DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS  
DIRECTOR’S OFFICE  
BOARD OF NURSING - GENERAL RULES  
Filed with the secretary of state on May 8, 2024  
These rules become effective immediately after filing with the secretary of state unless  
adopted under section 33, 44, or 45a(9) of the administrative procedures act of 1969,  
1969 PA 306, MCL 24.233, 24.244, or 24.245a. Rules adopted under these sections  
become effective 7 days after filing with the secretary of state.  
(By authority conferred on the director of the department of licensing and regulatory affairs  
by section 16141, 16145, 16148, 16174, 16175, 16178, 16181, 16182, 16184, 16186,  
16186a, 16201, 16204, 16205, 16206, 16215, 16287, 17210, 17213, and 17241 of the  
public health code, 1978 PA 368, MCL 333.16141, 333.16145, 333.16148, 333.16174,  
333.16175, 333.16178, 333.16181, 333.16182, 333.16184, 333.16186, 333.16186a,  
333.16201, 333.16204, 333.16205, 333.16206, 333.16215, 333.16287, 333.17210,  
333.17213, and 333.17241, and Executive Reorganization Order Nos. 1991-9, 1996-2,  
2003-1, and 2011-4, MCL 338.3501, 445.2001, 445.2011, and 445.2030)  
R 338.10101, R 338.10105, R 338.10202, R 338.10203, R 338.10204, R 338.10206,  
R 338.10207, R 338.10208, R 338.10208a, R 338.10209, R 338.10210, R 338.10211,  
R 338.10212, R 338.10212a, R 338.10213, R 338.10301, R 338.10303, R 338.10303a,  
R 338.10303b, R 338.10303c, R 338.10303d, R 338.10304, R 338.10305, R 338.10305a,  
R 338.10305b, R 338.10305c, R 338.10307, R 338.10308, R 338.10309, R 338.10310,  
R 338.10310a, R 338.10312, R 338.10402, R 338.10404, R 338.10404b, R 338.10404c, R  
338.10405, R 338.10405a, R 338.10405b, R 338.10601, R 338.10602, R 338.10703, and  
R 338.10704 of the Michigan Administrative Code are amended, as follows:  
PART 1. GENERAL PROVISIONS  
R 338.10101 Definitions.  
Rule 101. (1) As used in these rules:  
(a) “Board” means the Michigan board of nursing.  
(b) “CASN” means the Canadian Association of Schools of Nursing.  
(c) “CES” means the Credential Evaluation Service.  
(d) “CGFNS” means the Commission on Graduates of Foreign Nursing Schools.  
(e) “Code” means the public health code, 1978 PA 368, MCL 333.1101 to 333.25211.  
(f) “CP” means the CGFNS Certification Program.  
(g) “Department” means the department of licensing and regulatory affairs.  
(h) “FBI” means the Federal Bureau of Investigation.  
(i) “JS&A” means the Josef Silny & Associates, Inc. International Education  
Consultants.  
(j) “NACES” means the National Association of Credential Evaluation Services.  
February 16, 2024  
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(k) “NCSBN” means the National Council of State Boards of Nursing.  
(2) Unless otherwise defined in these rules, the terms defined in the code have the same  
meaning as used in these rules.  
R 338.10105 Training standards for identifying victims of human trafficking;  
requirements.  
Rule 105. (1) Under section 16148 of the code, MCL 333.16148, the individual who is  
licensed or seeking licensure shall have completed training in identifying victims of  
human trafficking that meets the following standards:  
(a) Training content must cover all of the following:  
(i) Understanding the types and venues of human trafficking in this state or the United  
States.  
(ii) Identifying victims of human trafficking in healthcare settings.  
(iii) Identifying the warning signs of human trafficking in healthcare settings for adults  
and minors.  
(iv) Identifying resources for reporting the suspected victims of human trafficking.  
(b) Acceptable providers or methods of training include any of the following:  
(i) Training offered by a nationally recognized or state-recognized health-related  
organization.  
(ii) Training offered by, or in conjunction with, a state or federal agency.  
(iii) Training obtained in an educational program that has been approved by the board  
for initial licensure, or by a college or university.  
(iv) Reading an article related to the identification of victims of human trafficking that  
meets the requirements of subdivision (a) of this subrule and is published in a peer-  
review journal, healthcare journal, or professional or scientific journal.  
(c) Acceptable modalities of training include any of the following:  
(i) Teleconference or webinar.  
(ii) Online presentation.  
(iii) Live presentation.  
(iv) Printed or electronic media.  
(2) The department may select and audit an individual and request documentation of  
proof of completion of training. If audited by the department, the individual shall  
provide acceptable proof of completion of training, including either of the following:  
(a) Proof of completion certificate issued by the training provider that includes the date,  
provider name, name of training, and individual’s name.  
(b) A self-certification statement by the individual. The certification statement must  
include the individual’s name and either of the following:  
(i) For training completed under subrule (1)(b)(i) to (iii) of this rule, the date, training  
provider name, and name of training.  
(ii) For training completed under subrule (1)(b)(iv) of this rule, the title of article,  
author, publication name of peer-review journal, healthcare journal, or professional or  
scientific journal, and the date, volume, and issue of publication, as applicable.  
PART 2. LICENSURE  
R 338.10202 Examination; adoption; passing scores.  
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Rule 202. The board approves and adopts the examinations developed by the NCSBN,  
identified as the "NCLEX-RN" for the registered nurse and the "NCLEX-PN" for the  
practical nurse. Examinees shall achieve a passing score on the NCLEX computerized  
adaptive test. The passing score is determined by the NCSBN.  
R 338.10203 Licensure by examination; registered professional nurse; requirements.  
Rule 203. (1) An applicant for licensure by examination shall submit a completed  
application on a form provided by the department, together with the requisite fee.  
(2) In addition to meeting the requirements of R 338.7001 to R 338.7005, and any rules  
promulgated under the code, an applicant shall satisfy the requirements of this rule.  
(3) An applicant shall establish that the applicant meets the eligibility requirements to sit  
for the NCLEX-RN examination set forth in R 338.10204 and pass the NCLEX-RN  
examination.  
(4) An applicant shall comply with section 16174(3) of the code, MCL 333.16174, by  
providing their fingerprints to the department of state police to have a criminal  
background check conducted by the state police and the FBI.  
(5) An applicant shall satisfy the requirements of section 16174(2) of the code, MCL  
333.16174, including verification from the issuing entity showing that disciplinary  
proceedings are not pending against the applicant and sanctions are not in force at the  
time of application.  
R 338.10204 Examinations; registered professional nurse; eligibility; reexaminations.  
Rule 204. (1) To determine eligibility for the NCLEX-RN examination, an applicant  
shall submit a completed application on forms provided by the department, together with  
the requisite fee.  
(2) To be eligible to take the NCLEX-RN examination, an applicant must establish that  
the applicant has successfully completed a registered nurse education program that  
satisfies 1 of the following:  
(a) The program is in this state and approved by the board.  
(b) The program is accredited by CASN.  
(c) The program is located in another state, and complies with either of the following:  
(i) The program is accredited by a nursing education accrediting agency listed in R  
338.10303d(2).  
(ii) If the program is not accredited by a nursing education accrediting agency listed in  
R 338.10303d(2), the applicant shall provide both of the following:  
(A) The applicant’s official transcripts from the academic institution where the  
nursing education program was completed.  
(B) Either of the following:  
(1) A letter to the department from the program, on official program letterhead,  
signed by the director of nursing, attesting that the program curriculum complies with  
both of the following:  
(a) The registered nurse education program includes courses providing theory and  
clinical practice that comply with R 338.10306 to R 338.10308.  
(b) The registered nurse education program curriculum contains the core curriculum  
for registered professional nurse students, as that term is defined in R 338.10301(l).  
(2) If the program is closed, a letter from the state board of nursing where the program  
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was located attesting that the nursing program was in good standing when the applicant  
completed the program.  
(d) The program is a registered professional nurse education program or an equivalent  
education program outside the United States and, the applicant submits 1 of the following  
to the department that shows the applicant graduated from a program with substantially  
equivalent education credentials as a program approved by the board:  
(i) A CES professional report from the CGFNS or its successor agency.  
(ii) A certification from the CGFNS CP or its successor agency.  
(iii) An Evaluation of Foreign Educational Credentials for Boards of Nursing from  
JS&A.  
(3) The department shall evaluate the proof of substantially equivalent education  
credentials in this subrule before the applicant receives authorization from the department  
to take the NCLEX-RN examination. Information about the CES professional report and  
CGFNS CP can be obtained from the CGFNS website at www.cgfns.org. Information  
about the Evaluation of Foreign Educational Credentials for Boards of Nursing from  
JS&A can be obtained from the JS&A website at https://www.jsilny.org/.  
(4) An applicant who did not pass the NCLEX-RN examination within 3 years after 1 of  
the following events is not eligible to repeat the NCLEX-RN examination until the  
applicant receives a written certification of skills competency covering the subjects in  
subrule (5) of this rule, from a nurse education program approved under R 338.10303a:  
(a) Graduation from a board-approved registered nurse education program under  
subrule (2)(a) of this rule or from a registered nurse education program accredited by  
CASN under subrule (2)(b) of this rule.  
(b) Satisfying the requirements of subrule 2(c) of this rule.  
(c) Obtaining 1 of the required evaluations or the certification in subrule (2)(d) of this  
rule.  
(5) A certification of skills competency must cover the following skills:  
(a) Head-to-toe physical assessment, including vital signs.  
(b) Medication administration.  
(c) Documentation.  
(d) Surgical asepsis and infection control.  
(e) Safety, including fall prevention, body mechanics, and transfers.  
(6) Except as otherwise provided under subrule (7) of this rule, the applicant has 1 year  
after the date of a certification of skills competency to pass the NCLEX-RN examination.  
(7) As an alternative to subrule (6) of this rule, on written application and  
documentation to support the request to the board, the board may grant up to a 6-month  
extension to the time requirement in subrule (4) of this rule to sit for the NCLEX-RN  
examination if the board finds the failure of the licensee to sit for the NCLEX-RN  
examination was due to the applicant’s disability, military service, absence from the  
continental United States, or a circumstance beyond the applicant’s control that the board  
considers good and sufficient.  
R 338.10206 Licensure by endorsement from another state or reciprocity from Canada;  
registered professional nurse; requirements.  
Rule 206. (1) An applicant who currently holds an active registered professional nurse  
license in good standing in another state and who has never been licensed as a registered  
professional nurse in this state may apply for a license by endorsement.  
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(2) The applicant is presumed to meet the requirements of section 16186 of the code,  
MCL 333.16186, if the applicant meets the requirements of R 338.7001 to R 338.7005;  
any rules promulgated under the code; submits a completed application, on a form  
provided by the department, together with the requisite fee; and complies with all of the  
following requirements:  
(a) Meets either of the following requirements:  
(i) Has been licensed or registered for not less than 5 years as a registered professional  
nurse in another state, was initially licensed by taking the NCLEX-RN examination,  
holds a license in good standing, and provides transcripts showing graduation from a  
nursing education program in another state.  
(ii) Is currently licensed in good standing in another state for less than 5 years, was  
initially licensed by taking the NCLEX-RN examination, and meets all of the following  
requirements:  
(A) Completes a registered nurse education program that meets either of the following  
requirements:  
(1) The program is located in this state and is approved by the board.  
(2) The program is located in another state and complies with 1 of the following:  
(a) The program is accredited by a nursing education accrediting agency listed in R  
338.10303d(2).  
(b) If the program is not accredited by a nursing education accrediting agency listed in  
R 338.10303d(2), the applicant shall provide all the following:  
(i) The applicant’s official transcripts.  
(ii) Provides either of the following:  
(A) A letter to the department from the program, on official program letterhead,  
signed by the director of nursing, attesting that the program curriculum complies with  
both of the following:  
(1) The registered nurse education program includes courses providing theory and  
clinical practice that comply with R 338.10306 to R 338.10308.  
(2) The registered nurse education program curriculum contains the core curriculum  
for registered professional nurse students as that term is defined in R 338.10301(l).  
(B) If the program is closed, a letter from the state board of nursing where the  
program was located attesting that the nursing program was in good standing when the  
applicant completed the program.  
