidate for the position of nurse administrator of any educational program have administrative experience in the field of education. The Board is of the opinion that such a requirement is unnecessarily restrictive and that administrative experience gained outside of education is acceptable. Under the proposed amendments, a diploma program will no longer have the option of seeking Board approval for a candidate who lacks the required master's degree but who has made outstanding contributions to nursing education.
The current §§ 21.71(a)(5) and 21.74(a)(3) require that the faculty members of all types of program have a master's degree in nursing with graduate preparation relevant to their clinical areas of responsibility. Under the proposed amendments in § 21.71(a)(6), every faculty member will be required to have a master's degree in nursing or an earned doctoral degree in nursing with graduate preparation and clinical experience relevant to their clinical areas of responsibility. Under both the current regulations and the proposed amendments, nursing education programs may apply to the Board for permission to employ a faculty member without a master's degree in nursing for up to 5 years if qualified candidates are not available.
Section 21.71(b)(9) is being added to authorize clinical preceptors to guide nursing students in clinical activities. Under current regulations, only a faculty member could guide students in clinical activities. The Board believes the current regulation is unnecessarily restrictive.
§§ 21.61--21.126. Reorganization and consolidation of provisions pertaining to nursing education programs.
These amendments would consolidate the separate and sometimes repetitive provisions pertaining to baccalaureate, associate degree and diploma programs into one category under the statutory phrase, ''nursing education programs.'' This consolidation simplifies the organization of the regulations and makes clear that the Board's approval of any program, whether a baccalaureate, associate degree or diploma, assures that the program provides the minimal education necessary for licensure. Section 21.61 will contain the organizational requirements for all three types of programs. Section 21.71 will contain the faculty and staff requirements for all three types of programs.
The proposed rulemaking makes clear that the nursing education program faculty will be on the same footing as other faculty in the institution (§ 21.61(b)), that the administrative responsibility for the program must be in the nurse administrator (§ 21.61(f)), that the nurse administrator and the faculty will be required to conduct periodic evaluations of the program (§ 21.61(g)), and that the faculty must formulate all policies that relate to the operation of the nursing education program (§ 21.61(k)).
Under the heading ''Student Services'' the Board proposes to delete §§ 21.112, 21.113 and 21.115 (relating to student employment; student housing; and financial aid). The Board has had a minimal role in these areas; these regulations are obsolete. The Board does not believe that it can lawfully regulate student employment. Most diploma programs do not provide student housing. Housing for baccalaureate and associate degree programs is established and regulated on an institution-wide basis and regulated by the colleges themselves. Financial aid programs are regulated by other state and Federal agencies.
As a result, of this reorganization it will be possible to delete §§ 21.62, 21.63, 21.74--21.76 and 21.81--21.89. New §§ 21.90, 21.90a--21.90c and 21.131 will be added to cover curriculum, educational and program evaluation criteria for all three types of programs. Additionally §§ 21.61, 21.71--21.73, 21.91, 21.101--21.103, 21.114, 21.118, 21.121--21.122 and 21.124--21.125 will be revised either for editorial improvement or to reflect current terminology appropriate to all nursing education programs and current practice.
Other Changes
§§ 21.21--21.23. Applications for examination.
The conversion of NCLEX from a ''pencil and paper'' examination to computer adaptive testing (CAT) on April 1, 1994, requires changes to §§ 21.21 and 21.23 and allows the deletion of § 21.22. Prior to CAT, the examination was scheduled a few times a year. The current § 21.21(a) (relating to application for examination) authorizes the applicant to submit an application during the last term of the nursing program to be scheduled to take the next examination, as long as the applicant completed the program before taking the examination. Under CAT, the examination can be administered on 6 days of the week on a date and at a location chosen by the applicant. It is no longer necessary for the Board to receive applications before the applicant actually completes the program because under CAT, after the applicant completes the nursing education program, the applicant may submit the application and take the test when the applicant wishes.
Section 21.22 (relating to date and location of examinations) may be deleted because under CAT it is no longer relevant. Section 21.23(a) is modified to remove the potential implication that the examination must be handwritten.
§ 21.27. Temporary Practice Permits.
