Title 201 | Chapter 020 | Regulation 260E
SUPERSEDED
This document is no longer current.
PREVIOUS VERSION
The previous document that this document is based upon is available.
STATEMENT OF EMERGENCY
201 KAR 20:260E
This emergency amendment to an existing administrative regulation is being promulgated to comply with an executive order issued under KRS Chapter 39A. On December 9, 2021, Governor Andy Beshear signed Executive Order 2021-913 to address the current nursing shortage in the Commonwealth of Kentucky. This administrative regulation is being filed on an emergency basis under KRS 13A.180, and pursuant to Executive Order 2021-913, KRS 39A.180, and Section 1.(13) of 2020 RS SB 150, 2020 Ky. Acts ch. 73, to ensure that programs of nursing may increase enrollments beyond their baselines to introduce more nurses into Kentucky’s healthcare system. This emergency amendment differs from the existing administrative regulation. Under the existing administrative regulation, a program of nursing must submit a request to increase enrollment two months prior to the increase, except in exigent circumstances; Board staff has discretion to deny an increase; and each new campus was considered a separate program of nursing. This emergency amendment requires the Kentucky Board of Nursing to approve requests from programs of nursing to increase enrollment within 30 days if the program of nursing has demonstrated that it has sufficient resources to support the increase, and it requires new campuses to be considered enrollment increases and not separate programs of nursing. An ordinary amendment to the existing administrative regulation will not follow.
ANDY BESHEAR, Governor
JESSICA WILSON, President
BOARDS AND COMMISSIONS
Board of Nursing
(Emergency Amendment)
201 KAR 20:260E.Organization and administration standards for prelicensure registered nurse or practical nurse programs of nursing.
Section 1.
Definitions.(1)
"Campus" means a division of a college or university that has its own grounds, buildings, and students, but is administratively joined to the rest of the college or university.(2)
"Clerical assistance" means the provision of administrative, secretarial, or clerical help by qualified individuals that assists the program of nursing.(3)
"Clinical instructor" means a nurse who is employed by a program of nursing solely to provide students with traditional clinical or simulated experiences.(4)
"Nurse faculty" means a nurse who is employed by a program of nursing, either full-time, part-time, or adjunct, to provide didactic instruction, and may also provide clinical instruction or simulated experiences.(5)
"Preceptor" means a nurse with demonstrated competence in a specific clinical area who serves as a role model and mentor to assist in the development and validation of the competencies of a student.(6)
"Program of nursing" means the educational unit that prepares a person for licensure as a registered or licensed practical nurse.(7)
"Nursing track" means a path within a program of nursing that leads to licensure as a nurse.Section 2.
Organization or Administration Standards for Prelicensure Registered Nurse and Practical Nurse Programs. To be eligible for approval by the board, a program shall have:(1)
A governing institution.(a)
The governing institution that establishes and conducts the program of nursing shall hold accreditation as a postsecondary institution, college, or university by an accrediting body recognized by the U.S. Department of Education.(b)
The governing institution shall assume full legal responsibility for the overall conduct of the program of nursing. The program of nursing shall have comparable status with the other programs in the governing institution and the relationship shall be clearly delineated.(c)
The governing institution shall:1.
Designate a program administrator for the prelicensure program of nursing who is qualified pursuant to 201 KAR 20:310 and is responsible for fulfilling the duties specified in subsection (3) of this section on a twelve (12) month basis;2.
Assure that at least fifty (50) percent of the program administrator's time shall be dedicated to complete the duties specified in this administrative regulation at each program of nursing. A governing institution that is unable to comply with this standard may request an exemption from the board in writing.a.
The request shall state the reasons for noncompliance and the efforts the institution has taken and will take to comply with the standard.b.
If the exemption is granted, it shall be for twelve (12) months from the date of board approval. During this time, the governing institution shall not open a new program of nursing and shall not increase enrollment at an existing program of nursing;3.
Provide evidence that the fiscal, human, physical, clinical, and technical learning resources shall be adequate to support program mission, processes, security, and outcomes;4.
Provide student support programs, services, and activities consistent with the mission of the governing institution that promote student learning and enhance the development of the student;5.
Make financial resources available to the program of nursing consistent with equivalent programs at the governing institution;6.
Employ nurse faculty pursuant to 201 KAR 20:310 in sufficient number and expertise to accomplish program outcomes and quality improvement;7.
Provide written policies for faculty related to qualifications for the position, rights and responsibilities of the position, criteria for evaluation of performance, workload, and retention;8.
Involve the nurse faculty in determining academic policies and practices for the program of nursing; and9.
Provide for the security, confidentiality, and integrity of faculty employment and student records.(d)
The governing institution shall provide an organizational chart that describes the organization of the program of nursing and its relationship to the governing institution;(2)
Administrative policies.(a)
There shall be written administrative policies for the program of nursing that shall be:1.
In accord with those of the governing institution; and2.
Available to the board for review.(b)
The board shall be notified in writing of a change, vacancy, or pending vacancy, in the position of the program administrator within thirty (30) days of the program of nursing's awareness of the change, vacancy, or pending vacancy.1.
The head of the governing institution shall submit to the board in writing the name of the registered nurse who has been designated to assume the administrative duties for the program, the date the person will assume the duties of program administrator, and a copy of his or her curriculum vitae.2.
a.
If there is to be a lapse between the date of the change or vacancy and the date the newly-appointed program administrator assumes duties, the head of the governing institution shall submit a plan of transition to ensure the continuity of the program.b.
Progress reports shall be submitted if requested by the board.3.
a.
The length of the appointment of an interim program administrator shall not exceed six (6) months.b.
Additional six (6) month periods may be granted upon request to the board based on a documented inability to fill the position.(c)
A written plan for the orientation of the nurse faculty to the governing institution and to the program shall be implemented.(d)
There shall be a written contract between the governing institution and each agency or institution that provides a learning experience for a student. A contract shall not be required for an observational experience.1.
