DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS  
DIRECTOR’S OFFICE  
BOARD OF NURSING - GENERAL RULES  
Filed with the secretary of state on April 6, 2020  
These rules take effect immediately upon filing with the secretary of state unless adopted  
under section 33, 44, or 45a(6) 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 16145(3) and 17210 of the public health code, 1978 PA 368, MCL  
333.16145 and 333.17210, 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 338.10105, R 338.10202, R 338.10204, R 338.10206, R 338.10207, R 338.10210,  
R 338.10211, R 338.10301, R 338.10303, R 338.10303a, R 338.10303b, R 338.101303c,  
R 338.10303d, R 338.10304, R 338.10305, R 338.10305a, R 338.10305b, R 338.10305c,  
R 338.10307, R 338.10309, R 338.10310, R 338.10310a, R 338.10312, R 338.10404c,  
R 338.10601, R 338.10602, R 338.10702, R 338.10703, R 338.10704, and R 338.10705  
of the Michigan Administrative Code are amended as follows:  
PART 1. GENERAL PROVISIONS  
R 338.10105 Training standards for identifying victims of human trafficking;  
requirements.  
Rule 105. (1) Pursuant to section 16148 of the code, MCL 333.16148, an individual  
licensed or seeking licensure shall complete 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 health care settings.  
(iii) Identifying the warning signs of human trafficking in health care 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.  
September 23, 2019  
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(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, health care 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 a sample of individuals and request  
documentation of proof of completion of training. If audited by the department, an  
individual shall provide an 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 an individual. The certification statement must  
include the individual’s name and either of the following:  
(i) For training completed pursuant to subrule (1)(b)(i) to (iii) of this rule, the date,  
training provider name, and name of training.  
(ii) For training completed pursuant to subrule (1)(b)(iv) of this rule, the title of  
article, author, publication name of peer review journal, health care journal, or  
professional or scientific journal, and date, volume, and issue of publication, as  
applicable.  
(3) Pursuant to section 16148 of the code, MCL 333.16148, the requirements specified  
in subrule (1) of this rule apply for license renewals beginning March 31, 2018 and for  
initial licenses issued after January 6, 2022.  
PART 2. LICENSURE  
R 338.10202 Examination; adoption; passing scores.  
Rule 202. The board approves and adopts the examinations developed by the National  
Council of State Boards of Nursing, Inc., hereafter identified as the "NCLEX-RN" for the  
registered nurse and the "NCLEX-PN" for the practical nurse. Examinees shall achieve a  
score of pass on the NCLEX computerized adaptive test (CAT).  
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  
he or she has successfully completed a registered nurse education program that satisfies 1  
of the following:  
(a) The applicant has successfully completed a registered professional nurse education  
program that is located in this state and is approved by the board.  
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(b) The applicant has successfully completed a registered professional nurse education  
program that is located in another state of the United States, and that program is  
substantially equivalent to the program requirements of article 15 of the code, MCL  
333.16101 to 333.18838, and the rules promulgated by the board.  
(c) The applicant is a graduate of a registered professional nurse education program or  
an equivalent education program that is outside the United States and has been certified  
pursuant to R 338.10208 by the Commission on Graduates of Foreign Nursing Schools  
(CGFNS) or its successor agency, to have substantially similar education credentials as a  
program approved by the board, or is exempt from CGFNS certification under R  
338.10208(3) and (4).  
(3) An applicant for licensure as a registered professional nurse shall comply with all of  
the following:  
(a) Take the initial NCLEX-RN examination within 2 years of either graduation from a  
board-approved registered nurse education program under subrule (2)(a) or after  
obtaining certification from the certification program of the CGFNS.  
(b) Successfully pass the NCLEX-RN examination within 12 months of the initial  
NCLEX-RN examination attempt in this state or another state.  
(c) An applicant who fails the NCLEX-RN examination shall comply with the  
following provisions:  
(i) An applicant who did not pass the NCLEX-RN examination on any attempt shall  
wait 45 days before taking the NCLEX-RN examination again.  
(ii) An applicant who did not pass the NCLEX-RN examination by the third attempt  
is not eligible to repeat the NCLEX-RN examination until he or she has completed an  
approved NCLEX-RN review course with content pertaining specifically to the registered  
nurse scope of practice, and complies with the both of the following:  
(A) An applicant shall submit to the department, before retesting, documentation of  
having completed an approved NCLEX-RN review course.  
(B) An applicant who has completed the NCLEX-RN review course may sit for the  
NCLEX-RN examination a maximum of 3 times after completion of the review course,  
and must still meet the timing requirements of this subrule.  
(d) An applicant who has not passed the NCLEX-RN examination after attempting the  
NCLEX-RN examination a maximum of 6 times within 3 years from the date of either  
graduation or after obtaining certification from the certification program of the CGFNS  
shall repeat an entire registered professional nurse education program that has been  
approved by the board pursuant to R 338.10303a and is in compliance with R  
338.10303b.  
(4) “Approved NCLEX-RN review course” means 1 of the following:  
(a) A review course sponsored by a nursing education program that is approved by the  
board pursuant to R 338.10303a and is in compliance with R 338.10303b.  
(b) A review course sponsored by 1 of the following providers:  
(i) Assessment Technologies Institute Nursing Education.  
(ii) Elsevier/Health Education System Incorporated.  
(iii) Hurst Review Services.  
(iv) Kaplan.  
(v) National Council of State Boards of Nursing.  