The current § 21.27 (relating to unlicensed candidate) is based on earlier law which provided for a graduate of a nursing education program to practice as a graduate nurse for 1 year. The proposed amendments to § 21.27 reflects the addition of section 4.1 of the law which requires that graduates obtain a temporary practice permit during the 1-year period from completion of the person's nursing education program or from the date a licensee of another jurisdiction of the United States or Canada files an application for a license from the Commonwealth.
§ 21.28. Licensure By Endorsement.
Section 7(a) of the law authorizes the Board to issue a license without examination to an applicant who has completed a course of study equivalent to that required in this Commonwealth and who is licensed by examination in another jurisdiction of the United States or Canada. The proposed amendment to § 21.28 (relating to licensure by endorsement) brings the Board's regulation pertaining to endorsement into harmony with the law. The proposed amendment identifies those who are licensed by examination in Canada as among those who would be eligible for licensure by endorsement. The proposed amendment also recognizes that the licensure examination in Canada is not NCLEX. The current regulation in § 21.28(a) would authorize licensure by endorsement to a Canadian educated nurse only if the nurse passed NCLEX. NCLEX, however, is not employed as a licensing examination in Canada. The proposed amendment makes it clear that the Canadian examination will support licensure by endorsement for nurses who have been educated and obtained licensure in Canada.
§ 21.29. Expiration and renewal of license.
The recitation of the schedule for renewing licenses in subsection (a), published in 1985, and now in effect for over a decade, is eliminated in this proposed rulemaking and replaced with the simple statement that licenses shall be renewed biennially. Nurses have actual knowledge of the expiration and renewal date of their licenses because the expiration date is printed on their licenses and wallet cards. Renewal applications are sent to nurses 2 months before their licenses expire.
§ 21.30. Registered nurses licensed outside of the United States, its territories or Canada.
Section 21.30(b) may be eliminated because it is obsolete. This provision authorized a graduate nurse licensed in another country to participate in an approved exchange-visitor program or in an accredited graduate program in nursing for 2 years without a license and compensation. These programs have not been available for a decade. Moreover, the Board is not aware of any barrier that would prevent a credentialed graduate nurse licensed in another country from either obtaining licensure in this Commonwealth or participating in a nursing education program.
The current § 21.30(c) requires an applicant from a nondegree granting institution outside of the United States or Canada to obtain a certificate of preliminary education through the Department of Education. This provision may be deleted as obsolete. Since January 1, 1995, the Department of Education ceased evaluating foreign credentials for professional licensing boards. The Board itself under the authority of section 6 of the law makes the determination that an applicant has completed work equal to a standard high school course.
§ 21.31. Compliance Reviews of Nursing Education Programs.
The amendment to § 21.31 would replace ''survey visits'' of nursing education programs with ''compliance reviews'' and announce that a compliance review of every basic nursing education program will be conducted at least once every 3 years.
Section 6.1 of the law requires an approved nursing education program to submit an annual report to the Board and that a site visit of the program be made at least once every 3 years to assure that the program maintains acceptable standards. Since 1995, the Board has been accepting the accreditation reviews of the National League of Nursing Accreditation Association (NLN), which include site visits, in place of site visits made by Board personnel. The onsite evaluations conducted by the NLN are in accordance with standards acceptable to the Board. The Board still conducts site visits every 3 years to nursing education programs which do not have NLN accreditation. Every nursing education program continues to submit an annual report to the Board and a compliance review every 3 years. A recognized National accreditation survey assures that an approved nursing education program continues to meet Board standards. This change is reflected in the amendments to § 21.31.
Section 6.2 of the law requires the Board to annually prepare and make available a list of all approved programs. The new § 21.31(b) tracks this provision.
§ 21.33. Types of approval.
The Board grants initial approval to a new program, full approval to a program that maintains acceptable standards and provisional approval to a program that does not meet acceptable standards. Under the current § 21.33(c), a program not meeting acceptable standards could remain on provisional status for up to 2 years. This provision also provides for removing a nursing education program from the list of approved programs if it does not meet acceptable standards. The amendment would allow for more flexibility in both restricting and correcting programs not meeting acceptable standards. The amendment would eliminate the 2-year maximum time period and enable the Board to set a specific time for a program to comply with Board requirements. The amendment also provides notice that a nursing education program downgraded to provisional status may be restricted from establishing new satellite campuses or offering alternative scheduling plans.