The contract shall clearly identify the responsibilities and privileges of both parties.2.
The contract shall bear the signature of the administrative authorities of each organization.3.
The contract shall vest in the nurse faculty control of the student learning experiences subject to policies of the contractual parties.4.
The contract shall be current and may include an annual automatic renewal clause.5.
The contract shall contain a termination clause by either party;(3)
A program or an interim program administrator who shall have authority and responsibility in the following areas:(a)
Development and maintenance of collaborative relationships with the administration of the institution, other divisions or departments within the institution, related facilities, and the community;(b)
Participation in the preparation and management of the program of nursing budget;(c)
Screening and recommendation of candidates for nurse faculty appointment, retention, and promotion;(d)
Submission of the qualifications of all nurse faculty and clinical instructors as set forth in 201 KAR 20:310, Section 4;(e)
To provide leadership within the nurse faculty for the development, implementation, and evaluation of the program of nursing and program outcomes;(f)
To facilitate the implementation of written program policies for the following:1.
Student admission;2.
Student readmission and advance standing;3.
Student progression, which shall include:a.
The level of achievement a student shall maintain in order to remain in the program or to progress from one (1) level to another; andb.
Requirements for satisfactory completion of each course in the nursing curriculum.4.
Requirements for completion of the program;5.
Delineation of responsibility for student safety in health related incidents both on campus and at any clinical activity required by the program of nursing;6.
Availability of student guidance and counseling services;7.
The process for the filing of grievances and appeals by students;8.
Periodic evaluation by the nurse faculty of each nursing student's progress in each course and in the program;9.
Student conduct that incorporates the standards of safe nursing care; and10.
Publication and access to current academic calendars and class schedules;(g)
To facilitate the continuing academic and professional development for the nurse faculty;(h)
1.
To initiate and coordinate the development of contracts with clinical facilities, the number and variety of which shall be adequate to meet curricular outcomes;2.
To develop written criteria for the selection and evaluation of clinical facilities and ensure that the criteria shall be utilized by the program of nursing; and3.
To assure that clinical facilities show evidence of approval by the appropriate accreditation, evaluation, or licensure bodies, if applicable;(i)
The establishment of student-nurse faculty ratio in the clinical practice experience.1.
The maximum ratio of nurse faculty to students in the clinical area of patients-clients shall be defensible in light of safety, learning objectives, student level, and patient acuity.2.
The student-nurse faculty ratio shall not exceed ten (10) to one (1) in the clinical practice experience, including observational or other supervised learning experiences.3.
This ratio shall not apply to on campus skill lab experiences;(j)
The submission of the Certified List of Kentucky Program of Nursing Graduates, as incorporated by reference in 201 KAR 20:070, upon student completion of all requirements for a degree, diploma, or certificate, regardless of the state in which the graduate intends to seek licensure;(k)
The development and maintenance of an environment conducive to the teaching and learning process;(l)
To facilitate the development of long-range goals and objectives for the nursing program;(m)
To ensure that equipment, furnishings, and supplies be current and replaced in a timely manner;(n)
To ensure that the nurse faculty has sufficient time to accomplish those activities related to the teaching-learning process and program outcomes;(o)
To coordinate an orientation to the roles and responsibilities of full-time, part-time, adjunct nurse faculty, and clinical instructors to the program of nursing and, as appropriate, to clinical facilities so that the mission, goals, and expected outcomes of the program shall be achieved;(p)
To facilitate regular communication with the full and part time nurse faculty and clinical instructors in the planning, implementation, and evaluation of the program of nursing;(q)
To ensure that recruitment materials provide accurate and complete information to prospective students about the program including the:1.
Admission criteria;2.
Program description, including course sequence, prerequisites, and corequisites;3.
Length of the program;4.
Current cost of the program, including tuition and all associated fees and expenses; and5.
Transferability of credits to other public and private institutions in Kentucky;(r)
To conduct or participate in the written evaluation of each nurse faculty member, clinical instructor, and program of nursing support staff according to published criteria, regardless of contractual or tenured status;(s)
To ensure the adherence to the written criteria for the selection and evaluation of clinical facilities utilized by the program of nursing;(t)
To maintain current knowledge of requirements pertaining to the program of nursing and licensure as established in 201 KAR Chapter 20;(u)
To attend the next available board orientation for program administrators but not later than within six (6) months of appointment;(v)
To develop a structure to allow nurse faculty to assist in the governance of the program;(w)
To ensure that the curriculum is developed and implemented pursuant to 201 KAR 20:320; and(x)
To ensure that the program of nursing posts a link provided by the board to the information published by the board pursuant to 201 KAR 20:360, Section 5(4) on its Web site and refers all individuals seeking information about the program to this link.(4)
A system of official records and reports essential to the operation of the program of nursing maintained according to institutional policy. Provisions shall be made for the security and protection of records against loss and unauthorized distribution or use. The system shall include records of:(a)
Currently enrolled students to include admission materials, courses taken, grades received, scores for standardized tests, and clinical performance records;(b)
Minutes of faculty and committee meetings, which shall be maintained a minimum of five (5) years, irrespective of institutional policy;(c)
Faculty records including:1.
Validation of current licensure or privilege to practice as a Registered Nurse in Kentucky;2.
Evidence of fulfilling the faculty orientation requirements established in 201 KAR 20:310, Section 3(5); and3.
