Subchapter C. CERTIFIED REGISTERED NURSE PRACTITIONERS

§ 21.251. Definitions.

 The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise:

   Boards—The State Board of Nursing and the State Board of Medicine.

   Certified Registered Nurse Practitioner (CRNP)—A registered nurse licensed in this Commonwealth who is certified by the Boards in a particular clinical specialty area and who, while functioning in the expanded role as a professional nurse, performs acts of medical diagnosis or prescription of medical therapeutic or corrective measures in collaboration with and under the direction of a physician licensed to practice medicine in this Commonwealth. Nothing in this subchapter is to be deemed to limit or prohibit a nurse from engaging in those activities which normally constitute the practice of nursing as defined in section 2 of The Professional Nursing Law (63 P. S. §  212).

   Direction—The incorporation of physician supervision to the certified registered nurse practitioner’s performance of medical acts in the following ways:

     (i)   Immediate availability of a licensed physician through direct communications or by radio, telephone or telecommunications.

     (ii)   A predetermined plan for emergency services which has been jointly developed by the supervising physician and the certified registered nurse practitioner.

     (iii)   A physician available on a regularly scheduled basis for:

       (A)   Referrals.

       (B)   Review of the standards of medical practice incorporating consultation and chart review.

       (C)   Establishing and updating standing orders, drug and other medical protocols within the practice setting.

       (D)   Periodic updating in medical diagnosis and therapeutics.

       (E)   Cosigning records when necessary to document accountability by both parties.

   The provisions of this §  21.251 adopted July 22, 1977, effective July 23, 1977, 7 Pa.B. 2063.

   Chart Review

 The Boards have established rules and regulations to govern acts of medical diagnosis or prescription of medical therapeutic or corrective measures as authorized by The Professional Nursing Law (63 P. S. § §  211—225.5) and the Medical Practice Act of 1985 (63 P. S. § §  422.1—422.51a).

 The following fees are charged by the Board:

 Certification… $100

 Biennial renewal of certification… $50

 Verification of certification… $15

 Application for prescriptive authority… $50

 Each additional collaborative agreement for
prescriptive authority… $30

 Biennial renewal of prescriptive authority… $25

 Application for approval of new nursing
program… $735

 Application for approval of CRNP continuing
education course… $100

   The provisions of this §  21.253 issued under section 8.1(c) and 11.2(a) and (d) of The Professional Nursing Law (63 P. S. § §  218.1(c), 221.2(a) and (d)); amended under section 11.2 of The Professional Nursing Law (63 P. S. §  221.2); and section 17.5 of the Practical Nurse Law (63 P. S. §  667.5).

   The provisions of this §  21.253 adopted December 25, 1987, effective December 26, 1987, 17 Pa.B. 5329; amended June 12, 1992, effective immediately and applies to biennial renewals commencing May 1, 1992; amended June 16, 2000, effective June 17, 2000, 30 Pa.B. 3040; amended November 17, 2000, effective November 18, 2000, 30 Pa.B. 5952; amended December 9, 2005, effective December 10, 2005, 35 Pa.B. 6658; amended June 2, 2006, effective June 3, 2006, 36 Pa.B. 2673; amended July 3, 2008, effective July 5, 2008, 38 Pa.B. 3656. Immediately preceding text appears at serial pages (319596) to (319597).

   This section cited in 49 Pa. Code §  21.605 (relating to biennial renewal); and 49 Pa. Code §  21.336 (relating to continuing education course approval).

LEGAL RECOGNITION

§ 21.261. Designation of CRNP; authority to use CRNP.

 (a)  A registered nurse who has satisfactorily met the requirements set forth in this subchapter and in additional rules and regulations that may be jointly promulgated by the Boards shall be designated on his license ‘‘Certified Registered Nurse Practitioner (CRNP),’’ in the area for which qualified.

 (b)  A nurse may not practice or offer to practice as a Certified Registered Nurse Practitioner in this Commonwealth or use the abbreviation CRNP unless authorized to do so by the State Board of Nursing.

   The provisions of this §  21.261 adopted July 22, 1977, effective July 23, 1977, 7 Pa.B. 2063.

REQUIREMENTS FOR APPROVAL

§ 21.271. Currently licensed; course of study and experience; continuing education.

 (a)  The applicant for whom approval is requested shall be currently licensed as a registered nurse by the State Board of Nursing.

 (b)  The applicant shall have successfully completed a course of study consisting of at least 1 academic year in a program administered by nursing in an institution of higher education as approved by the Boards.

 (c)  Nurses currently practicing in the role covered by this subchapter prior to the promulgation of this subchapter who have not completed an approved course of study, may individually petition the Boards for certification within 2 years following the final filing of this subchapter.

 (d)  Evidence of continuing competency in the area of medical diagnosis and therapeutics at the time of renewal of the applicant’s certification renewal.

 (a)  A registered nurse who has been granted certification by another state board may be granted certification in this Commonwealth by endorsement of the original certifying board if the credentials are equivalent to those required by the Boards.

 (b)  The applicant for certification in this Commonwealth by endorsement shall meet the requirements as stated in the act for licensure as a registered nurse.

   The provisions of this §  21.272 adopted July 22, 1977, effective July 23, 1977, 7 Pa.B. 2063.

APPLICATION FOR APPROVAL

§ 21.281. Application for approval.

 The applicant shall submit an application form provided by the State Board of Nursing to the Board for its review and approval. The application shall include the following:

   (1)  An official document from the program.

   (2)  Additional information as identified on the application.

 Applicants approved by the State Board of Nursing may use the designation C.R.N.P., and the designation and area of specialty will be indicated on the current license of the nurse.

   The provisions of this §  21.282 adopted July 22, 1977, effective July 23, 1977, 7 Pa.B. 2063.

CRNP PRACTICE

§ 21.283. Prescribing and dispensing drugs.

 A CRNP may prescribe and dispense drugs if the following requirements are met:

   (1)  The CRNP has completed a CRNP program which is approved by the Boards or, if completed in another state, is equivalent to programs approved by the Boards.

   (2)  The CRNP has successfully completed at least 45 hours of course work specific to advanced pharmacology in accordance with the following:

     (i)   The course work in advanced pharmacology may be either part of the CRNP education program or, if completed outside of the CRNP education program, an additional course or courses taken from an educational program or programs approved by the Boards.

     (ii)   The course work shall be at an advanced level above a pharmacology course required by a professional nursing (RN) education program.