§ 21.51. Establishment of a nursing education program.
Most of the proposed changes to this section attempt to clarify the process under which a new program obtains approval from the Board. Under both the current and proposed rulemaking, the program first submits a feasibility study (§ 21.51(b)(1)--(4) of the current regulations, § 21.51(b)(1)--(2) of the proposed rulemaking). After the feasibility study is approved by the Board, the program submits an educational plan (§ 21.51(b)(5) of the current regulations, § 21.51(b)(3) of the proposed rulemaking). The distinction between the feasibility study and the educational plan is clarified in the amendment (proposed § 21.51(b)(3)).
Aspects of the current regulation which appeared subjective and not subject to enforcement, § 21.51(b) (relating to compatibility of the philosophy of the parent institution)) will be deleted. Similarly, provisions which appear to place restraints on the establishment of a new program based on the ''need'' for a program, assurances of an ''adequate supply and flow of interested candidates'' and impact on other nursing programs are also deleted. (See, § 21.51(b)(1)(i)--(iii).) The amendments require the feasibility study for the establishment of a new nursing education program to demonstrate that the program has an appropriate curriculum, the necessary hours of instruction, adequate academic and clinical resources and reasonably committed financial resources.
After the Board approves a feasibility study, a new nursing education program will be required to submit a report at least 8 months before students are admitted. The report must include an outline of the administrative structure of the new program, a job description for each faculty position, a statement of philosophy and objectives, admissions policies, a 4-year budget projection and information about various agencies which will provide supervised clinical experience for the nursing students.
Under the current regulations the new education program must employ the faculty at least 1 semester before they start teaching. (See § 21.51(b)(6).) The proposed amendment deletes this costly requirement and implicitly authorizes a new program to employ the faculty when it becomes necessary.
The current regulations treat the change of ownership of a nursing education program as the establishment of a new program, requiring a new feasibility study. (See § 21.51(c).) The proposed § 21.51(d) recognizes that a change in ownership may not result in any change to a program and, in such a situation, only requires the administrator of the program to inform the Board of a change in ownership.
§ 21.72. Faculty policies.
A proposed amendment to § 21.72(f) will require faculty members to maintain a record of participation in continuing education, self-development and other activities which promote the maintenance of expertise in their teaching area. While many professionals maintain the records as part of their resume, this proposed rulemaking makes the recordkeeping mandatory.
§§ 21.90--21.90b. Curriculum, philosophy, purposes and objectives; core curriculum requirements; and general education criteria.
These provisions require types of nursing education programs to formulate a statement of philosophy and purpose, to have a curriculum which addresses the areas of entry level nursing practice identified in the job analysis of the National Council of State Boards of Nursing and to stress critical thinking. These provisions replace the current §§ 21.81, 21.82 and 21.84--21.89.
§ 21.90c. Changes requiring Board approval.
This section would replace the current § 21.83. The proposal makes clear that major changes to curriculum require Board approval and simplifies the procedure for obtaining Board approval.
§ 21.91. Facility and resource requirements.
The proposal simplifies this provision, eliminating requirements that are subjective (such as, the ''facilities shall be attractive'') and not subject to the Board's enforcement jurisdiction or expertise (such as, ''effective lighting, adequate heating and ventilation''), but rather are under the jurisdiction of other agencies.
§ 21.114. Counseling and guidance.
Current regulations encourage student counseling programs to include personal, professional and academic counseling and referral of students to appropriate counselors. Under the proposed amendments, these services will be required.
§ 21.122. Record maintenance.
The current regulations require a nursing education program to keep student records ''ad infinitum.'' The proposed amendment reduces this time to 50 years. The proposed amendment will require that minutes of organizational and faculty meetings, annual reports and program evaluations be retained for 10 years and budgets for 3 years. The current regulations do not specify how long these records should be kept.
§ 21.124. Records to be filed with the Board.
The proposed § 21.124(b) is simplified because the only information that a nursing education program need provide the Board consists of a list of those who completed the program and are eligible for a temporary practice permit. The student submits the application.
§ 21.131. Evaluation.