Performance evaluation for faculty employed more than one (1) year;(d)
Systematic plan of evaluation;(e)
Graduates of the program of nursing; and(f)
Administrative records and reports from accrediting agencies; and(5)
Official publications of the governing institution including:(a)
A description of the governing institution and program of nursing;(b)
Policies on admission, progression, dismissal, graduation, and student grievance procedures; and(c)
A description of student services;(6)
Clerical assistance and support staff.(a)
There shall be clerical assistance and support staff sufficient to meet the needs of the nursing program for the administrator, faculty, and students.(b)
Each campus shall have at least one (1) dedicated clerical staff.(c)
If the program of nursing does not have at least one (1) dedicated clerical staff, the program administrator shall provide written justification to the board. The board shall evaluate the justification to determine whether the program may operate effectively without dedicated staff sufficient to meet the needs of the nursing program. If the board rejects the justification, the program of nursing shall comply with the board's determination on clerical staffing.(7)
Nurse faculty, full-time, and part-time, with the authority and responsibility to:(a)
Plan, implement, evaluate, and update the program;(b)
Assist in the design, implementation, evaluation, and updating of the curriculum using a written plan;(c)
Participate in the development, implementation, evaluation, and updating of policies for student admission, progression, and graduation in keeping with the policies of the governing institution;(d)
Participate in academic advisement and guidance of students;(e)
Provide theoretical instruction and clinical learning experiences;(f)
Evaluate student achievement of curricular outcomes related to nursing knowledge and practice;(g)
Develop and implement student evaluation methods and tools for each course that measure the progression of the student's cognitive, affective, and psychomotor achievement of course and clinical outcomes based on published rubrics and sound rationale;(h)
Participate in academic and professional level activities that maintain the faculty member's competency and professional expertise in the area of teaching responsibility;(i)
Communicate clinical outcomes to the student, clinical instructor, preceptor, and staff at the clinical site;(j)
Assume responsibility for utilizing the criteria in the selection of clinical sites and in the evaluation of clinical experiences on a regular basis;(k)
Evaluate the student's experience, achievement, and progress in relation to course and clinical outcomes, with input from the clinical instructor and preceptor, if applicable; and(l)
Delegate to a nurse employed by a clinical agency the supervision of a student performing a procedure; and(8)
Clinical instructors with the authority and responsibility to:(a)
Design, at the direction of the nurse faculty member, the student's clinical experience to achieve the stated outcomes of the nursing course in which the student is enrolled;(b)
Clarify with the nurse faculty member:1.
The role of the preceptor, if applicable;2.
The course responsibilities;3.
The course or clinical outcomes;4.
A course evaluation tool; and5.
Situations in which collaboration and consultation shall be needed;(c)
Participate in the evaluation of the student's performance by providing information to the nurse faculty member and the student regarding the student's achievement of established outcomes; and(d)
Delegate to a nurse employed by a clinical agency the supervision of a student performing a procedure.Section 3.
Notification of Change in Enrollment.(1)
All programs of nursing shall have on record with the board the maximum number of new students that the program is able to enroll in one (1) academic year. This number shall be referred to as the program's enrollment baseline.(2)
(a)
A program of nursing that desires to increase its enrollment beyond its enrollment baseline shall submit a request to the board.1.
If the enrollment baseline is fifty (50) or less, an increase of ten (10) students;2.
If the enrollment baseline is fifty-one (51)-100, an increase of twenty (20) students; or3.
If the enrollment baseline is greater than 100, an increase of twenty-five (25) students.(b)
The request shall demonstrate that the program has sufficient resources to fulfill the standards established by this administrative regulation for the anticipated increase in enrollment. These sufficient resources shall include adequate:1.
Number of qualified faculty;2.
Classroom space;3.
Clinical sites or simulation resources, pursuant to 201 KAR 20:320 Section 3;4.
Clerical support; and5.
Financial support.(c)
The program shall investigate the projected impact of the increase on the operation of programs of nursing within a fifty (50) mile radius and shall submit a report to the board.(d)
The program of nursing shall submit evidence that it has met the benchmarks set out in 201 KAR 20:360, Section 5(2)(f).(3)
(a)
The request shall be reviewed by board staff. Board staff shall(b)
IfSection 4.
Multiple Campuses.(1)
(a)
A governing institution may have programs of nursing located on different campuses.(b)
(2)
(a)
The governing institution shall designate a main campus headed by a program administrator.(b)
The program administrator shall have final responsibility and authority for the non-main campuses, but shall designate an assistant program administrator to assist in the governance of each non-main location. The assistant program administrator shall meet the qualification for a nurse faculty as set out in 201 KAR 20:310. The program administrator may designate the amount of release time for the assistant program administrator for administrative duties, but it shall not be less than twenty-five (25) percent.(3)
For purposes of calculating benchmarks set out in 201 KAR 20:360, Section 5(2)(f), each campus shall individually report its data annually to the board. The board shall evaluate the benchmarks for each campus individually.Section 5.
Suspension of Enrollment.(1)
A governing institution that decides to suspend enrollment in the program of nursing shall notify the board in writing within thirty (30) days following the decision. No longer enrolling in one (1) of several nursing tracks within a program of nursing shall not constitute suspension of enrollment for purposes of this administrative regulation.(2)
The notification shall identify the reasons leading to the decision and how long it is anticipated that the suspension will be in effect.(3)
The governing institution shall report to the board annually on the status of the suspension.(4)
(a)
If the decision to reinstate enrollment is made within three (3) years of the decision to suspend enrollment, the governing institution shall notify the board in writing of the decision within thirty (30) days.(b)
The notification shall state the date classes will begin. It shall also list the faculty and clinical sites that will be utilized.(5)
If the decision to reinstate enrollment is made three (3) years or more from the decision to suspend enrollment, the governing institution shall comply with the procedures outlined in 201 KAR 20:280.Section 6.
Change in Accreditation.(1)
A governing institution that seeks to change the U.S. Department of Education recognized accrediting body from which it receives accreditation shall notify the board when it has filed an application for accreditation.(2)
A governing institution with an application in process before the accrediting body shall be considered in compliance with Section 2(1)(a) of this administrative regulation.(3)
(a)
A governing institution whose application has been denied by its accrediting body shall not be considered to be in compliance with Section 2(1)(a) of this administrative regulation.(b)
The board shall begin the process established in 201 KAR 20:360, Section 7 for withdrawal of approval.JESSICA WILSON, President
APPROVED BY AGENCY: January 11, 2022
FILED WITH LRC: January 11, 2022 at 10:44 a.m.
