STORAGE NAME: h0919b.CWS
DATE: 3/17/2025
1
FLORIDA HOUSE OF REPRESENTATIVES
BILL ANALYSIS
This bill analysis was prepared by nonpartisan committee staff and does not constitute an official statement of legislative intent.
BILL #: HB 919
TITLE: Nursing Education Programs
SPONSOR(S): Overdorf
COMPANION BILL: None
LINKED BILLS: None
RELATED BILLS: CS/SB 526 (Harrell)
Committee References
Health Professions & Programs
15 Y, 0 N
Careers & Workforce
Health & Human Services
SUMMARY
Effect of the Bill:
HB 919 establishes new requirements for nursing education programs approved by the Board of Nursing, including
the adoption of standardized evaluation and admission criteria, a comprehensive exit exam, and a remediation
program. The bill also revises existing accountability measures by reducing the number of years an approved
nursing education program can fail to meet statutory requirements before being placed on probation, and further
limiting the length of time an approved program can spend on probation. The bill also removes the Board of
Nursing’s authority to extend the deadline for nursing education programs required to obtain accreditation under
current law.
Fiscal or Economic Impact:
The Department of Health will incur an insignificant, negative fiscal impact implementing the provisions of this bill
which current resources are adequate to absorb.
JUMP TO SUMMARY ANALYSIS RELEVANT INFORMATION BILL HISTORY
ANALYSIS
EFFECT OF THE BILL:
Nursing Education Program Requirements
Florida is currently facing a nursing workforce shortage that is expected to grow to 59,000 nurses by 2035. Before
a potential nurse can be licensed to practice, they must first graduate from an approved nursing education
program and pass the National Council of State Boards of Nursing Licensing Exam (NCLEX). Florida’s first-time
test-takers have consistently scored below the nation’s average for the past decade and Florida currently ranks last
in the nation for NCLEX passage rates.
HB 919 revises existing accountability measures and imposes new requirements for pre-licensure nursing
education programs for practical nurses (LPN) and professional nurses (RN). Under the bill, nursing education
programs must include the legal name of the program director as well as documentation of the following program
components in the application for approval:
Standardized evaluation and admission criteria. The admission criteria must identify students who are
likely to need additional educational support and the program must maintain individualized student
academic support plans for these students.
A comprehensive exit examination to prepare students for the NCLEX.
Remediation to be offered to students who do not pass the exit examination. JUMP TO SUMMARY ANALYSIS RELEVANT INFORMATION BILL HISTORY
2
An educational institution seeking to administer a nursing education program must demonstrate to the
Department of Health (DOH) that it meets all statutory requirements for approval.
1 Nursing education programs
that have already been approved must affirm continued compliance with all requirements through an affidavit
submitted with the program’s annual report. The bill requires the Board of Nursing (Board) to terminate a nursing
education program for failing to adhere to the annual reporting requirements.
The bill gives the Board the express authority to deny an application from a nursing education program that has
had adverse action taken against it by another regulatory jurisdiction in the U.S., and to revoke the approval of an
existing approved program for the same.
The bill authorizes DOH staff to conduct on-site inspections or evaluations of nursing education programs to assess
compliance with statutory requirements. A nursing education program is subject to disciplinary action by the
Department if the program fails to allow such an inspection or evaluation during reasonable hours.
Program Director Responsibilities
Current law requires nursing education programs to be administered by a program director who is a registered
nurse. While current law requires the program director to appear before the Board in circumstances where the
program is failing to meet statutory requirements, it does not impose any accountability measures or disciplinary
actions against the program director for failing to comply with these requirements.
Under the bill, the program director is expressly responsible for submitting the required annual report to the
Board, as well as a written remediation plan in the case of a program that has failed to meet the required NCLEX
graduate passage rates. The program director must also certify the accuracy of the program faculty credentials
reported to the Board and ensure that the program’s average exit examination results are posted on the program’s
website. A program director’s failure to comply with requirements under this section constitute grounds for
discipline.
2
Accountability Requirements
Current law establishes minimum NCLEX passage rate requirements for approved nursing education programs.
3
Programs that fail to meet these requirements for two consecutive years are subject to a probationary process. A
program may remain on probation for up to two years, unless the Board has granted an extension for a third year.
Programs that fail to meet the required passage rate during the probationary period are terminated by the Board.