The proposed amendment requires each nursing education program to perform self-evaluations which examine the program's administration, faculty, curriculum, facilities and student policies.
E. Fiscal Impact and Paperwork Requirements.
Some of the provisions of this proposed rulemaking are likely to have a fiscal impact. It is not possible to estimate the impact with any likelihood of precision. The proposal in § 21.34 to downgrade the status of a nursing education program from full approval to provisional approval based on the performance of graduates on the licensure examination may increase costs for those programs which may have to increase student support services to raise the passing rate of its graduates. An increase in the passing rate will have a beneficial fiscal impact on students, possibly offsetting school costs.
The change proposed in § 21.31 from routine site visits of nursing education programs performed by Board staff to compliance reviews based on NLN accreditation site reviews every 3 years will result in savings to both the Commonwealth and to the nursing education programs. The Commonwealth benefits from saving staff time because staff no longer have to visit sites. The programs benefit by not having to prepare for two similar onsite surveys.
The change proposed in § 21.51(b)(6), which no longer requires a new nursing education program to hire the faculty 1 semester before they start teaching, will result in savings to the private sector and public institutions.
The change proposed in § 21.51(c), which will no longer consider a change of ownership of a nursing education program as the establishment of a new program, will result in savings to the private sector. Under the proposal, the program will only have to inform the Board and not prepare a new feasibility study.
F. Sunset Date
The Board continuously monitors its regulations. Therefore, no sunset date has been assigned.
G. Regulatory Review
Under section 5(a) of the Regulatory Review Act (71 P. S. § 745.5(a)), on January 25, 2001, the Board submitted a copy of this proposed rulemaking to the Independent Regulatory Review Commission (IRRC), the House Committee on Professional Licensure and the Senate Consumer Protection and Professional Licensure Committee. In addition to submitting the proposed rulemaking, the Board has provided the Committees and IRRC with a copy of a detailed Regulatory Analysis Form prepared by the Board in compliance with Executive Order 1996-1, ''Regulatory Review and Promulgation.'' A copy of this material is available to the public upon request.
If IRRC has objections to any portion of the proposed amendments, it will notify the Board within 10 days of the close of the Committees' review period. The notification shall specify the regulatory review criteria which have not been met by that portion. The Regulatory Review Act specifies detailed procedures for review of the objections prior to final publication of the regulations by the Board, the General Assembly and the Governor.
H. Public Comment
Interested persons are invited to submit written comments, suggestions or objections regarding the proposed rulemaking to Martha Brown, Counsel, State Board of Nursing, P. O. Box 2649, Harrisburg, Pennsylvania 17105-2649 within 60 days following publication for the proposed rulemaking in the Pennsylvania Bulletin. Please reference (16A-516) General Revisions when submitting comments.
M. CHRISTINE ALICHNIE, PhD, RN,
ChairpersonFiscal Note: 16A-516. No fiscal impact; (8) recommends adoption.
Annex A
TITLE 49. PROFESSIONAL AND VOCATIONAL STANDARDS
PART I. DEPARTMENT OF STATE
Subpart A. PROFESSIONAL AND OCCUPATIONAL AFFAIRS
CHAPTER 21. STATE BOARD OF NURSING
GENERAL PROVISIONS § 21.1 Definitions.
The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise:
Accredited program--A nursing education program which has been approved by an accrediting agency in nursing recognized by the United States Department of Education.
* * * * * Agency data form--A form provided by the Board which is used to collect demographic and other necessary information relevant to the clinical experience of nursing students at a cooperating clinical agency.
* * * * * Clinical preceptor--A professional nurse associated with a cooperating clinical agency who guides a nursing student in designated clinical learning activities after the student has received appropriate didactic and clinical instruction.
Compliance review--A process of self-evaluation by the nursing education program pursuant to guidelines of the Board, which may also include a site visit by professional Board staff for the purpose of determining compliance with Board regulations.
Cooperating clinical agency--A facility which enters into a written agreement with a nursing education program or controlling institution to provide nursing students with supervised clinical experience.
* * * * * NCSBN--National Council of State Boards of Nursing.
* * * * * Satellite or branch campus--A dependent part of a nursing education program established at a location other than that of the originally approved site. The satellite or branch campus offers a majority of the courses of the originally approved program.