   (3)  A CRNP who has prescriptive authority shall complete at least 16 hours of State Board of Nursing approved continuing education in pharmacology in the 2 years prior to the biennial renewal date of the CRNP certification. The CRNP shall show proof that the CRNP completed the continuing education when submitting a biennial renewal.

   (4)  In prescribing and dispensing drugs, a CRNP shall comply with standards of the State Board of Medicine in § §  16.92—16.94 (relating to prescribing, administering and dispensing controlled substances; packaging; and labeling of dispensed drugs) and the Department of Health in 28 Pa. Code § §  25.51—25.58, 25.61—25.81 and 25.91—25.95.

   The provisions of this §  21.283 issued under section 15(b) of the Medical Practice Act of 1985 (63 P. S. §  422.15(b)).

   The provisions of this §  21.283 adopted November 17, 2000, effective November 18, 2000, 30 Pa.B. 5943.

 (a)  The Board adopts the American Hospital Formulary Service Pharmacologic-Therapeutic Classification to identify drugs which the CRNP may prescribe and dispense subject to the parameters identified in this section.

 (b)  A CRNP may prescribe and dispense a drug relevant to the area of practice of the CRNP from the following categories if that authorization is documented in the collaborative agreement (unless the drug is limited or excluded under this or another subsection):

   (1)  Antihistamines.

   (2)  Anti-infective agents.

   (3)  Antineoplastic agents, unclassified therapeutic agents, devices and pharmaceutical aids if originally prescribed by the collaborating physician and approved by the collaborating physician for ongoing therapy.

   (4)  Autonomic drugs.

   (5)  Blood formation, coagulation and anticoagulation drugs, and thrombolytic and antithrombolytic agents.

   (6)  Cardiovascular drugs.

   (7)  Central nervous system agents, except that the following drugs are excluded from this category:

     (i)   General anesthetics.

     (ii)   Monoamine oxidase inhibitors.

   (8)  Contraceptives including foams and devices.

   (9)  Diagnostic agents.

   (10)  Disinfectants for agents used on objects other than skin.

   (11)  Electrolytic, caloric and water balance.

   (12)  Enzymes.

   (13)  Antitussive, expectorants and mucolytic agents.

   (14)  Gastrointestinal drugs.

   (15)  Local anesthetics.

   (16)  Eye, ear, nose and throat preparations.

   (17)  Serums, toxoids and vaccines.

   (18)  Skin and mucous membrane agents.

   (19)  Smooth muscle relaxants.

   (20)  Vitamins.

   (21)  Hormones and synthetic substitutes.

 (c)  A CRNP may not prescribe or dispense a drug from the following categories:

   (1)  Gold compounds.

   (2)  Heavy metal antagonists.

   (3)  Radioactive agents.

   (4)  Oxytocics.

 (d)  If a collaborating physician determines that the CRNP is prescribing or dispensing a drug inappropriately, the collaborating physician shall immediately take corrective action on behalf of the patient and notify the patient of the reason for the action and advise the CRNP as soon as possible. This action shall be noted by the CRNP or the collaborating physician, or both, in the patient’s medical record.

 (e)  Restrictions on CRNP prescribing and dispensing practices are as follows:

   (1)  A CRNP may write a prescription for a Schedule II controlled substance for up to a 72 hour dose. The CRNP shall notify the collaborating physician as soon as possible but in no event longer than 24 hours.

   (2)  A CRNP may prescribe a Schedule III or IV controlled substance for up to 30 days. The prescription is not subject to refills unless the collaborating physician authorizes refills for that prescription.

 (f)  A CRNP may not:

   (1)  Prescribe or dispense a Schedule I controlled substance as defined in section 4 of the Controlled Substance, Drug, Device and Cosmetic Act (35 P. S. §  780-14).

   (2)  Prescribe or dispense a drug for a use not approved by the United States Food and Drug Administration without approval of the collaborating physician.

   (3)  Delegate prescriptive authority specifically assigned to the CRNP by the collaborating physician to another health care provider.

 (g)  A prescription blank shall bear the certification number of the CRNP, name of the CRNP in printed format at the top of the blank and a space for the entry of the DEA registration number, if appropriate. The collaborating physician shall also be identified as required in §  16.91 (relating to identifying information on prescriptions and orders for equipment and service).

 (h)  The CRNP shall document in the patient’s medical record the name, amount and dose of the drug prescribed, the number of refills, the date of the prescription and the CRNP’s name.

   The provisions of this §  21.284 issued under section 15(b) of the Medical Practice Act of 1985 (63 P. S. §  422.15(b)).

   The provisions of this §  21.284 adopted November 17, 2000, effective November 18, 2000, 30 Pa.B. 5943.

 (a)  A collaborative agreement is the signed written agreement between a CRNP and a collaborating physician in which they agree to the details of the collaborative arrangement between them with respect to the care of CRNP patients.

 (b)  The collaborative agreement between a physician and a CRNP who will prescribe drugs shall satisfy the following requirements. The agreement shall:

   (1)  Identify the parties, including the collaborating physician, the CRNP, and a substitute physician who will provide collaboration and direction for up to 30 days if the collaborating physician is unavailable.

   (2)  Identify the area of practice in which the CRNP is certified.

   (3)  Identify the categories of drugs from which the CRNP may prescribe or dispense in accordance with §  21.284 (relating to prescribing and dispensing parameters).

   (4)  Contain attestation by the collaborating physician that the physician has knowledge and experience with any drug that the CRNP will prescribe.

   (5)  Specify the circumstances and how often the collaborating physician will personally see the patient, based on the type of practice, sites of service and condition of the patient, whether the treatment is for an ongoing or new condition, and whether the patient is new or continuing.

   (6)  Specify the conditions under which the CRNP may prescribe a Schedule II controlled substance for up to 72 hours.

   (7)  Be kept at the primary practice location of the CRNP and a copy filed with the Bureau of Professional and Occupational Affairs.

   (8)  Be made available for inspection to anyone seeking to confirm the scope of practice of the CRNP.

   (9)  Be updated by the collaborating physician and the CRNP whenever it is changed substantively.

   (10)  Specify the amount of professional liability insurance carried by the CRNP.

 (c)  The CRNP shall notify the Bureau whenever a collaborative agreement of a CRNP who prescribes and dispenses drugs is updated or terminated.

   The provisions of this §  21.285 issued under section 15(b) of the Medical Practice Act of 1985 (63 P. S. §  422.15(b)).

   The provisions of this §  21.285 adopted November 17, 2000, effective November 18, 2000, 30 Pa.B. 5943; amended December 29, 2000, effective November 18, 2000, 30 Pa.B. 6911. Immediately preceding text appears at serial pages (271715) to (271716).

