STATE BOARD
OF NURSING[ 49 PA. CODE CH. 21 ] Nursing Education Programs Examination Pass Rates [38 Pa.B. 344]
[Saturday, January 19, 2008]The State Board of Nursing (Board) proposes to amend §§ 21.1, 21.26, 21.33, 21.34, 21.141 and 21.162 and to add §§ 21.33a, 21.33b, 21.162a, 21.162b and 21.166, to read as set forth in Annex A. The proposed amendments set forth requirements and procedures for registered and practical nursing education programs on provisional approval status or subject to removal from approved lists and sets new minimum pass rates of program graduates on the licensing examination.
Effective Date
The proposed amendments will be effective upon publication of the final-form rulemaking in the Pennsylvania Bulletin.
Statutory Authority
Section 6.1 of The Professional Nursing Law (RN act) (63 P. S. § 216.1) requires the Board to establish standards for the operation and approval of nursing education programs for the preparation of registered professional nurses. Section 9 of the Practical Nurse Law (LPN act) (63 P. S. § 659) authorizes the Board to approve all schools and institutions that educate practical nurses. The Board is further authorized to establish rules and regulations for the practice of professional nursing and the administration of the RN act under section 2.1(k) of the RN act (63 P. S. § 212.1(k)) and for the practice of practical nursing and the administration of the LPN act under section 17.6 of the LPN act (63 P. S. § 667.6).
Background and Purpose
The proposed amendments result from the Board's ongoing review of nursing education programs and the regulations that govern the programs. The Board published a proposed rulemaking at 31 Pa.B. 809 (February 10, 2001) representing a systematic revision of its registered nursing education program approval regulations. The proposed rulemaking included new requirements for continuing approval of registered nursing programs, including the pass rates of first-time examinees on the licensing examination. The Board withdrew the proposed rulemaking on March 12, 2003, with the intention of republishing the proposal as proposed with a new public comment period.
On April 23, 2004, a draft of the current proposal was sent to 29 agencies, associations, health care entities and individuals who have been identified as interested parties or who have expressed an interest in proposed rulemaking by the Board and to all 128 prelicensure nursing education programs (78 RN and 50 LPN programs) which were on the Board's approved list as of December 22, 2003. The Board received three comments, which it reviewed at its meeting on May 27 and 28, 2004.
The Hospital and Healthsystem Association of Pennsylvania (HAP) supported the rulemaking and noted that percentages established by the Board were consistent with HAP's recommendations. HAP suggested that the Board clarify what actions a nursing education program would be required to take with regard to its enrolled students if a program were removed from the approved list. The Board has addressed this issue in §§ 21.34(b) and (c) and 21.166(b) and (c) (relating to removal from approved list).
A nurse from Avoca, Pennsylvania commented that the draft rulemaking was sound and reasonable.
The practical nursing education program at Wilson College expressed concern for schools that currently calculate pass rates on a quarterly, rather than annual, basis. The commentater also suggested that any program with a pass rate lower than the State average be forbidden from having flexible scheduling of classes and be required to use standard daytime programming. In response to the concerns of Wilson College, the Board defined ''examination year'' in §§ 21.1 and 21.141 (relating to definitions). Proposed §§ 21.33a(d) and 21.162a(d) (relating to failure to comply with standards; and minimum rate for graduates of nursing education programs to pass the National licensure examination) would authorize the Board to place restrictions on nursing education programs that are on provisional approval status. One restriction might be to restrict the school to standard daytime programming, if such a restriction appeared to advance the objective of bringing the school into compliance with the regulations.
The Board intends to revise the requirements for all nursing education programs regarding the pass rates of program graduates on the National licensure examination. Under existing § 21.26 (relating to failing rate of a school in examination), an approved school for registered nurses is placed on provisional status if less than 60% of its first-time examinees pass the examination. A nursing program which fails to correct deficiencies within 2 years may be removed from the Board's list of approved programs under existing § 21.33(c) (relating to types of approval). The regulations pertaining to the approval of practical nursing education programs in § 21.162 (relating to types of approval) do not currently provide for placement on provisional approval status of a licensed practical nursing school based on failure rates of first-time examinees. The proposed rulemaking would standardize requirements for both registered and practical nursing education programs. In addition, the Board proposes to increase the minimum pass rate over a 2-year period. The pass rate to be initiated in the second year is consistent with the minimum pass rates in other states.
