SECTION 219.4. Approval

(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 survey visits or other factors listed under this subsection. Types of approval include:

(1) Initial Approval.

(A) Initial approval is written authorization by the Board for a new program to enroll 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.

(B) The number of students to be enrolled while the program is on initial approval is determined by the Board, and the requirements are included in the Board Order.

(2) Approval With Warning.

(A) Issuance of warning. When the Board determines that a program is not meeting the Board's legal and/or education requirements, the program is issued a warning, is provided a list of the deficiencies, and is given a specified time in which to correct the deficiencies.

(B) Failure to correct deficiencies. If the program fails to correct the deficiencies within the prescribed period, the Board may:

(i) Restrict admissions or other program activities until the deficiencies are corrected,

(ii) Place the program on conditional approval, or

(iii) Deny approval.

(3) Conditional Approval. Conditional approval is granted for a time specified by the Board in order to provide additional time to correct the deficiencies.

(A) The program shall not admit students while on conditional approval.

(B) The Board may establish specific criteria to be met in order for the program's conditional approval status to be removed.

(C) Depending upon the degree to which the Board's legal and/or educational requirements are met, the Board may change the approval status to approved, approval with warning, or deny approval.

(4) Denial of Approval. The Board may deny initial or ongoing approval of a program that fails to meet legal and/or educational requirements within the specified time. The program shall be removed from the list of Board-approved advanced practice registered nursing education programs.

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

(1) When a program demonstrates non-compliance with Board requirements, approval may be changed to full with warning or conditional status, may be withdrawn, or the Board, in its discretion, may impose restrictions or conditions it deems appropriate and necessary. In addition to imposing restrictions or conditions, the Board may also require additional monitoring of the program. Board monitoring may include the review and analysis of program reports; extended communication with program directors; and additional survey visits. A monitoring plan may require the submission of quarterly reports of students' performance in courses and clinical learning experiences; remediation strategies and attrition rates; and reports from an assigned mentor to the program director. Additional survey visits by a Board representative may be conducted at appropriate intervals to evaluate the status of the program. The Board may alter a monitoring plan as necessary to address the specific needs of a particular program. When the Board requires monitoring activities to evaluate and assist the program, monitoring fees will apply.

(2) A change in approval status, requirements for restrictions or conditions, or a monitoring plan may be issued by the Board for any of the following reasons:

(A) deficiencies in compliance with the rule;

(B) noncompliance with the school's stated philosophy/mission, program design, objectives/outcomes, and/or policies;

(C) failure to submit records and reports to the Board office within designated time frames;

(D) failure to provide sufficient variety and number of clinical learning opportunities for students to achieve stated objectives/outcomes;

(E) failure to comply with Board requirements or to respond to recommendations within the specified time;

(F) student enrollments without resources to support the program, including sufficient qualified faculty, adequate educational facilities, and appropriate clinical affiliating agencies;

(G) failure to recruit qualified faculty and preceptors with appropriate role preparation for program type;

(H) failure to obtain nursing accreditation or approval within five (5) years from the date the first class completes the program; or

(I) other activities or situations that demonstrate to the Board that a program is not meeting Board requirements.

(c) Determination of Approval Status.

(1) Survey visit. Each advanced practice registered nursing education program will be visited as necessary once approval has been granted. A written report of the survey visit will be reviewed by the Board at a regularly scheduled meeting.

(2) Ongoing approval may be continued on the basis of pertinent data as determined by the Board when a program is not visited by staff.

(3) Notice of a program's approval status will be sent to the director, chief administrative officer of the governing institution, and others as determined by the Board.

(d) Withdrawal from the Approval Process.

(1) Board approval of an advanced practice registered nursing education program shall automatically be withdrawn with the first occurrence of any of the following:

(A) The program obtains accreditation by a national advanced practice registered nursing education accrediting agency recognized by the Board;

(B) Five years elapse from the date the first class completes the program; or

(C) The program is denied national accreditation.

(2) An advanced practice registered nursing education program approved by the Board may elect to withdraw from the Board approval process by notifying the Board of its intention to withdraw in writing.

(3) After withdrawal from the Board approval process, the advanced practice registered nursing education program shall be removed from the list of Board approved nursing education programs.

(4) Withdrawal of approval status will become effective on a date agreed upon by the Board and the program unless otherwise indicated in this subsection.

(5) Programs may reapply for initial approval at any time. Programs that have had Board approval withdrawn for failure to obtain accreditation by a national advanced practice registered nursing education accrediting agency recognized by the Board must reapply for initial approval by submitting a new proposal as described in this chapter and in Board guidelines.

Source Note: The provisions of this §219.4 adopted to be effective September 13, 2001, 26 TexReg 6889; amended to be effective January 8, 2008, 33 TexReg 184; amended to be effective December 9, 2018, 43 TexReg 7894