(b) Discloses each license, registration, or certification in a health profession or  
specialty issued by another state, the United States military, the federal government, or  
another country on the application form.  
(c) Satisfies the requirements of section 16174(3) of the code, MCL 333.16174, by  
providing the applicant’s fingerprints to the department of state police to have a criminal  
background check conducted by the department of state police and the FBI.  
(d) Satisfies the requirements of section 16174(2) of the code, MCL 333.16174,  
including verification from the issuing entity showing that disciplinary proceedings are  
not pending against the applicant and sanctions are not in force at the time of application.  
(3) An applicant who currently holds an active professional nurse license in Canada,  
who has never been licensed as a registered professional nurse in this state, may apply for  
a license by reciprocity, and is presumed to meet the requirements of section 16186 of the  
code, MCL 333.16186, if the applicant meets the requirements of section 16174 of the  
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code, MCL 333.16174, submits a completed application, on a form provided by the  
department, together with the requisite fee, and complies with all of the following:  
(a) Meets the requirements of section 16174(3) of the code, MCL 333.16174, and  
submits the applicant’s fingerprints to the department of state police to have a criminal  
background check conducted by the department of state police and the FBI.  
(b) Meets either of the following:  
(i) Has been licensed or registered for not less than 5 years as a registered professional  
nurse in Canada, was initially licensed by passing the NCLEX-RN or the Canadian  
Registered Nurse Examination before 2015, holds a license in good standing, and  
provides transcripts showing the applicant graduated from a nursing education program  
in another state or Canada.  
(ii) Meets both of the following:  
(A) Is currently licensed in good standing in Canada for less than 5 years, and was  
initially licensed by passing the NCLEX-RN or the Canadian Registered Nurse  
Examination before 2015.  
(B) Completes a nursing education program accredited by a nursing education  
accrediting agency listed in R 338.10303d(2) or by the CASN.  
(c) Discloses each license, registration, or certification in a health profession or  
specialty issued by another state, the United States military, the federal government, or  
another country on the application form.  
(d) Satisfies the requirements of section 16174(2) of the code, MCL 333.16174,  
including verification from the issuing entity showing that disciplinary proceedings are  
not pending against the applicant and sanctions are not in force at the time of application.  
R 338.10207 Lapsed registered professional nurse license; relicensure requirements.  
Rule 207. (1) An applicant for relicensure whose registered professional nurse license  
has lapsed in this state, under section 16201(3) or (4) of the code, MCL 333.16201, as  
applicable, may be relicensed by complying with the following requirements as noted by  
(√):  
(a) For a registered professional  
nurse who has let their license lapse lapsed  
License  
License lapsed License lapsed  
more than 3 7 or more  
in this state and is not currently  
licensed in another state or a  
Canadian province:  
0-3 Years.  
years, but less years.  
than 7 years.  
(i) Submit a completed application  
on a form provided by the  
department, together with the  
requisite fee.  
(ii) Establish that the applicant is of  
good moral character, as that term is  
defined in, and determined under,  
1974 PA 381, MCL 338.41 to  
338.47.  
√
√
√
√
√
√
7
(iii) Submit fingerprints as required  
under section 16174(3) of the code,  
MCL 333.16174.  
√
√
(iv) Submit proof of having  
completed 25 hours of continuing  
education in courses and programs  
approved by the board, including not  
less than 2 hours in pain and  
symptom management, all of which  
were earned within the 2-year period  
immediately before the application  
for relicensure. However, if the  
continuing education hours  
√
submitted with the application are  
deficient, the applicant has 2 years  
after the date of the application to  
complete the deficient hours. The  
application must be held and the  
license may not be issued until the  
continuing education requirements  
are met.  
(v) Submit proof of having  
completed 25 hours of continuing  
education in courses and programs  
approved by the board, including not  
less than 2 hours in pain and  
symptom management, with a  
minimum of 3 hours in each of the  
following areas, all of which were  
earned within the 2-year period  
immediately before the date of the  
application for relicensure:  
√
√
(A) Safe documentation for nurses.  
(B) Critical thinking skills for  
nurses.  
(C) Pharmacology.  
(D) Preventing medication errors.  
(E) Professional and legal  
accountability for nurses.  
(F) Delegation.  
However, if the continuing education  
hours submitted with the application  
are deficient, the applicant has 2  
years after the date of the application  
to complete the deficient hours. The  
application must be held and the  
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license may be issued until the  
continuing education requirements  
are met.  
(vi) Meet the implicit bias training  
required under R 338.7004.  
(vii) Within 3 years immediately  
before the application for  
relicensure, receive written  
certification of skills competency  
from a nurse education program  
approved under R 338.10303a.  
Certification of competency must  
cover the following skills utilizing  
nursing process:  
√
√
√
√
√
(A) Head-to-toe physical  
assessment, including vital signs.  
(B) Medication administration.  
(C) Documentation.  
(D) Surgical asepsis and infection  
control.  
(E) Safety, including fall  
prevention, body mechanics, and  
transfers.  
(viii): Within 2 years immediately  
after approval of the application for  
relicensure, retake and pass the  
NCLEX-RN examination.  
(ix) An applicant who is or has ever  
been licensed, registered, or certified  
in a health profession or specialty by  
another state, the United States  
military, the federal government, or  
another country, shall do both of the  
following:  
√
√
√
√
(A) Disclose each license,  
registration, or certification on the  
application form.  
(B) Satisfy the requirements of  
section 16174(2) of the code, MCL  
333.16174, which include  
verification from the issuing entity  
showing that disciplinary  
proceedings are not pending against  
the applicant and sanctions are not in  
force at the time of application.  
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(b) For a registered professional  
License  
License lapsed License lapsed  
more than 3 7 or more  
years, but less years.  
than 7 years.  
nurse who has let their license lapse lapsed  
in this state, but who holds a current 0-3 Years.  
and valid registered professional  
nurse license in good standing in  
another state or a Canadian province:  
(i) Submit a completed application  
on a form provided by the  
department, together with the  
requisite fee.  
√
√
√
√
√
√
√
√
√
√
(ii) Establish that the applicant is of  
good moral character, as that term is  
defined in, and determined under,  
1974 PA 381, MCL 338.41 to  
338.47.  
(iii) Submit fingerprints as required  
under section 16174(3) of the code,  
MCL 333.16174.  
(iv) Submit proof of completion of  
25 hours of continuing education,  
including not less than 2 hours in  
pain and symptom management,  
earned within the 2-year period  
immediately before the application  
for relicensure. However, if the  
continuing education hours  
submitted with the application are  
deficient, the applicant has 2 years  
after the date of the application to  
complete the deficient hours. The  
application must be held and the  
license may not be issued until the  
continuing education requirements  
are met.  
√
(v) Meet the implicit bias training  
required under R 338.7004.  
(vi) An applicant who is or has ever  
been licensed, registered, or certified  
in a health profession or specialty by  
another state, the United States  
military, the federal government, or  
another country, shall do both of the  
following:  
√
√
√
√
√
√
(A) Disclose each license,  
registration, or certification on the  
application form.  
10  
(B) Satisfy the requirements of  
section 16174(2) of the code, MCL  
333.16174, including verification  
from the issuing entity showing that  
disciplinary proceedings are not  
pending against the applicant and  
sanctions are not in force at the time  
of application.  
(2) If relicensure is granted and it is determined that a sanction has been imposed by  
another state, the United States military, the federal government, or another country, the  
disciplinary subcommittee may impose appropriate sanctions under section 16174(5) of  
the code, MCL 333.16174.  
R 338.10208 Graduate from registered professional nurse education program outside of  
the United States or Canada; licensure requirements.  
Rule 208. (1) An applicant for a registered nurse license who graduated from a  
registered professional nurse education program from a country outside of the United  
States or Canada, shall submit a completed application on a form provided by the  
department, together with the requisite fee, and comply with the following requirements:  
(a) Meet the requirements of section 16174(3) of the code, MCL 333.16174, by  
providing the applicant’s fingerprints to the department of state police to have a criminal  
background check conducted by the department of state police and the FBI.  
(b) If the applicant has not passed the NCLEX-RN examination, the applicant shall  
establish that the applicant meets the eligibility requirements to sit for the NCLEX-RN  
examination set forth in R 338.10204 and pass the NCLEX-RN examination.  
(c) Except as provided in subrule (2) of this rule, if the applicant is a graduate of a  
registered professional nurse education program that is located outside of the United  
States or Canada, has passed the NCLEX-RN examination, and is not licensed in another  
state or is licensed in another state for less than 5 years, the applicant shall submit 1 of  
the following to the department that shows the applicant graduated from a program with  
substantially equivalent education credentials as a program approved by the board:  
(i) A CES professional report from the CGFNS or its successor agency.  
(ii) A certification from the CGFNS CP or its successor agency.  
(iii) An Evaluation of Foreign Educational Credentials for Boards of Nursing from  
JS&A.  
(d) Disclose each license, registration, or certification in a health profession or specialty  
issued by another state, the United States military, the federal government, or another  
country on the application form.  
(e) Satisfy the requirements of section 16174(2) of the code, MCL 333.16174,  
including verification from the issuing entity showing that disciplinary proceedings are  
not pending against the applicant and sanctions are not in force at the time of application.  
(f) Meet R 338.7001 to R 338.7005 and any rules promulgated under the code.  
(2) Under section 17213(2) of the code, MCL 333.177213, if the applicant is a graduate  
of a registered professional nurse education program that is located outside of the United  
States or Canada, the applicant is exempt from obtaining an evaluation or certification of  
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their educational credentials as required in subrule (1)(c) of this rule if the applicant  
meets both of the following requirements:  
(a) The applicant has passed the NCLEX-RN examination.  
(b) The applicant has maintained an active license in good standing with no disciplinary  
sanctions in another state for 5 years or more immediately before the application for a  
license in this state.  
R 338.10208a Graduate from registered professional nurse education program in Canada;  
licensure requirements.  
Rule 208a. An applicant for a registered nurse license in this state, who graduated from  
a registered professional nurse education program in Canada, and is not licensed in  
Canada, shall submit a completed application on a form provided by the department,  
together with the requisite fee, and comply with the following requirements:  
(a) Meet the requirements of section 16174(3) of the code, MCL 333.16174, by  
providing the applicant’s fingerprints to the department of state police to have a criminal  
background check conducted by the department of state police and the FBI.  
(b) If the applicant has not passed the NCLEX-RN examination, the applicant shall  
establish that the applicant meets the eligibility requirements to sit for the NCLEX-RN  
examination set forth in R 338.10204 and pass the NCLEX-RN examination.  
(c) If the applicant has passed the NCLEX-RN examination, the applicant shall submit 1  
of the following to the department that shows the applicant graduated from a program  
with substantially equivalent education credentials as a program approved by the board:  
(i) Proof of program accreditation by the CASN.  
(ii) A CES professional report from the CGFNS or its successor agency.  
(iii) A certification from the CGFNS CP or its successor agency.  
(iv) An Evaluation of Foreign Educational Credentials for Boards of Nursing from  
JS&A.  
(d) Disclose each license, registration, or certification in a health profession or specialty  
issued by another state, the United States military, the federal government, or another  
country on the application form.  
(e) Satisfy the requirements of section 16174(2) of the code, MCL 333.16174, including  
verification from the issuing entity showing that disciplinary proceedings are not pending  
against the applicant and sanctions are not in force at the time of application.  
(f) Meet R 338.7001 to R 338.7005 and any rules promulgated under the code.  
R 338.10209 Licensure by examination; licensed practical nurse; requirements.  
Rule 209. (1) An applicant for licensure by examination shall submit a completed  
application on a form provided by the department, together with the requisite fee.  
(2) In addition to meeting the requirements of R 338.7001 to R 338.7005, and any rules  
promulgated under the code, an applicant shall satisfy the requirements of this rule.  
(3) An applicant shall establish that the applicant meets the eligibility requirements to  
sit for the NCLEX-PN examination set forth in R 338.10210 and pass the NCLEX-PN  
examination.  
(4) An applicant shall comply with section 16174(3) of the code, MCL 333.16174, by  
providing their fingerprints to the department of state police to have a criminal history  
check conducted by the state police and the FBI.  