Under the bill, a nursing education program that fails to meet the statutorily required NCLEX passage rates for a
single calendar year, compared to two calendar years under current law, must be placed on probationary status
pursuant to Chapter 120, F.S.
Upon being placed on probation, the bill requires the program’s director to submit a written remediation plan to
the Board, in addition to the oral presentation of a remediation plan to the Board required under current law. The
remediation plan must include specific, nationally recognized benchmarks to identify progress toward a passage
rate goal. The bill requires the Board to terminate the program if the program director fails to submit and present a
remediation plan within six months of the program’s placement on probation.
Under the bill, a nursing education program may stay on probation for one calendar year. The bill requires the
Board to terminate a program if it does not achieve the required passage rate in the year following its placement
on probationary status. Under the proposed framework, a nursing educational program may only fail to meet the
required NCLEX passage rate for two consecutive years before facing termination. This is a significantly shorter
1 See, s. 464.008(1), F.S.; graduation from an approved, or equivalent, nursing education program is a prerequisite for licensure by
examination as a practical or professional nurse.
2 See, s. 456.072(k)(1), F.S.; Under current law, every licensee is subject to discipline for failure to perform a statutory or legal obligation
placed upon a licensee
3 See, s. 464.019(5), F.S. JUMP TO SUMMARY ANALYSIS RELEVANT INFORMATION BILL HISTORY
3
timeframe than under current law, which allows a nursing education program to fail to meet the required passage
rate for up to five consecutive years before the program is terminated.
Additionally, the bill requires nursing education programs with an NCLEX passage rate below 30 percent in a given
year to reimburse the total cost of tuition and fees paid by each student who failed to pass the NCLEX as a first-time
test taker in that calendar year.
Student Remediation
As a requirement for Board approval, all nursing education programs must establish criteria for remediation
programs to be offered to students who fail the program’s exit exam. Additionally, nursing education programs
that are on probation must provide remediation at no cost, or otherwise pay for the student to obtain remediation
from a different Board-approved remediation course, to students who have failed the program’s exit exam, or have
failed the NCLEX.
Accreditation
Under current law, nursing education programs for professional nurses
4 must obtain accreditation within five
years of enrolling its first students, or face termination for failing to do. However, a program may apply to the
Board and receive a deadline extension of up to two years, for a total of seven years until a program must be
accredited.
5
The bill eliminates the Board’s authority to grant an extension of the accreditation deadline, thereby limiting
programs to only five years between enrolling students and obtaining accreditation.
The bill provides an effective date of July 1, 2025.
RULEMAKING:
The Board has limited rulemaking authority regarding the regulation of nursing education programs. The bill
expands the Board’s rulemaking authority to expressly include the enforcement and administration of
accountability provisions of this bill.
Lawmaking is a legislative power; however, the Legislature may delegate a portion of such power to executive
branch agencies to create rules that have the force of law. To exercise this delegated power, an agency must
have a grant of rulemaking authority and a law to implement.
FISCAL OR ECONOMIC IMPACT:
STATE GOVERNMENT:
Current resources are adequate to absorb the increase in workload that the Department of Health will experience
relating to enforcement and rulemaking under the provisions of this bill.
6
RELEVANT INFORMATION
SUBJECT OVERVIEW:
Nursing Practice and Regulation
4 Also known as Registered Nurses, or RNs.
5 S. 464.019(11), F.S.
6 Department of Health, 2025 Agency Legislative Bill Analysis for HB 919 (2025). On file with the Health Professions and Programs
Subcommittee. JUMP TO SUMMARY ANALYSIS RELEVANT INFORMATION BILL HISTORY
4
The Board of Nursing (Board), within the Department of Health (DOH), oversees the licensure and regulation of the
nursing profession, as well as the pre-licensure nursing education programs that prepare individuals to practice
nursing in the state. The Board is composed of 13 members appointed by the Governor and approved by the
Senate. The Board membership includes:
7
Seven professional nurses who have been practicing for at least four years, including one advanced practice
registered nurse, one nurse educator from an approved nursing education program, and one nurse
executive;
Three licensed practical nurses who have been practicing for at least four years; and
Three residents of this state who have never been licensed as nurses and who are in no way connected with
the practice of nursing.