 (a)  A patient shall be informed at the time of making an appointment that the patient will be seen by a CRNP.

 (b)  A CRNP shall wear a name tag that clearly identifies the CRNP with the title ‘‘certified registered nurse practitioner.’’

 (c)  A CRNP who holds a doctorate should take appropriate steps to inform patients that the CRNP is not a doctor of medicine or doctor of osteopathic medicine.

   The provisions of this §  21.286 issued under section 15(b) of the Medical Practice Act of 1985 (63 P. S. §  422.15(b)).

   The provisions of this §  21.286 adopted November 17, 2000, effective November 18, 2000, 30 Pa.B. 5943.

 (a)  At any time a physician may not supervise more than four CRNPs who prescribe and dispense drugs. This section, however, does not limit the number of collaborative agreements that a physician may have with prescribing CRNPs. By way of example, a physician may supervise four prescribing CRNPs who work in the morning and four other prescribing CRNPs who work in the afternoon as long as the physician has a collaborative agreement with each CRNP.

 (b)  A physician may apply for a waiver of the supervision requirements expressed in subsection (a) for good cause, as determined by the Boards.

 (c)  The limit of the general rule of not more than four prescribing CRNPs to one physician does not apply to CRNPs who do not prescribe or dispense drugs. By way of example, a physician may supervise at the same time four CRNPs who prescribe and dispense drugs and one or more CRNPs who do not prescribe and dispense drugs.

   The provisions of this §  21.287 issued under section 15(b) of the Medical Practice Act of 1985 (63 P. S. §  422.15(b)).

   The provisions of this §  21.287 adopted November 17, 2000, effective November 18, 2000, 30 Pa.B. 5943.

   This section cited in 49 Pa. Code §  21.369 (relating to general curriculum requirements).

HEALTH CARE FACILITY POLICIES

§ 21.291. Institutional health care facility committee; committee
determination of standard policies and procedures.

 (a)  In those health care facilities providing health services in which the practice of certified registered nurse practitioners involves the acts of medical diagnosis or prescription of medical therapeutic or corrective measures, there shall be a committee in each area of practice whose function is to establish standard policies and procedures, in writing, pertaining to the scope and circumstances of the practice of the nurses in the medical management of the patient.

 (b)  The committee may serve not only as a policy making body for the special area but also as an advisory and interpretative body to the various staff of the health facility. The committee shall include equal representation from the medical staff, the nursing staff, including a nurse practitioner and nursing administration.

   The provisions of this §  21.291 adopted July 22, 1977, effective July 23, 1977, 7 Pa.B. 2063.

 If a certified registered nurse practitioner is associated with a physician or group of physicians, the committee may consist of, but need not be limited to, the nurse practitioners and the physicians.

 The standard policies and procedures shall be reviewed and accepted by the committee at least annually and at such other times as necessary.

 The committee shall review annually the effectiveness of the medical functions of the C.R.N.P. through an evaluation of the care rendered to patients using the data sources as patient records, statistics and patient follow-up.

   The provisions of this §  21.294 adopted July 22, 1977, effective July 23, 1977, 7 Pa.B. 2063.

ACCOUNTABILITY

§ 21.311. Accountability of CRNP.

 The CRNP is responsible for his own professional judgments and is accountable to the individual consumer. He is also accountable to the physician and the employing agency in the area of medical diagnosis and therapeutics.

   The provisions of this §  21.311 adopted July 22, 1977, effective July 23, 1977, 7 Pa.B. 2063.

TERMINATION OF APPROVAL

§ 21.321. Performance of tasks without direction; performance of tasks without training; other.

 (a)  The approval as provided in this subchapter for a certified registered nurse practitioner may be terminated by the State Board of Nursing when, after notice and hearing, the Board finds the following:

   (1)  That the registrant has engaged in the performance of medical functions and tasks other than at the direction of a physician licensed by the State Board of Medicine, except in the situations as provided for in section 1 of the act of August 8, 1963 (P. L. 582, No. 301) (Reserved).

   (2)  That the registrant has performed a medical task or function which the registrant is not qualified by education to perform.

   The provisions of this §  21.231 adopted July 22, 1977, effective July 23, 1977, 7 Pa.B. 2063.

MAINTENANCE OF CERTIFICATION

§ 21.331. Biennial renewal of certification.

 (a)  Effective October 31, 1985, the certifications of Certified Registered Nurse Practitioners shall be renewed at the same time as their registered nurse licenses. See §  21.29 (relating to expiration and renewal of license).

 (b)  The certification renewal fee for certifications that expire on April 30, 1986 will be 25% of the renewal fee for the usual 2-year renewal period. The renewal fee for certifications that expire on a biennial anniversary of April 30, 1986 will be the renewal fee for the usual 2-year renewal period.

 (c)  The certification renewal fee for certifications that expire on October 31, 1986 will be 50% of the renewal fee for the usual 2-year renewal period. The renewal fee for certifications that expire on a biennial anniversary of October 31, 1986 will be the renewal fee for the usual 2-year renewal period.

 (d)  The certification renewal fee for certifications that expire on April 30, 1987 will be 75% of the renewal fee for the usual 2-year renewal period. The renewal fee for certifications that expire on a biennial anniversary of April 30, 1987 will be the renewal fee for the usual 2-year renewal period.

 (e)  The certification renewal fee for certifications that expire on October 31, 1987 will be the renewal fee for the usual 2-year renewal period. The renewal fee for certifications that expire on a biennial anniversary of October 31, 1987 will be the renewal fee for the usual 2-year renewal period.

 (f)  The certification renewal fees for certifications that expire on April 30, 1986, October 31, 1986, April 30, 1987 or October 31, 1987 shall be paid to the Board by October 30, 1985. The certification renewal fees for certifications that expire on a biennial anniversary of April 30, 1986, October 31, 1986, April 30, 1987 or October 31, 1987 shall be paid to the State Board of Nursing by that anniversary date.

 (a)  A CRNP shall comply with this section and § §  21.332a—21.337.

 (b)  Continuing education requirements shall be completed each biennial cycle.

   (1)  An applicant for biennial renewal of certification is required to complete, during the 2 years preceding renewal, a minimum of 30 hours of Board-approved continuing education, as set forth in section 8.1(c) of the act (63 P. S. §  218.1(c)). Completion of a course described in §  21.283(2) (relating to prescribing and dispensing drugs) satisfies the continuing education requirement for the biennial renewal period in which it is completed.

