Title 19 W. Va. C.S.R.

Registered Nurses, WV Board of Registered Nurses, WV Board of

Series 01 Policies, Standards and Criteria for the Evaluation, Approval and National Nursing Accreditation of Prelicensure Nursing Education Programs

W. Va. Code R. § 19-1-1 General

1.1. Scope. -- This rule establishes the policies and standards criteria for the evaluation, approval and accreditation of colleges, departments or schools of nursing.

1.2. Authority. -- W. Va. Code §§30-7-4 and 30-1-4.

1.3. Filing Date. - May 2, 2024.

1.4. Effective Date. -- May 2, 2024.

1.5. Sunset Provision. -- This rule shall terminate and have no further force or effect upon August 1, 2029.

W. Va. Code R. § 19-1-2 Definitions

These words and terms mean the following:

2.1. "Accredited college, department or school of nursing" means a college, department or school nursing education program which has Board Approval, or is accredited by a national nursing accreditor recognized by the United States Department of Education and therefore has Board Approval and meets the requirements of W. Va. Code §30-7-1 et seq, this rule, and any other applicable laws and rules. For purposes of considering applications for licensure, the Board recognizes nursing education programs accredited by a national nursing accreditor recognized by the United States Department of Education or approved by a comparable Board or other recognized authority in another jurisdiction. All nursing education programs shall provide evidence of current accreditation by a national nursing accrediting agency recognized by the United States Department of Education by July 1, 2022 and a program created after July 1, 2018 shall have 5 years after full Board approval to obtain this accreditation.

2.2. Administrator employment time means the devotion of 80% time to school administrative duties. The administrator of the nursing program's teaching responsibilities is not to exceed 6 academic semester credits per year, no more than 3 academic credits per semester. Administrators may teach more semester credits per year and per semester if they request to do so.

2.3. "Associate degree program in nursing" means a program conducted by a college or university that leads to an associate degree with a major in nursing.

2.4. "Baccalaureate degree program in nursing" means a program conducted by a college or university and leads to a baccalaureate degree with a major in nursing.

2.5. "Board" means the West Virginia board of examiners for registered professional nurses.

2.6. Board approved means a nursing program that meets the requirements of W. Va. Code §30-7-1 et seq, this rule, and any other applicable laws and rules. For purposes of considering applications for licensure, the Board may recognize nursing education programs approved by a comparable Board or other recognized authority in another jurisdiction. Programs accredited by a national nursing accrediting agency recognized by the United States Department of Education are considered Board approved and exempt from rules related to Board approval.

2.7. "Clinical Preceptor" means a registered professional nurse in good standing in the state in which he or she is providing the preceptorship with education preparation at or above the level for which the student is preparing; who: may serve as a teacher, mentor, role model or supervisor in a clinical setting, shall possess competencies related to the area of assigned clinical teaching responsibilities and has a minimum of 1 years of experience as a registered professional nurse providing direct patient care during the 5 years immediately preceding the date of the written agreement.

2.8. "College", "Department" or "School" mean a nursing education unit charged with responsibility to prepare its graduates for practice as registered professional nurses, qualified to meet licensing requirements in West Virginia. This nursing education unit may have multiple programs and may be structured in a university, college, or hospital.

2.9. Continuing Board Approval means continuation of board approval of a nursing education program because the program meets the requirements of W. Va. Code §30-7-1 et seq, of this rule, any other applicable laws and rules and when applicable, has current accreditation by a national nursing accrediting agency recognized by the United States Department of.

2.10. Curriculum means a planned nursing educational experience based on the philosophy, mission, goals and outcomes of the nursing education program. The curriculum will include clinical assignments to meet the objectives of each nursing course.

2.11. Diploma program" means a program which is usually, but not necessarily, conducted by a hospital and leads to a diploma in nursing.

2.12. Distance education means a formal educational process in which the majority of the instruction in a course/program occurs when instructors and students are not physically in the same location. The educational process may use various methodologies for communication, instruction, and evaluation.

2.13. Generic Masters degree program means a program conducted by a university and leads to a masters degree in nursing for individuals preparing for initial licensure as a registered professional nurse.

2.14. "Governing organization" means the university, college, or other organization of which the nursing education unit is an integral part.

2.15. "Graduation" means the candidate has satisfied all requirements of the college, department or school of nursing granting the diploma or degree.

2.16. New program means any education program planning to prepare individuals for initial licensure that has not been Board approved and has not received a unique NCLEX-RN program code by the Board.

2.17. Online Program Manager means any entity that provides services to assist programs with the conversion or development of its curriculum to a distance education modality or that provides services to deliver the curriculum via distance education. OPM services could include, but are not limited to: student recruitment and enrollment, student and graduate retention, curriculum development, course design, course delivery or instruction, student placement for educational purposes, or any program administrative function required to be administered by the nursing administrator or its faculty under 19CSR1.

2.18. Part-time faculty means faculty employed by the nursing education program in a position with fewer hours than the organization's definition of full-time faculty status.

2.19. Prelicensure Nursing Education Standards means a standard prescribed by the Board for educational programs preparing persons for licensure to practice registered professional nursing.

2.20. "Provisionally approved college, department or school of nursing" means a college, department or school of nursing which has not been in operation long enough to qualify for full approval, or one which fails to meet the requirements of the law and of the Board, and has received notification of its deficiencies. 2.21 Recommendations" means suggestions for the guidance of colleges, departments or schools of nursing in the development of their programs.

2.22. "Requirements" means mandatory conditions which a college, department or school of nursing must meet in order to be approved.

2.23. Visit means the on-site evaluation occurring as part of the ongoing approval process of the nursing education unit.

W. Va. Code R. § 19-1-3 Purposes of Nursing Education Approval

3.1. The purposes of approval include:

3.1.a. To promote the safe practice of nursing by implementing educational standards for prelicensure nursing programs educating individuals who desire to seek licensure as a registered professional nurse;

3.1.b. To grant legal recognition to nursing education programs that meet the requirements of the Board;

3.1.c. To provide criteria for the development, evaluation and improvement of new nursing education programs; and

3.1.d. To ensure ongoing evaluation and improvement of nursing education programs.

W. Va. Code R. § 19-1-4 Prelicensure Nursing Education Standards

4.1. All nursing education programs shall meet these standards:

4.1.a. The purpose and outcomes of the nursing program shall be consistent with requirements of W. Va. Code §30-7-1 et seq, of this rule, any other applicable laws and rules.

4.1.b. The purpose and outcomes of the nursing program shall be consistent with accepted standards of nursing practice appropriate for graduates of the type of nursing program offered.

4.1.c. The input of stakeholders shall be considered in developing and evaluating the purpose and outcomes of the program.

4.1.d. The nursing program shall implement a comprehensive, systematic plan for ongoing evaluation that is based on program outcomes and incorporates continuous improvement.

4.1.e. The curriculum shall provide diverse didactic and clinical learning experiences consistent with program outcomes.

4.1.f. Faculty and students shall participate in program planning, implementation, evaluation and continuous improvement.

4.1.g. The nursing program administrator shall be a professionally and academically qualified RN with institutional authority and administrative responsibility for the program.

4.1.h. Professionally, academically and clinically qualified nurse faculty shall be sufficient in number and expertise to accomplish program outcomes and quality improvement.

4.1.i. The fiscal, human, physical, clinical and technical learning resources shall be adequate to support program processes, security and outcomes.

4.1.j. Program information communicated by the nursing program shall be accurate, complete, consistent and readily available.

W. Va. Code R. § 19-1-5 Required Criteria for Prelicensure Nursing Education Programs

5.1. The organization and administration of the nursing education program shall be consistent with the law governing the practice of nursing. The nursing education program shall be an integrated part of a governing academic institution that is accredited by an accrediting agency that is recognized by the U.S. Department of Education. The nursing education program shall provide evidence of current accreditation by a national nursing accrediting agency recognized by the United States Department of Education by July 1, 2022.

5.1.a. Curriculum. The curriculum of the nursing education program shall enable the student to develop the nursing knowledge, skills and abilities necessary for the level, scope and standards of competent nursing practice expected at the level of licensure. Curriculum will be revised as necessary to maintain a program that reflects advances in health care and its delivery.

5.1.a.1. The curriculum, as defined by nursing education, professional and practice standards, shall include:

5.1.a.1.A. Experiences that promote the development and subsequent demonstration of evidence-based clinical judgment, skill in clinical management, and the professional commitment to collaborate in continuously improving the quality and safety of the healthcare system for patients;

5.1.a.1.B. Evidence-based learning experiences and methods of instruction, including distance education methods, consistent with the written curriculum plan.