There are two nursing licensure categories:
Professional nurses; often referred to as “registered nurses,” (RNs), professional nurses perform acts
requiring substantial specialized knowledge, judgement, and nursing skill based on applied principles of
psychological, biological, physical, and social sciences. Advanced Practice Registered Nurses (APRNs) are a
subcategory of professional nurses who have completed additional education and training.
Practical nurses; a licensed practical nurse (LPN) performs selected acts, including the administration of
treatments and medications, in the care of the ill, injured, or infirm; the promotion of wellness,
maintenance of health, and prevention of illness of others under the direction of a registered nurse, a
licensed physician, a licensed osteopathic physician, a licensed podiatric physician, or a licensed dentist.
To be licensed as either a professional or practical nurse, an applicant must, among other requirements, have
graduated from an approved
8 prelicensure nursing education program and passed the national licensure
examination, the National Council of State Boards of Nursing Licensure Exam (NCLEX), for the level of nursing the
applicant is seeking to practice.
9
Nursing Education Programs
Pre-licensure nursing education programs prepare students to safely practice as either an RN or LPN. A key
component of this preparation is ensuring that students are ready and able to pass the NCLEX. Successful
completion of the NCLEX is required for licensure as a nurse.
In Florida, nursing education programs are offered by state universities, Florida colleges, public school districts,
private institutions licensed by the Commission for Independent Education (CIE), private institutions that are
members of the Independent Colleges and Universities of Florida (ICUF), and religious institutions authorized by
law to offer nursing education programs.
10
Board-approved Nursing Education Programs
Nursing education programs are overseen by the Board, in conjunction with DOH. An educational institution
seeking to conduct a nursing education program must apply to DOH for approval, DOH reviews the application for
completion, and then forwards the complete application to the Board for final approval.
11 As of January 9, 2025,
there are 319 approved RN education programs and 194 approved LPN education programs.
12
7 S. 464.004, F.S.
8 Or a program that the Board has determined to be equivalent to an approved program; see, s. 464.008(1)(c), F.S.
9 s. 464.008(1), F.S.
10 Florida Center for Nursing, The State of Nursing Education in Florida (2025). Available at https://www.flcenterfornursing.org/research-
data/nursing-education-reports/the-state-of-nursing-education-in-florida-2025/ (last visited March 15, 2025).; see also, s. 1005.06, F.S.
11 S. 464.019(2), F.S.
12 Department of Health, 2025 Agency Legislative Bill Analysis for HB 919 (2025). On file with the Health Professions and Programs
Subcommittee. JUMP TO SUMMARY ANALYSIS RELEVANT INFORMATION BILL HISTORY
5
The application must include the legal name of the educational institution, the legal name of the nursing education
program, and, if the institution is accredited, the name of the accrediting agency. The application must also
document:
13
For an RN education program, the program director and that at least 50 percent of the program’s faculty
members must be RNs who have a master’s degree or higher in nursing or a bachelor’s degree in nursing
and a master’s or higher degree in a field related to nursing;
For an LPN education program, the program director and at least 50 percent of the program’s faculty
members must be RNs who have a bachelor’s degree or higher in nursing;
The program’s nursing major curriculum consists of at least:
o Fifty percent clinical training in the U.S., the District of Columbia (D.C.), or a possession or territory
of the U.S. for an LPN, ARN, or a diploma RN;
o Forty percent of clinical training in a U.S. state, D.C., or a possession or territory of the U.S. for a B.S.