12  
(5) An applicant shall satisfy the requirements of section 16174(2) of the code, MCL  
333.16174, including verification from the issuing entity showing that disciplinary  
proceedings are not pending against the applicant and sanctions are not in force at the  
time of application.  
R 338.10210 Examinations; licensed practical nurse; eligibility; reexaminations.  
Rule 210. (1) To determine eligibility for the NCLEX-PN examination, an applicant  
shall submit a completed application on forms provided by the department, together with  
the requisite fee.  
(2) To be eligible to take the NCLEX-PN examination, an applicant shall establish that  
the applicant has successfully completed a licensed practical nurse education program  
that satisfies 1 of the following:  
(a) The applicant has successfully completed a practical nurse education program that is  
located in this state and is approved by the board.  
(b) The applicant has successfully completed a practical nurse education program  
accredited by CASN.  
(c) The applicant has successfully completed a practical nurse education program that is  
located in another state and that program complies with either of the following:  
(i) Is accredited by a nursing education accrediting agency listed in R 338.10303d(2).  
(ii) If the program is not accredited by a nursing education accrediting agency listed in  
R 338.10303(d)(2), the applicant shall provide all the following:  
(A) The applicant’s official transcripts from the academic institution where the  
nursing education program was completed.  
(B) Provide either of the following:  
(1) A letter to the department from the program, on official program letterhead,  
signed by the director of nursing, attesting that the program curriculum complies with  
both of the following:  
(a) The practical nursing education program is not less than 40 weeks in duration and  
includes courses in both theory and clinical practice that comply with R 338.10306, R  
338.10307, and R 338.10309.  
(b) The practical nursing education program curriculum contains the core curriculum  
for licensed practical nurse students, as that term is defined in R 338.10301(k).  
(2) If the program is closed, a letter from the state board of nursing where the program  
was located attesting that the nursing program was in good standing when the applicant  
completed the program.  
(d) The applicant is a graduate of a practical nurse education program or an equivalent  
education program that is outside the United States and the applicant submits 1 of the  
following to the department that shows the applicant graduated from a program with  
substantially equivalent education credentials as a program approved by the board:  
(i) A CES professional report from the CGFNS, or its successor agency.  
(ii) An Evaluation of Foreign Educational Credentials for Boards of Nursing from  
JS&A.  
(iii) A certification from the NACES, or its successor agency.  
(e) The applicant has completed a registered nurse education program and requests to  
sit for the NCLEX-PN examination. The applicant shall comply with both of the  
following:  
13  
(i) The applicant has completed a registered nurse education program that meets the  
requirements of R 338.10204(2).  
(ii) The applicant is certified to take the NCLEX-PN examination by a practical nurse  
program from the same institution as the registered nurse education program that has  
been approved by the board under subdivision (a) of this subrule.  
(3) The department shall evaluate the proof of substantially equivalent education  
credentials in subrule (2)(c) of this rule before the applicant receives authorization from  
the department to take the NCLEX-PN examination. Information about the CES  
professional report can be obtained from the CGFNS website at www.cgfns.org.  
Information about the Evaluation of Foreign Educational Credentials for Boards of  
Nursing from JS&A can be obtained from the JS&A website at https://www.jsilny.org/.  
A list of NACES approved credentialing agencies can be found on its website at  
www.naces.org.  
(4) Except as otherwise provided in subrule (7) of this rule, an applicant who did not  
pass the NCLEX-PN examination within 3 years after 1 of the following events is not  
eligible to repeat the NCLEX-PN examination until the applicant receives a written  
certification of skills competency covering the subjects in subrule (5) of this rule, from a  
nurse education program approved under R 338.10303a:  
(a) Graduation from a board-approved practical nurse education program under subrule  
(2)(a) of this rule or from a practical nurse education program accredited by CASN under  
subrule (2)(b) of this rule. (b) Satisfying the requirements of subrule (2)(c) of this rule.  
(c) Obtaining 1 of the required evaluations or certifications in subrule (2)(d) of this rule.  
(d) Graduation from a board approved registered nurse education program under  
subrule (2)(e) of this rule.  
(5) A certification of skills competency must cover the following skills:  
(a) Head-to-toe physical assessment, including vital signs.  
(b) Medication administration.  
(c) Documentation.  
(d) Surgical asepsis and infection control.  
(e) Safety, including fall prevention, body mechanics, and transfers.  
(6) The applicant has 1 year after the date of a certification of skills competency to pass  
the NCLEX-PN examination.  
(7) On written application and documentation to support the request to the board, the  
board may grant up to a 6-month extension to the time requirement in subrule (4) of this  
rule to sit for the NCLEX-PN examination if the board finds the failure of the licensee to  
sit for the NCLEX-PN examination was due to the applicant’s disability, military service,  
absence from the continental United States, or a circumstance beyond their control which  
the board considers good and sufficient.  
R 338.10211 Licensure by endorsement from another state; licensure by reciprocity from  
Canada; licensed practical nurse; requirements.  
Rule 211. (1) An applicant who currently holds an active practical nurse license in good  
standing from another state and who has never been licensed as a practical nurse in this  
state may apply for a license by endorsement.  
(2) The applicant is presumed to meet the requirements of section 16186 of the code,  
MCL 333.16186, if the applicant meets the requirements of R 338.7001 to R 338.7005;  
14  
any rules promulgated under the code; submits a completed application, on a form  
provided by the department, together with the requisite fee; and complies with all of the  
following requirements:  
(a) Meets 1 of the following requirements:  
(i) Has been licensed or registered for not less than 5 years as a practical nurse in  
another state, was initially licensed by taking the NCLEX-PN examination, holds a  
license in good standing, and provides transcripts showing graduation from a nursing  
education program in another state.  
(ii) Is currently licensed in good standing in another state for less than 5 years, was  
initially licensed by taking the NCLEX-PN examination, and meets all of the following  
requirements:  
(A) Completes a practical nurse education program that meets either of the following  
requirements:  
(1) The program is located in this state and is approved by the board.  
(2) The program is located in another state and the program complies with either of  
the following:  
(a) The program is accredited by a nursing education accrediting agency listed in R  
338.10303d(2).  
(b) If the program is not accredited by a nursing education accrediting agency  
listed in R 338.10303(d)(2), the applicant shall provide all of the following:  
(i) The applicant’s official transcripts.  
(ii) Provides either of the following:  
(A) A letter to the department on official program letterhead, signed by the  
director of nursing, attesting that the program curriculum complies with both of the  
following:  
(1) The practical nursing education program is not less than 40 weeks in  
duration and includes courses in both theory and clinical practice that comply with R  
338.10306, R 338.10307, and R 338.10309.  
(2) The practical nursing education program curriculum contains the core  
curriculum for licensed practical nurse students as that term is defined in R 338.10301(k).  
(B) If the program is closed, a letter from the state board of nursing where the  
program was located attesting that the nursing program was in good standing when the  
applicant completed the program.  
(b) Discloses each license, registration, or certification in a health profession or  
specialty issued by another state, the United States military, the federal government, or  
another country on the application form.  
(c) Satisfies the requirements of section 16174(2) of the code, MCL 333.16174,  
including verification from the issuing entity showing that disciplinary proceedings are  
not pending against the applicant and sanctions are not in force at the time of application.  
(d) Satisfies the requirements of section 16174(3) of the code, MCL 333.16174, by  
providing the applicant’s fingerprints to the department of state police to have a criminal  
background check conducted by the department of state police and the FBI.  
(3) An applicant who currently holds an active practical nurse license in Canada who  
has never been licensed as a practical nurse in this state may apply for a license by  
reciprocity and is presumed to meet the requirements of section 16186 of the code, MCL  
15  
333.16186, if the applicant submits a completed application, on a form provided by the  
department, together with the requisite fee, and complies with all the following:  
(a) Meets the requirements of section 16174(3) of the code, MCL 333.16174, by  
providing the applicant’s fingerprints to the department of state police to have a criminal  
background check conducted by the department of state police and the FBI.  
(b) Meets either of the following:  
(i) Has been licensed or registered for not less than 5 years as a practical nurse in  
Canada, was initially licensed by passing the NCLEX-PN examination or the Practical  
Nurse Registration Examination, holds a license in good standing, and provides  
transcripts showing the applicant graduated from a nursing education program in another  
state or Canada.  
(ii) Meets both of the following:  
(A) Is currently licensed in good standing for less than 5 years in Canada and was  
initially licensed by passing the NCLEX-PN or the Practical Nurse Registration  
Examination.  
(B) Completes a nursing education program accredited by a nursing education  
accrediting agency listed in R 338.10303d(2) or by the CASN.  
(c) Discloses each license, registration, or certification in a health profession or  
specialty issued by another state, the United States military, the federal government, or  
another country on the application form.  
(d) Satisfies the requirements of section 16174(2) of the code, MCL 333.16174,  
including verification from the issuing entity showing that disciplinary proceedings are  
not pending against the applicant and sanctions are not in force at the time of application.  
R 338.10212 Graduate of a practical nurse education program outside of the United  
States and Canada; licensure requirements.  
Rule 212. (1) An applicant for a practical nurse license who graduated from a nurse  
education program from a country outside of the United States or Canada, shall submit a  
completed application on a form provided by the department, together with the requisite  
fee, and comply with the following requirements:  
(a) Meet the requirements of section 16174(3) of the code, MCL 333.16174, by  
providing the applicant’s fingerprints to the department of state police to have a criminal  
background check conducted by the department of state police and the FBI.  
(b) If the applicant has not passed the NCLEX-PN examination, the applicant shall  
establish that the applicant meets the eligibility requirements to sit for the NCLEX-PN  
examination set forth in R 338.10210 and pass the NCLEX-PN examination.  
(c) Except as provided in subrule (2) of this rule, if the applicant is a graduate of a  
licensed practical nurse education program that is located outside of the United States, or  
Canada, has passed the NCLEX-PN examination, and is not licensed in another state or is  
licensed in another state for less than 5 years, the applicant shall submit 1 of the  
following to the department that shows the applicant graduated from a program with  
substantially equivalent education credentials as a program approved by the board:  
(i) A CES professional report from the CGFNS, or its successor agency.  
(ii) An Evaluation of Foreign Educational Credentials for Boards of Nursing from  
JS&A.  
(iii) A certification from the NACES or its successor agency.  
16  
(d) Disclose each license, registration, or certification in a health profession or specialty  
issued by another state, the United States military, the federal government, or another  
country on the application form.  
(e) Satisfy the requirements of section 16174(2) of the code, MCL 333.16174,  
including verification from the issuing entity showing that disciplinary proceedings are  
not pending against the applicant and sanctions are not in force at the time of application.  
(f) Meet R 338.7001 to R 338.7005 and any rules promulgated under the code.  
(2) If the applicant is a graduate of a licensed practical nurse education program that is  
located outside of the United States or Canada, the applicant is exempt from obtaining an  
evaluation or certification as required in subrule (1)(c) of this rule if the applicant meets  
both of the following requirements:  
(a) The applicant has passed the NCLEX-PN examination.  
(b) The applicant has maintained an active license in good standing with no disciplinary  
sanctions in another state for 5 years or more immediately before the application for a  
license in this state.  
R 338.10212a Graduate from practical nurse education program in Canada; licensure  
requirements.  
Rule 212a. An applicant for a practical nurse license who graduated from a practical  
nurse education program in Canada, and is not licensed in Canada, shall submit a  
completed application on a form provided by the department, together with the requisite  
fee, and comply with the following requirements:  
(a) Meet the requirements of section 16174(3) of the code, MCL 333.16174, by  
providing the applicant’s fingerprints to the department of state police to have a criminal  
background check conducted by the department of state police and the FBI.  
(b) If the applicant has not passed the NCLEX-PN examination approved by the board,  
the applicant shall establish that the applicant meets the eligibility requirements to sit for  
the NCLEX-PN examination set forth in R 338.10210 and pass the NCLEX-PN  
examination.  
(c) If the applicant has passed the NCLEX-PN examination, the applicant shall submit 1  
of the following to the department that shows the applicant graduated from a program  
with substantially equivalent education credentials as a program approved by the board:  
(i) Proof of program accreditation by the College of Nurses of Ontario.  
(ii) A CES professional report from the CGFNS or its successor agency.  
(iii) An Evaluation of Foreign Educational Credentials for Boards of Nursing from  
JS&A.  