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(c) A college or university provided NCLEX-RN review course that is approved by  
another state board of nursing.  
(d) A review course approved by the board that includes NCLEX subject areas,  
NCLEX style questions, simulated examinations, and test taking strategies.  
R 338.10206 Licensure by endorsement; registered professional nurse; requirements.  
Rule 206. (1) An applicant for licensure by endorsement shall submit a completed  
application on a form provided by the department, together with the requisite fee. In  
addition to meeting the other requirements of the code and the administrative rules  
promulgated pursuant to the code, an applicant who satisfies the requirements of this rule  
is considered to meet the requirements of section 16186(1) of the code, MCL 333.16186.  
(2) An applicant for a registered nurse professional license by endorsement shall meet  
both of the following requirements:  
(a) Complete a registered nurse education program specified in R 338.10204(2)(a) or  
(b).  
(b) Is currently licensed in another state and was initially licensed by taking the  
NCLEX-RN examination in another state.  
(3) An applicant who is a graduate of a nurse education program that is located outside  
the United States shall comply with the provisions of R 338.10208(3) or (4) and submit  
evidence of compliance with all of the following:  
(a) Graduation from a registered nurse education program that is not less than 60  
weeks in duration and that includes courses in both theory and clinical practice for  
registered nurse applicants.  
(b) Completion of the core curriculum for registered nurse applicants.  
(4) An applicant’s license must be verified by the licensing agency of all other states of  
the United States in which the applicant holds a current license or ever held a license as a  
registered professional nurse. Verification must include the record of any disciplinary  
action taken or pending against the applicant.  
R 338.10207 Lapsed registered professional nurse license; relicensure requirements.  
Rule 207. An applicant for relicensure whose Michigan registered professional nurse  
license has lapsed, under the provisions of 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 (√):  
(1) For a registered professional nurse who has let  
his or her Michigan license lapse and who is not  
currently licensed in another state:  
Lapsed  
0-3  
Years  
Lapsed  
more than 3  
years, but  
less than 7  
years  
Lapsed  
7 or  
more  
years  
(a) Application and fee: Submit a completed  
application on a form provided by the department,  
together with the requisite fee.  
(b) Establish that he or she is of good moral character  
as defined under sections 1 to 7 of 1974 PA 381,  
MCL 338.41 to 338.47.  
√
√
√
√
√
√
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(c) Submit fingerprints as required under section  
16174(3) of the code, MCL 333.16174.  
√
√
(d) Continuing education: Submit proof of having  
completed 25 hours of continuing education in  
courses and programs approved by the board,  
including at least 2 hours in pain and symptom  
management, all of which were earned within the 2-  
year period immediately preceding the date of the  
application for relicensure. However, if the  
continuing education hours submitted with the  
application are deficient, the applicant has 2 years  
from the date of the application to complete the  
deficient hours. The application will be held and the  
license will not be issued until the continuing  
education requirements have been met.  
√
(e) Continuing education: Submit proof of having  
completed 25 hours of continuing education in  
courses and programs approved by the board,  
including at least 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 preceding the date of  
the application for relicensure:  
√
√
(i) Safe documentation for nurses.  
(ii) Critical thinking skills for nurses.  
(iii) Pharmacology.  
(iv) Preventing medication errors.  
(v) Professional and legal accountability for  
nurses.  
(vi) Delegation.  
However, if the continuing education hours  
submitted with the application are deficient, the  
applicant has 2 years from the date of the application  
to complete the deficient hours. The application will  
be held and the license will not be issued until the  
continuing education requirements have been met.  
(f) Certification of skill competency: Within 3 years  
of the period immediately preceding the application  
for relicensure, receive written certification of skill  
competency from a nurse education program  
approved pursuant to R 338.10303a. Certification of  
competency must cover the following skills utilizing  
nursing process:  
√
√
(i) Head-to-toe physical assessment, including  
vital signs.  
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(ii) Medication administration.  
(iii) Documentation.  
(iv) Surgical asepsis and infection control.  
(v) Safety, including fall prevention, body  
mechanics, and transfers.  
(g) NCLEX-RN Examination: Within 3 years of the  
period immediately following approval of the  
application for relicensure, retake and pass the  
NCLEX-RN examination.  
(h) Proof of license verification from another state:  
An applicant’s license must be verified by the  
licensing agency of all other states of the United  
States in which the applicant ever held a license as a  
registered professional nurse. Verification must  
include the record of any disciplinary action taken or  
pending against the applicant.  
√
√
√
√
(2) For a registered professional nurse who has let Michigan Michigan  
Michigan  
license  
Lapsed  
his or her Michigan license lapse, but who holds a license  
license  
Lapsed  
current and valid registered professional nurse  
license in another state:  
Lapsed  
0-3 Years more than 3 7  
or  
years,  
but more  
less than 7 years  
years  
(a) Application and fee: Submit a completed  
application on a form provided by the department,  
together with the requisite fee.  
(b) Establish that he or she is of good moral  
character as defined under sections 1 to 7 of 1974  
PA 381, MCL 338.41 to 338.47.  
√
√
√
√
√
√
√
√
√
√
(c) Submit fingerprints as required under section  
16174(3) of the code, MCL 333.16174.  
(d) Continuing education: Submit proof of  
completion of 25 hours of continuing education,  
including at least 2 hours in pain and symptom  
management, earned within the 2-year period  
immediately preceding the date of the application  
for relicensure. However, if the continuing  
education hours submitted with the application are  
deficient, the applicant has 2 years from the date  
of the application to complete the deficient hours.  