5.1.a.1.C. Curriculum content including, but not limited to:

5.1.a.1.C.1. Content in the biological, physical, social and behavioral sciences to provide a foundation for safe and effective nursing practice;

5.1.a.1.C.2. Content regarding professional responsibilities, legal and ethical issues, history and trends in nursing and health care; and

5.1.a.1.C.3. Didactic content and supervised clinical experience in the prevention of illness and the promotion, restoration and maintenance of health in patients across the lifespan and from diverse cultural, ethnic, social and economic backgrounds. Patient experiences will occur in a variety of clinical settings and will include: 5.1.a.1.C.3.(a). Integrating patient safety principles throughout the didactic and clinical coursework. 5.1.a.1.C.3.(b). Implementing evidence-based practice to integrate best research with clinical expertise and patient values for optimal care, including skills to identify and apply best practices to nursing care. 5.1.a.1.C.3.(c). Providing patient-centered, culturally competent care that recognizes that the patient or designee is the source of control and full partner in providing coordinated care by: (a) Respecting patient differences, values, preferences and expressed needs; (b) Involving patients/designees in decision-making and care management; (c) Coordinating and managing patient care across settings; (d) Explaining appropriate and accessible interventions to patients and populations that may positively affect their ability to achieve healthy lifestyles. 5.1.a.1.C.3(d). Collaborating with interprofessional teams to foster open communication, mutual respect, and shared decision-making in order to achieve quality patient care. 5.1.a.1.C.3(e). Participating in quality improvement processes to monitor patient care outcomes, identify possibility of hazards and errors, and collaborate in the development and testing of changes that improve the quality and safety of health care systems. 5.1.a.1.C.3(f). Using information technology to communicate, mitigate error and support decision making.

5.1.a.1.D. Faculty supervised clinical practice shall include development of skills in direct patient care; making clinical judgments; care and management of both individuals and groups of patients across the lifespan; and delegation to and supervision of, as appropriate to level of education, other health care providers.

5.1.a.1.D.1. The program shall provide clinical hours comparable to those provided by an approved program of equivalent size and program type or, in the case of no equivalent program, clinical hours scaled relative to an approved program.

5.1.a.1.D.2. Clinical experiences shall be supervised by qualified faculty.

5.1.a.1.D.3. All student clinical experiences, including those with preceptors, shall be directed by nursing faculty.

5.1.a.1.D.4. Measurement of students competencies shall focus on the students demonstration of care management and decision making skills when providing patient care in a variety of clinical situations and care settings.

5.1.a.1.E. Delivery of instruction by distance education methods must be consistent with the program curriculum plan and enable students to meet the goals, competencies and outcomes of the educational program and standards of the Board.

5.1.b. Students.

5.1.b.1. The program shall provide students the opportunity to acquire and demonstrate the knowledge, skills, and abilities required for safe and effective nursing practice, in theory and clinical experience, through faculty supervision.

5.1.b.2. The program shall hold students accountable for professional behavior, including honesty and integrity, while in their program of study.

5.1.b.3. All policies relevant to applicants and students shall be readily available in writing.

5.1.b.4. Students shall meet health standards and criminal background check requirements for clinical placements.

5.1.c. Administrator qualifications.

5.1.c.1. Administrator qualifications in a program shall include:

5.1.c.1.A. A current, active RN license or privilege to practice that is not encumbered and meets requirements of the Board;

5.1.c.1.B. A graduate degree in nursing for baccalaureate nursing education programs and for associate degree nursing programs;

5.1.c.1.C. Educational preparation or experience in teaching and knowledge of learning principles for adult education, including nursing curriculum development, administration and evaluation; and

5.1.c.1.D. A current knowledge of registered nursing practice

5.1.d. Faculty.

5.1.d.1. There shall be sufficient number of qualified faculty to meet the outcomes and purposes of the nursing education program.

5.1.d.2. The nursing faculty shall hold a current, active RN license or privilege to practice that is not encumbered and meets requirements of the Board.

5.1.d.3. Faculty supervising clinical experiences shall hold a current active RN license or privilege to practice that is not encumbered and meets requirements in the jurisdiction where the clinical practicum is conducted.

5.1.d.4. Faculty who teach in a program shall be academically and experientially qualified and meet the qualifications contained in this rule.

5.1.d.5. Interprofessional faculty teaching non-clinical nursing courses shall have advanced preparation appropriate for the content being taught.

5.1.d.6. Clinical preceptors shall possess competencies related to the area of assigned clinical teaching responsibilities and will serve as role models and educators for students. Clinical preceptors may be used to enhance faculty-directed clinical learning experiences. Clinical preceptors shall have an unencumbered license to practice as a nurse at or above the level for which the student is being prepared, in the jurisdiction where they are precepting students.

W. Va. Code R. § 19-1-6 Faculty of the Nursing Education Unit

6.1. Nursing faculty members, both full and part-time shall be academically and professionally qualified and shall:

6.1.a. Full-time nursing faculty members shall:

6.1.a.1. Have a graduate degree with a major in nursing; have a bachelors degree with a major in nursing and be enrolled in a graduate degree program with a major in nursing within one year of employment as a faculty member; or have a bachelors degree with a major in nursing and at least 10 years of direct patient care experience in nursing.

6.1.a.2. Have evidence of current experience in nursing practice and education sufficient to demonstrate professional competence. For faculty with less than two years experience in education, the nursing program administrator will submit to the Board mentoring and orientation plans as defined by Board guidelines and function under the guidance of a faculty member fully qualified in the specific teaching area and professional competence; and 6.1.a.3 Have credentials which verify status as a registered professional nurse in West Virginia.

6.1.b. Part-time nursing faculty members shall:

6.1.b.1. Have a graduate degree with a major in nursing; Have a bachelors degree with a major in nursing and be enrolled in a graduate degree program with a major in nursing within one year of employment as a faculty member; or have a bachelors degree with a major in nursing and at least two years of direct patient care experience in nursing; 6.1.b.2 Have evidence of current experience in nursing practice and education sufficient to demonstrate professional competence. For faculty with less than two years experience in education, the nursing program administrator will submit to the Board mentoring and orientation plans as defined by Board guidelines and function under the guidance of a faculty member fully qualified in the specific teaching area and professional competence; and 6.1.b.3 Have credentials which verify status as a registered professional nurse in West Virginia.

6.1.c. The board may grant an exception to the requirements in 30-7-5a(a) and 30-7-5a(b) for faculty members who have qualifications other than those set forth in these subsections which are acceptable to the board.

6.2. Malpractice insurance for nursing faculty. The faculty shall have liability insurance for clinical practice required in nursing education courses.

W. Va. Code R. § 19-1-7 Students in the Nursing Education Unit

7.1. The nursing education unit shall base the selection and admission of students on established criteria, and be consistent in the recruitment and admission of students, and shall determine student enrollment by the clinical and teaching facilities available and by the numbers of nursing faculty. Enrollment into the nursing education program may not increase if the program does not have full approval by the Board. An increase in enrollment of greater than 10 % must have prior approval by the Board.

7.2. Student policies. All policies relevant to applicants and students shall be readily available in writing.

7.3. Liability insurance for students. Students shall be covered by liability insurance for clinical practice.

7.4. Students shall adhere to the standards for professional conduct as stated in the Board's rule, Standards for Professional Nursing Practice, 19CSR10, and are subject to disciplinary action by the Board for acts of professional misconduct as defined in the Board's rule, Professional Misconduct, 19CSR3.

W. Va. Code R. § 19-1-8 Curriculum

8.1. The curriculum of each nursing education program within the nursing education unit shall be based on the philosophy or mission and goals or outcomes of the nursing education unit.

8.1.a. The curriculum shall incorporate the concepts of nursing process and the standards for nursing practice as defined in the Board's rule, Standards for Professional Nursing, 19CSR10. Clinical assignments shall be designed to meet the objectives of each nursing course. Faculty shall provide evidence of ongoing review and updating of instructional materials, lecture notes, handouts and resources provided to students to ensure students receive current information and standards of practice.

8.1.b. Curricula for programs offering the diploma, the associate degree, baccalaureate degree, generic masters, accelerated programs, cohorts, sites, or distance education in nursing shall include theory and practice in nursing, encompassing the attainment and maintenance of physical and mental health and the prevention of illness for individuals and groups throughout the life process.

8.2. The nursing courses shall be supported by content which meet the requirements of the governing organization, including biological, physical, social and behavioral science content to provide a foundation for safe and effective nursing practice.

8.3. Simulation. A prelicensure nursing education program (program) may use simulation as a substitute for traditional clinical experiences, not to exceed 50% of its clinical hours. A program that uses simulation shall adhere to the standards set in this section.

8.3.a. Evidence of Compliance. A program shall provide evidence to the Board of Nursing that these standards have been met.

8.3.a.1. The program shall have an organizing framework that provides adequate fiscal, human, and material resources to support the simulation activities.