(iv) A certification from the NACES or its successor agency.  
(d) Disclose each license, registration, or certification in a health profession or specialty  
issued by another state, the United States military, the federal government, or another  
country on the application form.  
(e) Satisfy the requirements of section 16174(2) of the code, MCL 333.16174, including  
verification from the issuing entity showing that disciplinary proceedings are not pending  
against the applicant and sanctions are not in force at the time of application.  
(f) Meet R 338.7001 to R 338.7005 and any rules promulgated under the code.  
R 338.10213 Lapsed licensed practical nurse license; relicensure requirements.  
17  
Rule 213. (1) An applicant for relicensure whose licensed practical nurse license in this  
state has lapsed under section 16201(3) or (4) of the code, MCL 333.16201, may be  
relicensed by complying with the following requirements as noted by (√):  
(a) For a licensed practical nurse who has let their License  
License  
License  
licensed practical nurse license in this state lapse  
and is not currently licensed in another state or a  
Canadian province:  
lapsed  
0-3  
Years.  
lapsed more lapsed  
than 3  
7 or  
years, but  
less than 7  
years.  
more  
years.  
(i) Submit a completed application on a form  
provided by the department, together with the  
requisite fee.  
(ii) Establish that the applicant is of good moral  
character, as that term is defined in, and  
determined under, 1974 PA 381, MCL 338.41 to  
338.47.  
√
√
√
√
√
√
(iii) Submit fingerprints as set forth in section  
16174(3) of the code, MCL 333.16174.  
(iv) Submit proof of having completed 25 hours of  
continuing education in courses and programs  
approved by the board, including not less than 2  
hours in pain and symptom management, all of  
which were earned within the 2-year period  
immediately before the application for relicensure.  
However, if the continuing education hours  
submitted with the application are deficient, the  
applicant has 2 years after the date of the  
application to complete the deficient hours. The  
application must be held and the license may not  
be issued until the continuing education  
requirements are met.  
√
√
√
(v) Submit proof of having completed 25 hours of  
continuing education in courses and programs  
approved by the board, including not less than 2  
hours in pain and symptom management, with a  
minimum of 3 hours in each of the following  
areas, all of which were earned within the 2-year  
period immediately before the application for  
relicensure:  
√
√
(A) Safe documentation for nurses.  
(B) Critical thinking skills for nurses.  
(C) Pharmacology.  
(D) Preventing medication errors.  
(E) Professional and legal accountability for  
nurses.  
18  
However, if the continuing education hours  
submitted with the application are deficient, the  
applicant has 2 years after the date of the  
application to complete the deficient hours. The  
application must be held and the license may not  
be issued until the continuing education  
requirements are met.  
(vi) Meet the implicit bias training required under  
R 338.7004.  
√
√
√
√
√
(vii) Within 3 years immediately before the  
application for relicensure, receive written  
certification of skill competency from a nurse  
education program approved under R 338.10303a.  
Certification of competency must cover the  
following skills:  
(A) Head-to-toe physical assessment, including  
vital signs.  
(B) Medication administration.  
(C) Documentation.  
(D) Surgical asepsis and infection control.  
(E) Safety, including fall prevention, body  
mechanics, and transfers.  
(viii) Within 2 years immediately after approval of  
the application for relicensure, retake and pass the  
NCLEX-PN examination.  
√
√
(ix) An applicant who is or has ever been licensed,  
registered, or certified in a health profession or  
specialty by another state, the United States  
military, the federal government, or another  
country, shall do both of the following:  
(A) Disclose each license, registration, or  
certification on the application form.  
(B) Satisfy the requirements of section 16174(2)  
of the code, MCL 333.16174, including  
verification from the issuing entity showing that  
disciplinary proceedings are not pending against  
the applicant and sanctions are not in force at the  
time of application.  
√
√
(b) For a licensed practical nurse who has let their License  
License  
License  
license in this state lapse, but who holds a current  
and valid licensed practical nurse license in good  
standing in another state or a Canadian province:  
lapsed  
0-3  
Years.  
lapsed more lapsed  
than 3  
7 or  
years, but  
less than 7  
years.  
more  
years.  
19  
(i) Submit a completed application on a form  
provided by the department, together with the  
requisite fee.  
(ii) Establish that the applicant is of good moral  
character, as that term is defined in, and  
determined under, 1974 PA 381, MCL 338.41 to  
338.47.  
√
√
√
√
√
√
(iii) Submit fingerprints as set forth in section  
16174(3) of the code, MCL 333.16174.  
(iv) Submit proof of completion of 25 hours of  
continuing education, including not less than 2  
hours in pain and symptom management, all of  
which was earned within the 2-year period  
immediately before the application for relicensure.  
However, if the continuing education hours  
submitted with the application are deficient, the  
applicant has 2 years after the date of the  
application to complete the deficient hours. The  
application must be held and the license may not  
be issued until the continuing education  
requirements are met.  
√
√
√
√
(v) Meet the implicit bias training required under  
R 338.7004.  
√
√
√
√
√
√
(vi) An applicant who is or has ever been licensed,  
registered, or certified in a health profession or  
specialty by another state, the United States  
military, the federal government, or another  
country, shall do both of the following:  
(A) Disclose each license, registration, or  
certification on the application form.  
(B) Satisfy the requirements of section 16174(2)  
of the code, MCL 333.16174, including  
verification from the issuing entity showing that  
disciplinary proceedings are not pending against  
the applicant and sanctions are not in force at the  
time of application.  
(2) If relicensure is granted and it is determined that a sanction has been imposed by  
another state, the United States military, the federal government, or another country, the  
disciplinary subcommittee may impose appropriate sanctions under section 16174(5) of  
the code, MCL 333.16174.  
PART 3. NURSING EDUCATION PROGRAMS  
R 338.10301 Definitions.  
Rule 301. (1) As used in this part:  
20  
(a) “Accreditation” means a self-regulatory process that meets or exceeds educational  
quality standards and criteria set forth by a national nursing education accrediting  
organization.  
(b) “Accrediting organization” means a board approved accrediting organization of  
nursing education programs listed in R 338.10303d.  
(c) “Accredited program” means a program that has obtained accreditation from a  
board approved accrediting organization of nursing education programs, as that term is  
defined in R 338.10303d.  
(d) “ADN” means an associate’s degree in nursing.  
(e) “Capstone course” means a clinical experience completed in the final year of the  
nursing education program that synthesizes the cognitive, affective, and psychomotor  
skills acquired throughout the program to prepare the student for professional nursing  
practice.  
(f) "Clinical experience" means direct nursing care experiences with actual patients or  
clients that offer students the opportunity to integrate, apply, and refine specific skills and  
abilities that are based on theoretical concepts and scientific principles. Clinical  
experience may include simulated nursing experiences subject to R 338.10306 and R  
338.10309.  
(g) "Clinical laboratory hours" means those hours of the curriculum that are assigned to  
laboratory practice, basic skills training, and observational experiences that offer the  
student the opportunity to meet educational outcomes.  
(h) “Cohort” means a group of students admitted in the same academic semester or  
term with the intention of completing the nursing program at the same graduation date.  
Cohort includes students who transfer into the program at the same academic level.  
(i) “Conceptual framework” means the distinct, systematic organization of concepts and  
planned student outcomes of the program that are consistent with relevant professional  
nursing standards and the mission, goals, philosophy, and purposes of the sponsoring  
institution, and gives direction to the curriculum.  
(j) “Cooperating agency” means an individual, organization, or institution that, by  
written agreement or letter of intent, accepts students and faculty for nursing educational  
experiences.  
(k) “Core curriculum for licensed practical nurse students” means courses in didactic  
instruction and planned clinical experience, which encompass the LPN scope of practice,  
in each of the following areas of nursing:  
(i) Adult health nursing, which must consist of the study of nursing care throughout  
the adult lifespan; providing care for the acute and chronic phases of a medical illness;  
health promotion; and disease prevention.  
(ii) Maternal and reproductive nursing, which must consist of the study of nursing care  
for women and their families in the gynecological, antepartum, labor and delivery, and  
postpartum phases of pregnancy, and includes the care of a newborn infant.  
(iii) Children’s nursing, which must consist of the study of nursing care for children  
whose ages range from birth through adolescence and who are receiving nursing care for  
both medical and surgical reasons.  
(iv) Surgical nursing, which must consist of the study of nursing care throughout the  
adult lifespan, providing care before, during, and after a surgical procedure, health  
promotion, and disease prevention.  
21  
(l) “Core curriculum for registered professional nurse students” means didactic  
instruction and planned clinical experience, which encompass the RN scope of practice,  
in each of the following areas of nursing:  
(i) Adult health nursing, which must consist of the study of nursing care throughout the  
adult lifespan; providing care for the acute or chronic phases of a medical illness; health  
promotion; and disease prevention.  
(ii) Maternal and reproductive nursing, which must consist of the study of nursing care  
for women and their families in the gynecological, antepartum, labor and delivery, and  
postpartum phases of pregnancy, and includes the care of a newborn infant.  
(iii) Children’s nursing, which must consist of the study of nursing care for children  
whose ages range from birth through adolescence and who are receiving nursing care for  
both medical and surgical reasons.  
(iv) Psychiatric/mental health nursing, which must consist of the study of nursing care  
of individuals with an acute or chronic mental health or psychiatric disorder.  
(v) Surgical nursing, which must consist of the study of nursing care throughout an  
adult lifespan, providing care before, during, and after a surgical procedure, health  
promotion, and disease prevention.  
(m) “Course student learning outcomes” means statements of educational expectations  
written in measurable terms for the knowledge, skills, or behaviors students must  
demonstrate by the end of the course. The statements must reflect contemporary  
evidence-based nursing practice and enhance achievement of end of program student  
learning outcomes.  
(n) “Curriculum” means implementation of appropriate learning experiences that  
accomplish measurable course and program outcomes, which incorporate the nursing  
program’s purpose, philosophy, and conceptual framework of the nursing program  
through the systematic arrangement of courses. This includes outcomes stated in  
measurable terms and accomplished through appropriate learning experiences planned for  
a clearly defined group of students and extending over a defined period of time  
depending on the type of nursing education program. Systematic and ongoing evaluation  
within the context of measurable outcomes is inherent in the curriculum.  
(o) “End of program student learning outcomes” means statements of educational  
expectations written in measurable terms for the knowledge, skills, or behaviors students  
must demonstrate by the end of the program. The statements must reflect professional  
standards, guidelines, contemporary nursing practice, guide the curriculum, and increase  
in complexity as students progress through the curriculum.  
(p) “Final program approval report” means an updated self-study done after the  
graduation of the second cohort and before the graduation of the fourth cohort that is  
submitted to the board when the program is seeking full program approval.  
(q) “Full program approval” means approval of a program granted after satisfactory  
demonstration to the board of compliance with these rules.  
(r) “Initial approval” means approval that is granted by the board to inaugurate a  
program of nursing education.  
(s) “Instruction” means educational methodology for achieving curriculum outcomes.  
(t) “Learning experiences” means planned learning situations, which may include  
clinical experiences, clinical laboratory hours, or classroom instruction.  
(u) “MSN” means a master’s of science in nursing.  
22  
(v) “Nurse site reviewer” means a nurse with expertise in curriculum development  
and nursing program administration or education that independently examines a nursing  
program applying for program approval.  
(w) “Nursing education program report” means a report completed and submitted  
between the self-study submissions. It provides the board with information as to the  
program’s admissions, attrition, courses, clinical experience, faculty program evaluation,  
and outcomes and is submitted as follows:  
(i) For programs that have received initial approval under R 338.10303, the report must  
be submitted each year during the program approval phase.  
(ii) For programs that have received full approval under R 338.10303a, the report must  
be completed and submitted at the halfway point between the self-study submissions.  
(x) “Nursing faculty” means a member of the faculty qualified to teach nursing courses  
and evaluate learning.  
(y) “Nursing process” means the ongoing assessment, analysis, nursing diagnosis,  
planning, implementation, and evaluation of nursing care.  
(z) “Observational experience” means a planned learning situation that is not direct  
patient care, does not require intervention by the student, meets preplanned stated  
outcomes, and provides for student evaluation.  