   (2)  An applicant for biennial renewal of prescriptive authority approval is required to complete, during the 2 years preceding renewal, a minimum of 16 of the 30 hours of continuing education in pharmacology. Completion of a course described in §  21.283(2) shall satisfy the continuing education requirement for the biennial renewal period in which it is completed.

   (3)  A person failing to meet the continuing education requirements for a biennial renewal period will be subject to formal disciplinary action under section 14(a)(3) of the act (63 P. S. §  224(a)(3)).

   (4)  The Board may waive the requirements of continuing education in cases of illness or undue hardship. It is the duty of each licensee who seeks a waiver to notify the Board in writing and request the waiver prior to the end of the renewal period. The Board will grant, deny or grant in part the request for waiver. An individual who requests a waiver may not prescribe or dispense drugs after the expiration of his current prescriptive authority and until the Board grants the waiver request.

   The provisions of this §  21.332 issued under sections 2.1(k) and 8.1(c) of the Professional Nursing Law (63 P. S. § §  211(k) and 218.1(c).

   The provisions of this §  21.332 adopted December 3, 2004, effective December 4, 2004, 34 Pa.B. 6409.

 (a)  A CRNP who places his certification on inactive status is not required to meet the continuing education requirements in §  21.332(b)(1) (relating to requirement of continuing education) during the period the certification is on inactive status. Upon application for reactivation of certification, the CRNP shall show proof of meeting the continuing education requirements for the biennial period immediately preceding the request for reactivation.

 (b)  A CRNP who places his prescriptive authority approval on inactive status for less than 3 years is not required to meet the continuing education requirements in §  21.332(b)(2) during the period the prescriptive authority approval is on inactive status. Upon application for reactivation of prescriptive authority approval, the CRNP shall show proof of meeting the continuing education requirements for the biennial period immediately preceding the request for reactivation.

 (c)  A CRNP who places his prescriptive authority approval on inactive status for 3 years or longer may reactivate the prescriptive authority approval by meeting one of the following conditions:

   (1)  Complete the requirement in §  21.283(2) (relating to prescribing and dispensing drugs) by taking at least 45 hours of course work in advanced pharmacology.

   (2)  Provide evidence to the Board that:

     (i)   The CRNP has practiced, for at least 1 of the last 3 years, as a CRNP with prescriptive authority in another jurisdiction.

     (ii)   The scope of the prescriptive authority in the other jurisdiction is equivalent to prescriptive authority in this Commonwealth.

     (iii)   The CRNP was required, as a condition for continued practice in the other jurisdiction, to complete continuing education that is substantially equivalent to the requirements of §  21.283(3).

     (iv)   The CRNP met the continuing education requirements of the other jurisdiction within 1 year of the request for reactivation of prescriptive authority.

   The provisions of this §  21.332a issued under sections 2.1(k) and 8.1(c) of the Professional Nursing Law (63 P. S. § §  211(k) and 218.1(c).

   The provisions of this §  21.332a adopted December 3, 2004, effective December 4, 2004, 34 Pa.B. 6409.

 (a)  Continuing education courses shall address the CRNP’s area of practice and meet the requirements of §  21.332(b)(1) (relating to requirement of continuing education).

 (b)  Pharmacology continuing education courses shall meet the requirements of section 8.1(c) of the act (63 P. S. §  218.1(c)) and §  21.332(b)(2) and must provide the knowledge and skills to understand the pharmacokinetics and pharmacodynamics of broad categories of drugs and to analyze the relationship between pharmacologic agents and physiologic/pathologic responses.

   The provisions of this §  21.333 issued under sections 2.1(k) and 8.1(c) of the Professional Nursing Law (63 P. S. § §  211(k) and 218.1(c).

   The provisions of this §  21.333 adopted December 3, 2004, effective December 4, 2004, 34 Pa.B. 6409.

 (a)  The following providers of continuing education and credentialing organizations have currently met the standards for course approval for continuing education.

   (1)  Accordingly, provided that these providers agree to abide by §  21.336(a) (relating to continuing education course approval), the courses offered or approved by the following providers or credentialing organizations are approved:

     (i)   Board-approved CRNP programs.

     (ii)   The American Nurses Credentialing Center’s Commission on Accreditation (ANCC).

     (iii)   The American Academy of Nurse Practitioners (AANP).

     (iv)   The National Association of Pediatric Nurse Practitioners (NAPNP).

     (v)   The American Medical Association (AMA).

   (2)  The approval given to the providers and credentialing organizations in paragraph (1) is subject to reevaluation. A rescission of provider or credentialing organization approval will be made only in accordance with 1 Pa. Code Part II (relating to General Rules of Administrative Practice and Procedure) or by amendment of this section.

 (b)  CRNPs may obtain credit for courses offered by providers not indicated in subsection (a)(1) if the provider receives approval of the course under §  21.336 prior to its implementation.

 (c)  CRNPs may obtain credit for continuing education hours on an individual basis if the CRNP, prior to attendance at the course, obtains Board approval by submitting a request for course approval and supporting documentation listed in §  21.336(b).

 (d)  CRNPs may obtain credit for correspondence courses, taped study courses and other independent study courses if the course is Board approved.

 (e)  Up to 4 hours will be credited for service as a teacher, preceptor, lecturer or speaker and for publication in a refereed journal or other scholarly publication relating to pharmacology or the CRNP’s area of practice. Application shall be made prior to the service or within 90 days of the publication to assure that the Board will approve the service or publication and to allow the Board to determine the number of contact hours that will be granted.

 (f)  An hour for purposes of nurse practitioner continuing education is 50 minutes.

   The provisions of this §  21.334 issued under sections 2.1(k) and 8.1(c) of the Professional Nursing Law (63 P. S. § §  211(k) and 218.1(c).

   The provisions of this §  21.334 adopted December 3, 2004, effective December 4, 2004, 34 Pa.B. 6409.

 Each course shall have:

   (1)  An established mechanism to measure its quality, established criteria for selecting and evaluating faculty, and established criteria for the evaluation of each participant who completes the course.

   (2)  Adequate facilities with appropriate instructional materials to carry out continuing education programs.

   (3)  Instructors who have suitable qualifications as detailed in §  21.336(d) (relating to continuing education course approval).

   The provisions of this §  21.335 issued under sections 2.1(k) and 8.1(c) of the Professional Nursing Law (63 P. S. § §  211(k) and 218.1(c).

   The provisions of this §  21.335 adopted December 3, 2004, effective December 4, 2004, 34 Pa.B. 6409.