8.3.a.2. Simulation activities shall be managed by an individual who is academically and experientially qualified. The individual shall demonstrate continued expertise and competence in the use of simulation while managing the program.

8.3.a.3. There shall be a budget that will sustain the simulation activities and training of the faculty.

8.3.b. Facilities and Resources. The program shall have appropriate facilities for conducting simulation. This shall include educational and technological resources and equipment to meet the intended objectives of the simulation.

8.3.c. Faculty Preparation. Faculty involved in simulations, both didactic and clinical, shall have training in the use of simulation. Faculty involved in simulations, both didactic and clinical, shall engage in on-going professional development in the use of simulation.

8.3.d. Curriculum. The program shall demonstrate that the simulation activities are linked to programmatic outcomes.

8.3.e. Policies and Procedures. The program shall have written policies and procedures on the following:

8.3.e.1. Short-term and long-term plans for integrating simulation into the curriculum;

8.3.e.2. Method of debriefing each simulated activity; and

8.3.e.3. Plan for orienting faculty to simulation.

8.3.f. Evaluation. The program shall develop criteria to evaluate the simulation activities and students shall evaluate the simulation experience on an ongoing basis.

8.3.g. Annual Report. The program shall include information about its use of simulation in its annual report to the Board of Nursing.

8.4. Programs that contract with online program managers (OPMs) are required to submit contracts with OPMs to the Board for review prior to implementation. Any contract with an OPM in place prior to the passage of this rule must be submitted to the Board within 30 days of the effective date of this rule. Whatever services are provided must meet the same standards or rules as set forth by 19CSR1 and the institutions accrediting agency.

W. Va. Code R. § 19-1-9 Establishment of a New Prelicensure Nursing Education Program

9.1. The application fee for establishing a new program of a professional nursing education program is $50. A governing institution that plans to establish a new nursing education program for the preparation of practitioners of registered professional nursing shall complete and submit such application for approval to the Board in at least 30 days prior to a regularly scheduled Board meeting and in advance of the expected opening date.

9.2. Approval for admission of students: The proposed program shall provide the Board with verification that the following program components and processes have been completed: 9.2.a Employment of a program administrator to develop the program;

9.2.b. Overview of the total curriculum, including the content, sequence of courses, course description, contracts with clinical agencies, program evaluation plan and course syllabi for the first year with identified timeline for the submission of syllabi for the next years;

9.2.c. Establishment of student policies for admission, progression, retention and graduation. 9.3 If all standards for approval are met, the program shall receive provisional approval and shall be authorized to admit students to the program.

9.4. Following receipt of the first calendar year report of performance of graduates on the national licensure examination, the Board shall conduct a visit to determine if all standards for approval of a nursing education program have been met. The Board may:

9.4.a. Grant full approval if standards of a nursing education program are met;

9.4.b. Continue provisional approval and provide to the nursing program administrator a written notice of deficiencies that establishes a reasonable time, based upon the number and severity of deficiencies, to correct deficiencies.

W. Va. Code R. § 19-1-10 Continuing Approval of Prelicensure Education Programs

10.1. Visits and evaluation: The Board, through its executive director and/or other qualified persons, shall evaluate all non-national nursing accredited nursing education programs every other year until the program receives national nursing accreditation. The Board shall review and analyze various sources of information regarding program performance, including, but not limited to:

10.1.a. Evidence of seeking national nursing accreditation by an accrediting agency approved by the U.S. Department of Education. National nursing accreditation shall be obtained within 5 years of the Boards full approval of the new program; 10.1.b Results of ongoing program evaluations;

10.1.c. Other evidence regarding achievement of program outcomes including, but not limited to student retention, attrition and on-time graduation rates; sufficient type and number of faculty, faculty competence and faculty retention and turnover; adequate laboratory, simulation and clinical learning experiences; NCLEX-RN pass rates which are at least 80% for first-time test-takers in the last calendar year; trend data and action planning related to NCLEX-RN performance, employer and graduate satisfaction; performance improvement initiative related to program outcomes and program complaints or grievances review and resolution. nursing education programs accredited by the Board, including all satellite sites of any program.

10.2. Maintenance of Board Approval Status. A nursing program without national accreditation shall maintain approval as set forth in this rule. A national nursing accredited education unit shall maintain national nursing accreditation and submit to the Board a copy of all national nursing accreditation reports, recommendations, annual reports and final decisions for each national nursing accreditation visit once received or sent by the program within 30 days of the program's receipt or submission of the report.

10.3. Program visits to a new nursing program shall be conducted as outlined by the board. Additional program visits to a non national nurse accredited program shall be conducted if:

10.3.a. The director of the nursing program changes;

10.3.b. A major curriculum change is proposed; and/or

10.3.c. A complaint has been submitted to the Board.

10.4. Board approval of an existing program when ownership and control are changed. When a governing organization contemplates a change of ownership and control of a program, it shall send notice of the intended change to the Board 90 days prior to the effective date of the intended change. The owner or governing organization expecting to assume responsibility for the program shall immediately make application for Board approval. If the Board determines the owner or governing organization which will be responsible for the new program meets the criteria for approval and will comply with the recommendations of the Board, it may be provisionally approved.

10.5. A distance-learning program shall establish a means for assessing individual student and program outcomes.

10.6. Expansion of a non-national nursing accredited nursing education program requires agreement from the Board if the program seeks greater than a 10% expansion. Only those programs with full approval status may submit requests to the Board to initiate expansion of a program.

W. Va. Code R. § 19-1-11 Loss of Board Approval or National Nursing Accreditation

11.1. The Board shall immediately withdraw approval of a program if the programs national nursing accreditation is lost. Board approval shall be granted once the nursing programs national accreditation is fully reinstated. Any program seeking approval by the Board which does not have national accreditation must submit an application as a new program and meet all new program requirements contained in this rule.

11.1.a. Factors jeopardizing program Board approval of a non-national nurse accredited program shall include but may not be limited to:

11.1.a.1. Deficiencies in compliance with this rule, student retention, attrition and on-time graduation rates;

11.1.a.2. Utilization of students to meet staffing needs in health care facilities and/or sufficient/adequate type and number of faculty, faculty competence and faculty retention/turnover ;

11.1.a.3. Noncompliance with school's stated philosophy/mission, program design, objectives/outcomes, and/or policies;

11.1.a.4. Continual failure to submit records and reports to the Board office within designated time frames;

11.1.a.5. Failure to provide sufficient variety and number of clinical learning opportunities for students to achieve stated objectives/outcomes and/or inadequate laboratory and simulation learning experiences;

11.1.a.6. Failure to comply with Board requirements or to respond to Board recommendations within a specified time;

11.1.a.7. Student enrollments without sufficient faculty, facilities and/or patient census;

11.1.a.8. Failure to maintain at least 80% passing rate on the licensure examination by first-time candidates;

11.1.a.9. Failure of the program dean or director to document annually the currency of faculty licenses;

11.1.a.10. Failure to maintain adequate budget to meet the needs of the program; or

11.1.a.11. Other activities or situations that demonstrate to the Board that a program is not meeting legal requirements and standards.

11.2. Loss of approval through change of organization. When a program changes ownership or control, the Board shall automatically withdraw approval. The new owner or organization shall comply with the provisions of subsection 7.4. of this rule to continue the nursing education program.

11.3. Provisional approval for failure to meet standards. At the Board's discretion, it may grant provisional approval to a nursing education program during the time in which it takes corrective action in order to meet the standards set forth in this rule. 11.4 Any non-national nursing accredited professional nursing education program having a 20% or higher failure rate on the national licensure examination, shall receive a warning from the Board. If changes, correction and/or adjustments relative to faculty, facilities, student admission, curriculum content, and/or methods of teaching are not initiated within a specified time and such action approved by the Board, the Board may impose additional requirements or restrictions on the program.

W. Va. Code R. § 19-1-12 Closing of a Program

12.1. The governing organization shall advise the Board in writing of the intent to close a nursing education program at least 6 months prior to the planned closing date. The governing organization shall submit a plan for safeguarding the quality of instruction and practice during the closing period.

12.2. The governing organization shall ensure that all standards for nursing education programs are maintained and all necessary courses are taught until the last student is transferred or graduated.

12.3. The governing institution shall secure and provide for the permanent custody and storage of records of students and graduates. The Board shall be notified of the location and method of retrieving information from these records.

12.4. At the Board's discretion, it may request additional information and plans for the closing of a nursing education program and the transfer of students and records.

12.5. The Board shall automatically withdraw accreditation of the program on the day the last student completes curriculum requirements of the program that is closing.

