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 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. (1) Initial Approval.

      1. (A) Initial approval is written authorization by the Board for a new program to admit students and is granted if the program meets the requirements and addresses the recommendations issued by the Board.
      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 professional pre-licensure nursing educational program that is in compliance with all Board requirements and has responded to all Board recommendations.
      2. (B) Only programs with full approval status may initiate extension programs, grant faculty waivers and petition for faculty waivers.

   3. (3) Full approval with warning is issued by the Board to a professional 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 the 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 removed.
      3. (C) Depending upon the degree to which the Board's legal and educational requirements are met, the Board may change the approval status 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 professional nursing educational programs.
   6. (6) 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 by 2015 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. At a minimum, a graduate of a diploma program will be entitled to receive an associate degree in nursing.

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 the program dean or 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-RN® examination pass rate, and other pertinent data.

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

   2. (2) NCLEX-RN® 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-RN® examination.
      2. (B) When the passing score of first-time candidates who complete the professional nursing educational program of study is less than 80% on the NCLEX-RN® 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-RN® examination and a description of the corrective measures to be implemented. The report shall follow Board guidelines.
      3. (C) A warning shall be issued to the program when the pass rate of first-time candidates, as described in subparagraph (A) of this paragraph, is less than 80% for two consecutive examination years.
      4. (D) A program shall be placed on conditional approval status if, within one examination year from the date of the warning, the performance of first-time candidates on the NCLEX-RN® examination fails to be at least 80%, or the faculty fails to implement appropriate corrective measures.
      5. (E) Approval may be withdrawn if the performance of first-time candidates fails to be at least 80% during the examination year following the date that the program is placed on conditional approval.
      6. (F) 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 the program's pass rate for first-time candidates during one examination year is at least 80%.

   3. (3) Survey Visit. Each professional 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-RN® examination pass rate shall be reviewed by the Board biennially at a regularly scheduled meeting.
   4. (4) 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.
   5. (5) 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.

   6. (6) 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 (7) of this subsection, with the national nursing accrediting agency selected by the Board under which it was approved or sought approval by the Board; and
      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.

   7. (7) 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.
   8. (8) 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.
   9. (9) A school of nursing or educational program, approved by the Board as stated in paragraph (7) 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.
   10. (10) The Board may assist the school or program in its effort to achieve compliance with the Board's standards.
   11. (11) A school or program from which approval has been withdrawn may reapply for approval.

   12. (12) 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 §215.4 adopted to be effective January 9, 2005, 29 TexReg 12190; amended to be effective February 19, 2008, 33 TexReg 1328; amended to be effective October 19, 2008, 33 TexReg 8509.