* * * * * § 21.2 Scope.
(a) The Board administers the act by providing rules and regulations on standards for nursing [schools and the conduct of the] education programs.
(b) The Board provides for licensure of graduate nurses from approved [schools] nursing education programs by examination[,] . The Board also provides for licensure of nurses by endorsement and by renewal of licenses.
(c) The Board has the [right] authority to establish rules and regulations for the practice of nursing.
(d) The Board may suspend or revoke licenses for cause as well as impose civil penalties.
(e) The Board will approve [basic] nursing education programs conducted in hospitals, colleges[,] and universities[; approve foreign exchange visitor programs; and promulgate] and compile a list of approved programs.
(f) The Board will [approve applications] provide for inactive status under section 11(b) of the act (63 P. S. § 221).
* * * * * § 21.3 Purposes of the Board.
[The Board will insure safe nursing services for the citizens of this Commonwealth.] The purpose of the Board is to assure the public health, safety and welfare of the residents of this Commonwealth. Embodied in this purpose are the following responsibilities:
(1) To establish safe minimum standards for the preparation of registered and practical nurses in approved [educational] nursing education programs.
(2) To assure safe standards of nursing practice through examination and licensure of graduates of approved [educational] nursing education programs, through endorsement of registered and practical nurses from other jurisdictions, and through the regulation of the practice of nursing in this Commonwealth.
LICENSES § 21.21. Application for examination.
(a) An application for the licensing examination [without transcript] together with the required fee in the form of a check or money order may be submitted [during the last term] to the Board office upon completion of the nursing education program. [The applicant will be scheduled for the subsequent examination.]
* * * * * (c) A copy of the transcript for out-of-State candidates validating program completion shall be filed [at least 2 weeks prior to the testing dates in the Board office] in the Board Office.
[(d) The Board will not proctor an applicant for another state board. The Board will not permit an applicant for Commonwealth licensure to be proctored by another state board.]
§ 21.22. [Date and location of examinations] (Reserved).
[ (a) The Board conducts licensing examinations at least twice a year.
(b) A list of examination dates and locations are published annually.]
§ 21.23. Qualifications of applicant for examination.
(a) An applicant shall pass [a written] an examination as provided by the Board.
* * * * * § 21.24. Examination score requirements.
The candidate for licensure shall achieve a [minimum] passing score as mandated by the Board.
§ 21.25. Reexamination.
(a) [A candidate shall submit the required fee in the form of a check for reexamination.] An application for reexamination may be submitted together with the required fee in the form of a check or money order to the Board office.
(b) [(Reserved).
(c)]
* * * * * [ (d) A request to retake an examination for the purpose of elevating a passing score will not be granted.]
§ 21.26. [Failing rate of a school in examination] (Reserved).
[ If 40% or more of the first-time examinees of a school of nursing writing the examination in this Commonwealth fail the examination, the school will be placed on provisional approval status. The Board may consider additional documented statistics concerning the examination scores received in other states by Commonwealth graduates in determining the status of the school.]
§ 21.27. [Unlicensed candidate] Candidates for licensure; temporary practice permits.
[The] A candidate for licensure as a professional nurse who has completed a nursing education program may practice as a graduate nurse [until the licensing examination is passed subject to the following:] upon the issuance of a temporary practice permit under section 4.1 of the act (63 P. S. § 214.1).
(1) [Unless licensed, the candidate may be employed as a graduate nurse for 1 year only from the date of completion of a nursing program except in the case where special permission is granted by the Board due to extenuating circumstances. In such a case the candidate shall present validating documentation.] A candidate for licensure as a professional nurse shall apply to the Board for admission to the examination and may apply for a temporary practice permit.
* * * * * § 21.28. Licensure by endorsement.
(a) [A registered nurse who has graduated from an approved nursing program in another state or territory of the United States or Canada and who is licensed by writing the National Council Licensure Examination in another jurisdiction of the United States or Canada may be granted licensure in this Commonwealth by endorsement of the original licensing board.] A registered nurse who has graduated from an approved nursing education program in another state or jurisdiction of the United States or the Dominion of Canada and obtained the license by passing the National Council of State Boards of Nursing Licensure Examination or the examination required for licensure in the Dominion of Canada may be granted licensure in this Commonwealth by endorsement of the license issued by the original jurisdiction.