 (a)  As a condition of approval, providers and credentialing organizations are required to provide CRNPs who complete continuing education courses with a certificate of completion which contains the information listed in §  21.337(a) (relating to CRNP responsiblities). Providers and credentialing organizations shall maintain records of course attendance for at least 5 years.

 (b)  Providers referenced in §  21.334(b) (relating to sources of continuing education) or CRNPs applying for individual approval in §  21.334(c), when seeking Board approval of a continuing education course shall pay the required fee (see §  21.253 (relating to fees)) and complete and submit an application for course approval at least 60 days prior to the date the course is to be offered, which shall include the following information:

   (1)  The full name and address of the provider.

   (2)  The title of the program.

   (3)  The dates and location of the program.

   (4)  The faculty names, titles, affiliations, degrees and areas of expertise.

   (5)  The schedule of program—title of subject, lecturer and time allocated.

   (6)  The total number of hours requested.

   (7)  The method of certifying and assuring attendance, and draft of certificate of attendance to be provided to course participants.

   (8)  The course objectives.

   (9)  The target audience.

   (10)  The core subjects.

   (11)  The program coordinator.

   (12)  The instruction and evaluation methods.

   (13)  Other information requested by the Board.

 (c)  Upon approval of a course, the Board will assign a course number and determine the number of hours awarded. The provider shall place the course number on the certificate of attendance and shall provide CRNPs who successfully complete a course with a certificate of attendance.

 (d)  Courses will be approved only in the instructor’s demonstrated areas of expertise. Expertise may be demonstrated by the instructor’s certification in the specialty area to be presented.

 (e)  A separate application shall be submitted whenever a change is made to any information submitted under subsection (b), except for information related to a change in date or location, or both, of the program submitted under subsection (b)(3).

   The provisions of this §  21.336 issued under sections 2.1(k) and 8.1(c) of the Professional Nursing Law (63 P. S. § §  211(k) and 218.1(c).

   The provisions of this §  21.336 adopted December 3, 2004, effective December 4, 2004, 34 Pa.B. 6409.

 (a)  A CRNP is required to maintain documentation of completion of continuing education, including:

   (1)  CRNP name.

   (2)  Dates attended.

   (3)  Continuing education hours.

   (4)  Title of course.

   (5)  Course provider.

   (6)  Location of course.

   (7)  Course number.

 (b)  Primary responsibility for documenting completion of the continuing education requirements rests with the CRNP. A CRNP seeking to renew certification or prescriptive authority shall verify compliance with continuing education requirements. Documentation of completion of continuing education requirements must be maintained for 5 years. The certificate issued by the course provider must be acceptable documentation. Acceptable documentation of hours obtained through §  21.334(c) or (e) (relating to sources of continuing education) must be the Board approval letter sent to the applicant.

 (c)  Falsification of information required under this section or failure to complete continuing education requirements by those who continue to practice as a CRNP or to prescribe, may result in the institution of formal disciplinary action under section 14(a)(3) of the act (63 P. S. §  224(a)(3)).

   The provisions of this §  21.337 issued under sections 2.1(k) and 8.1(c) of the Professional Nursing Law (63 P. S. § §  211(k) and 218.1(c).

   The provisions of this §  21.337 adopted December 3, 2004, effective December 4, 2004, 34 Pa.B. 6409.

   The provisions of this §  21.341 adopted July 22, 1977, effective July 23, 1977, 7 Pa.B. 2063; reserved December 25, 1987, effective December 26, 1987, 17 Pa.B. 5329. Immediately preceding text appears at serial page (117197).

PENALTIES FOR VIOLATION

§ 21.351. Penalties for violation.

 Certification as a CRNP may be suspended or revoked or the violator may be placed on probation as the Boards, or a joint committee thereof, determine after a formal hearing has been held, and a violation of The Medical Practice Act of 1974 (63 P. S. § §  421.1—421.18) and of The Professional Nursing Law (63 P. S. § §  211—225), of this subchapter, or of regulations pertaining to the aforementioned has been adjudicated.

   The provisions of this §  21.351 adopted July 22, 1977, effective July 23, 1977, 7 Pa.B. 2063.

APPROVAL OF CERTIFIED REGISTERED NURSE
PRACTITIONER PROGRAMS

§ 21.361. General criteria for approval of programs.

 (a)  A CRNP program must require, at a minimum, a baccalaureate degree in nursing for admission and must culminate with a master’s degree in nursing or postmaster’s certificate.

 (b)  A CRNP program must prepare the registered nurse (RN) to function as a nurse practitioner in an expanded role in a particular specialty.

 (c)  A CRNP program must prepare the registered nurse to perform acts of medical diagnosis and prescription of medical, therapeutic or corrective measures in collaboration with a physician licensed to practice medicine in this Commonwealth.

 (d)  A CRNP program may be formed as a master’s program, an RN to master’s program, an RN to nursing doctorate program or a pilot or accelerated program that culminates with at least a master’s degree in nursing.

   The provisions of this §  21.361 issued under sections 6.1 and 8.1 of the Professional Nursing Law (63 P. S. § §  216.1 and 218.1).

   The provisions of this §  21.361 adopted June 2, 2006, effective June 3, 2006, 36 Pa.B. 2667.

 (a)  Approved programs must complete an annual report to the Board on a form provided by the Board. The annual report must update information regarding the program’s administration, faculty, curriculum and student enrollment.

 (b)  Approved programs must conduct a compliance review of CRNP programs at least once every 3 years. The compliance review shall be submitted to the Board on a form provided by the Board. The compliance review must include information regarding accreditation, administration, clinical sites, faculty, curriculum, testing, educational resources and student body of the program.

 (c)  The Board will send a written report of recommendations or requirements, or both, including compliance deadlines, based on the CRNP program’s compliance review, to the CRNP program. The Board will conduct an announced or unannounced site compliance visit at its discretion.

 (d)  Lists of approved CRNP programs will be compiled and published annually (the approved list) and will be made available for distribution. The approved list will consist of programs on initial, full and provisional approval status.

   The provisions of this §  21.362 issued under sections 6.1 and 8.1 of the Professional Nursing Law (63 P. S. § §  216.1 and 218.1).

 (a)  A program that meets and maintains the requirements of § §  21.361, 21.365—21.369 and 21.372—21.375 will be granted full approval status.

 (b)  The Board will place a CRNP program on provisional approval status if, as evidenced by the compliance review or other information, the program is not in compliance with the Board’s regulations. At its discretion, the Board will require progress reports or other information deemed necessary for the evaluation of a program on provisional approval status. Two years will be the maximum time allowed for the correction of the deficiencies that resulted in the program being placed on provisional approval status. If the program on provisional approval status is not in compliance within this designated time, the CRNP program will be removed from the approved list.