The application will be held and the license will  
not be issued until the continuing education  
requirements have been met.  
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(e) Proof of license verification from another  
state: An applicant’s license must be verified by  
the licensing agency of all other states of the  
United States in which the applicant holds a  
current license or ever held a license as a  
registered professional nurse. Verification must  
include the record of any disciplinary action taken  
or pending against the applicant.  
√
√
√
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  
he or she 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 that  
is located in another state of the United States and that program is substantially  
equivalent to the program requirements of article 15 of the code, MCL 333.16101 to  
333.18838, and the rules promulgated by the board.  
(c) The applicant is a graduate of a practical nurse education program or an equivalent  
program that is located outside the United States and has been certified by either the  
CGFNS, the National Association of Credential Evaluation Services (NACES), or their  
successor agencies, to have substantially similar education credentials as a program  
approved by the board, or is exempt from CGFNS and NACES certification under R  
338.10212(2) and (4).  
(d) The applicant has successfully completed a registered nurse education program that  
meets the requirements of R 338.10204(2). The applicant shall be certified to take the  
NCLEX-PN examination by a practical nurse program that is approved by the board  
pursuant to subdivision (a) of this subrule.  
(3) An applicant for licensure as a licensed practical nurse shall comply with all of the  
following:  
(a) Take the initial NCLEX-PN examination within 2 years of either graduation from a  
board approved practical nurse education program under subrule (2)(a) or subrule (2)(b)  
of this rule, or after obtaining certification by CGFNS or NACES.  
(b) Successfully pass the NCLEX-PN examination within 12 months of the initial  
NCLEX-PN examination attempt in this state or another state.  
(c) An applicant who has not successfully passed the NCLEX-PN examination shall  
comply with the following provisions:  
(i) An applicant who did not pass the NCLEX-PN examination on any attempt shall  
wait 45 days before taking the NCLEX-PN examination again.  
(ii) An applicant who did not pass the NCLEX-PN examination by the third attempt is  
not eligible to repeat the NCLEX-PN examination until he or she has completed an  
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approved NCLEX-PN review course with content pertaining specifically to the licensed  
practical nurse scope of practice  
(A) An applicant shall submit to the department, before retesting, documentation of  
having completed an approved NCLEX-PN review course.  
(B) An applicant who has completed the NCLEX-PN review course may sit for the  
NCLEX-PN examination a maximum of 3 times after completion of the review course  
and must still meet the timing requirements of this subrule.  
(d) An applicant who has not passed the NCLEX-PN examination after attempting the  
NCLEX-PN examination a maximum of 6 times within 3 years from either the date of  
graduation or after obtaining certification from the certification program of the CGFNS  
shall repeat an entire practical nurse education program that has been approved by the  
board pursuant to R 338.10303a and is in compliance with R 338.10303b.  
(4) “Approved NCLEX-PN review course” means 1 of the following:  
(a) A review course sponsored by a nursing education program that is approved by the  
board pursuant to R 338.10303a and is in compliance with R 338.10303b.  
(b) A review course sponsored by 1 of the following providers:  
(i) Assessment Technologies Institute Nursing Education.  
(ii) Elsevier/Health Education system Incorporated.  
(iii) Hurst Review Services.  
(iv) Kaplan.  
(v) National Council of State Boards of Nursing.  
(c) A college or university provided NCLEX-PN review course that is approved by  
another state board of nursing.  
(d) A review course approved by the board that includes NCLEX subject areas,  
NCLEX style questions, simulated examinations, and test taking strategies.  
R 338.10211 Licensure by endorsement; licensed practical nurse; requirements.  
Rule 211. (1) An applicant for licensure by endorsement shall submit a completed  
application on a form provided by the department, together with the requisite fee. In  
addition to meeting the other requirements of the code and the administrative rules  
promulgated pursuant to the code, an applicant who satisfies the requirements of this rule  
is deemed to meet the requirements of section 16186(1) of the code, MCL 333.16186.  
(2) An applicant for a practical nurse license shall meet both of the following  
requirements:  
(a) Complete a practical nurse education program specified in R 338.10210(2).  
(b) Be licensed in another state and initially licensed by taking the NCLEX-PN  
examination in another state.  
(3) An applicant’s license must be verified by the licensing agency of all other states of  
the United States in which the applicant holds a current license or ever held a license as a  
licensed practical nurse. Verification must include the record of any disciplinary action  
taken or pending against the applicant.  
PART 3. NURSING EDUCATION PROGRAMS  
R 338.10301 Definitions.  
Rule 301. As used in this part:  
9
(a) “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.  
(b) "Clinical experience" means direct nursing care experiences with 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.  
(c) "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.  
(d) “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.  
(e) “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 which gives direction to the curriculum.  
(f) “Cooperating agency” means an individual, organization, or institution that, by  
written agreement or letter of intent, accepts students and faculty for nursing educational  
experiences.  
(g) “Core curriculum for licensed practical nurse applicants” 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 the 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.  
(h) “Core curriculum for registered professional nurse applicants” 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 the newborn infant.  
10  
(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.  
(i) “Course student learning outcomes” means statements of educational expectations  
written in measurable terms for the knowledge, skills, or behaviors students should  
demonstrate by the end of the course. The statements should reflect contemporary  
evidence-based nursing practice and enhance achievement of end of program student  
learning outcomes.  