(aa) “Philosophy” means the stated beliefs of faculty about nursing education and  
practice that determine the design of the curriculum and the evaluation of the program  
and that are consistent with the educational philosophy of the sponsoring agency.  
(bb) “Practical nurse program” means a nursing program to prepare students for  
practical nurse licensure.  
(cc) “Preceptor” means an experienced nurse, paired in a 1-to-1 relationship with a  
nursing student, who actively participates in the education, mentoring, and evaluation of  
the nursing student in a clinical setting.  
(dd) “Probationary status” means the period when a program is under disciplinary  
action by the board.  
(ee) “Program director” means a nurse who is delegated the authority and  
accountability for the nursing program by the sponsoring agency.  
(ff) “Program of nursing education” means a plan or design indicating the relationship  
of the components necessary to achieve the goal of preparing individuals for licensure as  
registered or practical nurses under the code.  
(gg) “Program outcomes” means documented and measurable indicators that reflect the  
program’s overall effectiveness.  
(hh) “Registered professional nurse program” means a nursing program to prepare  
students for initial registered nurse licensure.  
(ii) “Self-study report” means an in-depth written review of all aspects of a nursing  
education program that contains evidence of the program’s compliance with all the  
requirements of these rules.  
(jj) “Simulation laboratory” means activities that replicate patient care scenarios and are  
designed to foster clinical decision-making and critical thinking. Scenarios may include  
the use of medium or high-fidelity mannequins, standardized patients, role playing, skills  
stations, and computer-based critical thinking simulations.  
23  
(kk) “Site visit” means a physical inspection of an institution and all the components of  
its program of nursing education for the purpose of determining compliance with the  
requirements of this part.  
(ll) “Sponsoring agency” means the organization or institution of which the nursing  
program is a component.  
(mm) “Unaccredited program” means a program that has not obtained accreditation  
from a board approved accrediting organization of nursing education programs, as that  
term is defined in R 338.10303d.  
(2) Unless otherwise defined in the rules, the terms defined in the code have the same  
meaning as used in these rules.  
R 338.10303 Initial program approval; procedure.  
Rule 303. The following requirements are established for initial approval of a program  
of nursing education:  
(a) The sponsoring agency shall submit all the following to the board:  
(i) A letter of intent to initiate a program of nursing education.  
(ii) A feasibility study that demonstrates all the following, with supporting  
documentation relative to the proposed program location:  
(A) Need for the program.  
(B) Need for graduates of the proposed program.  
(C) Availability of students.  
(D) Impact on all existing nursing education programs in a 50-mile radius of the  
proposed program. The applying institution is responsible for surveying schools within  
the radius to determine the perceived impact the proposed program will have on the  
availability of the existing program’s clinical placements, faculty, and student  
recruitment.  
(E) Ability of proposed clinical education sites to provide students with clinical  
experiences that meet course outcomes, provide students the opportunity to practice skills  
with individuals or groups across the life span and meet the requirements of R  
338.10307(5), (6), (7), and (8). Evidence must also include documentation of the effect  
on other schools utilizing the proposed clinical facilities and letters of intent from the  
proposed clinical education sites, signed by the chief nursing officer, or an equivalent  
position, outlining the plan to accommodate all the sponsoring agency’s students.  
(iii) Evidence that the mission of the sponsoring agency is consistent with the  
philosophy and purpose of a program to prepare students for the practice of nursing.  
(iv) Evidence that the sponsoring agency shall provide funding and other support for  
the nursing education program that meets all the following requirements:  
(A) A 5-year budget in which the first 2 years of the budget do not include tuition and  
the remaining 3 years of the budget includes tuition.  
(B) A financial statement prepared by an independent certified public accountant or  
auditor, a bank line of credit, or a surety bond that equals the total tuition for all students  
who have been enrolled for 2 years.  
(C) Submission of evidence that the sponsoring agency shall provide appropriate  
physical facilities and other support services for the nursing education program, in  
conjunction with other departments in the sponsoring agency, including faculty,  
administration, and student participation in governance of the sponsoring agency, a  
24  
grievance or complaint process, counseling, academic advising, career placement,  
financial aid, and learning resource centers or a library.  
(v) Evidence of approval to provide financial aid for students, under Title IV of the  
Higher Education Act of 1965, 20 USC 1070 to 1099d. If the sponsoring agency is  
unable to submit evidence that it is approved to provide financial aid under Title IV of the  
Higher Education Act of 1965, 20 USC 1070 to 1099d, until after the board approves the  
program, the program, with board approval, may submit the evidence to the department  
before enrolling students to the program.  
(vi) A sponsoring agency that is an institution requiring approval from the department’s  
proprietary schools unit, or its successor agency, to conduct a nursing education program  
or to confer a particular degree or certificate on the graduates of the program shall submit  
to the board a copy of the approval. A proprietary school shall possess a state-issued  
license, be in operation for 2 years, offer health-related programs, and demonstrate  
student success with results that meet or exceed state or national averages.  
(vii) Proposed number of students to be enrolled in the program annually, the number  
of times that enrollment periods are held per year, and the dates when enrollment periods  
are held annually.  
(viii) Proposed first date of admission of students to the nursing sequence of the  
program.  
(ix) Plans to recruit and employ a program director and other nursing faculty members  
sufficiently in advance of admitting students to the nursing sequence to ensure  
consistency in the planning and implementation of the curriculum. The plan should  
include a timeline for recruitment and disclose recruitment resources. If already  
appointed, the names and qualifications of the director of the program and other nursing  
faculty members must be provided.  
(x) The sponsoring agency shall provide evidence of a tuition policy in which students  
pay as they proceed through the program either by semesters, terms, units, or other time  
frame as specified by the sponsoring agency. The sponsoring agency shall also provide  
evidence of a refund policy that adheres to the refund policies of applicable state, federal,  
and accrediting agencies.  
(xi) Evidence that students possess the necessary prerequisite education before  
admission to the program. The program shall not be the provider of the prerequisite  
education, unless it is a state-approved higher educational institution or has the approval  
of this state to offer prerequisite courses.  
(xii) A student contract or enrollment application that outlines the nursing education  
program’s admission requirements, a tuition refund policy that complies with paragraph  
(x) of this subdivision, a withdrawal and failure policy, and academic progression and  
program completion requirements.  
(xiii) History of sponsoring agency.  
(b) Following board approval of the required documentation in subdivision (a) of this  
rule and before admitting the first cohort, the program director shall submit a self-study  
report to be approved by the board. The report must set forth evidence of plans for and  
compliance with the following:  
(i) History of sponsoring agency.  
(ii) Philosophy.  
(iii) Conceptual framework.  
25  
(iv) Curriculum to include end of program student learning outcomes and course  
student learning outcomes.  
(v) Course descriptions and outlines.  
(vi) Detailed plan of study that includes all of the following:  
(A) Program plan of study including all required courses.  
(B) Course sequence.  
(C) Credits per course including theory, laboratory, clinical and simulation hours.  
(vii) Signed clinical contracts for clinical placements.  
(viii) Evaluation methods and tools.  
(ix) Program outcomes.  
(x) Director and nursing faculty credentials.  
(xi) Student policies and support services.  
(c) The board shall require a site visit to the program by a board-approved nurse site  
reviewer. The report of the site visit must be prepared by the nurse site reviewer and  
provided to the board and the sponsoring agency. The program may admit students after  
the board determines that all deficiencies noted in the report are sufficiently resolved.  
(d) After the first cohort has been admitted and during the initial approval period, the  
program director shall submit an annual nursing education program report to the board.  
The nursing education program report must include information about each of the  
following:  
(i) Admission, progression, and retention of students.  
(ii) Student achievement on the required licensure NCLEX examination.  
(iii) Systematic program evaluation results, including analysis of end of program  
student learning outcomes and program outcomes, including but not limited to, NCLEX  
pass rates for first time takers, program completion rates and employment rates.  
(iv) Program changes.  
(v) Nursing faculty qualifications, assignments, and any nursing faculty exceptions.  
R 338.10303a Full program approval; procedure.  
Rule 303a. (1) The sponsoring agency may apply to the board for full approval of the  
program after graduation of the second cohort, but no later than graduation of the fourth  
cohort. The sponsoring agency shall comply with the following requirements for full  
approval of a nursing education program:  
(a) The sponsoring agency shall submit a final program approval report to the board.  
The report must provide an update of the self-study that was submitted for initial  
approval under R 338.10303(b), review the program’s progress since initial approval was  
granted, and include a review and evaluation of program implementation.  
(b) The board may require a site visit to the program by a board-approved nurse site  
reviewer before considering full approval. If conducted, a report of the site visit must be  
prepared by the nurse site reviewer and provided to the board and the sponsoring agency.  
If deficiencies are noted in the report, the program shall resolve the deficiencies within  
the timeline set by the board.  
(2) NCLEX scores for the program up to the point of application of full approval must  
equate to the passage rates as required in R 338.10310.  
(3) If by the end of the fourth cohort, a program does not satisfy the criteria for full  
approval set forth in this rule or has failed to apply for full approval as required under this  
26  
rule, the board may begin the evaluation process of the program under section 17242 of  
the code, MCL 333.17242, and R 338.10310.  
(4) When granted full approval for the program of nursing education, the sponsoring  
agency shall continue to meet all the requirements of this part.  
R 338.10303b Continued program approval; self-study and nursing education program  
report requirements.  
Rule 303b. (1) Self-study reports: After full approval has been granted under R  
338.10303a, a sponsoring agency of an unaccredited program shall submit a  
comprehensive self-study report every 8 years. The report must include all the following  
information for all of the years since the last self-study report was approved by the board.  
(a) History of sponsoring agency.  
(b) Philosophy.  
(c) Conceptual framework.  
(d) Curriculum to include end of program student learning outcomes and course student  
learning outcomes.  
(e) Detailed plan of study that includes all the following:  
(i) Program plan of study including all required courses.  
(ii) Course sequence.  
(iii) Credits per course including theory, laboratory, clinical and simulation hours.  
(f) Course descriptions and outlines.  
(g) Signed clinical contracts or current letters of commitment for clinical placements.  
(h) Evaluation methods and tools.  
(i) Program outcomes.  
(j) Director and nursing faculty credentials.  
(k) Student policies and support services.  
(2) Sponsoring agencies of accredited programs shall comply with all the following:  
(a) All reporting requirements set forth by the accrediting organization.  
(b) A sponsoring agency may submit to the board a letter of accreditation or  
reaccreditation from the accrediting organization instead of submitting a self-study report  
prepared for the board if no deficiencies were found.  
(i) The letter must be submitted to the board within 90 days after the date on the  
decision letter.  
(ii) If the sponsoring agency fails to submit the letter within 90 days, a self-study  
report must be prepared for the board in accordance with subrule (1) of this rule.  
(c) If the letter of accreditation or reaccreditation from the accrediting organization  
noted deficiencies, the program shall provide the decision letter and supporting  
documentation from the accrediting organization along with all follow-up reports,  
supporting documentation, and resulting decision letters from the accrediting  
organization to the board.  
(i) The letter of accreditation or reaccreditation and any follow up report decision  
letters must be submitted to the board within 90 days after the date on the letter.  
(ii) The board may request further documentation from the sponsoring agency.  
(d) Programs shall immediately notify the board of changes in the accreditation status,  
cycle, or reporting dates.  
27  
(3) Nursing education program reports: After a program has been granted full approval  
under R 338.10303a, the sponsoring agency of an unaccredited program shall submit a  
nurse education program report to the board every 4 years. Subject to subrule (4) of this  
rule, the sponsoring agency of an accredited program shall submit a nurse education  
program report to the board at the midpoint of the accreditation cycle. The nursing  
education program report must include all the following information for each year since  
the last self-study report was approved by the board:  
(a) Program information pertaining to total program length, required credits, and all  
required courses, including any prerequisite courses, in the program’s plan of study.  
(b) Analysis and action plans for program performance outcomes including program  
completion rates, first-time NCLEX pass rates, and job placement rates.  
(c) Systematic program evaluation results and action plan, including  
analysis of end of program student learning outcomes, including but not limited to,  
NCLEX pass rates for first time takers, program completion rates, and employment rates.  
(d) Major program changes.  
(e) Nursing faculty qualified to teach nursing courses, assignments, and any nursing  
faculty exceptions.  
(f) End of program student learning outcomes for each program option.  