PUBLIC HEARING AND COMMENT PERIOD: A public hearing on this administrative regulation shall be held on Monday, February 21, 2022, at 10:00 a.m. (EDT) in the office of the Kentucky Board of Nursing, 312 Whittington Parkway, Suite 300, Louisville, Kentucky. Individuals interested in being heard at this hearing shall notify this agency in writing by Monday, February 14, 2022, five workdays prior to the hearing of their intent to attend. If no notification of intent to attend the hearing is received by that date, the hearing may be canceled. This hearing is open to the public. Any person who wishes to be heard will be given an opportunity to comment on the proposed administrative regulation. A transcript of the public hearing will not be made unless a written request for a transcript is made. If you do not wish to be heard at the public hearing, you may submit written comments on the proposed administrative regulation. Written comments shall be accepted until end of day (11:59 p.m. EDT) Monday, February 28, 2022. Send written notification of intent to be heard at the public hearing or written comments on the proposed administrative regulation to the contact person.
CONTACT PERSON: Jeffrey R. Prather, General Counsel, Kentucky Board of Nursing, 312 Whittington Parkway, Suite 300, Louisville, Kentucky 40222, phone (502) 338-2851, email Jeffrey.Prather@ky.gov
REGULATORY IMPACT ANALYSIS AND TIERING STATEMENT
Contact Person:
Jeffrey R. Prather
(1) Provide a brief summary of:
(a) What this administrative regulation does:
Under the existing administrative regulation, a program of nursing must submit a request to increase enrollment two months prior to the increase, except in exigent circumstances; Board staff has discretion to deny an increase; and each new campus was considered a separate program of nursing. This emergency amendment requires the Kentucky Board of Nursing to approve requests from programs of nursing to increase enrollment within 30 days if the program of nursing has demonstrated that it has sufficient resources to support the increase, and it requires new campuses to be considered enrollment increases and not separate programs of nursing.
(b) The necessity of this administrative regulation:
This emergency amendment is being promulgated to comply with Executive Order 2021-913.
(c) How this administrative regulation conforms to the content of the authorizing statutes:
By establishing criteria for the approval of enrollment increases.
(d) How this administrative regulation currently assists or will assist in the effective administration of the statutes:
It sets criteria for the approval of enrollment increases.
(2) If this is an amendment to an existing administrative regulation, provide a brief summary of:
(a) How the amendment will change this existing administrative regulation:
The existing administrative regulation mandates that a program of nursing must submit a request to increase enrollment two months prior to the increase, except in exigent circumstances; Board staff has discretion to deny an increase; and each new campus was considered a separate program of nursing. This emergency amendment requires the Kentucky Board of Nursing to approve requests from programs of nursing to increase enrollment within 30 days if the program of nursing has demonstrated that it has sufficient resources to support the increase, and it requires new campuses to be considered enrollment increases and not separate programs of nursing.
(b) The necessity of the amendment to this administrative regulation:
Governor Andy Beshear signed Executive Order 2021-913. This administrative regulation is being filed on an emergency basis to comply with the Executive Order.
(c) How the amendment conforms to the content of the authorizing statutes:
By establishing criteria for the approval of enrollment increases. (d) How the amendment to the administrative regulation will assist in the effective administration of the statutes: The amendment brings the regulation into compliance with Executive Order 2021-913, pursuant to KRS 13A.180.
(d) How the amendment will assist in the effective administration of the statutes:
The amendment brings the regulation into compliance with Executive Order 2021-913, pursuant to KRS 13A.180.
(3) List the type and number of individuals, businesses, organizations, or state and local governments affected by this administrative regulation:
Prelicensure registered nurse or practical nurse programs of nursing. There are currently approximately 90 programs of nursing.
(4) Provide an analysis of how the entities identified in question (3) will be impacted by either the implementation of this administrative regulation, if new, or by the change, if it is an amendment, including:
(a) List the actions that each of the regulated entities identified in question (3) will have to take to comply with this administrative regulation or amendment:
To increase enrollment, the program of nursing must notify the Board of Nursing and demonstrate that it has sufficient resources to support the increase, and it requires new campuses to be considered enrollment increases and not separate programs of nursing.
(b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question (3):
There are no additional costs imposed.
(c) As a result of compliance, what benefits will accrue to the entities identified in question (3):
Programs of Nursing will be able to increase enrollment more quickly.
(5) Provide an estimate of how much it will cost the administrative body to implement this administrative regulation:
(a) Initially:
There is no additional cost.
(b) On a continuing basis:
There is no additional cost.
(6) What is the source of the funding to be used for the implementation and enforcement of this administrative regulation:
Agency general funds.
(7) Provide an assessment of whether an increase in fees or funding will be necessary to implement this administrative regulation, if new, or by the change if it is an amendment:
It will not.
(8) State whether or not this administrative regulation established any fees or directly or indirectly increased any fees:
It does not.
(9) TIERING: Is tiering applied?
Tiering is not applicable.
FISCAL NOTE ON STATE OR LOCAL GOVERNMENT
(1) What units, parts or divisions of state or local government (including cities, counties, fire departments, or school districts) will be impacted by this administrative regulation?
The Kentucky Board of Nursing.
(2) Identify each state or federal statute or federal regulation that requires or authorizes the action taken by the administrative regulation.
KRS 13A.190, KRS 39A.180, KRS 314.111, KRS 314.041, KRS 314.131.
(3) Estimate the effect of this administrative regulation on the expenditures and revenues of a state or local government agency (including cities, counties, fire departments, or school districts) for the first full year the administrative regulation is to be in effect.
(a) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for the first year?
None.
(b) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for subsequent years?
None.
(c) How much will it cost to administer this program for the first year?
None.
(d) How much will it cost to administer this program for subsequent years?
No additional costs.
Note: If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.
