1. (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 response to the Board's recommendations. Change from one status to another is based on NCLEX-PN® examination pass rates, compliance audits, survey visits, and other factors listed under subsection (b) of this section. Types of approval include:

   1. (1) Initial Approval.

      1. (A) Initial approval is written authorization by the Board for a new program to admit 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.
      2. (B) Student enrollment is determined by the Board and the specifics are included in the Board's initial approval letter.
      3. (C) Change from initial approval status to full approval status cannot occur until the program has met requirements and responded to all recommendations issued by the Board and the licensing examination result of the first graduating class is evaluated by the Board.

   2. (2) Full Approval.

      1. (A) Full Approval is granted by the Board to a vocational nursing educational program that is in compliance with all requirements and has responded to all recommendations.
      2. (B) Only programs with full approval status may initiate extension programs, grant faculty waivers, and petition for faculty waivers.

   3. (3) Full or initial approval with warning is issued by the Board to a vocational nursing educational program that is not meeting legal and educational requirements.

      1. (A) A program issued a warning will receive written notification from the Board of the warning.
      2. (B) The program is given a list of the deficiencies and a specified time in which to correct the deficiencies.

   4. (4) Conditional Approval. Conditional approval is issued by the Board for a specified time to provide the program opportunity to correct deficiencies.

      1. (A) The program shall not admit students while on conditional status.
      2. (B) The Board may establish specific criteria to be met in order for the program's conditional approval status to be changed.
      3. (C) Depending upon the degree to which the Board's legal and educational requirements are met, the Board may change the approval status from conditional approval to full approval or full approval with warning, or may withdraw approval.
   5. (5) Withdrawal of Approval. The Board may withdraw approval from a program which fails to meet legal and educational requirements within the specified time. The program shall be removed from the list of Board approved vocational nursing educational programs.

2. (b) Factors Jeopardizing Program Approval Status--Approval may be changed or withdrawn for any of the following reasons:

   1. (1) deficiencies in compliance with the rule;
   2. (2) utilization of students to meet staffing needs in health care facilities;
   3. (3) noncompliance with school's stated philosophy/mission, program design, objectives/outcomes, and/or policies;
   4. (4) continual failure to submit records and reports to the Board office within designated time frames;
   5. (5) failure to provide sufficient variety and number of clinical learning opportunities for students to achieve stated objectives/outcomes;
   6. (6) failure to comply with Board requirements or to respond to Board recommendations within the specified time;
   7. (7) student enrollments without sufficient faculty, facilities and/or patient census;
   8. (8) failure to maintain a 80% passing rate on the licensing examination by first-time candidates;
   9. (9) failure of program director to document annually the currency of faculty licenses; or
   10. (10) other activities or situations that demonstrate to the Board that a program is not meeting legal requirements and standards.

3. (c) Ongoing Approval Procedures. Approval status is determined biennially by the Board on the basis of the program's compliance audit, NCLEX-PN® examination pass rate, and other pertinent data.

   1. (1) Compliance Audit. Each approved vocational nursing educational program shall submit a biennial audit regarding its compliance with the Board's legal and educational requirements.

   2. (2) NCLEX-PN® Pass Rates.

      1. (A) Eighty percent (80%) of first-time candidates who complete the program of study are required to achieve a passing score on the NCLEX-PN® examination.
      2. (B) When the passing score of first-time candidates who complete the vocational nursing educational program is less than 80% on the NCLEX-PN® examination during the examination year, the nursing program shall submit a self-study report that evaluates factors which contributed to the graduates' performance on the NCLEX-PN® examination and a description of the corrective measures to be implemented. The report shall follow Board guidelines.

   3. (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 NCLEX-PN® examination pass rates, compliance audits, survey visits, and other factors listed under subsection (b) of this section.

      1. (A) A warning may be issued to a program when:

         1. (i) the pass rate of first-time candidates, as described in paragraph (2)(A) of this subsection, is less than 80% for two consecutive examination years;
         2. (ii) the program has been in serious violation of the rules and regulations; or
         3. (iii) the program has engaged in activities or situations that demonstrate to the Board that the program is not meeting legal requirements and standards.

      2. (B) A program may be placed on conditional approval status if:

         1. (i) within one examination year from the date of the warning, the performance of first-time candidates on the NCLEX-PN® examination fails to be at least 80%;
         2. (ii) the faculty fails to implement appropriate corrective measures during the year; or
         3. (iii) the program has continued to engage in activities or situations that demonstrate to the Board that the program is not meeting legal requirements and standards.

      3. (C) Approval may be withdrawn if:

         1. (i) the performance of first-time candidates fails to be at least 80% during the examination year following the date the program is placed on conditional approval;
         2. (ii) the program is consistently unable to meet requirements issued by the Board; or
         3. (iii) the program persists in engaging in activities or situations that demonstrate to the Board that the program is not meeting legal requirements and standards.

      4. (D) A program issued a warning or placed on conditional approval status may request a review of the program's approval status by the Board at a regularly scheduled meeting if:

         1. (i) the program's pass rate for first-time candidates during one examination year is at least 80%; and
         2. (ii) the program has met all Board requirements.

   4. (4) Survey Visit. Each vocational nursing educational program shall be visited at least every six years after full approval has been granted, unless accredited by a Board-recognized national nursing accrediting agency.

      1. (A) The Board may authorize staff to conduct a survey visit at any time based upon established criteria.
      2. (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.
      3. (C) A written report of the survey visit, compliance audit, and NCLEX-PN® examination pass rate shall be reviewed by the Board biennially at a regularly scheduled meeting.
   5. (5) The Texas Board of Nursing will select one 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. Identified areas that are not equivalent to the Board's ongoing approval standards will be monitored by the Board on an ongoing basis.
   6. (6) The Texas Board of Nursing 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. (7) The Texas Board of Nursing will deny or withdraw approval from a school of nursing or educational program that fails to:

      1. (A) meet the prescribed course of study or other standard under which it sought approval by the Board.
      2. (B) meet or maintain voluntary accreditation, by a school of nursing or educational program approved by the Board as stated in paragraph (8) of this subsection, with the national nursing accrediting agency selected by the Board under which it was approved or sought approval by the Board.
      3. (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. (8) A school of nursing or educational program is considered approved by the Board and exempt from Board rules that require ongoing approval if the program:

      1. (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; and
      2. (B) maintains an acceptable pass rate, as determined by the Board, on the applicable licensing exam.
   9. (9) A school of nursing or educational program that fails to meet or maintain an acceptable pass rate, as determined by the Board, on applicable licensing examinations is subject to review by the Board.
   10. (10) A school of nursing or educational program, approved by the Board as stated in paragraph (8) of this subsection, that 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. (11) The Board may assist the school or program in its effort to achieve compliance with the Board's standards.
   12. (12) A school or program from which approval has been withdrawn may reapply for approval.

   13. (13) A school of nursing or educational program accredited by an agency recognized by the Board shall:

       1. (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 official reports;
       2. (B) notify the Board of any change in accreditation status within two (2) weeks following receipt of official notification letter; and
       3. (C) provide other information required by the Board as necessary to evaluate and establish nursing education and workforce policy in this state.
4. (d) Notice of a program's approval status shall be sent to the director, chief administrative officer of the controlling agency/governing institution, and others as determined by the Board.

Source Note:The provisions of this §214.4 adopted to be effective February 13, 2005, 30 TexReg 545; amended to be effective January 10, 2008, 33 TexReg 179; amended to be effective October 19, 2008, 33 TexReg 8501; amended to be effective December 27, 2010, 35 TexReg 11662.