(j) “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.  
(k) “End of program student learning outcomes” means statements of educational  
expectations written in measurable terms for the knowledge, skills, or behaviors students  
should demonstrate by the end of the program. The statements should reflect professional  
standards, guidelines, contemporary nursing practice, guide the curriculum, and increase  
in complexity as students progress through the curriculum.  
(l) “Final program approval report” means a 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.  
(m) “Full program approval” means approval of a program granted after satisfactory  
demonstration to the board of compliance with these rules.  
(n) “Initial approval” means approval that is granted by the board to inaugurate a  
program of nursing education.  
(o) “Instruction” means educational methodology for achieving curriculum outcomes.  
(p) “Learning experiences” means planned learning situations, which may include  
clinical experiences, clinical laboratory hours, or classroom instruction.  
(q) “National accreditation” means a self-regulatory process that meets or exceeds  
educational quality standards and criteria set forth by a national nursing accreditation  
organization.  
(r) “Nurse education consultant” means a nurse with expertise in curriculum  
development and nursing program administration or education that independently  
examines a nursing program under disciplinary review.  
(s) “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:  
11  
(i) For programs that have received initial approval pursuant to R 338.10303, the report  
must be submitted each year during the program approval phase.  
(ii) For programs that have received full approval pursuant to R 338.10303a, the report  
must be completed and submitted at the halfway point between the self-study  
submissions.  
(t) “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.  
(u) “Nursing process” means the ongoing assessment, analysis, nursing diagnosis,  
planning, implementation, and evaluation of nursing care.  
(v) “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.  
(w) “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.  
(x) “Practical nurse program” means a nursing program to prepare students for practical  
nurse licensure.  
(y) “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.  
(z) “Probationary status” means the period when a program is under disciplinary action  
by the board.  
(aa) “Program director” means a nurse who is delegated the authority and accountability  
for the nursing program by the sponsoring agency.  
(bb) “Program of nursing education” means a plan or design indicating the relationship  
of the components necessary to achieve the goal of preparing persons for licensure as  
registered or practical nurses under the code.  
(cc) “Program outcomes” means documented and measurable indicators that reflect the  
program’s overall effectiveness.  
(dd) “Registered professional nurse program” means a nursing program to prepare  
students for initial registered nurse licensure.  
(ee) “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.  
(ff) “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.  
(gg) “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.  
(hh) “Sponsoring agency” means the organization or institution of which the nursing  
program is a component.  
R 338.10303 Initial program approval; procedure.  
12  
Rule 303. The following requirements are established for initial approval of a program  
of nursing education:  
(a) The sponsoring agency shall submit all of the following to the board:  
(i) A letter of intent to initiate a program of nursing education.  
(ii) A feasibility study that clearly demonstrates all of 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.  
(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 of 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 as  
defined in section 17201(1)(c) of the code, MCL 333.17201.  
(iv) Evidence that the sponsoring agency will provide funding and other support for the  
nursing education program that meets all of 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 will 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  
grievance or complaint process, counseling, academic advising, career placement,  
financial aid, and learning resource centers or library.  
(v) Evidence of approval to provide financial aid for students, under Title IV of the  
Higher Education Act of 1965, 20 USC 1070 et seq.  
(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 upon 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 courses,  
and demonstrate student success by certifying that exam results 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 will be held per year, and the dates when enrollment  
periods will be held annually.  
13  
(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 faculty members  
sufficiently in advance of admitting students to the nursing sequence to ensure  
consistency in the planning and implementation of the curriculum. If already appointed,  
the names and qualifications of the director of the program and other 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  
admissions 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 the 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 initial approval from the board 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.  
(iv) Curriculum to include end of program student learning outcomes and course  
student learning outcomes.  
(v) Course descriptions and outlines.  
(vi) Signed clinical contracts or letters of commitment for clinical placements.  
(vii) Evaluation methods and tools.  
(viii) Program outcomes.  
(ix) Director and faculty credentials.  
(x) 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.  
(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, but not limited to, student  
evaluations, faculty reviews, NCLEX evaluation results, and attrition rates.  
14  
(iv) Program changes.  
(v) Faculty qualifications, assignments, and any 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 shall apply 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 may apply to the board in the form of a letter.  
(b) 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 pursuant to R 338.10303(b), review the program’s progress since initial  
approval was granted, and include a review and evaluation of program implementation.  
(c) The board may require a subsequent 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.  
(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  
rule, the board may begin the evaluation process of the program pursuant to 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 of the requirements of this part.  
R 338.10303b Continued program approval; requirements.  
Rule 303b. (1) After full approval has been granted under R 338.10303a, a sponsoring  
agency shall submit a comprehensive self-study report every 8 years for a non-accredited  
program or at the designated reporting times directed by the national accrediting  
organization for accredited programs. The report must include all of 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) Course descriptions and outlines.  
(f) Signed clinical contracts or letters of commitment for clinical placements.  
(g) Evaluation methods and tools.  
(h) Program outcomes.  
(i) Director and faculty credentials.  
(j) Student policies and support services.  
(2) A program may submit a letter of accreditation or reaccreditation from a nationally  
recognized accrediting organization of nursing education programs instead of a self-study  
report prepared for the board. The schedule for submission of a self-study report for  
accredited programs must follow the schedule of the nationally recognized accrediting  
15  
organization. The accreditation letter must include documentation of decisions and  
recommendations from the accrediting organization and be submitted to the board within  
1 month following receipt of the nationally recognized accrediting organization’s  
decision on accreditation of the nursing education program. The board may request  
further documentation regarding accreditation from the sponsoring agency. Programs that  
have accreditation date changes shall notify the board of nursing to determine a  
submission date.  