Revenues (+/-):
Expenditures (+/-):
Other Explanation:
STATEMENT OF EMERGENCY
201 KAR 20:260E
This emergency amendment to an existing administrative regulation is being promulgated to comply with an executive order issued under KRS Chapter 39A. On December 9, 2021, Governor Andy Beshear signed Executive Order 2021-913 to address the current nursing shortage in the Commonwealth of Kentucky. This administrative regulation is being filed on an emergency basis under KRS 13A.180, and pursuant to Executive Order 2021-913, KRS 39A.180, and Section 1.(13) of 2020 RS SB 150, 2020 Ky. Acts ch. 73, to ensure that programs of nursing may increase enrollments beyond their baselines to introduce more nurses into Kentucky’s healthcare system. This emergency amendment differs from the existing administrative regulation. Under the existing administrative regulation, a program of nursing must submit a request to increase enrollment two months prior to the increase, except in exigent circumstances; Board staff has discretion to deny an increase; and each new campus was considered a separate program of nursing. This emergency amendment requires the Kentucky Board of Nursing to approve requests from programs of nursing to increase enrollment within 30 days if the program of nursing has demonstrated that it has sufficient resources to support the increase, and it requires new campuses to be considered enrollment increases and not separate programs of nursing. An ordinary amendment to the existing administrative regulation will not follow.
ANDY BESHEAR, Governor
JESSICA WILSON, President
BOARDS AND COMMISSIONS
Board of Nursing
(Emergency Amendment)
201 KAR 20:260E.Organization and administration standards for prelicensure registered nurse or practical nurse programs of nursing.
Section 1.
Definitions.(1)
"Campus" means a division of a college or university that has its own grounds, buildings, and students, but is administratively joined to the rest of the college or university.(2)
"Clerical assistance" means the provision of administrative, secretarial, or clerical help by qualified individuals that assists the program of nursing.(3)
"Clinical instructor" means a nurse who is employed by a program of nursing solely to provide students with traditional clinical or simulated experiences.(4)
"Nurse faculty" means a nurse who is employed by a program of nursing, either full-time, part-time, or adjunct, to provide didactic instruction, and may also provide clinical instruction or simulated experiences.(5)
"Preceptor" means a nurse with demonstrated competence in a specific clinical area who serves as a role model and mentor to assist in the development and validation of the competencies of a student.(6)
"Program of nursing" means the educational unit that prepares a person for licensure as a registered or licensed practical nurse.(7)
"Nursing track" means a path within a program of nursing that leads to licensure as a nurse.Section 2.
Organization or Administration Standards for Prelicensure Registered Nurse and Practical Nurse Programs. To be eligible for approval by the board, a program shall have:(1)
A governing institution.(a)
The governing institution that establishes and conducts the program of nursing shall hold accreditation as a postsecondary institution, college, or university by an accrediting body recognized by the U.S. Department of Education.(b)
The governing institution shall assume full legal responsibility for the overall conduct of the program of nursing. The program of nursing shall have comparable status with the other programs in the governing institution and the relationship shall be clearly delineated.(c)
The governing institution shall:1.
Designate a program administrator for the prelicensure program of nursing who is qualified pursuant to 201 KAR 20:310 and is responsible for fulfilling the duties specified in subsection (3) of this section on a twelve (12) month basis;2.
Assure that at least fifty (50) percent of the program administrator's time shall be dedicated to complete the duties specified in this administrative regulation at each program of nursing. A governing institution that is unable to comply with this standard may request an exemption from the board in writing.a.
The request shall state the reasons for noncompliance and the efforts the institution has taken and will take to comply with the standard.b.
If the exemption is granted, it shall be for twelve (12) months from the date of board approval. During this time, the governing institution shall not open a new program of nursing and shall not increase enrollment at an existing program of nursing;3.
Provide evidence that the fiscal, human, physical, clinical, and technical learning resources shall be adequate to support program mission, processes, security, and outcomes;4.
Provide student support programs, services, and activities consistent with the mission of the governing institution that promote student learning and enhance the development of the student;5.
Make financial resources available to the program of nursing consistent with equivalent programs at the governing institution;6.
Employ nurse faculty pursuant to 201 KAR 20:310 in sufficient number and expertise to accomplish program outcomes and quality improvement;7.
Provide written policies for faculty related to qualifications for the position, rights and responsibilities of the position, criteria for evaluation of performance, workload, and retention;8.
Involve the nurse faculty in determining academic policies and practices for the program of nursing; and9.
Provide for the security, confidentiality, and integrity of faculty employment and student records.(d)
The governing institution shall provide an organizational chart that describes the organization of the program of nursing and its relationship to the governing institution;(2)
Administrative policies.(a)
There shall be written administrative policies for the program of nursing that shall be:1.
In accord with those of the governing institution; and2.
Available to the board for review.(b)
The board shall be notified in writing of a change, vacancy, or pending vacancy, in the position of the program administrator within thirty (30) days of the program of nursing's awareness of the change, vacancy, or pending vacancy.1.
The head of the governing institution shall submit to the board in writing the name of the registered nurse who has been designated to assume the administrative duties for the program, the date the person will assume the duties of program administrator, and a copy of his or her curriculum vitae.2.
a.
If there is to be a lapse between the date of the change or vacancy and the date the newly-appointed program administrator assumes duties, the head of the governing institution shall submit a plan of transition to ensure the continuity of the program.b.
Progress reports shall be submitted if requested by the board.3.
a.
The length of the appointment of an interim program administrator shall not exceed six (6) months.b.
Additional six (6) month periods may be granted upon request to the board based on a documented inability to fill the position.(c)
A written plan for the orientation of the nurse faculty to the governing institution and to the program shall be implemented.(d)
There shall be a written contract between the governing institution and each agency or institution that provides a learning experience for a student. A contract shall not be required for an observational experience.1.
The contract shall clearly identify the responsibilities and privileges of both parties.2.
The contract shall bear the signature of the administrative authorities of each organization.3.
The contract shall vest in the nurse faculty control of the student learning experiences subject to policies of the contractual parties.4.
The contract shall be current and may include an annual automatic renewal clause.5.