* * * * * § 21.29. Expiration and renewal of license.
(a) [Registered nurses whose licenses expire on October 31, 1985 will thereafter be subject to the following license renewal schedule:
(1) Licenses of registered nurses whose license numbers end in the numbers 01 through 25 will expire on April 30, 1986 and, following renewal, will thereafter expire on April 30 in the even-numbered years. The license renewal fee for licenses that expire on April 30, 1986 will be 25% of the renewal fee for the usual 2-year renewal period. The renewal fee for licenses that expire on an anniversary of April 30, 1986 will be the renewal fee for the usual 2-year renewal period.
(2) Licenses of registered nurses whose license numbers end in the numbers 26 through 50 will expire on October 31, 1986 and, following renewal, will thereafter expire on October 31 in the even-numbered years. The license renewal fee for licenses that expire on October 31, 1986 will be 50% of the renewal fee for the usual 2-year renewal period. The renewal fee for licenses that expire on an anniversary of October 31, 1986 will be the renewal fee for the usual 2-year renewal period.
(3) Licenses of registered nurses whose license numbers end in the numbers 51 through 75 will expire on April 30, 1987 and, following renewal, will thereafter expire on April 30 in the odd-numbered years. The license renewal fee for licenses that expire on April 30, 1987 will be 75% of the renewal fee for the usual 2-year renewal period. The renewal fee for licenses that expire on an anniversary of April 30, 1987 will be the renewal fee for the usual 2-year renewal period.
(4) Licenses of registered nurses whose license numbers end in the numbers 76 through 00 will expire on October 31, 1987 and, following renewal, will thereafter expire on October 31 in the odd-numbered years. The license renewal fee for licenses that expire on October 31, 1987 will be the renewal fee for the ususal 2-year renewal period. The renewal fee for licenses that expire on an anniversary of October 31, 1987 will be the renewal fee for the usual 2-year period.
(5) Registered nurses who obtain initial licensure on or after November 1, 1985 and registered nurses who reactivate their licenses on or after November 1, 1985 will be assigned to one of the following license expiration dates:
(i) April 30 in the even-numbered years.
(ii) October 31 in the even-numbered years.
(iii) April 30 in the odd-numbered years.
(iv) October 31 in the odd-numbered years.]
Licenses of registered nurses shall be renewed biennially.
* * * * * § 21.30. Registered nurses licensed outside of the United States, its territories or Canada.
[(a)] A nurse educated and licensed in another country other than Canada may not be employed as a nurse in this Commonwealth until the requirements for Commonwealth licensure have been met.
[(b) A graduate nurse licensed in another country may participate in an approved exchange-visitor program or in an accreditation graduate program in nursing for a period of 2 years without licensure and compensation in this Commonwealth.
(c) An applicant coming from a country outside of the United States or Canada who is from a nondegree granting institution shall obtain a Certificate of Preliminary Education through the Department of Education.]
APPROVAL OF [SCHOOLS OF] NURSING EDUCATION PROGRAMS § 21.31. [Surveys] Compliance reviews; list of approved schools.
(a) [Survey visits are made] A compliance review of every basic nursing [programs conducted in hospitals, colleges or universities of exchange visitor programs and of cooperating agencies. In this section, ''cooperating agency'' means an educational institution or health care delivery system which cooperates with the controlling institution. The survey] education program approved in this Commonwealth shall be conducted at least once every 3 years. A report is presented to the Board and a written report of recommendations or requirements, or both, is sent to the [school, college or university] nursing education program. A site compliance visit may be made at the discretion of the Board and will be made at least once every 3 years to a nursing education program which is not accredited.
(b) [Classified lists of approved schools of nursing and of exchange visitor programs are compiled and published annually and are made available for distribution.
(c) A list of approved cooperating agencies that provide educational programs for schools of nursing is compiled and published annually and is made available for distribution.]
The Board will compile and publish annually a list of approved nursing education programs located in this Commonwealth.
§ 21.32. Objectives of the approval process.