(3) After a program has been granted full approval under R 338.10303a, the sponsoring  
agency shall submit a nurse education program report to the board every 4 years for a  
non-accredited program or at the midpoint of the accreditation cycle for nationally  
accredited programs. The nursing education program report must include all of the  
following information for all of the years since the last self-study report was approved by  
the board:  
(a) Admission, progression, and retention of students.  
(b) Student achievement on the required licensure NCLEX examination.  
(c) Systematic program evaluation results and action plan, including but not limited to,  
student evaluations, faculty reviews, NCLEX evaluation results, and attrition rates.  
(d) Program changes.  
(e) Faculty qualifications, assignments, and any faculty exceptions.  
(4) The board shall notify the program director of the date by which a nursing education  
program report must be submitted.  
R 338.10303c Program changes; requirements.  
Rule 303c. (1) A major program change means any of the following:  
(a) Revision of the program’s philosophy, conceptual framework, curriculum, program  
outcomes, student learning outcomes, or changes that increase the use of simulation more  
than 10% of the total clinical hours in a program.  
(b) Change in primary instruction delivery methods.  
(c) Elimination of separate course content for an integrated approach.  
(d) A permanent expansion in the number of students served.  
(e) Increase or decrease in overall program credits.  
(f) 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 anything other than theory is  
taught at the additional location.  
(2) A nursing education program shall submit major program changes to the board in  
writing and the major program changes must be approved by the board before  
implementation. All of the following information must be submitted when requesting  
approval of 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) Documents evidencing support for the requested change.  
(3) A minor program change means a change that does not permanently affect the  
program’s philosophy, conceptual framework, program outcomes, student learning  
16  
outcomes, approved enrollment numbers, increase simulation experiences by more than  
10%, change the primary instruction delivery methods, eliminate a separate course  
content for an integrated approach, permanently expand the number of students served, or  
increase or decrease the overall program credits.  
(4) A nursing education program shall submit minor program changes to the board in  
writing before implementation. Minor program changes include, but are not limited to, all  
of the following:  
(a) Changing prerequisites, co-requisites, or both.  
(b) A temporary expansion of students. After 1 year, if the program desires to make  
the temporary increase in seats permanent, a major program change must be submitted  
pursuant to subrule (1) of this rule.  
(c) Separation of 1 course into 2 courses.  
(d) Moving a course from 1 semester to another.  
(e) Combining 2 courses.  
(f) Changing the sequence in which courses are offered.  
(5) A nursing education program shall submit all of the following information if  
requesting approval of a minor program change:  
(a) A comparative description of the current and proposed program or portion of the  
program that is proposed for change.  
(b) Rationale for the change.  
(c) Plans to evaluate the effect of the change.  
(6) If a program closure occurs, the department may grant a temporary seat increase to  
another program to assist displaced students if the following criteria are met:  
(a) Additional seats that are needed are identified.  
(b) Documentation that there is sufficient faculty on staff to handle the increase in  
students is provided.  
(c) Documentation that there is sufficient classroom and laboratory space to handle the  
increase in students is provided.  
(d) Documentation from clinical sites that they can handle the increase of students in  
the program is provided.  
(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  
pursuant to 1 of the following:  
(a) A nursing education program that has received full board approval pursuant to R  
338.10303a, before the promulgation of this rule, 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 of receiving full program approval pursuant to 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 pursuant to section 17242 of the code, MCL  
333.17242.  
17  
(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 to maintain accreditation from an approved national nursing accrediting  
organization shall result in withdrawal of school approval pursuant to section 17242 of  
the code, MCL 333.17242, and R 338.10311.  
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 which shall be  
conducted pursuant to 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 of the following requirements:  
(a) Comply with the curriculum requirements established by the board and with other  
requirements set forth in this part.  
(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 as defined in section 17201(1)(c) of the code, MCL 333.17201.  
(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) 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 the state or Canadian province  
where the clinical experience is located.  
18  
(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. The majority of the didactic/theory faculty shall 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 Associate’s Degree in Nursing to Master’s of Science in Nursing  
(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 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 by January 6, 2022.  
(7) An exception may be made to the requirements of subrule (4) of this rule for full-  
time or part-time nursing faculty and shall be 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 shall be  
granted to any full-time or part-time faculty member.  
(8) Nursing faculty shall be 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 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) 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 the 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.  
19  
(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 by January 6, 2022.  
(6) An exception may be made to the requirements of subrule (4) of this rule for full-  
time or part-time nursing faculty and shall be 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 shall be  
granted to any full-time or part-time faculty member.  
(7) Nursing faculty shall be 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 of the following requirements:  
(a) Each preceptor shall be approved by the faculty of the program of nursing  
education.  
(b) Each preceptor shall possess a minimum of 1 year of clinical nursing experience  
and supervisor recommendation.  
(c) Each preceptor shall hold an unencumbered license in the state where the clinical  
experience occurs.  
(d) The faculty of the program of nursing education shall ensure that 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 faculty of the program  
of nursing shall develop written learning outcomes for the clinical experience and provide  
a copy of those outcomes to each preceptor.  