W. Va. Code R. § 19-1-13 Reports

13.1. The nursing education unit shall submit an annual report to the Board by September 1 of each year for each nursing program accredited by the Board. Non-national nursing accredited nursing education programs shall submit annual reports on forms provided by the Board. Data included in this annual report shall be determined by the Board. National nursing accredited nursing education programs shall submit a copy of the national nursing accreditor annual report to the Board.

13.2. A non-national nursing accredited nursing education unit shall submit a program evaluation report to the Board one month prior to a scheduled on-site visit to the nursing education program. The Board shall determine the format and guidelines for the submission of this report.

13.3. At the Board's discretion, it may request additional reports from a nursing education unit to include, but not be limited to, written plans for improving licensure examination pass rates of graduates and progress reports.

W. Va. Code R. § 19-1-14 Resources, Facilities, and Services

14.1. The nursing education unit shall provide adequate teaching facilities to accomplish the goals or outcomes of the nursing education programs. These shall include well-equipped classrooms, conference rooms, libraries, laboratories and offices for faculty members.

14.2. Comprehensive and current library resources, computer facilities, laboratory and other learning resources shall be available and accessible. The nursing faculty shall have input into the development and provision of learning resources.

14.3. The resources, facilities and services of the governing organization shall be available to and used by the nursing education unit.

14.4. The hospitals or other health care facilities and services utilized for clinical learning experiences shall be adequate in number and kind to meet program goals or outcomes. A preceptor serves as a role model and resource to students in the clinical setting in conjunction with a faculty member.

W. Va. Code R. § 19-1-15 Evaluation of the Nursing Education Unit

15.1. The nursing education unit shall have an ongoing systematic evaluation of all program components which is used for development, maintenance and revision of the program. The evaluation shall include but not be limited to curriculum content review and test review.

15.2. The evaluation plan shall include measurable outcomes, e.g., licensure examination passage rate, employment patterns, graduation rates and attrition.

19CSR1

Series 03 Requirements for Registration and Licensure and Conduct Constituting Professional Misconduct

W. Va. Code R. § 19-3-1 General

1.1. Scope. -- This rule establishes the requirements for registration and licensure of a registered professional nurse and describes behavior which constitutes professional misconduct subject to disciplinary action.

1.2. Authority. -- W. Va. Code §30-7-4.

1.3. Filing Date. -- May 2, 2024.

1.4. Effective Date. -- May 2, 2024.

1.5. Sunset date. This rule will terminate and have no further force or effect on August 1, 2033.

W. Va. Code R. § 19-3-2 Definitions

The following words and phrases as used in this rule have the following meanings, unless the context requires otherwise:

2.1. Direct supervision means the activity of a registered professional nurse with an unencumbered license in West Virginia being present at all times in the same assigned physical work area as the person being supervised.

2.2. "Impaired" means the condition of a licensee whose performance or behavior is altered through the use of alcohol, drugs, or other means.

2.3. National Council Licensure Examination (NCLEX-RN) means the licensure examination for registered nurses which is owned and controlled by the National Council of State Boards of Nursing.

2.4. "Structured treatment program" means a program for physical, psychological, social and/or spiritual rehabilitation, if the program has been expressly approved by the board.

2.5. "Temporary permit" means a permit authorizing the individual to practice registered professional nursing in this state until the permit is no longer effective or the individual is granted a license by the board. An individual with a temporary permit is subject to all provisions of W. Va. Code §30-7-1 et.seq., and all other relevant sections of the West Virginia Code and rules promulgated by the board.

2.6. License requirements to practice registered professional nursing means an individual who is at least 18 years of age; has completed an approved four-year high school course of study or the equivalent thereof, as determined by the appropriate educational agency; has completed a nursing education program; has passed an examination approved by the board; has paid the application fee specified by rule; has completed a criminal background check, as required by §30-1D-1 et seq. of this code; is not an alcohol or drug abuser, as these terms are defined in §27-1A-11 of this code, unless an applicant in an active recovery process, which may be evidenced by participation in a Nurse Health Program, structured aftercare, or a 12-step program or other similar group or process, may be considered.

W. Va. Code R. § 19-3-3 Application for Licensure by Examination as a Registered Nurse

3.1. An applicant for licensure by exam as a Registered Nurse shall:

3.1.a. Applicants educated in the United States or United States Territory shall:

3.1.a.1. Have completed an approved four-year high school course of study or an equivalent thereof, as determined by the appropriate educational agency;

3.1.a.2. Be at least 18 years of age;

3.1.a.3. Have completed a prelicensure nursing education program approved by the board, or a program that meets criteria comparable to those established by the West Virginia Board of Registered Nurses in 19CSR01. An official transcript showing the type of degree and date conferred shall be sent directly to the office of the board from a board approved nursing education program with an affidavit of graduation from the nursing education program as proof of education. The board will not consider an application for approval until the final, official transcript is received in the board office; and,

3.1.a.4. The applicant shall submit state and federal criminal history records information using fingerprints or other biometric data from the Federal Bureau of Investigation and the agency responsible for retaining this states criminal records.

3.1.a.5. Report any criminal conviction, nolo contendere plea, Alford plea, deferred judgment, or other pleas arrangements in lieu of conviction.

3.1.a.6. Report any condition or impairment (including but not limited to substance abuse, or a mental emotional or nervous disorder or condition) which in any way currently affects or limits your ability to practice safely and in a competent and professional manner.

3.1.a.7. Report any actions taken or initiated against any professional or occupational license, registration or certification.

3.1.a.8. Identify any state, territory or country in which the applicant holds a professional license or credential, if applicable. Provide the number and status of the license or credential as well as the original state or country of licensure or credentialing.

3.1.a.9. Provide employment information including current employer if employed in health care, including address, telephone number, position and dates of employment and previous employer in health care if any, if current employment is less than 12 months.

3.1.a.10. Provide information regarding whether the application previously applied for a license in another jurisdiction and either was denied a license, or withdrew the application or allowed the application to expire, if applicable.

3.1.a.11. Provide detailed explanation and supporting documentation for each affirmative answer to questions, as applicable, regarding the applicants background.

3.1.a.12. Submit a completed board application and pay the required fee for licensure by examination set forth in the boards rule, Fees, 19 CSR 12. Payment shall be in the form established by the West Virginia Board for Registered Nurses. Application fees are not refundable, nor applicable to other test dates. 3.1a.13 An approved applicant for licensure by examination shall submit an application directly to the contracted test service for the National Council Licensure Examination (NCLEX-RN) with the application fee prior to the date the applicant wishes to take the examination. The authorization to test for any one application is valid for 90 days, and may not be extended.

3.1.b. Applicants seeking licensure as veterans in lieu of the educational qualifications specified in subdivision 3.1.c. of this rule, and qualifying under W. Va. Code §30-24-1 et seq. an applicant who is a veteran shall:

3.1.b.1. Have completed an approved four-year high school course of study or an equivalent thereof, as determined by the appropriate educational agency;

3.1.b.2. Be at least 18 years of age;

3.1.b.3. Have served on active duty in the medical corps of any of the armed forces of the United States and have successfully completed the course of instruction required to qualify her or him for the level of academic training as determined by the National Council of State Boards of Nursing that is equal to that received by a student studying and training for a similar health occupation in civilian life;

3.1.b.4. Be honorably discharged from military service; and,

3.1.b.5. The applicant shall submit to West Virginia and federal criminal background checks.

3.1.b.6. Report any criminal conviction, nolo contendere plea, Alford plea, deferred judgment, or other pleas arrangements in lieu of conviction.

3.1.b.7. Report any condition or impairment (including but not limited to substance abuse, or a mental emotional or nervous disorder or condition) which in any way currently affects or limits your ability to practice safely and in a competent and professional manner.

3.1.b.8. Report any actions taken or initiated against any professional or occupational license, registration or certification.

3.1.b.9. Identify any state, territory or country in which the applicant holds a professional license or credential, if applicable. Provide the number and status of the license or credential as well as the original state or country of licensure or credentialing.

3.1.b.10. Provide employment information including current employer if employed in health care, including address, telephone number, position and dates of employment and previous employer in health care if any, if current employment is less than 12 months.

3.1.b.11. Provide information regarding whether the application previously applied for a license in another jurisdiction and either was denied a license, or withdrew the application or allowed the application to expire, if applicable.

3.1.b.12. Provide detailed explanation and supporting documentation for each affirmative answer to questions, as applicable, regarding the applicants background.

3.1.b.13. Submit a completed board application and pay the required fee for licensure by examination set forth in the boards rule, Fees, 19 CSR 12. Payment shall be in the form established by the West Virginia Board of Examiners for Registered Professional Nurses. Application fees are not refundable, nor applicable to other test dates.

3.1.b.14. An approved applicant for licensure by examination shall submit an application directly to the contracted test service for the National Council Licensure Examination (NCLEX-RN) with the application fee prior to the date the applicant wishes to take the examination. The authorization to test for any one application is valid for 90 days, and may not be extended.