[Nursing schools in this Commonwealth are approved to effectuate the following] The purpose of the Board's approval process for nursing education programs is to make certain that each approved nursing program meets the following objectives:
(1) Safeguard the [preparation] quality of [nurses] nursing education programs and assure safe minimum standards of nursing practice in this Commonwealth.
(2) Stimulate and maintain continued growth and improvement of professional nursing education in this Commonwealth.
(3) [Guide prospective students in the selection of approved schools which offer adequate resources for sound basic nursing education.
(4)] Assure the graduates of professional nursing education programs of eligibility for admission to examination for licensure.
[(5)](4) Assist graduates of [schools of] nursing education programs in this Commonwealth to qualify for licensure by endorsement in other jurisdictions.
§ 21.33. Types of approval.
The Board will grant initial, provisional or full approval status to a nursing education program contingent upon compliance with this chapter, and may require progress reports or other information deemed necessary for the evaluation of the program.
[(a)] (1) Initial. The Board may grant initial approval to a new [schools] nursing education program, with evidence that acceptable standards are being met, for a period of time necessary to evaluate the results of the licensing examination taken by the first graduates. Board action to grant initial approval authorizes a nursing education program to recruit students.
[(b)] (2) Full. The Board will place on full approval [those schools] a nursing education program which [attain] attains and [maintain the] maintains acceptable standards and [adhere] adheres to the policies and regulations of the Board [considered essential for a sound program of nursing education.]
[(c)] (3) Provisional. The Board may place on provisional approval a [school] nursing education program not meeting [the] acceptable standards. [A period of 2 years will be the maximum time allowed for the correction of deficiencies resulting in provisional approval.] If the standards are not met within [this designated time] the time designated by the Board, the [school] program will be removed from the approved list as provided in § 21.34 (relating to removal from approved list; percentage failure rate in examination). A nursing education program placed on provisional status may be restricted from establishing new satellite campuses or offering alternative scheduling plans until the program resumes full approval status.
§ 21.34. Removal from approved list; percentage failure rate in examination.
(a) Notice of intent. The Board will give [sufficient notification of intent of removal from the approved list and provide an opportunity for school officials to show cause as to why approval should not be withdrawn] 90 days notice of its intent to remove a nursing education program from the approved list and will provide an opportunity for the program to show cause why approval should not be withdrawn.
(b) Removal based on failure rate.
(1) Until ______ (Editor's Note: The blank refers to a date 1 year after the effective date of adoption of this proposal.), a nursing education program will be placed on provisional approval status if, in one examination year, 40% or more of its graduates taking the licensure examination for the first time fail the examination.
(2) Beginning ______ (Editor's Note: The blank refers to a date 1 year after the effective date of adoption of this proposal.), a nursing education program will be placed on provisional approval status if, in one examination year, 20% or more of its graduates taking the licensure examination for the first time fail the examination.
(3) An examination year is the period beginning October 1 of one year through September 30 of the following year.
(4) The Board may consider additional documented statistics concerning the examination scores received in other states by Commonwealth graduates in determining the approval status of the program.
DISCONTINUANCE OF A [SCHOOL OF] NURSING EDUCATION PROGRAM § 21.41. Notification: completion of program; records.
(a) Written notification of intent to discontinue a nursing education program [of nursing] shall be submitted to the Board within a reasonable time, but not less than 6 months prior to discontinuance.
(b) When a class is not admitted in a given year, the nursing education program shall close unless approval has been granted by the Board based on the justification for continuation submitted to the Board.
(c) If a nursing education program is discontinued, it is the responsibility of the controlling institution to provide for the completion of the program for students currently enrolled, either by placing the students in an approved program or continuing the enrolled classes until completion. If the program is continued until completion, approved and qualified instruction shall be assured. A controlling institution is a university, college or hospital which conducts programs of education in nursing.
(d) The controlling institution has the legal responsibility to make provision for permanent retention of student and graduate records in conformity [of] with § 21.125 (relating to custody of records).
[Continued on next Web Page]
No part of the information on this site may be reproduced for profit or sold for profit.This material has been drawn directly from the official Pennsylvania Bulletin full text database. Due to the limitations of HTML or differences in display capabilities of different browsers, this version may differ slightly from the official printed version.