degree RN education program, and no more than 50 percent of the program’s clinical training may
consist of clinical simulation;
The RN and LPN educational degree requirements may be documented by an official transcript or by a
written statement from the educational institution verifying that the institution conferred the degree;
The program must have signed agreements with each agency, facility, and organization included in the
curriculum plan as clinical training sites and community-based clinical experience sites;
The program must have written policies for faculty which include provisions for direct or indirect
supervision by faculty or clinical preceptors for students in clinical training consistent with the following
standards:
o The number of program faculty members must equal at least one faculty member directly
supervising every 12 students unless the written agreement between the program and the agency,
facility, or organization providing clinical training sites allows more students, not to exceed 18, to
be directly supervised by one program faculty member;
o For a hospital setting, indirect supervision may occur only if there is direct supervision by an
assigned clinical preceptor and a supervising program faculty member is available by telephone,
and such arrangement is approved by the clinical facility;
o For community-based clinical experiences that involve student participation in invasive or complex
nursing activities, students must be directly supervised by a program faculty member or clinical
preceptor and such arrangement must be approved by the community-based clinical facility;
o For community-based clinical experiences not involving student participation in invasive or
complex nursing activities, indirect supervision may occur only when a supervising program faculty
member is available to the student by telephone; and
o A program’s clinical training policies must require that a clinical preceptor who is supervising
students in an RN education program be an RN or, if supervising students in an LPN education
program, be an RN or LPN;
The RN or LPN nursing curriculum plan must document clinical experience and theoretical instruction in
medical, surgical, obstetric, pediatric, and geriatric nursing. An RN curriculum plan must also document
clinical experience and theoretical instruction in psychiatric nursing. Each curriculum plan must document
clinical training experience in appropriate settings that include, but are not limited to, acute care, long-term
care, and community settings;
An RN or LPN education program must provide theoretical instruction and clinical application in the
following:
o Personal, family, and community health concepts;
o Nutrition;
o Human growth and development throughout the lifespan;
o Body structure and function;
o Interpersonal relationship skills;
o Mental health concepts;
o Pharmacology and administration of medications; and Legal aspects of practice; and
An RN nursing education program must also provide theoretical instruction and clinical experience in:
13 S. 464.019(1), F.S. JUMP TO SUMMARY ANALYSIS RELEVANT INFORMATION BILL HISTORY
6
o Interpersonal relationships and leadership skills;
o Professional role and function; and
o Health teaching and counseling skills.
DOH has 30 days after receiving an application to notify the applicant of any errors or omissions in the application.
DOH will forward complete applications to the Board who may then conduct an onsite evaluation if necessary to
document the applicant’s compliance with staffing and curriculum requirements. Within 90 days of DOH’s receipt
of the complete application, the Board must either:
14
Approve the application; or
Provide the educational institution with a notice of intent to deny citing specific reasons for the denial.
The applicant may request may request a hearing on the notice of intent to deny pursuant to the Administrative
Procedures Act.
15
Nursing Education Program Annual Report
Approved nursing education programs are required to submit an annual report to the Board by November 1
st of
each year. The annual report must include:
An affidavit certifying continued compliance with s. 465.019(1), F.S;
A summary description of the program’s compliance with s. 465.019(1), F.S; and
Documentation for the previous academic year that describes:
o The number of student applications received, qualified applicants, applicants accepted, accepted
applicants who enroll in the program, students enrolled in the program, and program graduates;
o The program’s retention rates for students tracked from program entry to graduation; and
o The program’s accreditation status, including identification of the accrediting agency.
16
If an approved nursing education program fails to submit the required annual report, the Board must notify the
program director and president or chief executive officer of the institution in writing within 15 days after the due
date. The program director must appear before the Board to explain the delay. If the program director fails to
appear, or if the program does not submit the annual report within six months after the due date, the BON must
terminate the program.
17 In 2024, the Board terminated 31 programs for failing to submit their annual report.
18
Accountability Requirements
The NCLEX is developed by the National Council of State Boards of Nursing (NCSBN) to test the competency of
nursing education program graduates in the United States and Canada. The NCSBN is a non-profit organization
whose membership is composed of state boards of nursing and other nursing regulatory bodies that are charged
with regulating public health, safety, and welfare.
19 The NCLEX-RN and NCLEX-PN are variable-length, valid, and
reliable computerized adaptive tests designed to measure nursing competence according to the intended practice
level of the test-taker.
Approved nursing education programs are required to meet accountability requirements related to graduate
passage rates on the NCLEX. The graduate passage rate is the percentage of a nursing education program’s
graduates who, as first-time test-takers, pass the NCLEX in a given calendar year.
20 The national passage rates for
2024 are 91.16 percent for the NCLEX-RN and 88.38 percent for the NCLEX-PN.; compared to Florida’s passage
14 S. 464.019(2), F.S.
15 Id. See also, Ch. 120, F.S.
16 S. 464.019(3), F.S.
17 s. 464.019(5), F.S.
18 Supra, note 12.
19 National Council of State Boards of Nursing, History. Available at https://www.ncsbn.org/about/history.page (last visited March 15,
2025).
20 S. 464.003(14), F.S. JUMP TO SUMMARY ANALYSIS RELEVANT INFORMATION BILL HISTORY
7
rates of 84.9 percent for the NCLEX-RN and 80.78 percent for the NCLEX-PN.
21 These scores place Florida last
among all 50 states for NCLEX passage rates in 2024.
22
The number of test-takers passing the NCLEX can indicate the number of new nurses entering the nursing
workforce. In 2024, Florida had fewer total NCLEX-RN test-takers than in 2023, but a higher pass rate, producing
almost the same number of new nurses.
23
Approved nursing education programs must achieve graduate passage rates that are no more than ten percentage
points lower than the average passage rate for the same calendar year for graduates of comparable degree
programs who are U.S. educated, first-time NCLEX test takers.
24 Individual nursing education programs are
compared to other programs based on level of nursing and degree type. Programs are categorized according to the
following program types:
25
RN nursing education programs that terminate in a bachelor’s degree;
RN nursing education programs that terminate in an associate degree;
RN nursing education programs that terminate in a diploma; and
LPN nursing education programs.
Approved nursing education programs that fail to meet the required passage rates for two consecutive years must
be placed on probation by the Board. The program director of a program placed on probation must appear before
the Board to present a remediation plan including specific benchmarks to identify progress toward a graduate
passage rate goal. A program is taken off of probation once it achieves a graduate passage rate that meets the
statutory requirement in a calendar year. A program’s probationary status is automatically carried over for a
second year if the program does not meet the required passage rate in the first year on probation. The Board may
grant a program a third year of probation if the program still does not meet the required passage rate, but is able to
demonstrate improvement. If the program is not granted the one-year extension of probation, or if the program
fails to meet the required passage rates after the third year of probation, the Board must terminate the program.
26
The current probationary process allows nursing education programs to have up to five consecutive years of
unsatisfactory NCLEX passage rates, including three years of probation.
In 2024, three LPN education programs and 13 RN education programs were placed on probation. Of the 16
programs placed on probation, 12 were for-profit programs.
27
Accreditation
An “accredited” nursing education program is a program operated in the U.S. and is accredited by a specialized
nursing accrediting agency that is nationally recognized by the United States Secretary of Education to accredit
nursing education programs.
28 The specialized nursing accreditors are the:
29
Accreditation Commission for Education in Nursing;
Commission on Collegiate Nursing Education; and
National League for Nursing Commission for Nursing Education Accreditation.
Board-approved RN education programs are required to obtain accreditation within five years of enrolling its first
students.
30 However, a program may apply to the Board and receive an extension of the deadline for up to two
21 Supra, note 23.
22 Supra, note 12.
23 Florida Center for Nursing, The State of Nursing Education in Florida (2025). Available at https://www.flcenterfornursing.org/research-
data/nursing-education-reports/the-state-of-nursing-education-in-florida-2025/ (last visited March 15, 2025).
24 s. 464.019(5), F.S.
25 Id.
26 s. 464.019(5), F.S.
27 Supra, note 12.
28 S. 464.003(1), F.S.
29 Supra, note 23.
30 S. 464.019(11), F.S. JUMP TO SUMMARY ANALYSIS RELEVANT INFORMATION BILL HISTORY
8
years. In order to be eligible for an extension, a program must meet NCLEX graduate passage rate, student
retention, and graduate work placement requirements, among others.
31
Due to the stringent criteria required to maintain accreditation, accredited nursing education programs are exempt
from the reporting requirements that are used to monitor approved nursing education programs’ compliance with
requirements, however they are still required to meet the statutory requirements for graduate passage rates on
the NCLEX.
32
If an accredited nursing education program ceases to be accredited, the educational institution conducting the
program must provide written notice to that effect to the BON, the program’s students and applicants, and each
entity providing clinical training sites or experiences. It may then apply to be an approved program.
33
OTHER RESOURCES:
Florida Center for Nursing, The State of Nursing Education in Florida: 2025
BILL HISTORY
COMMITTEE REFERENCE ACTION DATE
STAFF
DIRECTOR/
POLICY CHIEF
ANALYSIS
PREPARED BY
Health Professions & Programs
Subcommittee
15 Y, 0 N 3/13/2025 McElroy Osborne
Careers & Workforce
Subcommittee
Kiner Dixon
Health & Human Services
Committee
31 S. 464.019(11)(f), F.S.
32 S. 464.019(9)(a), F.S.
33 S. 464.019(9)(b), F.S.