3.1.c. Applicants educated outside the United States or United States Territory shall:

3.1.c.1. Have completed an approved four-year high school course of study or an equivalent thereof, as determined by the appropriate educational agency;

3.1.c.2. Be at least 18 years of age;

3.1.c.3. Submit the Credentials Evaluation Service (CES) Professional Report certificate (CES) and English Language Proficiency (ELP) Exam issued by the commission on graduates of foreign nursing schools (CGFNS), unless the applicant meets the CGFNS criteria for an exemption from the ELP requirement;

3.1.c.4. The applicant shall submit to West Virginia and federal criminal background checks.

3.1.c.5. Report any criminal conviction, nolo contendere plea, Alford plea, deferred judgment, or other pleas arrangements in lieu of conviction.

3.1.c.6. Report any condition or impairment (including but not limited to substance abuse, or a mental emotional or nervous disorder or condition) which in any way currently affects or limits your ability to practice safely and in a competent and professional manner.

3.1.c.7. Report any actions taken or initiated against any professional or occupational license, registration or certification.

3.1.c.8. Identify any state, territory or country in which the applicant holds a professional license or credential, if applicable. Provide the number and status of the license or credential as well as the original state or country of licensure or credentialing.

3.1.c.9. Provide employment information including current employer if employed in health care, including address, telephone number, position and dates of employment and previous employer in health care if any, if current employment is less than 12 months.

3.1.c.10. Provide information regarding whether the application previously applied for a license in another jurisdiction and either was denied a license, or withdrew the application or allowed the application to expire, if applicable.

3.1.c.11. Provide detailed explanation and supporting documentation for each affirmative answer to questions, as applicable, regarding the applicants background.

3.1.c.12. Submit a completed board application and pay the required fee for licensure by examination set forth in the boards rule, Fees, 19 CSR 12. Payment shall be in the form established by the West Virginia Board of Examiners for Registered Professional Nurses. Application fees are not refundable, nor applicable to other test dates.

3.1.c.13. An approved applicant for licensure by examination shall submit an application directly to the contracted test service for the National Council Licensure Examination (NCLEX-RN) with the application fee prior to the date the applicant wishes to take the examination. The authorization to test for any one application is valid for 90 days, and may not be extended. If the applicant has taken and passed the NCLEX-RN previously, have the scores transferred to the West Virginia Board of Registered Nurses by Pearson VUE.

3.2. Temporary Permit for Exam Applicant.

3.2.a. A temporary permit may be issued to an applicant awaiting initial examination for licensure as a registered professional nurse The temporary permit expires 180 days following graduation, or until the date the applicant's licensing examination results are released to the office of the board by the National Council Licensure Examination (NCLEX-RN), whichever comes first. A temporary permit is not renewable.

3.2.b. The board shall not issue a temporary permit which permits the individual to practice registered professional nursing while awaiting initial examination for licensure and the reporting of the results of the examination until it has received and approved an application for licensure by examination.

3.2.c. The individual with a temporary permit is subject to all provisions of West Virginia Code § 30-7-1 et.seq. and all other relevant provisions of the West Virginia Code and rules promulgated by the board.

3.2.d. The individual with a temporary permit shall work under the direct supervision of a registered professional nurse with an unencumbered license, until the applicant has successfully passed the NCLEX-RN and a license is issued.

W. Va. Code R. § 19-3-4 Licensure Examination

4.1. The licensure examination is the national council licensure examination for registered nurses (NCLEX-RN) which is owned and controlled by the National Council of State Boards of Nursing, Inc.

4.2. The board shall determine the availability of the examination dates, times, and places of administration.

W. Va. Code R. § 19-3-5 Failure to Pass Licensure Examination

5.1. An applicant for licensure by examination who fails to attain a passing score on the examination will have his or her temporary permit to practice registered professional nursing placed in an inactive status by the office of the board.

5.2. In considering an application for licensure by examination, the number of times the applicant has taken the licensing examination shall include each time that the applicant has taken an examination for licensure as a registered professional nurse in any jurisdiction.

5.3. In the event an applicant fails the licensure examination two times, he or she may petition the board for permission to repeat the licensure examination. The board may deny approval for an applicant to repeat an examination after two failures if more than two years has lapsed since the applicant graduated from a nursing education program. In addition, the board may deny approval to repeat the examination after two failures if the applicant cannot show in the petition to repeat the examination more than two times that any further education has been taken by the applicant to correct deficiencies in his or her nursing knowledge.

5.4. An examination applicant may not repeat the licensure examination more than four times per year, nor more often than every 45 days.

5.5. A repeat examination applicant shall complete the application for examination as specified in subsection 3.2. of this rule and be subject to other requirements as established by the board.

W. Va. Code R. § 19-3-6 Licensure by Endorsement

6.1. An applicant for permanent licensure by endorsement shall:

6.1.a. Be currently licensed in another state and shall have passed the licensure examination that was used in the state of West Virginia at the time of his or her graduation from a professional nursing education program.

6.1.b. Complete and submit to the board an accurately completed application for licensure by endorsement;

6.1.c. Submit the non-refundable fee set forth in the boards rule, Fees, 19 CSR 12.

6.1.d. Have submitted a verification of licensure from the state in which he or she was originally licensed and the state in which he or she is currently employed if it is different than the original state of licensure. If these boards participate in the licensure verification system maintained by the National Council of State Boards of Nursing, the applicant shall follow the process of verification to another state in accordance with the procedures set in place for that system. 6.1.e The applicant shall submit to West Virginia and federal criminal background checks.

6.2. Temporary permit for endorsement applicant.

A temporary permit may be issued to an applicant awaiting endorsement for licensure as a registered professional nurse. The temporary permit expires 180 days following issue, or until the date the applicant's endorsement is completed whichever comes first. The holder of a temporary permit is subject to all provisions of W. Va. Code §30-7-1 et. seq. and all other relevant sections of the West Virginia Code and rules promulgated by the board.

6.2.a. A complete endorsement application shall be on file in the board office prior to the issuance of a temporary permit including the endorsement application fee.

6.2.b. The board shall not issue a temporary permit until a complete board application for a temporary permit for an endorsement applicant is on file in the board office including the form and the fee set forth in the boards rule, Fees, 19 CSR 12.

6.2.c. The temporary permit expires 180 days from the date of issuance and the expiration date shall be displayed on the on its website at wvrn.boardsofnursing.org/licenselookup.

6.2.d. An individual with a temporary permit who fails to complete the endorsement application for full licensure is not entitled to an extension of the temporary permit. An applicant must provide a satisfactory explanation to the board prior to any subsequent request for endorsement by the applicant if the 180 day period expires prior to the completion of the required procedure for licensure by endorsement by an applicant licensed as a registered professional nurse in another state, territory, or foreign country. The applicant shall repeat the process for endorsement in its entirety if the explanation is considered acceptable by the board.

6.2.e. A temporary permit is not renewable, and the board shall not extend the initial 180 days.

6.2.f. The individual with a temporary permit to practice registered professional nursing shall furnish the board with his or her address and telephone number, and the name, address, and telephone number of his or her employer at all times while the permit is effective.

6.2.g. The board shall not issue a temporary permit if it determines upon satisfactory proof that the applicant has in any way falsified his or her qualifications for the temporary permit.

6.2.h. The board shall not issue the temporary permit if it is presented with satisfactory proof that the applicant has any action pending against his or her license to practice registered professional nursing in another state, territory, or foreign country, or if the license is encumbered in any way.

6.2.i. A temporary permit becomes void during the 180 days if the board determines, upon satisfactory proof, that it will deny the applicant full licensure for any of the causes set forth in West Virginia Code §30-7-6. The board may also revoke the temporary permit at any time if the board has sufficient information indicating the temporary permit was issued in error or if the board receives information establishing probable cause that the applicant violated the boards laws or rules while practicing under the temporary permit.

W. Va. Code R. § 19-3-7 Change of Name and/or Address

7.1. If a licensee legally changes his or her name through marriage, divorce court order or other means, he or she shall send this information to the office of the board. The information shall include both the full prior name and the new name, in a properly executed affidavit or a certified copy of the marriage certificate or divorce decree. The licensee shall submit an application and these documents to the nurse portal on its website at wvrn.boardsofnursing.org .

7.2. A licensee shall notify the board of any change in residence or mailing address within 30 days of the change. This notification shall be submitted in writing to the via the nurse portal.