Description of Amendments
The Board is charged with the responsibility of approving and regulating nursing education programs in this Commonwealth. The Board has a three-category approval system--a new program is on initial approval status until it has graduated its first class and demonstrated an acceptable pass rate on the National licensure examination. At that time, the program is placed on full approval status. A program may be placed on provisional approval status if it fails to meet the standards in this chapter. Examples of reasons a program may be placed on provisional approval status include unacceptable student-faculty ratio, inability to conduct clinical educational experiences or failure to meet the minimum pass rate standards. The Board proposes to add a new subsection (b) to § 21.33 that requires a program to notify applicants for admission and students of the program's approval status.
One of the criteria used by the Board, as well as by many other state boards of nursing, in approving a nursing education program is the pass rate of graduates of the program who take the National licensure examination (NCLEX-RN and NCLEX-PN) for the first time. Under existing § 21.26, the Board will downgrade a registered nursing (RN) education program from fully approved to provisionally approved status if 40% or more of its first time examinees fail the NCLEX. The Board proposes to rescind § 21.26 and move the minimum pass rate to § 21.33b (relating to minimum rate for graduates of nursing education programs to pass the National licensure examination). The Board also proposes to create the same requirements for LPN education programs by the addition of § 21.162b (relating to minimum rate for graduates of nursing education programs to pass the National licensure examination).
Under the proposal, the existing 60% minimum pass rate will continue in effect and will apply to practical nursing education programs on the effective date of this rulemaking. Beginning 1 year after final rulemaking is implemented, a nursing education program will be downgraded from full approval status to provisional approval status if less than 70% of its graduates pass the NCLEX when they take it the first time. Beginning 2 years after final-form rulemaking is implemented, a nursing education program will be downgraded from full approval status to provisional approval status if less than 80% of its graduates pass the NCLEX when they take it the first time.
The Board proposes this change for the following reasons. This Commonwealth's minimum pass rate is the least stringent standard in the Nation when compared with the 32 other states that use the NCLEX pass rate as a criterion for approving a nursing education program. At least seven states have established 75% as the minimum pass rate, at least eight states have established 80% as the minimum and at least four states have established 85% or greater as the minimum. Other states have established a percentage of the National pass rate as the minimum standard for program approval, but in no case less than 10% of the National pass rate. (Source: National Council of State Boards of Nursing Member Board Profiles.)
For the examination year October 1, 2005, to September 30, 2006, 21 of 56 jurisdictions had NCLEX-RN pass rates below that of this Commonwealth. The overall pass rate for first time examinees applying for RN licensure in this Commonwealth who were educated in programs in this Commonwealth during the examination year October 1, 2005, to September 30, 2006, was 87.00%. The overall pass rate for the United States in the same period was 88.11%.
For the examination year October 1, 2005, to September 30, 2006, 20 of 56 jurisdictions had NCLEX-PN pass rates below that of this Commonwealth. The overall pass rate for first time examinees applying for practical nursing licensure in this Commonwealth who were educated in the programs in this Commonwealth during the examination year October 1, 2005, to September 30, 2006, was 90.53%. The overall pass rate for the United States in the same period was 88.22%.
For the examination year October 1, 2005, to September 30, 2006, 16 of the Commonwealth's 80 RN education programs had examination pass rates below 80%. Of these, four were associate degree programs, seven were baccalaureate programs and four were hospital-based diploma programs. For the examination year October 1, 2005, to September 30, 2006, five of this 50 LPN education programs in this Commonwealth had examination pass rates below 80%. Of these, three were vocational-technical schools and two were private licensed schools. If the amendments were in effect and pass rates were raised to 80% as proposed, these 21 programs would be placed on provisional status. These programs would be required to correct the deficiencies in the program that hinder the program's graduates from satisfactory performance on the NCLEX. If a program fails to achieve the minimum pass rate by a date specified, removal proceedings would commence in accordance with §§ 21.34 and 21.166. Removal proceedings include notice to the program and an opportunity for the program to show why it should not be removed. The Board considered lowering the proposed pass rates, but after consultation with the Board's education advisors, the Board believes that the schools are ready to meet the challenge of the higher pass rate and that the higher pass rate will benefit students in nursing education programs by ensuring the best chance of passing the examination and obtaining licensure. In addition, none of the schools of nursing provided negative comments regarding the proposed amendment to the minimum pass rate.