(f) The faculty member shall retain authority and responsibility for the student’s  
learning experiences and shall 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 faculty member must be  
not more than 10 students to 1 faculty member.  
(h) If the faculty member is not physically present in the area in which students are  
practicing, he or she shall be immediately available by telephone or other means of  
telecommunication when students are engaged in clinical activities with a preceptor.  
20  
(i) Preceptors shall not be used to replace clinical 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 must 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 and from the known to the unknown, with  
each learning experience built on previously learned information of nursing and related  
scientific knowledge.  
(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 of the following areas:  
(a) The understanding of the roles and responsibilities of the members of the nursing  
profession.  
(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 of the following:  
(i) Communications.  
(ii) Critical thinking, clinical reasoning, and problem solving.  
21  
(iii) Understanding legal and professional responsibilities.  
(iv) Inter-professional relationships with other health care 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, he or she 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 will enable all students to meet the outcomes established for the clinical  
experience pursuant to R 338.10303.  
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 of 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 and simulation laboratory experiences in the care of  
individuals across diverse age groups, genders, races and cultures, in medical, surgical,  
pediatric, obstetrical, and geriatric nursing and provide supervised practice in the  
administration of medications. Clinical laboratory, simulation laboratory, and clinical  
experience hours must be sufficient to meet the outcomes of the curriculum.  
(c) Ensure that courses include content relating to all of 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.  
(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 in any single 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  
22  
International Nursing Association for Clinical Simulation and Learning, as specified in  
the publication entitled, “Standards of Best Practice: Simulation” 2016. 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 cost from the Board of Nursing, Bureau of  
Professional Licensing, Department of Licensing and Regulatory Affairs, 611 W. 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 National Council  
of State Boards of Nursing.  
(e) Complaints regarding the conduct of the program are received and it is necessary to  
validate the complaints, pursuant to 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 pursuant to the time frames set forth in R 338.10303b.  
(g) 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.  
(h) Program completion rate of less than 75% as submitted on a nursing education  
program report. The rate is calculated by determining the number of students who  
complete the nursing program in no more than 150% of the stated program length.  
(i) Failure of the nursing education program to evaluate a program to apply for full  
approval by the end of the fourth cohort.  
(j) Failure of a nursing education program to submit an annual nursing education  
program report pursuant to the time frames set forth in R 338.10303(d).  
R 338.10310a Nursing education program; board action following evaluation.  
Rule 310a. The board shall require a nursing education program evaluated pursuant to  
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 administrative rules to comply with  
all of the following, as applicable:  
(a) An action plan or NCLEX improvement plan: The board shall require an action 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 of the evaluation or with the next nursing education program report as  
defined in R 338.10303b, whichever comes first. All of the following apply:  
(i) The plan must indicate that an evaluation of the nursing education program was  
conducted by the program’s director and faculty to identify problem areas. The plan  
must include specific steps that are being taken to affect changes in the program. The  
action plan must also provide a method for the evaluation of the changes and further  
action to be taken, if program performance continues to be out of compliance.  
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(ii) The plan must include specific steps that are being taken to affect changes in the  
program.  
(iii) The plan must focus on improvements to the curriculum, student admission and  
progression, faculty expertise in nursing and teaching, and institutional support.  
(iv) The plan must provide a method for the evaluation of the changes and further  
action to be taken if program performance continues to be out of compliance.  
(v) The program has 1 year from report submission to implement the changes that are  
specified in the action plan.  
(vi) If there is no evidence of improvement 1 year from the plan’s implementation,  
then the board shall place the program on “probationary status” and the program shall  
comply with subdivision (b) of this rule.  
(b) A self-study: The board shall require a full self-study of the program of nursing  
education as the second step for improvement. The sponsoring agency shall submit the  
self-study within 6 months of notification from the board or department. All of the  
following apply:  
(i) The self-study must be a complete review of the program including, but not limited  
to, admission policies, curriculum, teaching methods, faculty credentials, testing  
methods, remediation methods, and failure policies.  
(ii) If the result of the self-study concludes that a major program change is necessary, a  
major program change must be developed by the sponsoring agency. The major program  
change must be submitted to the board for its review and approval before the changes  
taking effect.  
(iii) If the result of the self-study concludes that a minor program change is necessary,  
a minor program change must be developed by the sponsoring agency. The minor  
program change must be submitted to the board for its review and approval before the  
changes take effect.  
(iv) The program shall have 1 cohort cycle to demonstrate improvement.  
(v) After the graduation and NCLEX testing of that cohort, if there is no evidence of  
improvement, the program shall comply with subdivision (c) of this rule.  
(c) A nursing education consultant: The program shall employ the services of a nursing  
education consultant whose credentials must be submitted to the board. All of the  
following apply:  
(i) The program shall require the consultant to conduct a full and comprehensive  
review of the nursing education program and prepare a report of the findings and  
recommendations for improvement.  
(ii) The program shall submit the nursing education consultant’s report of the findings  
and recommendations to the board. The program shall also submit a plan to implement  
the recommendations of the consultant to the board.  
(iii) If the recommendation involves a major program change, the sponsoring agency  
shall submit it to the board for its approval before the implementation of the program  
change.  
(iv) The program shall have 1 cohort cycle under the major program change to  
demonstrate improvement.  
(v) If the recommendations do not involve a major program change, the school then  
has 1 year from report submission to implement the changes.  