The contract shall contain a termination clause by either party;(3)
A program or an interim program administrator who shall have authority and responsibility in the following areas:(a)
Development and maintenance of collaborative relationships with the administration of the institution, other divisions or departments within the institution, related facilities, and the community;(b)
Participation in the preparation and management of the program of nursing budget;(c)
Screening and recommendation of candidates for nurse faculty appointment, retention, and promotion;(d)
Submission of the qualifications of all nurse faculty and clinical instructors as set forth in 201 KAR 20:310, Section 4;(e)
To provide leadership within the nurse faculty for the development, implementation, and evaluation of the program of nursing and program outcomes;(f)
To facilitate the implementation of written program policies for the following:1.
Student admission;2.
Student readmission and advance standing;3.
Student progression, which shall include:a.
The level of achievement a student shall maintain in order to remain in the program or to progress from one (1) level to another; andb.
Requirements for satisfactory completion of each course in the nursing curriculum.4.
Requirements for completion of the program;5.
Delineation of responsibility for student safety in health related incidents both on campus and at any clinical activity required by the program of nursing;6.
Availability of student guidance and counseling services;7.
The process for the filing of grievances and appeals by students;8.
Periodic evaluation by the nurse faculty of each nursing student's progress in each course and in the program;9.
Student conduct that incorporates the standards of safe nursing care; and10.
Publication and access to current academic calendars and class schedules;(g)
To facilitate the continuing academic and professional development for the nurse faculty;(h)
1.
To initiate and coordinate the development of contracts with clinical facilities, the number and variety of which shall be adequate to meet curricular outcomes;2.
To develop written criteria for the selection and evaluation of clinical facilities and ensure that the criteria shall be utilized by the program of nursing; and3.
To assure that clinical facilities show evidence of approval by the appropriate accreditation, evaluation, or licensure bodies, if applicable;(i)
The establishment of student-nurse faculty ratio in the clinical practice experience.1.
The maximum ratio of nurse faculty to students in the clinical area of patients-clients shall be defensible in light of safety, learning objectives, student level, and patient acuity.2.
The student-nurse faculty ratio shall not exceed ten (10) to one (1) in the clinical practice experience, including observational or other supervised learning experiences.3.
This ratio shall not apply to on campus skill lab experiences;(j)
The submission of the Certified List of Kentucky Program of Nursing Graduates, as incorporated by reference in 201 KAR 20:070, upon student completion of all requirements for a degree, diploma, or certificate, regardless of the state in which the graduate intends to seek licensure;(k)
The development and maintenance of an environment conducive to the teaching and learning process;(l)
To facilitate the development of long-range goals and objectives for the nursing program;(m)
To ensure that equipment, furnishings, and supplies be current and replaced in a timely manner;(n)
To ensure that the nurse faculty has sufficient time to accomplish those activities related to the teaching-learning process and program outcomes;(o)
To coordinate an orientation to the roles and responsibilities of full-time, part-time, adjunct nurse faculty, and clinical instructors to the program of nursing and, as appropriate, to clinical facilities so that the mission, goals, and expected outcomes of the program shall be achieved;(p)
To facilitate regular communication with the full and part time nurse faculty and clinical instructors in the planning, implementation, and evaluation of the program of nursing;(q)
To ensure that recruitment materials provide accurate and complete information to prospective students about the program including the:1.
Admission criteria;2.
Program description, including course sequence, prerequisites, and corequisites;3.
Length of the program;4.
Current cost of the program, including tuition and all associated fees and expenses; and5.
Transferability of credits to other public and private institutions in Kentucky;(r)
To conduct or participate in the written evaluation of each nurse faculty member, clinical instructor, and program of nursing support staff according to published criteria, regardless of contractual or tenured status;(s)
To ensure the adherence to the written criteria for the selection and evaluation of clinical facilities utilized by the program of nursing;(t)
To maintain current knowledge of requirements pertaining to the program of nursing and licensure as established in 201 KAR Chapter 20;(u)
To attend the next available board orientation for program administrators but not later than within six (6) months of appointment;(v)
To develop a structure to allow nurse faculty to assist in the governance of the program;(w)
To ensure that the curriculum is developed and implemented pursuant to 201 KAR 20:320; and(x)
To ensure that the program of nursing posts a link provided by the board to the information published by the board pursuant to 201 KAR 20:360, Section 5(4) on its Web site and refers all individuals seeking information about the program to this link.(4)
A system of official records and reports essential to the operation of the program of nursing maintained according to institutional policy. Provisions shall be made for the security and protection of records against loss and unauthorized distribution or use. The system shall include records of:(a)
Currently enrolled students to include admission materials, courses taken, grades received, scores for standardized tests, and clinical performance records;(b)
Minutes of faculty and committee meetings, which shall be maintained a minimum of five (5) years, irrespective of institutional policy;(c)
Faculty records including:1.
Validation of current licensure or privilege to practice as a Registered Nurse in Kentucky;2.
Evidence of fulfilling the faculty orientation requirements established in 201 KAR 20:310, Section 3(5); and3.