The proposed amendments will bring this Commonwealth's nursing education programs in line with Nationwide standards and will motivate any marginal programs to improve to the benefit of the students and the general public. A nursing education program unable to prepare at least 80% of its graduates to pass the entrance examination to the profession does its students, recipients of nursing care, and the resources of this Commonwealth, a great disservice. The Board believes that a number of programs are not providing sufficient support services for students which results in lower pass rates for their graduates. It is the Board's understanding that programs with higher pass rates do not necessarily have more resources available to them than programs with lower pass rates; these schools are simply more effective in using their resources. Programs will be given 2 years from the effective date of the amendments to improve pass rates to 80%, so that existing program approval will not be affected. For these reasons, the Board does not anticipate that any programs will necessarily be removed from the approved list based on these increased requirements.
The Board also proposes to clarify the requirements for a nursing education program on provisional approval status in §§ 21.33a and 21.162a. Sections §§ 21.34 and 21.166 will be amended to provide the detailed procedure the Board will follow in removal proceedings. Under the current § 21.34, the Board gives ''sufficient'' notice of its intent to remove a program. The LPN regulations are silent on the procedure. The proposed amendments will expand and clarify the Board's procedure for RN education programs and create a parallel section for LPN education programs. The proposed amendments will provide the nursing education program 45 days notice of the Board's intent to remove the program. The proposed amendments will specify that the program may appear at a hearing and that posthearing briefs may be filed. The proposal also clarifies that the Board will issue a written decision that may be appealed according to the Pennsylvania Rules of Appellate Procedure. Finally in §§ 21.34(b) and (c) and 21.166(b) and (c), the Board proposes amendments to set forth a program's responsibilities to students if the program is removed from the approved list.
Fiscal Impact and Paperwork Requirements.
The proposed amendments may have a fiscal impact on nursing education programs that fall below the minimum requirements and will impose no additional paperwork on those programs beyond what is already required for the maintenance of the nursing education program. The amendments will not otherwise have any fiscal impact nor impose additional paperwork on the private sector, the general public and the Commonwealth and its political subdivisions.
Sunset Date
The Board continuously monitors its regulations. Therefore, no sunset date has been assigned.
Regulatory Review
Under section 5(a) of the Regulatory Review Act (act) (71 P. S. § 745.5(a)), on January 9, 2008, the Board submitted a copy of this proposed rulemaking and a copy of a Regulatory Analysis Form to the Independent Regulatory Review Commission (IRRC) and to the Chairpersons of the Senate Consumer Protection and Professional Licensure Committee and the House Professional Licensure Committee. A copy of this material is available to the public upon request.
Under section 5(g) of the act, IRRC may convey any comments, recommendations or objections to the proposed rulemaking within 30 days from the close of the public comment period. The comments, recommendations or objections must specify the regulatory review criteria that have not been met. The act specifies detailed procedures for review, prior to final publication of the rulemaking, by the Board, the General Assembly and the Governor of comments, recommendations and objections raised.
Public Comment
Interested persons are invited to submit written comments, recommendations or objections regarding this proposed rulemaking to Ann Steffanic, Board Administrator, State Board of Nursing, P. O. Box 2649, Harrisburg, Pennsylvania 17105-2649 within 30 days following publication of this proposed rulemaking in the Pennsylvania Bulletin. Please reference (16A-5123) Nursing Education Programs Examination Pass Rates when submitting comments.
MARY E. BOWEN, RN, DNS, CNAA,
ChairpersonFiscal Note: 16A-5123. No fiscal impact; (8) recommends adoption.
Annex A TITLE 49. PROFESSIONAL AND VOCATIONAL STANDARDS PART I. DEPARTMENT OF STATE Subpart A. PROFESSIONAL AND OCCUPATIONAL AFFAIRS CHAPTER 21. STATE BOARD OF NURSING Subchapter A. REGISTERED NURSES GENERAL PROVISIONS § 21.1. Definitions.
The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise:
* * * * * Examination year--The period beginning on October 1st of a year through September 30th of the following year.
* * * * * LICENSES § 21.26. [Failing rate of a school in examination] (Reserved).