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(vi) If there is no evidence of improvement after the NCLEX examination of the cohort  
or by the end of 1 year following report submission, the program shall comply with  
subdivision (d) of this rule.  
(d) A reduction in admissions: The program shall reduce admissions to a board-  
recommended level. Both of the following apply:  
(i) The program shall have 1 cohort cycle under the reduction in admissions to  
demonstrate improvement.  
(ii) If there is no evidence of improvement, the board shall commence withdrawal of  
program approval pursuant to section 17242(2) of the code, MCL 333.17242.  
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 be in accordance with all applicable  
federal and state laws and regulations. The board shall retain this information so that  
graduates may be given the source of information upon 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 pursuant to 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 pursuant to R  
338.10303 and obtain board approval before resuming admissions.  
(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 pursuant to 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 338.10404c Specialty certification qualifications; clinical nurse specialist.  
Rule 404c. (1) A specialty certification for a clinical nurse specialist must 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 clinical nurse specialist, on a form  
provided by the department with the required fee.  
(c) Possesses either of the following:  
(i) An advanced practice certification from either of the following certification  
organizations, or successor organizations:  
(A) The American Nurses Credentialing Center.  
(B) The American Association of Critical Care Nurses Certification Corporation.  
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(ii) If an applicant is unable to take a national certification exam due to graduation  
from an accredited clinical nurse specialist master’s or doctoral nursing program before  
the development of clinical nurse specialist core competencies and the requirement of  
500 clinical practice hours, he or she may be granted a specialty certification as a clinical  
nurse specialist based upon submission of a portfolio of evidence that demonstrates  
knowledge and skill competence in the clinical nurse specialist role and population focus.  
The portfolio must include all of the following:  
(A) Transcripts from an accredited master’s or doctoral level educational program in  
clinical nursing with preparation as a clinical nurse specialist.  
(B) Curriculum vitae demonstrating work history in a clinical nurse specialist  
position before April 9, 2017.  
(C) Three letters of recommendation, including 1 from a clinical nurse specialist  
with national board certification and 2 letters from nursing administrators, nursing  
supervisors, or advanced practice nurses attesting that the applicant has at least 3,000  
hours of practice as a clinical nurse specialist before April 9, 2017. These letters must  
provide evidence that the applicant engaged in practice consistent with the standards for a  
clinical nurse specialist as described by the National Association of Clinical Nurse  
Specialists (NACNS) in the publication entitled “Clinical Nurse Specialist and Core  
Competencies” 2010, which is adopted by reference. A copy of the standards and  
requirements is available at no cost from the association’s website at www.nacns.org . A  
copy of the standards and requirements also is available for inspection and distribution at  
no cost from the Board of Nursing, Michigan Department of Licensing and Regulatory  
Affairs, 611 West Ottawa, Lansing, MI 48909  
(2) Application for certification as a clinical nurse specialist granted under the criteria  
set forth in subrule (1)(c)(ii) of this rule is not permitted after March 8, 2020.  
PART 6. CONTINUING EDUCATION  
R 338.10601 License renewals; requirements; applicability.  
Rule 601. (1) Pursuant to section 16201 of the code, MCL 333.16201, an applicant for  
license renewal who has been licensed for the 2-year period immediately preceding the  
expiration date of the license, shall accumulate at least 25 hours of continuing education  
that are approved by the board pursuant to these rules during the 2 years before the  
expiration of the license.  
(2) An applicant for license renewal shall complete at least 2 hours, of the 25 required  
hours, of continuing education in pain and pain symptom management in each renewal  
period pursuant to 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) 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 from the date of applying for  
license renewal. The board may require an applicant to submit evidence to demonstrate  
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compliance with this rule. Failure to comply with this rule is a violation of section  
16221(h) of the code, MCL 333.16221.  
(4) A request for a waiver under section 16205 of the code, MCL 333.16205, must be  
received by the department before the expiration date of the license.  
(5) The requirements of this part do not apply to an applicant during an initial licensure  
cycle.  
R 338.10602 Acceptable continuing education; requirements; limitations.  
Rule 602. (1) The 25 hours of continuing education required pursuant to R 338.10601(1)  
for the renewal of a license must comply with the following, as applicable:  
(a) No more than 12 credit hours must be earned during a 24-hour period for online or  
electronic media, such as videos, internet web-based seminars, video conferences, online  
continuing education programs, and online journal articles.  
(b) An applicant 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:  
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 approved or offered for  
continuing education credit by any of the  
following:  
credit hour for each 60 minutes of  
participation may be earned.  
A minimum of 25 hours must be  
earned in each renewal period.  
The American Association of Nurse  
Anesthetists (AANA).  
The American Association of Nurse  
Practitioners (AANP).  
The Accreditation Council for  
Continuing Medical Education  
(ACCME).  
The American College of Nurse-  
Midwives (ACNM).  
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).  
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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.  
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 on  
which the program was held or activity  
completed.  
(b) Completion of academic courses related to  
nursing practice offered by a nursing  
education program in Michigan 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).  
Five hours of continuing education  
may be earned for each semester  
credit hour earned.  
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, which includes  
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 may be earned in the  
year in which the applicant  
achieves a passing score.  
If audited, an applicant shall submit proof of a  
passing score on the examination.  
A maximum of 20 hours may be  
earned in each renewal period.  
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Credit will 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 per publication.  
A maximum of 10 hours may be  
earned in each renewal period.  
A nursing or health care textbook.  
A peer-reviewed textbook.  