Performance evaluation for faculty employed more than one (1) year;(d)
Systematic plan of evaluation;(e)
Graduates of the program of nursing; and(f)
Administrative records and reports from accrediting agencies; and(5)
Official publications of the governing institution including:(a)
A description of the governing institution and program of nursing;(b)
Policies on admission, progression, dismissal, graduation, and student grievance procedures; and(c)
A description of student services;(6)
Clerical assistance and support staff.(a)
There shall be clerical assistance and support staff sufficient to meet the needs of the nursing program for the administrator, faculty, and students.(b)
Each campus shall have at least one (1) dedicated clerical staff.(c)
If the program of nursing does not have at least one (1) dedicated clerical staff, the program administrator shall provide written justification to the board. The board shall evaluate the justification to determine whether the program may operate effectively without dedicated staff sufficient to meet the needs of the nursing program. If the board rejects the justification, the program of nursing shall comply with the board's determination on clerical staffing.(7)
Nurse faculty, full-time, and part-time, with the authority and responsibility to:(a)
Plan, implement, evaluate, and update the program;(b)
Assist in the design, implementation, evaluation, and updating of the curriculum using a written plan;(c)
Participate in the development, implementation, evaluation, and updating of policies for student admission, progression, and graduation in keeping with the policies of the governing institution;(d)
Participate in academic advisement and guidance of students;(e)
Provide theoretical instruction and clinical learning experiences;(f)
Evaluate student achievement of curricular outcomes related to nursing knowledge and practice;(g)
Develop and implement student evaluation methods and tools for each course that measure the progression of the student's cognitive, affective, and psychomotor achievement of course and clinical outcomes based on published rubrics and sound rationale;(h)
Participate in academic and professional level activities that maintain the faculty member's competency and professional expertise in the area of teaching responsibility;(i)
Communicate clinical outcomes to the student, clinical instructor, preceptor, and staff at the clinical site;(j)
Assume responsibility for utilizing the criteria in the selection of clinical sites and in the evaluation of clinical experiences on a regular basis;(k)
Evaluate the student's experience, achievement, and progress in relation to course and clinical outcomes, with input from the clinical instructor and preceptor, if applicable; and(l)
Delegate to a nurse employed by a clinical agency the supervision of a student performing a procedure; and(8)
Clinical instructors with the authority and responsibility to:(a)
Design, at the direction of the nurse faculty member, the student's clinical experience to achieve the stated outcomes of the nursing course in which the student is enrolled;(b)
Clarify with the nurse faculty member:1.
The role of the preceptor, if applicable;2.
The course responsibilities;3.
The course or clinical outcomes;4.
A course evaluation tool; and5.
Situations in which collaboration and consultation shall be needed;(c)
Participate in the evaluation of the student's performance by providing information to the nurse faculty member and the student regarding the student's achievement of established outcomes; and(d)
Delegate to a nurse employed by a clinical agency the supervision of a student performing a procedure.Section 3.
Notification of Change in Enrollment.(1)
All programs of nursing shall have on record with the board the maximum number of new students that the program is able to enroll in one (1) academic year. This number shall be referred to as the program's enrollment baseline.(2)
(a)
A program of nursing that desires to increase its enrollment beyond its enrollment baseline shall submit a request to the board.. The request is only necessary if the increase is greater than the following:1.
If the enrollment baseline is fifty (50) or less, an increase of ten (10) students;2.
If the enrollment baseline is fifty-one (51)-100, an increase of twenty (20) students; or3.
If the enrollment baseline is greater than 100, an increase of twenty-five (25) students.(b)
The request shall demonstrate that the program has sufficient resources to fulfill the standards established by this administrative regulation for the anticipated increase in enrollment. These sufficient resources shall include adequate:1.
Number of qualified faculty;2.
Classroom space;3.
Clinical sites or simulation resources, pursuant to 201 KAR 20:320 Section 3;4.
Clerical support; and5.
Financial support.(c)
The program shall investigate the projected impact of the increase on the operation of programs of nursing within a fifty (50) mile radius and shall submit a report to the board.(d)
The program of nursing shall submit evidence that it has met the benchmarks set out in 201 KAR 20:360, Section 5(2)(f).(3)
(a)
The request shall be reviewed by board staff. Board staff shall approve the request within thirty (30) days of the receipt of the request, if the criteria listed in subsection (2) of this section have been met.(b)
If the criteria listed in subsection (2) of this section have not objectively been met, the request shall be held in abeyance until the program of nursing demonstrates that the criteria listed in subsection (2) of this section has been met, and the timeframe of thirty (30) days in subsection (3)(a) of this section shall be tolled until the program of nursing demonstrates that the criteria listed in subsection (2) of this section has been met.Section 4.
Multiple Campuses.(1)
A governing institution may have programs of nursing located on different campuses.(2)
(a)
The governing institution shall designate a main campus headed by a program administrator.(b)
The program administrator shall have final responsibility and authority for the non-main campuses, but shall designate an assistant program administrator to assist in the governance of each non-main location. The assistant program administrator shall meet the qualification for a nurse faculty as set out in 201 KAR 20:310. The program administrator may designate the amount of release time for the assistant program administrator for administrative duties, but it shall not be less than twenty-five (25) percent.(3)
For purposes of calculating benchmarks set out in 201 KAR 20:360, Section 5(2)(f), each campus shall individually report its data annually to the board. The board shall evaluate the benchmarks for each campus individually.Section 5.
Suspension of Enrollment.(1)
A governing institution that decides to suspend enrollment in the program of nursing shall notify the board in writing within thirty (30) days following the decision. No longer enrolling in one (1) of several nursing tracks within a program of nursing shall not constitute suspension of enrollment for purposes of this administrative regulation.(2)
The notification shall identify the reasons leading to the decision and how long it is anticipated that the suspension will be in effect.(3)
The governing institution shall report to the board annually on the status of the suspension.(4)
(a)
If the decision to reinstate enrollment is made within three (3) years of the decision to suspend enrollment, the governing institution shall notify the board in writing of the decision within thirty (30) days.(b)
The notification shall state the date classes will begin. It shall also list the faculty and clinical sites that will be utilized.(5)
If the decision to reinstate enrollment is made three (3) years or more from the decision to suspend enrollment, the governing institution shall comply with the procedures outlined in 201 KAR 20:280.Section 6.
Change in Accreditation.(1)
A governing institution that seeks to change the U.S. Department of Education recognized accrediting body from which it receives accreditation shall notify the board when it has filed an application for accreditation.(2)
A governing institution with an application in process before the accrediting body shall be considered in compliance with Section 2(1)(a) of this administrative regulation.(3)
(a)
A governing institution whose application has been denied by its accrediting body shall not be considered to be in compliance with Section 2(1)(a) of this administrative regulation.(b)
The board shall begin the process established in 201 KAR 20:360, Section 7 for withdrawal of approval.JESSICA WILSON, President
APPROVED BY AGENCY: January 11, 2022
FILED WITH LRC: January 11, 2022 at 10:44 a.m.
