Florida Senate - 2025 SB 526 By Senator Harrell 31-00793-25 2025526__ Page 1 of 13 CODING: Words stricken are deletions; words underlined are additions. A bill to be entitled 1

An act relating to nursing education programs; 2 amending s. 464.019, F.S.; revising application 3 requirements for nursing education program approval; 4 requiring the Board of Nursing to deny an application 5 under certain circumstances; authorizing the board to 6 revoke a program’s approval under certain 7 circumstances; revising requirements for annual 8 reports approved programs are required to submit to 9 the board; providing for the revocation of a program’s 10 approval, and discipline of its program director, 11 under certain circumstances; revising remediation 12 procedures for approved programs with graduate passage 13 rates that do not meet specified requirements; 14 subjecting program directors of approved programs to 15 specified disciplinary action under certain 16 circumstances; deleting a provision authorizing the 17 board to extend a program’s probationary status; 18 authorizing agents of the Department of Health to 19 conduct onsite evaluations and inspections of approved 20 and accredited nursing education programs; authorizing 21 the department to collect evidence as part of such 22 evaluations and inspections; deeming failure or 23 refusal of a program to allow such evaluation or 24 inspection as a violation of a legal obligation; 25 revising rulemaking authority of the board; deleting a 26 provision authorizing approved nursing education 27 programs to request an extension to meet the board’s 28 accreditation requirements; providing an effective 29

Florida Senate - 2025 SB 526 31-00793-25 2025526__ Page 2 of 13 CODING: Words stricken are deletions; words underlined are additions. date. 30 31 Be It Enacted by the Legislature of the State of Florida: 32 33

Section 1. Subsections (1), (2), (3), (5), and (8) and 34 paragraph (

f) of subsection (11) of

section 464.019, Florida 35 Statutes, are amended to read: 36 464.019 Approval of nursing education programs.— 37

(1) PROGRAM APPLICATION.—An educational institution that 38 wishes to conduct a program in this state for the prelicensure 39 education of professional or practical nurses must submit to the 40 department a program application and review fee of $1,000 for 41 each prelicensure nursing education program to be offered at the 42 institution’s main campus, branch campus, or other instructional 43 site.

The program application must include the legal name of the 44 educational institution, the legal name of the nursing education 45 program, the legal name of the nursing education program 46 director, and, if such institution is accredited, the name of 47 the accrediting agency. The application must also document that: 48 (a)1.

For a professional nursing education program, the 49 program director and at least 50 percent of the program’s 50 faculty members are registered nurses who have a master’s or 51 higher degree in nursing or a bachelor’s degree in nursing and a 52 master’s or higher degree in a field related to nursing. 53 2. For a practical nursing education program, the program 54 director and at least 50 percent of the program’s faculty 55 members are registered nurses who have a bachelor’s or higher 56 degree in nursing. 57 58

Florida Senate - 2025 SB 526 31-00793-25 2025526__ Page 3 of 13 CODING: Words stricken are deletions; words underlined are additions. The educational degree requirements of this paragraph must may 59 be documented by an official transcript or by a written 60 statement from the program director of the educational 61 institution verifying that the institution conferred the degree. 62 The program director shall certify the official transcript or 63 written statement as true and accurate. 64 (

b) The program’s nursing major curriculum consists of at 65 least: 66 1. Fifty percent clinical training in the United States, 67 the District of Columbia, or a possession or territory of the 68 United States for a practical nursing education program, an 69 associate degree professional nursing education program, or a 70 professional diploma nursing education program. 71 2. Forty percent clinical training in the United States, 72 the District of Columbia, or a possession or territory of the 73 United States for a bachelor’s degree professional nursing 74 education program. 75 (

c) No more than 50 percent of the program’s clinical 76 training consists of clinical simulation. 77 (

d) The program has signed agreements with each agency, 78 facility, and organization included in the curriculum plan as 79 clinical training sites and community-based clinical experience 80 sites. 81 (

e) The program has written policies for faculty which 82 include provisions for direct or indirect supervision by program 83 faculty or clinical preceptors for students in clinical training 84 consistent with the following standards: 85 1. The number of program faculty members equals at least 86 one faculty member directly supervising every 12 students unless 87

Florida Senate - 2025 SB 526 31-00793-25 2025526__ Page 4 of 13 CODING: Words stricken are deletions; words underlined are additions. the written agreement between the program and the agency, 88 facility, or organization providing clinical training sites 89 allows more students, not to exceed 18 students, to be directly 90 supervised by one program faculty member. 91 2.