(g) The plan of study that demonstrates progression of learning across the curriculum.  
(4) Sponsoring agencies of accredited programs that are required to submit a midcycle  
report shall comply with all the following:  
(a) All midcycle reporting requirements set forth by the accrediting organization.  
(b) A sponsoring agency may submit to the board a midcycle report decision letter  
from the accrediting organization if no deficiencies requiring a supplemental report were  
found.  
(i) The letter must be submitted to the board within 90 days after the date on the  
decision letter.  
(ii) If the sponsoring agency fails to submit the letter within 90 days, a nursing  
education program report must be prepared for the board in accordance with subrule (3)  
of this rule.  
(c) If the midcycle accreditation report decision letter from the accrediting organization  
noted deficiencies, the program shall provide the decision letter and supporting  
documentation from the accrediting organization along with all follow-up reports,  
supporting documentation, and resulting decision letters from the accrediting  
organization to the board.  
(i) The midcycle report decision letter and any follow up report decision letters must  
be submitted to the board within 90 days after the date on the letter.  
(ii) The board may request further documentation from the sponsoring agency.  
(5) The board shall notify the program director of the date by which a nursing education  
program report must be submitted.  
R 338.10303c Major program changes and temporary seat increase requirements.  
Rule 303c. (1) A major program change means any of the following:  
(a) Revision of the program’s philosophy, conceptual framework, course sequence-plan  
of study, curriculum, program outcomes, student learning outcomes, or changes that  
28  
increase the use of simulation more than 10% of the current total clinical hours in a  
program.  
(b) Change in primary instruction delivery methods for more than 50% of the program,  
if the delivery method does not allow for live or synchronous instruction, in-person or  
virtual, that provides for the opportunity of direct interaction between faculty and  
participants, including but not limited to, lectures, symposia, live teleconferences, and  
workshops.  
(c) A permanent expansion in the number of students served.  
(d) Increase or decrease in overall program credits.  
(e) Providing the theory portion of the curriculum at an additional location that is  
separate from the primary campus using the same curriculum as the primary campus.  
Initial approval under R 338.10303 must be obtained if more than theory is taught at the  
additional location.  
(2) A nursing education program shall submit major program changes to the board in  
writing. The changes must be approved before implementation. All the following must be  
provided when requesting a major program change:  
(a) A comparative description of the current and proposed program or portion of the  
program which is proposed for change.  
(b) Rationale for the change.  
(c) Plans to evaluate the effect of the change.  
(d) If a program requests a permanent increase in students, a campus relocation, or to  
utilize an additional site, it shall provide all the following:  
(i) The number of additional seats requested.  
(ii) Documentation that there is sufficient faculty on staff to handle the increase in  
students.  
(iii) A list identifying current and additional clinical sites available for use.  
(e) Documents evidencing support for the requested change.  
(3) Requests for a temporary expansion of students must be submitted in writing and  
approved by the board before implementation.  
(4) All the following must be provided when requesting a temporary expansion of  
students:  
(a) The number of additional seats.  
(b) Rationale for the change.  
(c) Documentation that there is sufficient faculty on staff to handle the increase in  
students.  
(d) Documentation that there is sufficient classroom and laboratory space to handle the  
increase in students.  
(e) A list identifying current and additional clinical sites available for use.  
(5) A temporary expansion of students requested under subrule (4) of this rule is valid  
for 1 year. If the nursing education program desires to make the temporary expansion of  
students permanent, a major program change must be submitted under subrule (1) of this  
rule.  
(6) If a program closure occurs, the department or board may grant a temporary  
expansion of students to another program to assist displaced students if the criteria in  
subrule (4) of this rule is satisfied.  
29  
(7) The type of program approval, initial or full, under which a program is conducted,  
shall not be altered when program changes are approved.  
R 338.10303d Accreditation.  
Rule 303d. (1) A nursing education program approved by the board shall be  
accredited under 1 of the following:  
(a) A nursing education program that has received full board approval under R  
338.10303a, before, March 18, 2018, shall receive nursing accreditation by a board-  
recognized nursing accreditation organization no later than January 1, 2025.  
(b) A nursing education program that has initial approval of the board shall receive  
nursing accreditation by a board-recognized nursing accreditation organization within  
6 years after receiving full program approval under R 338.10303a.  
(c) A nursing education program that fails to achieve nursing accreditation by a board-  
recognized nursing accreditation organization as set forth by this rule shall be removed  
from the list of approved programs under section 17242 of the code, MCL 333.17242.  
(2) The board recognizes the following nursing education accrediting agencies or their  
successor organizations:  
(a) Accreditation Commission for Education in Nursing (ACEN).  
(b) Commission for Nursing Education Accreditation (CNEA).  
(c) Commission on Collegiate Nursing Education (CCNE).  
(3) Failure of a nursing education program to maintain accreditation from an approved  
national nursing accrediting organization shall result in withdrawal of school approval  
under section 17242 of the code, MCL 333.17242, and R 338.10311, after the graduation  
of the last cohort of currently enrolled students. If the program wishes to restart  
admission, it must apply for approval from the board as a new program under R  
338.10303.  
R 338.10304 Program approval; decision.  
Rule 304. (1) Within 90 days after all materials requested by the board have been  
received, the board shall do either of the following:  
(a) Grant initial or full approval of the program or approve the program change when  
the board finds that the requirements of this part are substantially met.  
(b) Deny initial or full approval or approval of the program change when the board  
finds that the requirements of this part are not substantially met.  
(2) The board shall issue its decision in writing.  
(3) If approval is denied, the sponsoring agency may request a hearing that is conducted  
under the provisions of the administrative procedures act of 1969, 1969 PA 306, MCL  
24.201 to 24.328.  
R 338.10305 Registered professional nurse and licensed practical nurse programs;  
program requirements.  
Rule 305. Programs of registered professional nursing education and licensed practical  
nursing education shall meet all the following requirements:  
(a) Comply with the curriculum requirements established by the board and with other  
requirements in this part.  
30  
(b) Contribute to the safe practice of nursing by including the standards of practice,  
nursing behaviors, and other skills and knowledge in the curriculum to prepare students  
for the practice of nursing.  
(c) Prepare students to meet the requirements for eligibility to take the required  
licensure NCLEX examination.  
(d) Establish requirements for admission, progression, and graduation which must be  
made known and available in written form to prospective and current students.  
(e) Establish a system for the permanent maintenance of course descriptions and student  
and graduate transcripts.  
R 338.10305a Registered professional nursing education program; program  
requirements; faculty requirements.  
Rule 305a. (1) Subject to subrule (2) of this rule, the program director and all nurse  
faculty members shall hold a current unrestricted license to practice as a registered  
professional nurse in this state.  
(2) If clinical experiences are offered by the nursing education program at sites that are  
not located in this state, then any nurse faculty members at those sites shall hold a current  
unrestricted license to practice as a registered nurse in this state or Canadian province  
where the clinical experience is located.  
(3) The program director shall hold a minimum of a graduate degree with a major in  
nursing. Written notification of a change in director must be provided to the board within  
30 days and include a copy of the new director’s curriculum vitae and school contact  
information.  
(4) A member of the nursing faculty who provides didactic/theory instruction shall hold  
a minimum of a graduate degree, and the program shall ensure that the majority of the  
didactic/theory faculty hold a graduate degree with a major in nursing, unless an  
exception is granted under subrule (7) of this rule. If the graduate degree is not in nursing,  
the faculty member shall hold a minimum of a baccalaureate degree in nursing or an  
equivalent standing in a nationally nursing accredited ADN to MSN nursing education  
program with attestation of baccalaureate level competency from that educational  
program. Courses that are non-nursing in content but are health-related are exempt from  
the requirements of this subrule and may be taught by non-nurse faculty.  
(5) A member of the nursing faculty who provides instruction in either the clinical,  
skills, laboratory, or simulation laboratory shall hold a minimum of a baccalaureate  
degree in nursing or an equivalent standing in a nationally nursing accredited ADN to  
MSN nursing education program with attestation of baccalaureate level competency from  
that educational program.  
(6) Notwithstanding section 16148(6) of the code, MCL 333.16148, all nursing faculty  
shall meet the requirements of subrules (4) and (5) of this rule.  
(7) An exception may be made to the requirements of subrule (4) of this rule for full-  
time or part-time nursing faculty based on the faculty member’s progress toward meeting  
the requirements of these rules during each year for which the exception is requested.  
Board approval for faculty exception requests must be received before the faculty  
member begins course instruction. A maximum of 5 yearly exceptions are granted to any  
full-time or part-time faculty member.  
(8) Nursing faculty is sufficient in number to prepare students to achieve the outcomes  
of the program. The maximum ratio of students to faculty in clinical areas involving  
31  
direct care of patients must be not more than 8 students to 1 faculty member. The  
maximum ratio of students to faculty in clinical areas involving non-direct and precepted  
patient care must meet the clinical affiliate’s guidelines and maintain patient and  
community safety.  
R 338.10305b Licensed practical nursing education program; program requirements;  
faculty requirements.  
Rule 305b. (1) Subject to subrule (2) of this rule, the program director and all nurse  
faculty members shall hold a current unrestricted license to practice as a registered  
professional nurse in this state.  
(2) If clinical experiences are offered by the nursing education program at sites that are  
not located in this state, then any nurse faculty members at those sites shall hold a current  
unrestricted license to practice as a registered professional nurse in this state or Canadian  
province where the clinical experience is located.  
(3) The program director shall hold a minimum of a graduate degree in nursing. Written  
notification of a change in director must be provided to the board within 30 days and  
include a copy of the new director’s curriculum vitae and school contact information.  
(4) Every member of the nursing faculty shall hold a minimum of a baccalaureate  
degree in nursing, unless an exception is granted under subrule (6) of this rule. Courses  
that are non-nursing in content but are health-related are exempt from the requirements of  
this subrule and may be taught by non-nurse faculty.  
(5) Notwithstanding section 16148(7) of the code, MCL 333.16148, all nursing faculty  
shall comply with the requirements of subrule (4) of this rule.  
(6) An exception may be made to the requirements of subrule (4) of this rule for full-  
time or part-time nursing faculty and is based on the faculty member’s progress toward  
meeting the requirements of these rules during each year for which the exception is  
requested. Board approval for faculty exception requests must be received before the  
faculty member begins course instruction. A maximum of 5 yearly exceptions may be  
granted to any full-time or part-time faculty member.  
(7) Nursing faculty is sufficient in number to prepare students to achieve the outcomes  
of the program. The maximum ratio of students to faculty in clinical areas involving  
direct care of patients must be not more than 8 students to 1 faculty member. The  
maximum ratio of students to faculty in clinical areas involving non-direct patient care  
must meet the clinical affiliate’s guidelines and maintain patient and community safety.  
R 338.10305c Registered professional nursing and licensed practical nursing education  
programs; preceptor requirements.  
Rule 305c. (1) A program of nursing education that uses the personnel of a clinical  
facility as preceptors to facilitate the faculty-directed clinical experience of students to  
meet the requirements for an internship or to meet the clinical requirements in the  
capstone course, shall meet all the following requirements:  
(a) Each preceptor is approved by the nursing faculty of the program. (b) Each  
preceptor shall possess a minimum of 1 year of clinical nursing experience as a registered  
nurse and supervisor recommendation.  
(c) Each preceptor shall hold an unencumbered license in this state where the clinical  
experience occurs.  
32  
(d) Each preceptor is provided education including the roles and responsibilities of  
students, faculty members, and preceptors. The program shall maintain documentation of  
preceptor education.  
(e) Before the preceptor begins instruction of the students, the nursing faculty of the  
program shall develop written learning outcomes for the clinical experience and provide  
a copy of those outcomes to each preceptor. (f) The nursing faculty member shall retain  
authority and responsibility for the student’s learning experiences and confer routinely  
and periodically with the preceptor and student to monitor and evaluate the learning  
experiences.  
(g) The maximum ratio of precepted students to a supervising nursing faculty member  
must be not more than 10 students to 1 nursing faculty member.  
(h) If the nursing faculty member is not physically present in the area in which students  
are practicing, the nursing faculty member is immediately available by telephone or  
other means of telecommunication when students are engaged in clinical activities with a  
preceptor.  