A nursing or health care peer-  
reviewed journal.  
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 for each 50 to 60  
listening to media related to nursing practice  
that do not include a self-assessment  
component.  
minutes of participation.  
A maximum of 4 hours 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 health care organization  
One hour for each 60 minutes of  
committee dealing with quality patient care or participation.  
utilization review.  
A maximum of 4 hours may be  
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.  
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 may be earned for  
each 60 minutes of presentation.  
A maximum of 6 hours may be  
If audited, an applicant shall submit a copy of earned in each renewal period.  
the curriculum and a letter from the program  
sponsor verifying the length and date of the  
presentation.  
(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  
120 hours and have a 1 student/employee to 1  
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preceptor ratio. This may involve more than 1  
student or employee.  
If audited, an applicant shall submit written  
documentation from the educational  
institution or preceptor’s supervisor verifying  
the dates and hours of the preceptorship.  
PART 7. NURSING PROFESSIONAL FUND SCHOLARSHIP PROGRAM  
R 338.10702 Board determination of categories and areas of need for designating  
awards; department required to communicate board's determination of need to nursing  
programs; applications.  
Rule 702. (1) The board shall annually determine categories and areas of need for  
designating scholarship awards to eligible programs of nursing. The board may consider  
any of the following in establishing categories and areas of need:  
(a) Data generated from Michigan licensure renewal information and nursing surveys.  
(b) National and state trends that have identified nursing shortages.  
(c) Data identifying medically underserved areas, medically underserved populations,  
or health professional shortage areas.  
(d) Health status and nursing care needs of the state’s residents.  
(2) The department shall communicate the board’s determination as to categories and  
areas of need to approved nursing education programs in this state.  
(3) The department shall provide applications to approved programs of nursing that  
meet the established eligibility criteria in R 338.10703.  
R 338.10703 Eligibility of and allocation to nursing education programs.  
Rule 703. (1) To be eligible for a scholarship award, a school shall meet 1 of the  
following criteria:  
(a) Provide a prelicensure nursing program that complies with all of the following:  
(i) Is approved by the Michigan board of nursing.  
(ii) Has a primary campus located in this state.  
(iii) Offers a program of nursing that meets the predetermined category and area of  
need as established by the board under R 338.10702.  
(iv) Submits an application approved by the department declaring a notice of intent to  
participate in the scholarship.  
(b) Provide a post-licensure nursing program that complies with all of the following:  
(i) Is accredited by a national nursing education accrediting entity.  
(ii) Has a primary campus located in this state.  
(iii) Submits an application approved by the department declaring a notice of intent to  
participate in the scholarship.  
(2) A school may submit an application for participation for only those programs that  
are included in the annual list of scholarship program categories and areas of need as  
determined by the board pursuant to R 338.10702.  
30  
(3) The department shall annually determine the allocation for each eligible education  
program.  
R 338.10704 Nursing education program awards to eligible students; requirements, ;  
procedures.  
Rule 704. (1) An eligible nursing education program, upon receiving an allocation, shall  
award a scholarship to a full-time or part-time student who meets all of the following  
criteria:  
(a) Is a permanent resident of this state.  
(b) If licensed as a nurse, holds an unencumbered Michigan license to practice nursing.  
(c) Is not in receipt of a full scholarship from another source.  
(d) Maintains satisfactory progress as determined by the eligible nursing education  
program.  
(2) A nursing education program shall apply a scholarship award first to the cost of  
tuition, books, and fees associated with the program. A nursing program shall then  
provide the remainder of the award, if any, to the student in the form of a stipend.  
(3) The nursing education program shall complete the notice of intent to award the  
board of nursing scholarship form supplied by the department. The notice must contain  
all of the following information:  
(a) The name, address, and date of birth of the recipient.  
(b) Course of study or program in which the recipient is enrolled.  
(c) Attestation that all criteria of subrule (1) of this rule have been met.  
(d) Information regarding electronic funds transfer from the department to the  
program.  
(e) Signature of the program director and financial aid director or other employee  
employed by the financial aid office who can attest to accuracy of the information on the  
form.  
(4) A student may receive a scholarship award only once for each level of nursing  
education.  
(5) If a recipient withdraws from the nursing education program, then within 30 days of  
withdrawal, the nursing education program shall notify the department, in writing, of its  
intent to do 1 of the following:  
(a) Award the scholarship funds to a recipient who has been chosen to receive the  
scholarship for the current scholarship year.  
(b) Select a new applicant and submit the recipient’s application and the notice of  
intent to award the board of nursing scholarship form to the department.  
(c) Return the unused funds to the department.  
(6) The nursing education program shall account for all of the funds disbursed by the  
department no later than February 15 of the academic year in which the funds were  
distributed. Both of the following apply:  
(a) The department shall supply the accounting form to each program that is  
participating in the nurse professional fund scholarship program.  
(b) Failure of a program to submit an accounting statement to the department in  
accordance with subrule (6) of this rule will result in the department withholding future  
scholarship funds from the program until all past due accounting statements have been  
submitted and approved.  
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R 338.10705 School ineligibility; notification; hearing.  
Rule 705. (1) If a school is deemed ineligible for a nursing scholarship award, then the  
department shall notify the school in writing.  
(2) Upon receipt of notification of ineligibility, a school may request a hearing. The  
department shall conduct a hearing under the administrative procedures act of 1969, 1969  
PA 306, MCL 24.201 to 24.328.  
;