 (c)  The Board may return a CRNP program on provisional approval status to full approval status if the program attains and maintains the acceptable standards in § §  21.365—21.377, and adheres to the policies and regulations of the Board.

   The provisions of this §  21.363 issued under sections 6.1 and 8.1 of the Professional Nursing Law (63 P. S. § §  216.1 and 218.1).

 (a)  The Board will give at least 30 days notice of intent to remove a CRNP program from full approval status to provisional approval status or from provisional approval status to removal from the approved list and will provide an opportunity for the program’s officials to present documentation, within 10 days of notification of intent to remove, to show why approval should not be withdrawn. The Board will hold a hearing, within 30 days of the submission of documentation, at which the program official may appear and present additional evidence to show cause as to why approval should not be withdrawn. The 30 day period for holding a hearing may be waived by consent of the parties. Failure to hold a hearing within 30 days will not be cause to withdraw the notice of intent to remove.

 (b)  Programs planning to discontinue must follow the procedures in §  21.41 (relating to notification; completion of program; records).

   The provisions of this §  21.364 issued under sections 6.1 and 8.1 of the Professional Nursing Law (63 P. S. § §  216.1 and 218.1).

 (a)  A CRNP program must be developed and maintained under the authority of a regionally accredited university or college or have current accreditation by the Credentialing Commission for Nurse Education or the National League of Nursing.

 (b)  A CRNP program must be under the direction of a faculty member who holds an active certification as a Pennsylvania CRNP and an earned doctorate degree or a specific plan for and evidence toward completion of the doctoral degree within 5 years. The length of appointment of temporary and acting directors of CRNP programs may not exceed 1 year.

 (c)  A university or college may conduct CRNP programs within the graduate program of the university or college where it resides, if the college or university has a professional nurse program and the philosophy of the parent institution encompasses dual programs of education. A college or university desiring to establish a program of nursing is required to:

   (1)  Submit a proposal to the Board, at least 12 months prior to the first intended admission of students, which includes the following:

     (i)   Sufficient statistical data to support the need for a CRNP program within the community and to assure availability of an adequate number of interested candidates.

     (ii)   Letters of intent from the cooperating agencies indicating positive commitment to the CRNP program and the availability of sufficient clinical resources to meet the educational requirements of the CRNP program.

     (iii)   The projected cost of the CRNP program including costs for faculty, clinical teaching resources, educational supplies, office supplies, and the like, and sufficient evidence of stable financial support.

   (2)  Employ the director of the CRNP program prior to the intended admission date of students.

 (d)  The planned CRNP educational program proposal must include:

   (1)  A statement of the organization and administrative policies of the college or university.

   (2)  A statement of the administrative structure and functions of the nursing school.

   (3)  A statement of the educational preparation and nursing experience of faculty members employed, which conforms to §  21.367(b) (relating to faculty requirements for CRNP programs).

   (4)  A statement of the philosophy, purposes and objectives of the program, which are congruent with the philosophy of the university or college.

   (5)  A statement of the curriculum, based on sound educational concepts, and including detailed course descriptions, objectives and descriptions of the relevant clinical practice related to the specialty area.

   (6)  A statement of admissions policies.

   (7)  A statement identifying the National educational standards and guidelines used in the development of the nursing practitioner program.

   (8)  Statements of financial viability for 5 years.

   (9)  A description of the clinical facilities.

 (e)  Following the review of the CRNP program proposal and before final Board action is taken to grant permission to recruit students, an initial facility survey may be made by the designee of the Board.

   The provisions of this §  21.365 issued under sections 6.1 and 8.1 of the Professional Nursing Law (63 P. S. § §  216.1 and 218.1).

   The provisions of this §  21.365 adopted June 2, 2006, effective June 3, 2006, 36 Pa.B. 2667.

 (a)  The CRNP program must be a definable entity distinguishable from other educational programs and services within the institution.

 (b)  Relationships with central administrative officers, interrelationships among other disciplines and services of the college or university, and representation on college or university councils and committees for faculty in a CRNP program must be consistent with the interaction and responsibilities accorded to other faculty members of the college or university.

 (c)  Adequate funds shall be allocated and properly budgeted for the sound and effective operation of the CRNP program.

 (d)  Policies in effect for faculty members of the CRNP program must be those in effect for faculty members throughout the college or university.

 (e)  The resources, facilities and services of the college or university must be available to and used by the CRNP program and be adequate to meet the needs of the faculty and students.

   The provisions of this §  21.366 issued under sections 6.1 and 8.1 of the Professional Nursing Law (63 P. S. § §  216.1 and 218.1).

   The provisions of this §  21.366 adopted June 2, 2006, effective June 3, 2006, 36 Pa.B. 2667.

 (a)  The minimum faculty requirements submitted under §  21.365(d)(3) (relating to establishment) for the program are:

   (1)  Qualified faculty members teaching in their areas of specialized practice encompassed within the curriculum.

   (2)  Additional faculty members as needed to insure an educationally effective student-faculty ratio.

 (b)  Faculty qualifications for clinical courses in the CRNP program are as follows:

   (1)  Faculty members shall provide evidence of expertise in their subject areas, and when appropriate, be currently licensed and certified in this Commonwealth and hold and maintain National certification. Faculty members already employed in a CRNP program who do not hold National certification in their area of specialization shall obtain National certification, if available, by June 3, 2008.

   (2)  Faculty members shall give evidence of maintaining expertise in their clinical or functional areas of specialization.

   (3)  Faculty members shall maintain currency in clinical practice through ongoing clinical practice.

   (4)  Faculty members shall meet specialty requirements for continuing competency in accordance with their educational program responsibilities.

   The provisions of this §  21.367 issued under sections 6.1 and 8.1 of the Professional Nursing Law (63 P. S. § §  216.1 and 218.1).

   The provisions of this §  21.367 adopted June 2, 2006, effective June 3, 2006, 36 Pa.B. 2667.

 (a)  The faculty shall be employed by and be responsible to the college or university.

 (b)  Policies, including personnel policies in effect for CRNP program faculty, must be those in effect for faculty members throughout the college or university.

 (c)  Functions and responsibilities of each faculty member shall be defined in writing.

 (d)  Teaching hours of CRNP faculty must be consistent with the policies of the college or university.