(i) Preceptors shall not be used to replace clinical nursing faculty in prelicensure  
certificate, associate, or baccalaureate degree nursing programs.  
(j) A preceptor shall supervise not more than 1 student during any 1 scheduled work  
time or shift.  
(2) This rule does not apply to staff nurses used by faculty intermittently during non-  
precepted clinical experiences.  
R 338.10307 Registered professional nursing and licensed practical nursing education  
programs; curriculum; organization, development, implementation, control, and  
evaluation.  
Rule 307. (1) The program director and faculty shall organize, develop, implement,  
control, and evaluate the curriculum on a regularly scheduled basis within the framework  
of the philosophy, purposes, and outcomes of the sponsoring agency and those approved  
by the board.  
(2) The curriculum outcomes must identify the behavioral expectations of the graduate  
of the program and be used for all of the following purposes:  
(a) Developing, organizing, implementing, and evaluating the curriculum.  
(b) Identifying outcomes for levels of progression and course and program completion.  
(c) Providing to the student an organized pattern to follow in which the sequence of  
learning is from the simple to the complex.  
(d) Organizing the courses to approximate, as closely as possible, the schedules of the  
sponsoring agency in terms, quarters, semesters, or trimesters.  
(e) Distributing the courses throughout the curriculum so that an unreasonable overload  
does not exist in any segment of the sequence.  
(3) The philosophy and conceptual framework or rationale for the program must be the  
basis for the organization of the nursing content of the curriculum.  
(4) The course content and other learning experiences must promote student growth in  
all the following areas:  
(a) The understanding of the roles and responsibilities of the members of the nursing  
profession.  
33  
(b) The application of the principles of nursing and the sciences which are basic to  
nursing practice in the development of plans of care for the patient or client.  
(c) The provision of direct and indirect nursing care.  
(d) The understanding of effective human relations and demonstrating the ability to use  
these principles in nursing situations.  
(e) The recognition of physical, psychosocial, and spiritual needs of diverse  
patient/client populations in the provision of nursing care.  
(f) The understanding of health, including the manifestations of disease and the  
initiation, organization, and application of the principles underlying the nursing care  
provided.  
(g) Developing skills and abilities in the administration of all aspects of nursing care  
using the nursing process, including all the following:  
(i) Communications.  
(ii) Critical thinking, clinical judgment, and problem solving.  
(iii) Understanding legal and professional responsibilities.  
(iv) Inter-professional relationships with other healthcare providers.  
(v) Evidence-based practice.  
(vi) Quality and safety.  
(h) Understanding and protecting the rights of patients or clients.  
(5) All cooperating agencies selected for clinical laboratory and simulation laboratory  
experiences shall have standards of nursing care that demonstrate concern for the patient  
or client and evidence the skillful application of all measures of quality and safe,  
evidence-based nursing practice.  
(6) All cooperating agencies shall have a current license, if required, for their operation  
and adhere to the local zoning ordinances governing their operation.  
(7) When a nurse site reviewer visits a site, the nurse site reviewer may survey  
cooperating agencies as a part of the review process to determine the contribution each  
makes to the course and program outcomes. Selection must be made by the nurse site  
reviewer.  
(8) Each resource selected to provide clinical experience shall indicate a willingness to  
cooperate in the curriculum by providing a letter of intent, a written agreement, or a  
formal contract. Each cooperating agency shall provide experiences of a quality and  
quantity that enable all students to meet the outcomes established for the clinical  
experience under R 338.10303.  
R 338.10308 Registered professional nursing education program; curriculum;  
implementation.  
Rule 308. (1) The director and faculty of a program of nursing education leading to  
licensure as a registered professional nurse shall comply with all the following  
provisions:  
(a) Select courses and ensure teaching concepts for basic content in the biological,  
physical, behavioral, and other courses supportive of the nursing major which assist the  
student to succeed in the nursing sequence.  
(b) Provide courses and clinical laboratory, skills laboratory, and simulation laboratory  
experiences in the care of individuals across diverse age groups, genders, races, and  
cultures, in medical, surgical, pediatric, geriatric, obstetrical, and psychiatric – mental  
34  
health nursing and provide supervised practice in the administration of medication.  
Opportunities for learning experiences in community aspects of nursing must be made  
available. The elements of the nursing process and clinical judgment must be  
emphasized in all nursing courses. Clinical laboratory, simulation laboratory, and clinical  
experience hours must be sufficient in number to meet the course and program outcomes.  
(c) Ensure that courses include content relating to all the following:  
(i) The legal scope of practice of a registered nurse.  
(ii) The standards of practice and performance and code of ethics for the nursing  
profession.  
(iii) Historical perspectives of nursing and current legal-ethical issues.  
(iv) Licensure requirements.  
(d) Select cooperating agencies that meet the requirements of R 338.10307(5), (6), and  
(8).  
(2) A registered professional nurse program may substitute up to 50% of clinical hours  
per specialty content area within a course with simulation laboratory experiences. For  
simulation laboratory experiences, the board adopts by reference the standards of the  
International Nursing Association for Clinical Simulation and Learning, as specified in  
the publication titled, “Standards of Best Practice: Simulation” 2021. The standards are  
available from the International Nursing Association for Clinical Simulation and  
Learning’s website at http://www.inacsl.org at no cost. Copies of the standards are  
available for inspection and distribution at a cost of 10 cents per page from the Board of  
Nursing, Bureau of Professional Licensing, Department of Licensing and Regulatory  
Affairs, 611 West Ottawa Street, P.O. Box 30670, Lansing, Michigan 48909.  
R 338.10309 Licensed practical nursing education program; curriculum; implementation.  
Rule 309. (1) The director and faculty of a program of nursing education leading to  
licensure as a licensed practical nurse shall comply with all the following provisions:  
(a) Select courses and ensure teaching concepts on which the theory and practice of  
practical nursing are based. The basic principles of the natural and applied sciences that  
are fundamental to the theory and practice of practical nursing and that are applied in the  
planning and implementation of nursing care must be included.  
(b) Provide courses and clinical laboratory, skills laboratory, and simulation laboratory  
experiences in the care of individuals across diverse age groups, genders, races, and  
cultures, in medical, surgical, pediatric, obstetrical, acute and chronic mental illness, and  
geriatric nursing and provide supervised practice in the administration of medications.  
The elements of the nursing process and clinical judgment must be emphasized in all  
nursing courses. Clinical laboratory, skills laboratory, simulation laboratory, and clinical  
experience hours must be sufficient to meet the course and program outcomes of the  
curriculum.  
(c) Ensure that courses include content relating to all the following:  
(i) The legal scope of practice of a licensed practical nurse.  
(ii) The standards of conduct for members of the nursing profession and, in particular,  
a licensed practical nurse.  
(iii) Historical perspectives of nursing and current legal-ethical issues.  
(iv) Licensure requirements.  
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(d) Select cooperating agencies that meet the requirements of R 338.10307(5), (6), and  
(8).  
(2) A licensed practical nursing education program may substitute up to 50% of clinical  
hours per specialty content area within a course with simulation laboratory experiences,  
except for pediatric and obstetric clinical hours. A licensed practical nursing education  
program may substitute up to 100% of pediatric and obstetric clinical hours with  
simulation laboratory. For simulation laboratory experiences, the board adopts by  
reference the standards of the International Nursing Association for Clinical Simulation  
and Learning, as specified in the publication titled, “Standards of Best Practice:  
Simulation” 2021. The standards are available from the International Nursing  
Association for Clinical Simulation and Learning’s website at http://www.inacsl.org at no  
cost. Copies of the standards are available for inspection and distribution at a cost of 10  
cents per page from the Board of Nursing, Bureau of Professional Licensing, Department  
of Licensing and Regulatory Affairs, 611 West Ottawa Street, P.O. Box 30670, Lansing,  
Michigan 48909.  
R 338.10310 Board evaluation of a nursing education program.  
Rule 310. The board may evaluate a program of nursing education when any of the  
following occurs:  
(a) A request for initiating a program of nursing education is submitted.  
(b) A request for full approval of a program is submitted.  
(c) A request for approval of a major program change is submitted.  
(d) The pass rate for first-time test takers on the required licensure NCLEX examination  
is less than 80% for any 1 year of compiled statistics provided from the NCSBN.  
(e) Complaints regarding the conduct of the program are received and it is necessary to  
validate the complaints, under section 17242 of the code, MCL 333.17242.  
(f) Failure of a nursing education program to submit a nursing education program report,  
or self-study report under the time frames set forth in R 338.10303b.  
(g) Finding of deficiencies by the national accrediting body that is listed in R  
338.10303d.  
(h) Failure of a nursing education program to submit faculty exception requests before  
the start date of the semester under R 338.10305a and R 338.10305b.  
(i) Program completion rate as submitted on a nursing education program report is  
below the standard set by the national accrediting organization for an accredited program  
or less than 70% for an unaccredited program.  
(j) Failure of a nursing education program to apply for full approval by the end of the  
fourth cohort.  
(k) Any violation or inconsistency with the code or rules.  
R 338.10310a Nursing education program; board action following evaluation.  
Rule 310a. (1) The board shall require an unaccredited nursing education program  
evaluated under section 17242 of the code, MCL 333.17242, and R 338.10310 and  
determined to be in noncompliance with any provision of the code or the rules to have  
an action plan or NCLEX improvement plan as the first step for improvement of the  
identified problem areas. The sponsoring agency shall submit the action plan or NCLEX  
improvement plan within 6 months after the evaluation or with the next nursing  
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education program report, as that term is defined in R 338.10303b, whichever comes  
first. The plan must include all the following:  
(a) A statement that the evaluation of the nursing education program was conducted  
by the program’s director and faculty to identify problem areas.  
(b) Specific steps that are being taken to affect changes in the program.  
(c) Improvements to the curriculum, student admission and progression, faculty  
expertise in nursing and teaching, and institutional support.  
(d) A method for the evaluation of the changes and further action to be taken if  
program performance continues to be out of compliance. The evaluation method should  
include, but is not limited to, an evaluation of student achievement of course learning  
outcomes and end of program student learning outcomes that reflect the changes.  
(2) If there is no evidence of improvement 1 year from the plan’s  
implementation, the program shall submit an amended action plan, progress report, or  
NCLEX improvement plan that contains the steps being taken to improve the problem  
areas of the program.  
(3) If there is no evidence of improvement 2 years after the initial improvement plan is  
submitted, the board may proceed under R 338.10311.  
(4) The board shall require an accredited nursing education program evaluated under  
section 17242 of the code, MCL 333.17242, and R 338.10310 and determined to be  
in noncompliance with any provision of the code or the rules to comply with all the  
following:  
(a) Follow the reporting requirements of its national accrediting organization.  
(b) Submit copies of all reports required by the accrediting organization and decision  
letters received from the organization to the board.  
(c) If a program is placed in a probationary status by its accrediting organization, this  
notation must be made on the board’s website.  
(d) If a program loses accreditation from its national accrediting organization, it shall  
immediately cease enrollment of new cohorts and the board shall proceed under R  
338.10311 and begin the process to withdraw approval of the program.  
R 338.10312 Program termination; interruption or reduction of admissions.  
Rule 312. (1) The program director shall inform the board if a date is established for  
termination of the program of nursing education.  
(2) The program director shall inform the board regarding the system of retention of  
student records which are needed for endorsement purposes and proof of scholastic  
achievement. The system of records retention must comply with all applicable federal  
and state laws and regulations. The program shall inform the board of where the records  
are maintained so that graduates may be given the source of information on request.  
(3) The program director shall inform the board if admissions to the program of nursing  
education are to be reduced, suspended, or interrupted.  
(4) A licensed practical nursing program that has suspended admissions for 2 years shall  
apply for initial program approval under R 338.10303 and obtain board approval before  
resuming admissions.  
(5) A registered professional nursing program that is 2 years in duration that has  
suspended admissions for 2 years shall apply for initial program approval under R  
338.10303 and obtain board approval before resuming admissions.  
37  
(6) A registered professional nursing program that is 4 years in duration that has  
suspended admissions for 4 years shall apply for initial program approval under R  
338.10303 and obtain board approval before resuming admissions.  
(7) The board shall withdraw approval of any program that has suspended admissions  
for more than 4 years.  