[If 40% or more of the first-time examinees of a school of nursing writing the examination in this Commonwealth fail the examination, the school will be placed on provisional approval status. The Board may consider additional documented statistics concerning the examination scores received in other states by Commonwealth graduates in determining the status of the school.]
APPROVAL OF [SCHOOLS OF] NURSING EDUCATION PROGRAMS § 21.31. Surveys; list of approved schools.
* * * * * (d) For purposes of activities relating to the approval and status of nursing education programs, the term ''Board'' used in this subchapter may mean the Board's educational advisors appointed under section 2.1(j) of the act (63 P. S. § 212.1(j)). Only the Board may confer initial approval status on a proposed nursing education program and only the Board may remove a program from the approved list.
§ 21.33. Types of approval.
(a) The Board grants the following types of approval to nursing education programs:
(1) Initial. The Board may grant initial approval to a new [schools] nursing education program, with evidence that [acceptable] the standards of this subchapter are being met, for a period of time necessary to evaluate the results of the licensing examination taken by the [first] graduates from the program's first examination year. A program will not be placed on full approval status until it has graduated its first class and the class has achieved an acceptable rate of passing the National licensure examination, as set forth in § 21.33b (relating to minimum rate for graduates of nursing education programs to pass the National licensure examination). A program on initial approval status that fails to achieve an acceptable rate of passing the National licensure examination upon graduation of its first class will be placed on provisional approval status.
[(b)] (2) Full. The Board will place on full approval [those schools] a nursing education program which [attain] attains and [maintain the acceptable] maintains the standards [and adhere to the policies and regulations of the Board considered essential for a sound program of nursing education] of this subchapter.
[(c)] (3) Provisional. The Board may place on provisional approval a [school] nursing education program not meeting the [acceptable] standards of this subchapter. A nursing education program on full approval status will be placed on provisional approval status if the program fails to meet the provisions of § 21.33b. [A period of 2 years will be the maximum time allowed for the correction of deficiencies resulting in provisional approval. If the standards are not met within this designated time, the school will be removed from the approved list.]
(b) A nursing education program shall notify applicants for admission of the program's approval status and notify applicants and students whenever the program's approval status changes. The program shall provide the Board with a copy of the notice sent to applicants and students. A program shall provide additional notice to applicants and students at the direction of the Board.
§ 21.33a. Failure to comply with standards.
(a) Whenever the Board receives information suggesting that a nursing education program has not maintained the standards of this subchapter, the Board may request information from the program or conduct a site visit and may informally resolve any deficiency. The failure of a program to cooperate will be considered a violation of this section and may result in immediate referral of the program for removal from the approved list as provided in § 21.34 (relating to removal from approved list).
(b) If the Board determines that a nursing education program should be placed on provisional approval status, the Board will notify the program, in writing, that the program has been placed on provisional approval status.
(c) If the Board places a nursing education program on provisional approval status, the Board will notify the program, in writing, of the deficiencies and the amount of time that will be allowed for correction of the deficiencies that resulted in the program's placement on provisional approval status. The Board may extend the time period for correction of deficiencies at its discretion if the program is making demonstrable progress toward the correction of deficiencies. If additional deficiencies are identified, the existing provisional period may be extended at the discretion of the Board.
(d) The Board may place restrictions on a nursing education program on provisional approval status as deemed necessary by the Board to bring the program into compliance with this subchapter. The failure of a program to adhere to the restrictions mandated by the Board will be considered a violation of this section and may result in immediate referral of the program for removal from the approved list as provided in § 21.34.
(e) The Board may require that a nursing education program on provisional approval status prepare and submit additional reports. The failure of a program to timely provide reports required by the Board will be considered a violation of this section and may result in immediate referral of the program for removal from the approved list as provided in § 21.34.
(f) The Board may make announced or unannounced site visits to a nursing education program on provisional approval status.
(g) Two years will be the maximum time allowed for the correction of deficiencies resulting in provisional approval status.
(h) If the standards of this subchapter are met within the designated time, the nursing education program will be removed from provisional approval status and returned to the approved list. The Board will notify the program in writing of this action.
(i) If the standards of this subchapter are not met within the designated time, the nursing education program will be removed from the approved list as provided in § 21.34.
(j) A nursing education program may appeal the decision to place the program on provisional approval status in accordance with 1 Pa. Code § 35.20 (relating to appeals from actions of the staff).
§ 21.33b. Minimum rate for graduates of nursing education programs to pass the National licensure examination.
A nursing education program shall prepare its graduates to pass the National licensure examination at a rate at least equal to the minimum rate set by the Board. The minimum rate for graduates to pass the National licensure examination are as follows:
(1) A nursing education program shall achieve and maintain a minimum pass rate of 60% or more of its first-time examinees during an examination year.
(2) Beginning on October 1, _____ (Editor's Note: The blank refers to the first October 1 that occurs after the effective date of adoption of this proposed rulemaking.), a nursing education program shall achieve and maintain a minimum pass rate of 70% or more of its first-time examinees during an examination year.
(3) Beginning on October 1, _____ (Editor's Note: The blank refers to a date 1 year after the date in paragraph (2).), a nursing education program shall achieve and maintain a minimum pass rate of 80% or more of its first-time examinees during an examination year.
§ 21.34. Removal from approved list.
[The Board will give sufficient notification of intent of removal from the approved list and provide an opportunity for school officials to show cause as to why approval should not be withdrawn.]
(a) The Board may remove a nursing education program from the approved list in accordance with the following procedures if the program fails to meet and maintain minimum standards, including the minimum passing rates on the National licensure examination, as established by this subchapter.
(1) The Board will give a nursing education program notice of its intent to remove the program from the approved list.
(2) The notice of intent to remove a program from the approved list will set forth the alleged violations of the standards for nursing education programs.
(3) A program served with notice of intent to remove will be given 45 days in which to file a written answer to the notice.
(4) The nursing education program will be provided an opportunity to appear at a hearing to demonstrate why approval should not be withdrawn.
(5) The nursing education program and the Commonwealth will be provided an opportunity to file posthearing briefs.
(6) The Board will issue a written decision which will set forth findings of fact and conclusions of law.
(7) The Board's written decision is a final decision of a governmental agency subject to review under 2 Pa.C.S. § 702 (relating to appeals).
(b) If a nursing education program is removed from the approved list, the controlling institution shall provide for the completion of the program for students currently enrolled by placing the students in an approved program.
(c) If a nursing education program is removed from the approved list, the controlling institution shall provide for permanent retention of student and graduate records in conformance with §§ 21.123 and 21.125 (relating to access and use of records; and custody of records).
Subchapter B. PRACTICAL NURSES GENERAL PROVISIONS § 21.141. Definitions.
The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise:
* * * * * Examination year--The period beginning on October 1st of a year through September 30th of the following year.
* * * * * APPROVAL OF PRACTICAL NURSING PROGRAMS § 21.162. Types of approval.
(a) The Board grants the following types of approval to nursing education programs:
(1) Initial. The Board may grant initial approval to a new [programs] nursing education program, with evidence that [acceptable] the standards of this subchapter are being met, for a period of time necessary to evaluate the results of the licensing examination [taken] by the [first] graduates from the program's first examination year. A program will not be placed on full approval status until it has graduated its first class and the class has achieved an acceptable rate of passing the National licensure examination, as set forth in § 21.162b (relating to minimum rate for graduates of nursing education programs to pass the National licensure examination). A program on initial approval status that fails to achieve an acceptable rate of passing the National licensure examination upon graduation of its first class will be placed on provisional approval status.
[(b)] (2) Full. The Board will place those nursing education programs on full approval status which attain and maintain the [acceptable] standards [and adhere to the policies and regulations of the Board considered essential for a sound program of practical nursing education] of this subchapter.
[(c)] (3) Provisional. The Board may place on provisional approval a nursing education program not meeting [acceptable] the standards of this subchapter. A nursing education program on full approval status will be placed on provisional approval status if the program fails to meet the provisions of § 21.162b. [Full approval status will not be granted until acceptable standards are met. If acceptable standards are not met, the program will be removed from the approved list.]
(b) A nursing education program shall notify applicants for admission of the program's approval status and notify applicants and students whenever the program's approval status changes. The program shall provide the Board a copy of the notice sent to applicants and students. A program shall provide additional notice to applicants and students at the direction of the Board.
(c) For purposes of activities relating to the approval and status of nursing education programs, the term ''Board'' used in this subchapter may mean the Board's educational advisors appointed under section 2.1(j) of the act (63 P. S. § 212.1(j)). Only the Board may confer initial approval status on a proposed nursing education program and only the Board may remove a program from the approved list.
§ 21.162a. Failure to comply with standards.
(a) Whenever the Board receives information suggesting that a nursing education program has not maintained the standards of this subchapter, the Board may request information from the program or conduct a site visit and may informally resolve any deficiency. The failure of a program to cooperate will be considered a violation of this section and may result in immediate referral of the program for removal from the approved list as provided in § 21.166 (relating to removal from approved list).
(b) If the Board determines that a nursing education program should be placed on provisional approval status, the Board will notify the program, in writing, that the program has been placed on provisional approval status.
(c) If the Board places a nursing education program on provisional approval status, the Board will notify the program, in writing, of the deficiencies and the amount of time that will be allowed for correction of the deficiencies that resulted in the program's placement on provisional approval status. The Board may extend the time period for correction of deficiencies at its discretion if the program is making demonstrable progress toward the correction of deficiencies. If additional deficiencies are identified, the existing provisional period may be extended at the discretion of the Board.
(d) The Board may place restrictions on a nursing education program on provisional approval status as deemed necessary by the Board to bring the program into compliance with this subchapter. The failure of a program to adhere to the restrictions mandated by the Board will be considered a violation of this section and may result in immediate referral of the program for removal from the approved list as provided in § 21.166.
(e) The Board may require that a nursing education program on provisional approval status prepare and submit additional reports. The failure of a program to timely provide reports required by the Board will be considered a violation of this section and may result in immediate referral of the program for removal from the approved list as provided in § 21.166.
(f) The Board may make announced or unannounced site visits to a nursing education program on provisional approval status.
(g) Two years will be the maximum time allowed for the correction of deficiencies resulting in provisional approval status.
(h) If the standards of this subchapter are met within the designated time, the nursing education program will be removed from provisional approval status and returned to the approved list. The Board will notify the program in writing of this action.
(i) If the standards of this subchapter are not met within the designated time, the nursing education program will be removed from the approved list as provided in § 21.166.
(j) A nursing education program may appeal the decision to place the program on provisional approval status in accordance with 1 Pa. Code § 35.20 (relating to appeals).
§ 21.162b. Minimum rate for graduates of nursing education programs to pass the National licensure examination.
A nursing education program shall prepare its graduates to pass the National licensure examination at a rate at least equal to the minimum rate set by the Board. The minimum rate for graduates to pass the National licensure examination are as follows:
(1) A nursing education program shall achieve and maintain a minimum pass rate of 60% or more of its first-time examinees during an examination year.
(2) Beginning on October 1, _____ (Editor's Note: The blank refers to the first October 1 after the effective date of adoption of this proposed rulemaking.), a nursing education program shall achieve and maintain a minimum pass rate of 70% or more of its first-time examinees during an examination year.
(3) Beginning on October 1, _____ (Editor's Note: The blank refers to a date 1 year after the date of the adoption of this proposed rulemaking.), a nursing education program shall achieve and maintain a minimum pass rate of 80% or more of its first-time examinees during an examination year.
§ 21.166. Removal from approved list.
(a) The Board may remove a nursing education program from the approved list in accordance with the following procedures if the program fails to meet and maintain minimum standards, including the minimum passing rates on the National licensure examination, as established by this subchapter.
(1) The Board will give a nursing education program notice of its intent to remove the program from the approved list.
(2) The notice of intent to remove a program from the approved list will set forth the alleged violations of the standards for nursing education programs.
(3) A program served with notice of intent to remove will be given 45 days in which to file a written answer to the notice.
(4) The nursing education program will be provided an opportunity to appear at a hearing to demonstrate why approval should not be withdrawn.
(5) The nursing education program and the Commonwealth will be provided an opportunity to file posthearing briefs.
(6) The Board will issue a written decision which will set forth findings of fact and conclusions of law.
(7) The Board's written decision will be a final decision of a governmental agency subject to review under 2 Pa.C.S. § 702 (relating to appeals).
(b) If a nursing education program is removed from the approved list, the controlling institution shall provide for the completion of the program for students currently enrolled by placing the students in an approved program.
(c) If a nursing education program is removed from the approved list, the controlling institution shall make provision for permanent retention of student and graduate records in conformity with §§ 21.233 and 21.234 (relating to custody or records; and access and use of records).
[Pa.B. Doc. No. 08-91. Filed for public inspection January 18, 2008, 9:00 a.m.]