   The provisions of this §  21.368 issued under sections 6.1 and 8.1 of the Professional Nursing Law (63 P. S. § §  216.1 and 218.1).

   The provisions of this §  21.368 adopted June 2, 2006, effective June 3, 2006, 36 Pa.B. 2667.

 (a)  The curriculum shall be developed, implemented and evaluated by the faculty and be based on the philosophy and objectives of the school.

 (b)  The curriculum must be organized and developed to include the knowledge, attitudes, skills and abilities necessary for practice as a CRNP and in accordance with this chapter as related to CRNP practice.

 (c)  The curriculum must provide for both clinical and theoretical experiences. The curriculum must have the following components incorporated into each CRNP program:

   (1)  Graduate nursing core. The graduate nursing core must include the following content:

     (i)   Research.

     (ii)   Health care policy and organization.

     (iii)   Ethics.

     (iv)   Professional role development.

     (v)   Theoretical foundations of nursing practice.

     (vi)   Human diversity and social issues.

     (vii)   Health promotion and disease prevention.

   (2)  Advanced nursing practice core. The advanced nursing practice core must include the following content:

     (i)   Advanced health/physical assessment.

     (ii)   Advanced physiology and pathophysiology.

     (iii)   Advanced pharmacology.

   (3)  Specialty content. The CRNP student shall receive sufficient clinical experience to provide depth and breadth in a given specialty or with designated populations, geared to nurse practitioner practice. Clinical hours must meet at least National certification requirements with a minimum of 500. Additional hours must be provided for specialties that provide care to multiple age groups (for example, family CRNPs) or for those who will practice in multiple care settings. When defining additional clinical hours, the complexity of the specialty content, as well as the need for clinical experience to enhance retention and skills, shall be considered. The expected graduate competencies must be the key determinant of the clinical component.

   (4)  Advanced pharmacology.

     (i)   CRNP program graduates shall have a well-grounded understanding of pharmacologic principles, which includes the cellular response level. This area of core content must also include both pharmacotherapeutics and pharmacokinetics of broad categories of pharmacologic agents. Advanced pharmacology shall be taught in a separate or dedicated 3-credit or 45-hour course. Pharmacology content shall also be integrated into the other content areas identified in the advanced practice nursing core. Additional application of this content shall also be presented within the specialty course content and clinical experiences of the program to prepare the CRNP to practice within a specialty scope of practice.

     (ii)   The purpose of this content is to provide the graduate with the knowledge and skills to assess, diagnose and manage (including the prescription of pharmacologic agents) a patient’s common health problems in a safe, high quality, manner.

     (iii)   The course work must provide graduates with the knowledge and skills to:

       (A)   Comprehend the pharmacotherapeutics of broad categories of drugs.

       (B)   Analyze the relationship between pharmacologic agents and physiologic/pathologic responses.

       (C)   Understand the pharmacokinetics and pharmacodynamics of broad categories of drugs.

       (D)   Understand the motivations of clients in seeking prescriptions and the willingness to adhere to prescribed regimens.

       (E)   Safely and appropriately select pharmacologic agents for the management of client health problems based on client variations, the problem being managed, and cost effectiveness.

       (F)   Provide comprehensive and appropriate client education in relation to prescribed pharmacologic agents.

       (G)   Analyze the effects of single and multiple drug regimens on the client’s health and functioning.

       (H)   Understand the variety of State legal requirements for CRNP prescriptive authority.

       (I)   Fulfill legal requirements for writing prescriptions as a CRNP in this Commonwealth in accordance with § §  21.283—21.287 (relating to CRNP).

   (5)  Professional role content. The course work must provide graduates with curriculum in:

     (i)   Management of client health/illness status.

     (ii)   The nurse-client relationship.

     (iii)   The teaching-mentoring function.

     (iv)   Professional role.

     (v)   Managing and negotiating health care delivery systems.

     (vi)   Monitoring and ensuring the quality of health care practice.

 (d)  The instructional strategies must be appropriate and consistent with the program’s philosophy, mission and objectives.

 (e)  The clinical facilities of the CRNP program must provide a variety of experiences with sufficient quality and quantity. Clinical experiences must be consistent with the scope of practice.

 (f)  CRNP courses and curriculum must be organized to continue the development of values, understandings, knowledge and skills needed in all aspects of practice as a CRNP and emphasize specialty areas.

 (g)  The ratio of students to faculty must insure optimal learning opportunities in clinical laboratory sessions, be consistent with the objectives of the CRNP courses, and comply with §  21.373(c)(3)(ii) (relating to facility and resource requirements).

 (h)  The curriculum for CRNP programs must give evidence of providing learning experiences which will prepare graduates for CRNP practice. The standards of practice are defined and delineated by the profession and § §  21.18 and 21.284 (relating to standards of nursing conduct; and prescribing and dispensing parameters).

 (i)  Course syllabi that identify all aspects of each course must be developed and readily available.

   The provisions of this §  21.369 issued under sections 6.1 and 8.1 of the Professional Nursing Law (63 P. S. § §  216.1 and 218.1).

   The provisions of this §  21.369 adopted June 2, 2006, effective June 3, 2006, 36 Pa.B. 2667.

 (a)  As part of the CRNP program approval process, the CRNP program shall submit an outline of, and appropriate time line for, its planned evaluative process. The evaluative process must include, at a minimum, the following:

   (1)  A self-evaluation process completed by faculty, administrators and students of the CRNP program evidencing input into the CRNP program by faculty, administrators and students. The self-evaluative process must include:

     (i)   Peer evaluation of teacher effectiveness.

     (ii)   Student evaluation of teaching and program effectiveness.

     (iii)   Periodic evaluation of the program by faculty, students and graduates of the program.

     (iv)   Periodic evaluation of the program’s human and fiscal resources, program policies, facilities and services.

   (2)  Provisions for the program’s curriculum evaluation process, completed by faculty, students and graduates of the program. The curriculum must:

     (i)   Assess the program’s effectiveness relative to current standards of practice.

     (ii)   Assess the program’s effectiveness relative to current trends in education and health care.

     (iii)   Assess the program’s effectiveness in attaining program objectives.

     (iv)   Demonstrate that curriculum changes have been evaluated by the CRNP program faculty and are consistent with core competencies in the CRNP specialties.

   (3)  Provision for ongoing student evaluative process that assesses the student’s progress toward and ultimate achievement of program objectives. The student evaluative process must:

     (i)   Be evident in the course outlines provided to students at the beginning of each course.

     (ii)   Include documentation of faculty-supervised performance evaluation of students.