For a hospital setting, indirect supervision may occur 92 only if there is direct supervision by an assigned clinical 93 preceptor, a supervising program faculty member is available by 94 telephone, and such arrangement is approved by the clinical 95 facility. 96 3. For community-based clinical experiences that involve 97 student participation in invasive or complex nursing activities, 98 students must be directly supervised by a program faculty member 99 or clinical preceptor and such arrangement must be approved by 100 the community-based clinical facility. 101 4.

For community-based clinical experiences not subject to 102 subparagraph 3., indirect supervision may occur only when a 103 supervising program faculty member is available to the student 104 by telephone. 105 106 A program’s policies established under this paragraph must 107 require that a clinical preceptor who is supervising students in 108 a professional nursing education program be a registered nurse 109 or, if supervising students in a practical nursing education 110 program, be a registered nurse or licensed practical nurse. 111 (

f) The professional or practical nursing curriculum plan 112 documents clinical experience and theoretical instruction in 113 medical, surgical, obstetric, pediatric, and geriatric nursing. 114 A professional nursing curriculum plan must shall also document 115 clinical experience and theoretical instruction in psychiatric 116

Florida Senate - 2025 SB 526 31-00793-25 2025526__ Page 5 of 13 CODING: Words stricken are deletions; words underlined are additions. nursing. Each curriculum plan must document clinical training 117 experience in appropriate settings that include, but are not 118 limited to, acute care, long-term care, and community settings. 119 (

g) The professional or practical nursing education program 120 provides theoretical instruction and clinical application in 121 personal, family, and community health concepts; nutrition; 122 human growth and development throughout the life span; body 123 structure and function; interpersonal relationship skills; 124 mental health concepts; pharmacology and administration of 125 medications; and legal aspects of practice. A professional 126 nursing education program must also provide theoretical 127 instruction and clinical application in interpersonal 128 relationships and leadership skills; professional role and 129 function; and health teaching and counseling skills. 130 (

h) The professional or practical nursing education program 131 has established evaluation and standardized admission criteria. 132 The admission criteria must, at a minimum, identify those 133 students who are likely to need additional educational support 134 to be successful program graduates. The program must maintain 135 documentation of the individualized student academic support 136 plan for those students identified as in need of additional 137 preparation and educational support. 138 (

i) The professional or practical nursing education program 139 has an established comprehensive examination to prepare students 140 for the National Council of State Boards of Nursing Licensing 141 Examination (NCLEX). The comprehensive examination must be 142 termed an exit examination that all programs will administer and 143 may not be the sole exclusion to graduation if the student has 144 otherwise successfully completed all coursework required by the 145

Florida Senate - 2025 SB 526 31-00793-25 2025526__ Page 6 of 13 CODING: Words stricken are deletions; words underlined are additions. program. The program director is responsible for ensuring that 146 the average exit examination results of the program are placed 147 on the program’s website and reported to the board along with 148 the annual report required in subsection (3). 149 (

j) The professional or practical nursing education program 150 has submitted to the board the established criteria for 151 remediation that will be offered to students who do not 152 successfully pass the exit examination. A program with NCLEX 153 passage rates at least 10 percentage points below the average 154 passage rate for the most recent calendar year must offer 155 remediation at no additional cost or refer the student to an 156 approved remedial program and pay for that program for the 157 student. 158

(2) PROGRAM APPROVAL.— 159 (

a) Upon receipt of a program application and review fee, 160 the department shall examine the application to determine if it 161 is complete. If the application is not complete, the department 162 must shall notify the educational institution in writing of any 163 errors or omissions within 30 days after the department’s 164 receipt of the application. A program application is deemed 165 complete upon the department’s receipt of: 166 1. The initial application, if the department does not 167 notify the educational institution of any errors or omissions 168 within the 30-day period; or 169 2.

A revised application that corrects each error and 170 omission of which the department notifies the educational 171 institution within the 30-day period. 172 (

b) Following the department’s receipt of a complete 173 program application, the board may conduct an onsite evaluation 174

Florida Senate - 2025 SB 526 31-00793-25 2025526__ Page 7 of 13 CODING: Words stricken are deletions; words underlined are additions. if necessary to document the applicant’s compliance with 175 subsection (1). Within 90 days after the department’s receipt of 176 a complete program application, the board shall: 177 1. Approve the application if it documents compliance with 178 subsection (1); or 179 2. Provide the educational institution with a notice of 180 intent to deny the application if it does not document 181 compliance with subsection (1).