PUBLIC HEARING AND COMMENT PERIOD: A public hearing on this administrative regulation shall be held on Monday, February 21, 2022, at 10:00 a.m. (EDT) in the office of the Kentucky Board of Nursing, 312 Whittington Parkway, Suite 300, Louisville, Kentucky. Individuals interested in being heard at this hearing shall notify this agency in writing by Monday, February 14, 2022, five workdays prior to the hearing of their intent to attend. If no notification of intent to attend the hearing is received by that date, the hearing may be canceled. This hearing is open to the public. Any person who wishes to be heard will be given an opportunity to comment on the proposed administrative regulation. A transcript of the public hearing will not be made unless a written request for a transcript is made. If you do not wish to be heard at the public hearing, you may submit written comments on the proposed administrative regulation. Written comments shall be accepted until end of day (11:59 p.m. EDT) Monday, February 28, 2022. Send written notification of intent to be heard at the public hearing or written comments on the proposed administrative regulation to the contact person.
CONTACT PERSON: Jeffrey R. Prather, General Counsel, Kentucky Board of Nursing, 312 Whittington Parkway, Suite 300, Louisville, Kentucky 40222, phone (502) 338-2851, email Jeffrey.Prather@ky.gov
REGULATORY IMPACT ANALYSIS AND TIERING STATEMENT
Contact Person:
Jeffrey R. Prather
(1) Provide a brief summary of:
(a) What this administrative regulation does:
Under the existing administrative regulation, a program of nursing must submit a request to increase enrollment two months prior to the increase, except in exigent circumstances; Board staff has discretion to deny an increase; and each new campus was considered a separate program of nursing. This emergency amendment requires the Kentucky Board of Nursing to approve requests from programs of nursing to increase enrollment within 30 days if the program of nursing has demonstrated that it has sufficient resources to support the increase, and it requires new campuses to be considered enrollment increases and not separate programs of nursing.
(b) The necessity of this administrative regulation:
This emergency amendment is being promulgated to comply with Executive Order 2021-913.
(c) How this administrative regulation conforms to the content of the authorizing statutes:
By establishing criteria for the approval of enrollment increases.
(d) How this administrative regulation currently assists or will assist in the effective administration of the statutes:
It sets criteria for the approval of enrollment increases.
(2) If this is an amendment to an existing administrative regulation, provide a brief summary of:
(a) How the amendment will change this existing administrative regulation:
The existing administrative regulation mandates that a program of nursing must submit a request to increase enrollment two months prior to the increase, except in exigent circumstances; Board staff has discretion to deny an increase; and each new campus was considered a separate program of nursing. This emergency amendment requires the Kentucky Board of Nursing to approve requests from programs of nursing to increase enrollment within 30 days if the program of nursing has demonstrated that it has sufficient resources to support the increase, and it requires new campuses to be considered enrollment increases and not separate programs of nursing.
(b) The necessity of the amendment to this administrative regulation:
Governor Andy Beshear signed Executive Order 2021-913. This administrative regulation is being filed on an emergency basis to comply with the Executive Order.
(c) How the amendment conforms to the content of the authorizing statutes:
By establishing criteria for the approval of enrollment increases. (d) How the amendment to the administrative regulation will assist in the effective administration of the statutes: The amendment brings the regulation into compliance with Executive Order 2021-913, pursuant to KRS 13A.180.
(d) How the amendment will assist in the effective administration of the statutes:
The amendment brings the regulation into compliance with Executive Order 2021-913, pursuant to KRS 13A.180.
(3) List the type and number of individuals, businesses, organizations, or state and local governments affected by this administrative regulation:
Prelicensure registered nurse or practical nurse programs of nursing. There are currently approximately 90 programs of nursing.
(4) Provide an analysis of how the entities identified in question (3) will be impacted by either the implementation of this administrative regulation, if new, or by the change, if it is an amendment, including:
(a) List the actions that each of the regulated entities identified in question (3) will have to take to comply with this administrative regulation or amendment:
To increase enrollment, the program of nursing must notify the Board of Nursing and demonstrate that it has sufficient resources to support the increase, and it requires new campuses to be considered enrollment increases and not separate programs of nursing.
(b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question (3):
There are no additional costs imposed.
(c) As a result of compliance, what benefits will accrue to the entities identified in question (3):
Programs of Nursing will be able to increase enrollment more quickly.
(5) Provide an estimate of how much it will cost the administrative body to implement this administrative regulation:
(a) Initially:
There is no additional cost.
(b) On a continuing basis:
There is no additional cost.
(6) What is the source of the funding to be used for the implementation and enforcement of this administrative regulation:
Agency general funds.
(7) Provide an assessment of whether an increase in fees or funding will be necessary to implement this administrative regulation, if new, or by the change if it is an amendment:
It will not.
(8) State whether or not this administrative regulation established any fees or directly or indirectly increased any fees:
It does not.
(9) TIERING: Is tiering applied?
Tiering is not applicable.
FISCAL NOTE ON STATE OR LOCAL GOVERNMENT
(1) What units, parts or divisions of state or local government (including cities, counties, fire departments, or school districts) will be impacted by this administrative regulation?
The Kentucky Board of Nursing.
(2) Identify each state or federal statute or federal regulation that requires or authorizes the action taken by the administrative regulation.
KRS 13A.190, KRS 39A.180, KRS 314.111, KRS 314.041, KRS 314.131.
(3) Estimate the effect of this administrative regulation on the expenditures and revenues of a state or local government agency (including cities, counties, fire departments, or school districts) for the first full year the administrative regulation is to be in effect.
(a) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for the first year?
None.
(b) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for subsequent years?
None.
(c) How much will it cost to administer this program for the first year?
None.
(d) How much will it cost to administer this program for subsequent years?
No additional costs.
Note: If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.
Revenues (+/-):
Expenditures (+/-):
Other Explanation: