PURPOSE: This rule defines the approval status and process for programs of practical nursing.

1. (1) Programs of practical nursing shall obtain approval from the board.

2. (2) Purposes of approval are—

   1. (A) To promote the safe practice of practical nursing by setting minimum standards for programs preparing entry-level practical nurses;
   2. (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;
   3. (C) To encourage continuing program improvement through assessment, evaluation and consultation; and
   4. (D) To assist programs of practical nursing in developing and maintaining academic standards (didactic and clinical) that are congruent with current educational and nursing practice standards.

3. (3) Classification of Approval.

   1. (A) Initial approval is the status granted a program of practical nursing until full approval is granted or denied.
   2. (B) Full approval is the status granted a program of practical nursing after the program has graduated one (1) class and has met and continues to meet regulations or requirements.
   3. (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. (4) Initial Approval Status.

   1. (A) Process for Obtaining Initial Status:

      1. 1. An institution desiring to establish a

program of practical nursing shall submit a letter of intent to the board at least three (3) months prior to the submission of a proposal. The letter of intent must include: the mission statement of the sponsoring institution; type and length of the nursing program proposed; and tentative budget plans including evidence of financial resources adequate for planning, implementing, and continuing the nursing program. The board will electronically notify nursing programs of the letter of intent;

1. 2. Each sponsoring institution shall have

only one (1) program proposal under consideration for initial approval at any one (1) time;

1. 3. A program proposal shall be written

and presented to the board by the administrator of the proposed program. The proposal shall bear the signature of the administrator who shall meet the criteria in 20 CSR 2200- 3.060(1)(B) and shall be active in the position on a full-time basis for at least nine (9) months and preferably one (1) year prior to the entry of the first class. The number of copies of the proposal, as specified by the board, must be accompanied with the required application fee. The proposal must be prepared following the reporting format and include each component as indicated in paragraph (4)(A)4. of this rule. Board approval of the proposal with or without contingencies must be obtained no later than six (6) months prior to the anticipated opening date;

1. 4. A proposal submitted shall contain

the following information:

1. A. Statement of need and feasibility

study which includes:

1. (I) Documentation of the need for

the nursing program including community and economic development need, rationale for why the program should be established, and documentation of employers’ need for graduates of the proposed program;

1. (II) Number of professional nursing

and practical nursing programs in the area and potential impact on those nursing programs;

1. (III) Number and source of antici-

pated student population;

1. (IV) Letters of support for the pro-

posed nursing program; and

1. (V) Source of potential qualified

faculty;

1. B. Curriculum.

   1. (I) Philosophy and/or mission.
   2. (II) Graduate competencies.
   3. (III) Curriculum sequence.
   4. (IV) Course descriptions and

objectives with number of credit hours or clock hours for all courses.

1. (V) Systematic evaluation plan;

2. C. Students.

   1. (I) Maximum number of students

per class.

1. (II) Number of classes admitted per

year.

1. (III) Number of students anticipat-

ed in initial class.

1. (IV) Plan for increase to maximum

enrollment, if applicable.

1. (V) Admission criteria.
2. (VI) Plans for progression and

retention of students.

1. (VII) Formal complaint procedure. (VIII) Availability of student ser-

vices and personnel;

1. D. Faculty.

   1. (I) Number of full-time and part-

time faculty.

1. (II) Position descriptions;

2. E. Support services personnel.

   1. (I) Number of full-time and part-

time ancillary support services personnel.

1. (II) Position descriptions;

2. F. Sponsoring institution.

   1. (I) Evidence of authorization to

conduct the program of practical nursing by the governing body of the sponsoring institution.

1. (II) Evidence of accreditation by an

agency recognized by the United States Department of Education.

1. (III) Provision of administrative

structure/organizational charts of the sponsoring institution and the nursing program.

1. (IV) Evidence of the financial sta-

bility and resources of the sponsoring institution and the program of nursing; and

1. G. Facilities.

   1. (I) Description of educational facil-

ities to be used by the practical nursing program such as classrooms, library, offices, clinical skills laboratory and other facilities.

1. (II) Description of planned or avail-

able learning resources to include such items as equipment, supplies, library services, computers, and technology.

1. (III) Description of proposed clini-

cal sites that will provide appropriate educational experiences.

1. (IV) A letter of intent from each

proposed cooperating agency stating its ability to provide the appropriate educational experiences;

1. 5. Site survey. Representatives from the

board shall 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

1. 6. 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.

1. (B) Throughout the period of initial approval, the program will submit an annual survey.

2. (C) Upon graduation of the program’s first class and receipt of results of the National Council Licensure Examination for Practical Nurses (NCLEX-PN® examination), the board shall review the following:

   1. 1. The program’s compliance with min-

imum standards during initial approval including the program’s adherence to the approved proposal and changes authorized by the board;

1. 2. Report of an on-site survey (if con-

ducted);

1. 3. Report of the National Council

Licensure Examination for Practical Nurses results (as per 20 CSR 2200-3.180(1));

1. 4. Identification and analysis of class

graduation rate; and,

1. 5. Submission of program’s ongoing

evaluation plan with available data.

1. (D) After its review, the board shall decide to continue initial approval for a period of not more than one (1) year, deny approval or grant full approval.

1. (5) Full Approval Status.

   1. (A) Annual Survey. Each program and each campus of each program shall complete and submit the board’s annual survey prior to the established deadline. Following review by the board, each program shall be notified of the board’s action(s).
   2. (B) On-Site Surveys. On-site surveys shall be made on a scheduled basis, at the direction of the board, or upon request of the nursing program. Each nursing program shall 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.
   3. (C) Additional Visits/Surveys. A representative of the board shall make additional visits/surveys as deemed necessary by the board. A program may request additional visits.

2. (6) Conditional Approval Status.

   1. (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 concerns.
   2. (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.
   3. (C) 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.

3. (7) Annual Registration Requirements.

   1. (A) An application for annual registration shall be sent to each approved program and each campus of each program from the board. Failure to receive the application will not relieve the program of its obligation to register.
   2. (B) A separate annual registration form and designated fee as established by 20 CSR 2200-4.010 shall be submitted to the board for each approved program and each campus of each program prior to June 1 of each year.
   3. (C) A program’s approval status shall be subject to review by the board if the required registration fee is not received within thirty
4. (30) days following the June 1 deadline.

AUTHORITY: sections 335.036 and 335.071, RSMo 2000.* 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. *Original authority: 335.036, RSMo 1975, amended 1981, 1985, 1993, 1995, 1999; 335.071, RSMo 1975, amended 1981, 1999.