The notice must specify written 182 reasons for the board’s denial of the application. The board may 183 not deny a program application because of an educational 184 institution’s failure to correct an error or omission that the 185 department failed to provide notice of to the institution within 186 the 30-day notice period under paragraph (a). The educational 187 institution may request a hearing on the notice of intent to 188 deny the program application pursuant to

chapter 120. 189 (

c) A program application is deemed approved if the board 190 does not act within the 90-day review period provided under 191 paragraph (b). 192 (

d) Upon the board’s approval of a program application, the 193 program becomes an approved program. 194 (

e) The board shall deny an application from a program that 195 has had adverse action taken against it by another regulatory 196 jurisdiction in the United States. The board may also revoke the 197 approval of an existing approved program that has had adverse 198 action taken against it by another regulatory jurisdiction in 199 the United States. 200

(3) ANNUAL REPORT.—By November 1 of each year, each 201 approved program’s director program shall submit to the board an 202 annual report comprised of an affidavit certifying continued 203

Florida Senate - 2025 SB 526 31-00793-25 2025526__ Page 8 of 13 CODING: Words stricken are deletions; words underlined are additions. compliance with subsection (1), a

summary description of the 204 program’s compliance with subsection (1), and documentation for 205 the previous academic year that, to the extent applicable, 206 describes: 207 (

a) The number of student applications received, qualified 208 applicants, applicants accepted, accepted applicants who enroll 209 in the program, students enrolled in the program, and program 210 graduates. 211 (

b) The program’s retention rates for students tracked from 212 program entry to graduation. 213 (

c) The program’s accreditation status, including 214 identification of the accrediting agency. 215 216 The board must terminate the program pursuant to

chapter 120 if 217 the requirements of this subsection are not met. The program 218 director is also subject to discipline under s. 456.072(1)(k) 219 for such failure. 220

(5) ACCOUNTABILITY.— 221 (a)1. An approved program must achieve a graduate passage 222 rate for first-time test takers which is not more than 10 223 percentage points lower than the average passage rate during the 224 same calendar year for graduates of comparable degree programs 225 who are United States educated, first-time test takers on the 226 National Council of State Boards of Nursing Licensing 227 Examination, as calculated by the contract testing service of 228 the National Council of State Boards of Nursing. For purposes of 229 this subparagraph, an approved program is comparable to all 230 degree programs of the same program type from among the 231 following program types: 232

Florida Senate - 2025 SB 526 31-00793-25 2025526__ Page 9 of 13 CODING: Words stricken are deletions; words underlined are additions. a. Professional nursing education programs that terminate 233 in a bachelor’s degree. 234 b. Professional nursing education programs that terminate 235 in an associate degree. 236 c. Professional nursing education programs that terminate 237 in a diploma. 238 d. Practical nursing education programs. 239 2. If an approved program’s graduate passage rates do not 240 equal or exceed the required passage rates for 1 calendar year 2 241 consecutive calendar years, the board must shall place the 242 program on probationary status pursuant to

chapter 120 and the 243 program director must submit a written remediation plan to the 244 board. The program director must shall appear before the board 245 to present the a plan for remediation, which must shall include 246 specific nationally recognized benchmarks to identify progress 247 toward a graduate passage rate goal. The board must terminate a 248 program pursuant to

chapter 120 if the program director fails to 249 submit a written remediation plan or fails to appear before the 250 board and present the remediation plan no later than 6 months 251 after the date of the program being placed on probation. The 252 program’s director is also subject to discipline under s. 253 456.072(1)(

k) for such failure. The program must remain on 254 probationary status until it achieves a graduate passage rate 255 that equals or exceeds the required passage rate for any 1 256 calendar year. The board must shall deny a program application 257 for a new prelicensure nursing education program submitted by an 258 educational institution if the institution has an existing 259 program that is already on probationary status. 260 3. Upon the program’s achievement of a graduate passage 261

Florida Senate - 2025 SB 526 31-00793-25 2025526__ Page 10 of 13 CODING: Words stricken are deletions; words underlined are additions. rate that equals or exceeds the required passage rate, the 262 board, at its next regularly scheduled meeting following release 263 of the program’s graduate passage rate by the National Council 264 of State Boards of Nursing, shall remove the program’s 265 probationary status.