PART 4. NURSE SPECIALTY CERTIFICATION  
R 338.10402 Automatic suspension or revocation of specialty certification.  
Rule 402. The suspension or revocation of a license as a registered nurse shall  
automatically void the specialty certification.  
R 338.10404 Specialty certification qualifications; nurse anesthetist.  
Rule 404. A specialty certification for a nurse anesthetist shall be granted to a registered  
professional nurse who satisfies all of the following requirements:  
(a) Holds a current and valid license to practice nursing in this state.  
(b) Submits an application for certification as a nurse anesthetist on a form provided by  
the department, with the required fee.  
(c) Possesses current certification from the National Board of Certification and  
Recertification of Nurse Anesthetists (NBCRNA), or a successor organization.  
R 338.10404b Specialty certification qualifications; nurse practitioner.  
Rule 404b. A specialty certification for nurse practitioner shall be granted to a  
registered professional nurse who satisfies all of the following requirements:  
(a) Holds a current and valid license to practice nursing in this state.  
(b) Submits an application for certification as a nurse practitioner, on a form provided  
by the department with the required fee.  
(c) Possesses advanced practice certification from 1 of the following certification  
organizations, or successor organizations:  
(i) The American Nurses Credentialing Center.  
(ii) The Pediatric Nursing Certification Board.  
(iii) The National Certification Corporation for Women’s Health Care Nurse  
Practitioner and Neonatal Nurse Practitioner.  
(iv) The American Academy of Nurse Practitioners for Emergency Nurse Practitioners,  
Family Nurse Practitioners, and Adult-Gerontology Primary Care Nurse Practitioners.  
(v) The Oncology Nursing Certification Corporation.  
(vi) The American Association of Critical Care Nurses Certification Corporation for  
Acute Care Nurse Practitioner.  
R 338.10404c Specialty certification qualifications; clinical nurse specialist.  
Rule 404c. A specialty certification for a clinical nurse specialist must be granted to a  
registered professional nurse who satisfies all the following requirements:  
(a) Holds a current and valid license to practice nursing in this state.  
(b) Submits an application for certification as a clinical nurse specialist, on a form  
provided by the department with the required fee.  
38  
(c) Possesses an advanced practice certification from either of the following certification  
organizations, or successor organizations:  
(i) The American Nurses Credentialing Center.  
(ii) The American Association of Critical Care Nurses Certification Corporation.  
R 338.10405 Nurse anesthetist specialty certification renewal or reregistration; schedule;  
requirements; maintenance of evidence of compliance.  
Rule 405. (1) Specialty certification renewal must correspond with the same schedule  
as the license renewal.  
(2) An applicant for renewal or reregistration of a lapsed certification shall have  
obtained recertification or maintained certification, within the 2-year period immediately  
before the application, from the NBCRNA, or a successor organization.  
(3) An applicant or licensee shall maintain evidence of compliance with the  
requirements of this rule for a period of 4 years after the date of application, during which  
time the board may require the applicant or licensee to submit the evidence for audit.  
R 338.10405a Nurse midwife specialty certification renewal or reregistration; schedule;  
requirements; maintenance of evidence of compliance.  
Rule 405a. (1) Specialty certification renewal must correspond with the same schedule  
as the license renewal.  
(2) An applicant for specialty certification renewal or reregistration of a lapsed  
certification shall have obtained recertification or maintained certification within the 2-  
year period immediately before the application, from the American Midwifery  
Certification Board (AMCB), or a successor organization.  
(3) An applicant or licensee shall maintain evidence of compliance with the  
requirements of this rule for a period of 4 years after the date of application, during which  
time the board may require the licensee to submit the evidence for audit.  
R 338.10405b Nurse practitioner specialty certification renewal or reregistration;  
schedule; requirements; maintenance of evidence of compliance.  
Rule 405b. (1) Specialty certification renewal must correspond with the same schedule  
as the license renewal.  
(2) An applicant for renewal or reregistration of a lapsed certification  
who holds national certification as a nurse practitioner shall have obtained  
recertification or maintained certification within the 2-year period immediately before the  
application from 1 of the following organizations or successor organizations:  
(a) The American Nurses Credentialing Center.  
(b) The Pediatric Nursing Certification Board.  
(c) The National Certification Corporation for Women’s Health Care Nurse  
Practitioner and Neonatal Nurse Practitioner.  
(d) The American Academy of Nurse Practitioners for Family Nurse Practitioners,  
Emergency Nurse Practitioners, and Adult-Gerontology Primary Care Nurse  
Practitioners.  
(e) The Oncology Nursing Certification Corporation.  
(f) The American Association of Critical Care Nurses Certification Corporation.  
(g) The American Association of Nurse Practitioners.  
39  
(3) An applicant or licensee shall maintain evidence of compliance with the requirements  
of this rule for a period of 4 years after the date of application, during which time the  
board may require the licensee to submit the evidence for audit.  
PART 6. CONTINUING EDUCATION  
R 338.10601 License renewals; requirements; applicability.  
Rule 601. (1) Under section 16201 of the code, MCL 333.16201, an applicant for  
license renewal who has been licensed for the 2-year period immediately before the  
expiration date of the license, shall accumulate not less than 25 hours of continuing  
education that are approved by the board under these rules during the 2 years before the  
expiration of the license.  
(2) An applicant for license renewal shall complete not less than 2 hours of the 25  
required hours, of continuing education in pain and pain symptom management in each  
renewal period under section 16204(2) of the code, MCL 333.16204. Continuing  
education in pain and pain symptom management may include, but is not limited to,  
courses in behavior management, psychology of pain, pharmacology, behavior  
modification, stress management, clinical applications, and drug interventions as they  
relate to professional practice.  
(3) An applicant for license renewal, who also applies for a controlled substance  
license, shall complete a 1-time training in opioids and other controlled substances  
awareness as required in R 338.3135.  
(4) Submission of an application for renewal constitutes the applicant’s certification of  
compliance with the requirements of this rule. A nurse shall retain documentation of  
meeting the requirements of this rule for a period of 4 years after the date of applying for  
license renewal. The board may require an applicant to submit evidence to demonstrate  
compliance with this rule. Failure to comply with this rule is a violation of section  
16221(h) of the code, MCL 333.16221.  
(5) A request for a waiver under section 16205 of the code, MCL 333.16205, must be  
received by the department for the board’s consideration not less than 30 days before the  
last regularly scheduled board meeting before the expiration date of the license. The  
public notice for the board meetings can be found at:  
https://www.michigan.gov/lara/bureau-list/bpl/health/hp-lic-health-prof/nursing.  
R 338.10602 Acceptable continuing education; requirements; limitations.  
Rule 602. (1) The 25 hours of continuing education required under R 338.10601(1) for  
the renewal of a license must comply with the following, as applicable:  
(a) No more than 12 credit hours may be earned during a 24-hour period.  
(b) Except for the implicit bias training required under R 338.7004 that may be used to  
comply with R 338.7004 and a continuing education requirement, an applicant may not  
earn continuing education credit for the human trafficking requirement and may not earn  
credit for a continuing education program or activity that is identical to a program or  
activity the applicant has already earned credit for during that renewal period.  
(2) The board shall consider the following as acceptable continuing education:  
40  
ACCEPTABLE CONTINUING EDUCATION ACTIVITIES  
(a) Completion of an approved continuing  
education program or activity related to the  
The number of hours approved by  
the sponsor or the approving  
practice of nursing or any non-clinical subject organization.  
relevant to the practice of nursing. A  
continuing education program or activity is  
If the activity was not approved  
approved, regardless of the format in which it for a set number of hours, then 1  
is offered, if it is offered for continuing  
education credit by any of the following:  
The American Association of Nurse  
Anesthetists (AANA).  
credit hour for each 60 minutes of  
participation may be earned.  
The American Association of Nurse  
Practitioners (AANP).  
The Accreditation Council for  
Continuing Medical Education  
(ACCME).  
The American College of Nurse-  
Midwives (ACNM).  
The American Medical Association  
(AMA).  
The American Nurses Credentialing  
Center (ANCC).  
The American Osteopathic  
Association (AOA).  
The National Association of Clinical  
Nurse Specialists.  
The National Association for Practical  
Nurse Education and Service, Inc.  
(NAPNES).  
The National League for Nursing  
(NLN).  
Another state or provincial board of  
nursing.  
A continuing nursing education  
program offered by a nursing  
education program that is approved by  
the board under R 338.10303a.  
A continuing education program or activity is  
approved, regardless of the format in which it  
is offered, if it is approved for continuing  
education credit by any of the following:  
Another state or provincial board of  
nursing.  
41  
If audited, an applicant shall submit a copy of  
a letter or certificate of completion showing  
the applicant’s name, number of hours earned,  
sponsor name or the name of the organization  
that approved the program or activity for  
continuing education credit, and the date the  
program was held or activity completed.  
(b) Completion of academic courses related to  
nursing practice offered by a nursing  
Five hours of continuing education  
may be earned for each semester  
credit hour earned.  
education program in this state approved by  
the board under part 3 of these rules or a post-  
licensure or graduate nursing program that is  
nationally accredited by a nursing education  
accrediting organization included in R  
338.10303d(2).  
Three hours of continuing  
education may be earned for each  
quarter credit hour earned.  
If audited, an applicant shall submit an  
official transcript that reflects completion of  
the academic course and number of semester  
or quarter credit hours earned.  
(c) Obtaining specialty certification or  
maintaining certification as 1 of the  
following:  
Twenty-five hours of continuing  
education, including 2 hours for  
pain and symptom management,  
may be credited for obtaining or  
maintaining specialty certification  
during the renewal period.  
Clinical nurse specialist.  
Nurse anesthetist.  
Nurse midwife.  
Nurse practitioner.  
If audited, an applicant shall submit proof of  
certification or recertification.  
(d) Successful completion of a national nursing  
specialty examination.  
Ten hours of continuing education  
may be earned in the year in which  
the applicant achieves a passing  
If audited, an applicant shall submit proof of a score.  
passing score on the examination.  
A maximum of 20 hours of  
continuing education may be  
earned in each renewal period.  
Credit must not be given for  
repeating the same examination in  
a renewal period.  
(e) Initial publication of a chapter or an article  
related to the practice of nursing or allied  
health in any of the following:  
Ten hours of continuing education  
may be earned per publication.  
A nursing or healthcare textbook.  
A peer-reviewed textbook.  
42  
A nursing or healthcare peer-reviewed  
journal.  
A maximum of 10 hours of  
continuing education may be  
earned in each renewal period.  
If audited, an applicant shall submit a copy of  
the publication that identifies the applicant as  
the author or a publication acceptance letter.  
(f) Independent reading of articles or viewing or One hour of continuing education  
listening to media related to nursing practice  
that do not include a self-assessment  
component.  
may be earned for each 50 to 60  
minutes of participation.  
A maximum of 4 hours of  
continuing education may be  
earned in each renewal period.  
If audited, an applicant shall submit an  
affidavit attesting to the number of hours the  
applicant spent participating in these activities  
and that includes a description of the activity.  
(g) Participation on a healthcare organization  
One hour of continuing education  
committee dealing with quality patient care or may be earned for each 60 minutes  
utilization review.  
of participation.  
If audited, an applicant shall submit a letter  
from an organization official verifying the  
applicant’s participation and the number of  
hours the applicant spent participating on the  
committee.  
A maximum of 4 hours of  
continuing education may be  
earned in each renewal period.  
(h) Presentation of an academic or continuing  
education program that is not a part of the  
applicant’s regular job description.  
Three hours of continuing  
education may be earned for each  
60 minutes of presentation.  
If audited, an applicant shall submit a copy of A maximum of 6 hours of  
the curriculum and a letter from the program  
sponsor verifying the length and date of the  
presentation.  
continuing education may be  
earned in each renewal period.  
(i) Participation as a preceptor for at least 1  
nursing student or a new employee  
undergoing orientation.  
A maximum of 5 hours of  
continuing education may be  
earned in each renewal period.  
A preceptorship must be for a minimum of 24  
preceptor hours with a preceptor ratio of 1  
student or employee to 1 preceptor. Twenty-  
four preceptor hours equals 1 continuing  
education hour.  
If audited, an applicant shall submit written  
documentation from the educational  
institution or preceptor’s supervisor verifying  
the dates and hours of the preceptorship.