PURPOSE: This rule defines accreditation in the minimum standards for accredited programs of practical nursing in Missouri.

1. (1) Programs of practical nursing shall obtain approval from the Missouri State Board of Nursing.

   1. (A) Purposes of Approval.

      1. 1. To promote the safe practice of prac-

tical nursing by setting minimum standards for schools preparing entry level practical nurses.

1. 2. To assure that educational require-

ments for admission to the licensure examination have been met and to facilitate endorsement in other states, territories, countries, or any combination of these. FINANCIAL INSTITUTIONS AND PROFESSIONAL REGISTRATION

1. 3. To encourage continuing program

improvement through self-study, evaluation and consultation.

1. 4. To assist programs of practical nurs-

ing in developing and maintaining academic standards (didactic and clinical) that are congruent with current educational and nursing practice standards.

1. (B) Classification of Approval.

   1. 1. Initial approval—is the status granted

a program of practical nursing until full approval is granted.

1. 2. Full approval—is the status granted a

program of practical nursing after the program has graduated one (1) class and has met minimum standards.

1. 3. Conditional approval—is the status of

a program that has failed to meet or maintain the regulations or requirements, or both, set by the board. This status is subject to the school or program conforming to the requirements set by the board.

1. (C) Approval Process.

   1. 1. Requirements for initial approval.

      1. A. An institution desiring to establish

a program of practical nursing should send 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 educational institution; approval status of the educational 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.

1. B. A program proposal shall be writ-

ten and presented to the board by the administrator of the proposed program with or without faculty assistance. The proposal shall bear the signature of the administrator who shall meet the criteria in 4 CSR 200- 3.060(2)(A) 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. Fourteen (14) copies of the proposal must be accompanied by the required application fee. The proposal must be prepared following the reporting format and include each component as indicated in 4 CSR 200-3.010(1)(C). 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. C. A proposal submitted shall contain

the following information:

1. (I) Statement of Need and feasibil-

ity study which includes:

1. (a) Documentation of the need

for the nursing program with rationale for why the program should be established;

1. (b) Number of professional nurs-

ing and practical nursing programs in the area and potential effect on those nursing programs;

1. (c) Number and source of antici-

pated student population;

1. (d) Number and type (practical

nurse, associate, diploma, and baccalaureate) of nurses available in service area;

1. (e) Number and type of employ-

ers in the service area including documentation that these employers need graduates of the proposed program, including projections of nursing staff needs;

1. (f) Documentation of community

and economic development need and support for the proposed nursing program;

1. (g) Letters of support for the

proposed nursing program; and

1. (h) Source of potential qualified

administrator and faculty;

1. (II) Curriculum.

   1. (a) Philosophy.
   2. (b) Graduate competencies.
   3. (c) Curriculum sequence.
   4. (d) Course objectives and des-

criptions including credit hours/clock hours for all courses;

1. (III) Students.

   1. (a) Number of students per class.
   2. (b) Number of classes admitted

per year.

1. (c) Admission criteria.
2. (d) Plans for progression and

retention of students.

1. (e) Grievance procedure.
2. (f) Plan for emergency health

care of nursing students;

1. (IV) Faculty.

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

time faculty.

1. (b) Qualifications of faculty.
2. (c) Position descriptions;

3. (V) Ancillary personnel.

   1. (a) Position descriptions.
   2. (b) Number of full-time and

part-time ancillary personnel;

1. (VI) Sponsoring institution.

   1. (a) Evidence of authorization to

conduct the program of practical nursing.

1. (b) Approval status of the spon-

soring institution.

1. (c) Description of the governing

body and copies of the organizational charts of the sponsoring institution and of the program of practical nursing.

1. (d) Evidence of the financial sta-

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

1. (VII) Facilities.

   1. (a) Description of education

facilities (classrooms, library, offices, clinical skills laboratory and other facilities).

1. (b) Description of available

equipment and supplies for clinical development, list of library and learning resources and number of computers available for student use.

1. (c) Description of clinical sites

that will provide educationally sound experiences.

1. (d) A letter of intent from each

proposed clinical site indicating that they are able to offer/provide the educational experiences necessary for student learning.

1. (D) Site Survey.

   1. 1. Prior to initial approval a representa-

tive from the board shall make an on-site survey to verify implementation of the proposal and compliance with 4 CSR 200-3.050–4 CSR 200-3.130.

1. (E) Board Decision.

   1. 1. Initial approval will be granted if the

site survey indicates the proposal has been implemented and the program is in compliance with 4 CSR 200-3.050–4 CSR 200- 3.130 as determined by the board or its representative(s). Throughout the period of initial approval, the program will be evaluated annually. Upon graduation of the first class to complete the entire program and receipt of results of the National Council Licensure Examination for Practical Nurses (NCLEX- PN® examination), the board will review—

1. A. 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;

1. B. Report of the on-site survey (if

conducted);

1. C. Report of the National Council

Licensure Examination NCLEX® results (see 4 CSR 200-3.180(1)); and

1. D. Identification and analysis of stu-

dent attrition rate.

1. 2. After its review, the board will decide

to continue initial approval for a period of not more than one (1) year, deny approval or grant full approval.

1. (2) Full Approval.

   1. (A) Annual Report. Each program and each campus of each program shall complete and submit an annual report to the board. A copy of a current operational budget and audited fiscal report showing income and expenditures shall be submitted with the annual report. Annual reports shall be completed with current information except where otherwise noted in the annual report form and sent to the board prior to the deadline established per board policy. Annual reports shall be submitted in a format provided by the board. Following review by the board, each program shall be notified of the board’s action(s).
   2. (B) Five (5)-Year Survey. Each approved program and each campus of each approved program shall be surveyed every five (5) years from the first year of full approval. An on-site survey or a paper survey may be conducted. If a nursing program is accredited by a nationally recognized nursing accrediting body AND accredited by North Central Association for Schools and Colleges or the Coordinating Board for Higher Education, or the Accrediting Council for Independent Colleges and Schools, a five (5)-year on-site survey may be deferred. A paper review may be completed to include a self-study, recommendations of accrediting body, attrition information as required by the board. Copies of correspondence regarding changes in accreditation status shall be submitted to the Board of Nursing immediately.
   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. (3) Annual Registration.

   1. (A) An application for annual registration shall be sent to each approved program and each campus of each approved 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 shall be submitted to the board for each approved program and each campus of each approved program prior to June 1.
   3. (C) Programs shall not operate without current registration. Failure to submit the required registration fee prior to June 1 will result in a lapsed status and the disciplinary process shall be initiated.

3. (4) Disciplinary Process.

   1. (A) Removal of Approval. A program’s approval may be removed pursuant to section 335.071.3, RSMo, for noncompliance with minimum standards.
   2. (B) 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.
   3. (C) A program which fails to correct identified deficiencies to the satisfaction of the board within a reasonable time shall, after notice and hearing, be removed from the board’s listing of approved programs. 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.

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