     (iii)   Utilize evaluation tools that reflect nurse practitioner National competencies in the specialty areas.

     (iv)   Include student evaluation of the quality of clinical experiences.

 (b)  Programs must measure outcomes of graduates at 1-year and 3-year intervals postgraduation.

   The provisions of this §  21.370 issued under sections 6.1 and 8.1 of the Professional Nursing Law (63 P. S. § §  216.1 and 218.1).

 Curriculum changes that require Board approval include changes in:

   (1)  Program objectives, course content or instruction that affect the integration of material into the total curriculum.

   (2)  An approved program which deems a new or different certification specialty title for graduates of that program requires approval as a new CRNP education program.

   The provisions of this §  21.371 issued under sections 6.1 and 8.1 of the Professional Nursing Law (63 P. S. § §  216.1 and 218.1).

 (a)  A clear statement of philosophy and purposes of the CRNP program, consistent with the philosophy and purposes of the college or university, shall be formulated and adopted.

 (b)  The philosophy, purposes and objectives of the CRNP program shall be developed and clearly stated by the faculty and be reviewed and revised at stated time intervals by this group.

 (c)  The philosophy and purposes of the CRNP program must be consistent with currently accepted social, educational and CRNP standards.

   The provisions of this §  21.372 issued under sections 6.1 and 8.1 of the Professional Nursing Law (63 P. S. § §  216.1 and 218.1).

   The provisions of this §  21.372 adopted June 2, 2006, effective June 3, 2006, 36 Pa.B. 2667.

 (a)  The support of the college or university must be adequate to meet CRNP program needs and include the following:

   (1)  Faculty and staff offices.

   (2)  Classrooms, conference rooms and laboratories.

   (3)  Administrative and secretarial support.

   (4)  Interactive information systems (computer/technical support) sufficient to develop, manage and evaluate the program.

 (b)  There must be current, appropriate, adequate and available learning resources to include audio/visual equipment, computers and library materials.

 (c)  The CRNP program must provide appropriate clinical resources and experience for students, including:

   (1)  Space for faculty’s and students’ needs.

   (2)  Exposure of appropriate duration to a patient population sufficient in number to insure that the student will meet program goals.

   (3)  Faculty to provide adequate supervision and evaluation.

     (i)   Supervision of all students in the clinical areas is the responsibility of the CRNP program faculty.

     (ii)   One program faculty member shall supervise no more than six students in a clinical course. If faculty are providing onsite preceptorship, the maximum ratio is two students per faculty member. If faculty are managing their own caseload of patients, the maximum ratio is one student per faculty member.

     (iii)   Onsite clinical preceptors may include:

       (A)   Advanced practice nurses who are currently licensed.

       (B)   Physicians who are currently licensed.

       (C)   CRNPs who are currently licensed and certified.

   The provisions of this §  21.373 issued under sections 6.1 and 8.1 of the Professional Nursing Law (63 P. S. § §  216.1 and 218.1).

   The provisions of this §  21.373 adopted June 2, 2006, effective June 3, 2006, 36 Pa.B. 2667.

 (a)  Policies and procedures related to the selection and admission of students are the responsibility of the individual program. Consideration must be given to scholastic aptitude, academic achievement, personal qualities and physical and emotional health necessary to fulfill the objectives of the program.

 (b)  Students admitted to CRNP programs shall meet the requirements for admission to the university or college for a master’s degree in nursing program and additional requirements that may be established for the CRNP program.

 (c)  Students admitted to CRNP programs shall have successfully completed the equivalent of a baccalaureate degree in nursing from an accredited institution of higher learning in a nursing program.

 (d)  Students admitted to CRNP programs shall be currently licensed as a registered nurse (RN) or, if enrolled in an RN to Master of Science in Nursing (MSN) or RN to Nursing Doctorate (ND) program, shall complete all competencies for undergraduate requirements prior to taking graduate courses.

   The provisions of this §  21.374 issued under sections 6.1 and 8.1 of the Professional Nursing Law (63 P. S. § §  216.1 and 218.1).

   The provisions of this §  21.374 adopted June 2, 2006, effective June 3, 2006, 36 Pa.B. 2667.

 The school shall have a written policy consistent with its philosophy and objectives concerning criteria for granting advanced standing. The policy of master’s degree programs must be consistent with that of the college or university.

   The provisions of this §  21.375 issued under sections 6.1 and 8.1 of the Professional Nursing Law (63 P. S. § §  216.1 and 218.1).

   The provisions of this §  21.375 adopted June 2, 2006, effective June 3, 2006, 36 Pa.B. 2667.

 (a)  The program shall employ a record system that ensures the operation of the program. Records shall be maintained in locked files which assure their safe keeping.

 (b)  Each nursing faculty shall select record forms specifically for the CRNP program that include the following:

   (1)  Student records, including the permanent record, containing both clinical and theoretical experience and achievement, shall be kept for 50 years.

   (2)  Faculty records, including the following:

     (i)   ‘‘Display portion’’ of current Pennsylvania licenses and certifications.

     (ii)   Records of preparation and experience, including official college transcripts.

     (iii)   Current records of continuing education activities.

     (iv)   Records of National certification, if applicable.

   (3)  Administrative records, including the following:

     (i)   Affiliation agreements with cooperating agencies.

     (ii)   Minutes of meetings.

     (iii)   Annual reports.

     (iv)   Follow-up studies of graduates.

     (v)   Budgets.

     (vi)   Current written policies.

   (4)  School bulletins, including the following:

     (i)   Comprehensive and current information.

     (ii)   Clearly defined refund policies governing fees and tuition paid by the students.

     (iii)   Clearly defined policies relating to admission, promotion, retention, transfer, advanced placement and dismissal.

   The provisions of this §  21.376 issued under sections 6.1 and 8.1 of the Professional Nursing Law (63 P. S. § §  216.1 and 218.1).

   The provisions of this §  21.376 adopted June 2, 2006, effective June 3, 2006, 36 Pa.B. 2667.

 (a)  When a program closes, the college or university is responsible for the safekeeping of the records of students for at least 50 years after graduation of the last class.

 (b)  If the college or university also closes, advice should be obtained from the Board concerning the permanent safekeeping and availability of the records of the school of nursing.

   The provisions of this §  21.377 issued under sections 6.1 and 8.1 of the Professional Nursing Law (63 P. S. § §  216.1 and 218.1).

   The provisions of this §  21.377 adopted June 2, 2006, effective June 3, 2006, 36 Pa.B. 2667.

   This section cited in 49 Pa. Code §  21.363 (relating to approval process).