If the program, during the 2 calendar year 266 years following its placement on probationary status, does not 267 achieve the required passage rate for any 1 calendar year, the 268 board must may extend the program’s probationary status for 1 269 additional year, provided the program has demonstrated adequate 270 progress toward the graduate passage rate goal by meeting a 271 majority of the benchmarks established in the remediation plan. 272 If the program is not granted the 1-year extension or fails to 273 achieve the required passage rate by the end of such extension, 274 the board shall terminate the program pursuant to

chapter 120. 275 (

b) If an approved program fails to submit the annual 276 report required in subsection (3), the board must shall notify 277 the program director and president or chief executive officer of 278 the educational institution in writing within 15 days after the 279 due date of the annual report. The program director must shall 280 appear before the board at the board’s next regularly scheduled 281 meeting to explain the reason for the delay. The board must 282 shall terminate the program pursuant to

chapter 120 if the 283 program director fails to appear before the board, as required 284 under this paragraph, or if the program does not submit the 285 annual report within 6 months after the due date. 286 (

c) A nursing education program, whether accredited or 287 nonaccredited, which has been placed on probationary status must 288 shall disclose its probationary status in writing to the 289 program’s students and applicants. The notification must include 290

Florida Senate - 2025 SB 526 31-00793-25 2025526__ Page 11 of 13 CODING: Words stricken are deletions; words underlined are additions. an explanation of the implications of the program’s probationary 291 status on the students or applicants. 292 (

d) If students from a program that is terminated pursuant 293 to this subsection transfer to an approved or an accredited 294 program under the direction of the Commission for Independent 295 Education, the board must shall recalculate the passage rates of 296 the programs receiving the transferring students, excluding the 297 test scores of those students transferring more than 12 credits. 298 (

e) Duly authorized agents or employees of the department 299 may conduct onsite evaluations or inspections at all reasonable 300 hours to ensure that approved programs or accredited programs 301 are in full compliance with this chapter, or to determine 302 whether this

chapter or s. 456.072 is being violated. The 303 department may collect any necessary evidence needed to ensure 304 compliance with this

chapter or for prosecution as deemed 305 necessary. A failure of a program to refuse or allow an onsite 306 evaluation or inspection is deemed a violation of a legal 307 obligation imposed by the board or the department. 308

(8) RULEMAKING.—The board does not have rulemaking 309 authority to administer this section, except that the board 310 shall adopt rules that prescribe the format for submitting 311 program applications under subsection (1) and annual reports 312 under subsection (3), to enforce and administer subsection (5), 313 and to administer the documentation of the accreditation of 314 nursing education programs under subsection (11).

The board may 315 adopt rules relating to the nursing curriculum, including rules 316 relating to the uses and limitations of simulation technology, 317 and rules relating to the criteria to qualify for an extension 318 of time to meet the accreditation requirements under paragraph 319

Florida Senate - 2025 SB 526 31-00793-25 2025526__ Page 12 of 13 CODING: Words stricken are deletions; words underlined are additions. (11)(f). The board may not impose any condition or requirement 320 on an educational institution submitting a program application, 321 an approved program, or an accredited program, except as 322 expressly provided in this section. 323

(11) ACCREDITATION REQUIRED.— 324 (

f) An approved nursing education program may, no sooner 325 than 90 days before the deadline for meeting the accreditation 326 requirements of this subsection, apply to the board for an 327 extension of the accreditation deadline for a period which does 328 not exceed 2 years.

An additional extension may not be granted. 329 In order to be eligible for the extension, the approved program 330 must establish that it has a graduate passage rate of 60 percent 331 or higher on the National Council of State Boards of Nursing 332 Licensing Examination for the most recent calendar year and must 333 meet a majority of the board’s additional criteria, including, 334 but not limited to, all of the following: 335 1. A student retention rate of 60 percent or higher for the 336 most recent calendar year. 337 2.

A graduate work placement rate of 70 percent or higher 338 for the most recent calendar year. 339 3. The program has applied for approval or been approved by 340 an institutional or programmatic accreditor recognized by the 341 United States Department of Education. 342 4. The program is in full compliance with subsections (1) 343 and (3) and paragraph (5)(b). 344 5. The program is not currently in its second year of 345 probationary status under subsection (5). 346 347 The applicable deadline under this paragraph is tolled from the 348

Florida Senate - 2025 SB 526 31-00793-25 2025526__ Page 13 of 13 CODING: Words stricken are deletions; words underlined are additions. date on which an approved program applies for an extension until 349 the date on which the board issues a decision on the requested 350 extension. 351

Section 2. This act shall take effect July 1, 2025. 352