W. Va. Code R. § 19-3-8 Renewal of License

8.1. Each license issued by the board expires on June 30 of each even numbered year. In order to continue practicing a licensee shall renew his or her license biennially. The deadline for receipt of the renewal application and fee is June 30 of each even numbered year. A license for which a renewal application is received after June 30 is lapsed. The board shall consider the application for renewal of the license of each licensee upon receipt of:

8.1.a. An accurately completed application for renewal of the license; 8.1b. Submission of additional documents as determined by the board;

8.1.c. Attestation that he or she meets the continuing competence requirements specified in the boards rule, Continuing Education, 19CSR11;

8.1.d. All additional requirements set forth by the board; and,

8.1.e. The fee for renewal set forth in the boards rule, Fees, 19 CSR 12.

8.2. Request for inactive status.

A licensee who is not practicing, and who has no disciplinary action pending against his or her license, may request his or her name be entered on the inactive list by completing an inactive application furnished by the board and indicating his or her desire to be placed on inactive status. The board shall then designate the licensee's records "inactive". No fee is required for inactive status and no license is issued. The board may provide the inactive licensee, upon application, payment of the current fee, and completion of required continuing education, an active license to practice registered professional nursing in West Virginia. The board may inquire into activities and events during the term of the inactive license period.

8.3. Request for retired status.

A licensee who has retired from the practice of nursing in all states may upon request be placed in a retired status. The retired status registered professional nurse may not practice as a registered professional nurse in any state and may not in any way indicate to any persons that he or she is licensed to practice as a registered professional nurse. If the individual in a retired status does practice in any form, voluntarily or for pay, as a registered professional nurse, he or she is guilty of practicing nursing without a license and shall be subject to the appropriate penalties contained in law and rule. If at any time the individual in the retired status desires to return to the practice of nursing, he or she shall submit the reinstatement application along with the current fee and shall meet all reinstatement requirements.

W. Va. Code R. § 19-3-9 Reinstatement of Lapsed License

9.1. Non-renewal of license. If a licensee fails to renew his or her license before the current license expires, the license shall lapse.

9.2. The fee to reinstate a lapsed license is set forth in the boards rule, Fees, 19 CSR 12.

9.3. Any person practicing registered professional nursing during the time his or her license has lapsed is considered an illegal practitioner and is subject to the penalties provided for violation of W.Va. Code §30-7-1 et seq.

W. Va. Code R. § 19-3-10 Verification of Licensure to Another State Board of Nursing

10.1. The board shall provide a verification of West Virginia licensure upon submission of a written request by the licensee for the verification and payment of a fee set forth in the boards rule, §19 CSR 12, Fees. Should the board participate in the licensure verification system as maintained by the National Council of State Boards of Nursing, the licensee shall follow the process of endorsement to another state in accordance with the procedures set in place for that system. If the licensee is a graduate of a school which has closed and his or her records are on file in the board office, the board shall provide a copy of school records upon written request and payment of the fees set forth in the boards rule, Fees, 19 CSR 12.

W. Va. Code R. § 19-3-11 Penalty for Presentation of Non-negotiable Check

11.1. The board shall assess the fee set forth in the boards rule, Fees, 19 CSR 12 to any individual who presents a check payable to the board that is later returned by the bank as non-negotiable. The presenter of the non-negotiable check shall redeem the non-negotiable check within 14 days of notification by certified mail. This fee is in addition to any reinstatement or other fee which may additionally become due because the applicant or licensee submits an application or registration form after a board deadline. The applicant, licensee, or other person who presents a non-negotiable check shall redeem it with cash, a money order, or a cashier's check.

11.2. The board shall designate the license or temporary permit of a registered professional nurse as invalid if fees are not paid within 14 days for a non-negotiable check submitted with an application for renewal or reinstatement or any other application form.

W. Va. Code R. § 19-3-12 Professional Misconduct

12.1. Conduct, including, but not limited to the following, if proven by a preponderance of evidence, constitutes professional misconduct subject to disciplinary action pursuant to W. Va. Code § 30-7-11(a)(6). The applicant or licensee:

12.1.a. Failed to adhere to common and current standards for professional nursing practice, including but not limited to standards established by a national professional nursing organization, nursing research, nursing education, or the board;

12.1.b. Failed to adhere to established standards in the practice setting to safeguard patient care;

12.1.c. Knowingly committed an act which could adversely affect the physical or psychological welfare of a patient;

12.1.d. Abandoned patients by terminating responsibility for nursing care, intervention, or observation without properly notifying appropriate personnel and ensuring the safety of patients;

12.1.e. Practiced or offered to practice beyond the scope permitted by law or accepted and performed professional responsibilities that the licensee knows or has reason to know that he or she is not licensed, qualified, or competent to perform;

12.1.f. Impersonated another licensed practitioner;

12.1.g. Permitted another person to use the licensee's license for any purpose;

12.1.h. Permitted, aided, or abetted an unlicensed, uncertified, or unregistered person to perform activities requiring a license, certificate, or registration;

12.1.i. Delegated professional responsibilities to a person when the licensee delegating the responsibilities knows or has reason to know that person is not qualified by training, experience or licensure to perform them;

12.1.j. Practiced registered professional nursing while his or her license is suspended, lapsed, or inactive; 12.k. Failed to comply with terms and conditions as may be imposed by the board based upon previous disciplinary action of the board; 12.l. Practiced professional nursing while the ability to safely and effectively practice is compromised by alcohol or drugs; 12.m. Is addicted to a controlled substance;

12.1.n. Is a chronic or persistent alcoholic;

12.1.o. Engaged in dishonorable, unethical or unprofessional conduct of a character likely to deceive, defraud or harm the public or any member of the public; thus, not exercising good professional character;

12.1.p. Practiced professional nursing while the ability to safely and effectively practice was compromised by physical or mental disability;

12.1.q. Refused or failed to report for a physical or mental examination, including but not limited to laboratory or other tests, requested by the board;

12.1.r. Provided false or incorrect information to an employer or potential employer regarding the status of a license, or failed to inform an employer or potential employer of a change in the status of a license;

12.1.s. Knowingly falsified an application for employment;

12.1.t. Knowingly provided false information regarding completion of educational programs;

12.1.u. Falsified patient records, intentionally charted incorrectly;

12.1.v. Improperly, incompletely, or illegibly documented the delivery of nursing care, including but not limited to treatment or medication;

12.1.w. Knowingly made or filed a false report;

12.1.x. Knowingly or negligently failed to file a report or record required by state or federal law;

12.1.y. Willfully impeded or obstructed the filing of a report or record required by state or federal law;

12.1.z. Induced another person to file a false report or obstructed the filing of a report required by state or federal law;

12.1.aa. Failed to report to the board within 30 days, knowledge of a violation by a registered professional nurse of W. Va. Code §§ 30-7-1 et seq., 30-15-1 et seq., this rule, any other applicable state law or rule or any applicable federal law or regulation;

12.1.bb. Failed to report through proper channels a violation of any applicable state law or rule, any applicable federal law or regulation or the incompetent, unethical, illegal, or impaired practice of another person who provided health care

12.1.cc. Impeded or obstructed an investigation by the board by failing to comply or respond to requests for action or information, whether the failure was known or negligent;

12.1.dd. Violated any provision of W. Va. Code §30-7-1 et seq., or rules governing the practice of registered professional nursing, or a rule or order of the board, or failed to comply with a subpoena or subpoena duces tecum issued by the board;

12.1.ee. Failed to register or notify the board of any changes of name or mailing address;

12.1.ff. Failed to accept certified mail from the board, when mailed to the licensees last address on record in the boards office;

12.1.gg. Failed to disclose to the board a criminal conviction in any jurisdiction;

12.1.hh. Was convicted of a misdemeanor with substantial relationship to the practice of registered professional nursing, in a court of competent jurisdiction.

12.1.ii. Failed to disclose information when required by the board concerning treatment or counseling for substance abuse, or participation in any professional peer assistance program;

12.1.jj. Provided false information on any application, or any other document submitted to the board for the purpose of licensure, advance practice recognition, or prescriptive authority;

12.1.kk. Misappropriated medications, supplies, or personal items of a patient or employer;

12.1.ll. Self-administered or otherwise took into his or her body any prescription drug in any way not in accordance with a legal, valid prescription or used any illicit drug;

12.1.mm. Prescribed, dispensed, administered, mixed or otherwise prepared a prescription drug, including any controlled substance under state or federal law, not in accordance with accepted nursing practice standards or not in accordance with the board's rule Limited Prescriptive Authority For Nurses in Advanced Practice, §19 CSR 8;

12.1.nn. Physically or verbally abused, or failed to provide adequate protection or safety for an incapacitated individual in the context of a nurse-patient/client relationship;

12.1.oo. Used the nurse-patient/client relationship to exploit a patient or client;

12.1.pp. Engaged a patient or client in sexual activity or became romantically involved with a patient or client while still responsible for the care of that patient or client;

12.1.qq. Failed to maintain appropriate professional boundaries in the nurse-patient/client relationship;

12.1.rr. Failed to report that his or her license to practice registered professional nursing in any other state, territory, jurisdiction or foreign nation was revoked, suspended, restricted or limited, or otherwise acted against, that he or she was subjected to any other disciplinary action by the licensing authority, or that he or she was denied licensure in any other state, territory, jurisdiction, or foreign nation;

12.1.ss. Violated the confidentiality of information or knowledge concerning a patient;

12.1.tt. Practiced registered professional nursing by way of telecommunications or otherwise, in any other state, territory, jurisdiction, or foreign nation, without a license to do so and not in accordance with the law of that state, territory jurisdiction, or foreign nation; or

12.1.uu. Was found guilty for improper professional practice or professional misconduct by a duly authorized professional disciplinary agency or licensing or certifying body or board in this or another state or territory, where the conduct upon which the finding was based would, if committed in this state, constitute professional misconduct under the laws of this state, may serve as a basis for disciplinary action by this board.

12.2. Upon a finding of probable cause that a basis for disciplinary action exists, the board may require a licensee or a person applying for licensure to practice as a registered professional nurse in this state to submit to a physical or psychological examination by a practitioner approved by the board. Any individual who applies for or accepts the privilege of practicing as a registered professional nurse in this state is considered to have given consent to submit to all such examinations when requested to do so in writing by the board and to have waived all objections to the admissibility of the testimony or examination report of any examining practitioner on the ground that the testimony or report is a privileged communication. If an applicant or licensee fails or refuses to submit to any examination under circumstances which the board finds are not beyond his or her control, that failure is prima facie evidence of his or her inability to practice as a registered professional nurse competently and in accordance with accepted standards for professional practice. A licensee or person applying for licensure as a registered professional nurse who is adversely affected by this provision may request a hearing within thirty days of any action taken by the board.

12.3. Based on the nature of the complaint filed against the licensee, technician, or of the information received about an applicant, the board may require the technician or applicant to request and submit to the board the results of a state and a national electronic criminal history records check by the State Police.

12.3.a. The licensee, technician, or applicant under investigation shall furnish to the State Police a full set of fingerprints and any additional information required to complete the criminal history records check.

12.3.b. The licensee, technician, or applicant under investigation is responsible for any fees required by the Sate Police in order to complete the criminal history records check.

12.3.c. The board may require the licensee, technician, or applicant to obtain an electronic criminal history records from a similar agency in the state of the technician or applicants residence, if outside of West Virginia.

12.3.d. Instead of requiring the licensee, technician, or applicant under investigation to apply directly to the State Police for the criminal history records checks, the board may contract with a private vendor to provide the services required in this subsection.

12.3.e. The board may deny licensure or certification or take disciplinary action against any licensee, technician, or applicant who fails or refuses to submit the criminal history records checks required by this subsection.;

12.4. If the board finds that public health, safety and welfare requires emergency action and incorporates a finding to that effect into its order, the board shall order summary suspension of a license pending proceedings for revocation of the license or other action. The board shall promptly institute and determine further disciplinary action. A licensee whose license has been summarily suspended is entitled to a hearing not less than 20 days after the license was summarily suspended. The licensee may waive his or her right to a hearing on the summary suspension within the 20 day period.

W. Va. Code R. § 19-3-13 Impaired Nurse Treatment Program

13.1. The board may permit a licensee or applicant for licensure who has been found guilty of prohibited conduct, to participate in a structured treatment program and meet other terms and conditions for continued licensure, in lieu of disciplinary action.

13.1.a. The board may appoint a designee to monitor participation in an approved treatment program;

13.1.b. The board may excuse an applicant or licensee that remains in compliance with the terms of an approved treatment program, to the satisfaction of the board's designee, from appearing before the board or hearing examiner to respond further to charges of misconduct;

13.1.c. An applicant or licensee that fails to comply with the terms of an approved treatment program, to the satisfaction of the board's designee, may be subject to further disciplinary action to the fullest extent of the board's authority;

13.2. The board may establish or approve impaired nurse treatment programs.

W. Va. Code R. § 19-3-14 Expungement of Records

The Disciplinary Review Committee shall expunge all complaints that it dismisses, upon request by the licensee, from the licensees file after three (3) years, if no other complaint is received against the same licensee within the three (3) year period.

W. Va. Code R. § 19-3-15 Use of criminal records as disqualification from authorization to practice

15.1. The board may not disqualify an applicant from initial licensure because of a prior criminal conviction that remains unreversed unless that conviction is for a crime that bears a rational nexus to the nursing profession. In determining whether a criminal conviction bears a rational nexus to the nursing profession the board shall consider at a minimum:

15.1. a. The nature and seriousness of the crime for which the individual was convicted;

15.1.b. The passage of time since the commission of the crime;

15.1.c. The relationship of the crime to the ability, capacity, and fitness required to perform the duties and discharge the responsibilities of the registered nurse; and 15.1d. Any evidence of rehabilitation or treatment undertaken by the individual.

15.2. Because the term moral turpitude is vague and subject to inconsistent applications, the board may not rely upon the description of a crime for which an applicant has been convicted as one of moral turpitude as a basis for denying licensure: Provided, That if the prior conviction for the underlying crime bears a rational nexus to the profession or occupation requiring licensure, the board may consider the conviction according to the requirements of subdivision (1) of this subsection.

15.3. Notwithstanding any other provision of this chapter to the contrary, if an applicant is disqualified from licensure because of a prior criminal conviction, the board shall permit the applicant to apply for initial licensure if:

15.3.a. A period of five years has elapsed from the date of conviction or the date of release from incarceration, whichever is later;

15.3.b. The individual has not been convicted of any other crime during the period of time following the disqualifying offense; and

15.3.c. The conviction was not for an offense of a violent or sexual nature: Provided, That a conviction for an offense of a violent or sexual nature may subject an individual to a longer period of disqualification from licensure, to be determined by the board.

15.4. An individual with a criminal record who has not previously applied for licensure may petition the board at any time for a determination of whether the individuals criminal record will disqualify the individual from obtaining a license. This petition shall include sufficient details about the individuals criminal record to enable the board to identify the jurisdiction where the conviction occurred, the date of the conviction, and the specific nature of the conviction. The board shall provide the determination within 60 days of receiving the petition from the applicant. The board may charge a fee to recoup its costs for each petition. The requirements of this section do not apply to the criteria that the board may consider when making determinations regarding relicensure or discipline of licensees.

19CSR3

Series 05 Contested Case Hearing Procedure

W. Va. Code R. § 19-5-1 General

1.1. Scope. -- These procedural rules establish the procedures for the adjudication of contested case hearings before the Board.

1.2. Authority. -- W. Va. Code §§30-7-1 et seq., 30-1-1 et seq., and 29A-5-1 et seq.

1.3. Filing Date. July 28, 2023

1.4. Effective Date. August 31, 2023

W. Va. Code R. § 19-5-2 Definitions

The following words and phrases as used in these rules shall have the following meanings, unless the context otherwise requires:

2.1. "Board" means the West Virginia Board of Examiners for Registered Professional Nurses.

2.2. The term "demanding party" means an individual who has been denied a license to practice registered professional nursing by the Board and who, as a result, demands that a hearing be held before the Board on the issue of such denial.

2.3. The term "charged party" means an individual who holds a license to practice registered professional nursing issued by the Board and who has been charged by the Board as described in Section 3.4 of these rules.

2.4. The term "licensee" means an individual who holds a license to practice registered professional nursing issued by the Board.

W. Va. Code R. § 19-5-3 Hearing Procedures

3.1. Any person denied a license by the Board who believes such denial was in violation of W. Va. Code §§30-1-1 et seq. and/or 30-7-1 et seq. shall be entitled to a hearing on the action denying such license.

3.2. Any person who desires a hearing for the reason described in subsection 3.1 of this section must present a written demand for such to the Board.

3.3. When the president of the Board or his or her authorized designee is presented with such a demand for a hearing, he or she shall schedule a hearing within forty-five (45) days of receipt by him or her of such written demand, unless postponed to a later date by mutual agreement.

3.4. Charges may be instituted against any licensed registered professional nurse by the Board when reasonable cause exists for believing that the nurse may have engaged in conduct or be in such condition that his or her license should be suspended, revoked or otherwise disciplined for one or more of the grounds set forth in W. Va. Code §30-7-1 et seq. or the Board's legislative rules. Charges may be based upon information received by way of a verified written complaint filed with the Board and further information gathered by the Board in the process of investigating such complaint. Charges may also be based upon information received solely through investigative activities undertaken by the Board.

3.5. Charges instituted against a licensee as described in subsection 3.4 of this section shall be set forth in a Complaint and Notice of Hearing issued in the name of the Board as the agency of the state regulating the practice of registered professional nursing. Such Complaint and Notice of Hearing shall designate the Board as the "Complainant", and shall designate the licensed registered professional nurse involved in the proceeding as the "Respondent"; shall set out the substance of each offense charged with sufficient particularity to reasonably apprise the Respondent of the nature, time and place of the conduct or condition complained of therein; shall state the date, time and place for the hearing; and, shall contain a statement of intention by the Board to appoint a hearing examiner.

3.6. Upon receipt of a demand for a hearing described in subsections 3.1 and 3.2 of this section, the president or his or her designee shall provide the demanding party, with a Complaint and Notice of Hearing issued in the name of the Board as the agency of the state regulating the practice of registered professional nursing. Such Complaint and Notice of Hearing shall designate the demanding party as the "Complainant" and shall designate the Board as the "Respondent"; shall set out the substance of each and every reason that the Board has denied the demanding party a license with sufficient particularity to reasonably apprise the demanding party of the nature, time and place of the conduct or condition at issue therein; shall state the date, time and place for the hearing; and, shall contain a statement of intention by the Board to appoint a hearing examiner.

3.7. The Board may amend the charges set forth in a Complaint and Notice of Hearing as it deems proper.

3.8. A Complaint and Notice of Hearing shall be served upon the demanding or charged party at least thirty (30) days prior to the date of hearing.

3.9. Upon written motion received by the Board no later than twenty (20) days prior to the date of hearing, a more definite statement of the matters charged or the reasons stated for denial of licensure shall be provided to the demanding or charged party or his or her counsel, at least fifteen (15) days prior to the hearing date.

3.10. Hearings shall be conducted as follows:

3.10.1. Any party to a hearing shall have the right to be represented by an attorney-at-law, duly qualified to practice law in the state of West Virginia.

3.10.2. The Board may be represented by the West Virginia Attorney General's Office.

3.10.3. Irrelevant, immaterial, or unduly repetitious evidence shall be excluded from the hearing. Furthermore, the rules of evidence as applied in civil cases in the circuit courts of this state shall be followed. However, when necessary to ascertain facts not reasonably susceptible of proof under those rules, evidence not admissible thereunder may be admitted, except where precluded by statute, if it is of a type commonly relied upon by reasonably prudent persons in the conduct of their affairs.

3.10.4. The rules of privilege recognized by the law of this state shall be followed.

3.10.5. Objections to evidentiary offers shall be noted in the record. Any party to the hearing may vouch the record as to any excluded testimony or other evidence.

3.10.6. Any party to a hearing may appear with witnesses to testify on his or her behalf; may be heard in person, by counsel or both; may present such other evidence in support of his or her position as deemed appropriate by the Board or its designated hearing examiner; and, when appropriate, may cross-examine witnesses called by the Board in support of the charges or in defense of its decision to deny licensure.

3.10.7. The hearing shall be held at such time and place as is designated by the Board, but no hearing shall be conducted unless and until at least thirty (30) days written notice thereof has been served upon the charged or demanding party and/or his or her attorney in person; or if he or she cannot be found, by delivering such notice at his or her usual place of abode, and giving information of its purport, to his wife or her husband, or to any other person found there who is a member of his or her family and above the age of sixteen (16) years; or if neither his wife or her husband nor any such person can be found there, and he or she cannot be found, by leaving such notice posted at the front door of such place of abode; or if he or she does not reside in this state, such notice may be served by the publication thereof once a week for three successive weeks in a newspaper published in this state; or such notice may by served by registered or certified mail.

3.10.8. The hearing shall be open to the general public.

3.10.9. Members of the Board and its officers, agents and employees shall be competent to testify at the hearing as to material and relevant matters: Provided, that no member of the Board who testifies at such hearing shall thereafter participate in the deliberations or decisions of the Board with respect to the case in which he so testified.

3.10.10. The hearing may be conducted by one or more Board members or by a hearing examiner appointed by the Board.

3.10.11. A record of the hearing, including the complaint(s), if applicable, the notice of hearing, all pleadings, motions, rulings, stipulations, exhibits, documentary evidence, evidentiary depositions and the stenographic report of the hearing, shall be made and a transcript thereof maintained in the Board's files. Upon request, a copy of the transcript shall be furnished to any party at his or her expense.

3.10.12. Documentary evidence may be received in the form of copies or excerpts or by incorporation by reference.

3.10.13. Where a hearing is held upon the instance of the Board after charges have been brought against a licensee pursuant to subsection 3.4 and 3.5 of this section, the Board shall have the burden of proof and shall present its evidence and/or testimony in support of the charges first.

3.10.14. Where a hearing is held upon demand under the provisions of subsections 3.1, 3.2, 3.3, and 3.6 of this section, the demanding party shall have the burden of proof and shall therefore be required to present his or her evidence first.

3.10.15. Following the conclusion of the Board's presentation of evidence in accordance with subsection 3.10.13 of this section the Respondent or charged party shall have the right to submit his or her evidence in defense.

3.10.16. Following the conclusion of the demanding party's presentation of evidence in accordance with subsection 3.10.14 of this section, the Board shall have the right to submit its evidence in defense.

3.10.17. The Board may call witnesses to testify in support of its decision to deny licensure or in support of the charges instituted against a licensee; may present such other evidence to support its position; and, may cross-examine witnesses called by the demanding party or charged party in support of his or her position.

3.10.18. All parties shall have the right to offer opening and closing arguments, not to exceed ten (10) minutes for each presentation.

3.10.19. Hearings held by the Board as a result of charges instituted against a licensee may be continued or adjourned to a later date or a different place by the Board or its designee by appropriate notice to all parties.

3.10.20. Motions for a continuance of a hearing may be granted upon a showing of good cause. Motions for continuance must be in writing and received in the office of the Board no later than seven (7) days before the hearing date. In determining whether good cause exists, consideration will be given to the ability of the party requesting the continuance to proceed effectively without a continuance. A motion for a continuance filed less than seven (7) days from the date of hearing shall be denied unless the reason for the motion could not have been ascertained earlier. Motions for continuance filed prior to the date of hearing shall be ruled on by the Executive Secretary or Assistant Executive Secretary of the Board. All other motions for continuance shall be ruled on by the Board member(s) or the hearing examiner presiding over the hearing.

3.10.21. All motions related to a case set for hearing before the Board, except motions for continuance and those made during the hearing, shall be in writing and shall be received in the office of the Board at least ten (10) days before the hearing. Prehearing motions shall be heard at a prehearing conference or at the hearing prior to the Commencement of testimony. The Board member(s) or the hearing examiner presiding at the hearing shall hear the motions and the response from the non-moving party and shall rule on such motions accordingly.

W. Va. Code R. § 19-5-4 Transcription of Testimony and Evidence

4.1. All testimony, evidence, arguments and rulings on the admissibility of testimony and evidence shall be reported by stenographic notes and characters or by mechanical means.

4.2. All reported materials shall be transcribed. The Board shall have the responsibility to make arrangements for the transcription of the reported testimony and evidence.

4.3. Upon the motion of the Board or any party assigning error or omission in any part of any transcript, the Board or its appointed hearing examiner, shall settle all differences arising as to whether such transcript truly discloses what occurred at the hearing and shall direct that the transcript be corrected and/or revised as appropriate so as to make it conform to the truth.

4.4. A transcript of the hearing shall be provided to all members of the Board for review at least ten (10) days before the vote is taken on its decision in any licensure or licensure disciplinary matter.

W. Va. Code R. § 19-5-5 Submission of Proposed Findings of Fact and Conclusions of Law

5.1. Any party may submit proposed findings of fact and conclusions of law at a time and manner designated by the Board or its duly appointed hearing examiner.

W. Va. Code R. § 19-5-6 Hearing Examiner

6.1. The Board may appoint a hearing examiner who shall be empowered to subpoena witnesses and documents, administer oaths and affirmations, examine witnesses under oath, rule on evidentiary matters, hold conferences for the settlement or simplification of issues by consent of the parties, cause to be prepared a record of the hearing so that the Board is able to discharge its functions and otherwise conduct hearings as provided in section 3.10 of this rule.

6.2. Hearing examiners appointed by the Board are not authorized or empowered to grant, suspend, revoke or otherwise discipline any license.

6.3. The hearing examiner shall prepare recommended findings of fact and conclusions of law for submission to the Board. The Board may adopt, modify or reject such findings of fact and conclusions of law.

W. Va. Code R. § 19-5-7 Summary Suspension

7.1. If the Board determines that licensee or certificate holders actions constitute an immediate danger to the public health, safety or welfare, they may summarily suspend a license pending a hearing.

7.2. A licensee or certificate holder whose permit has been summarily suspended is entitled to a hearing not later than twenty (20) days after the permit was summarily suspended. The permit holder may waive his/her right to a hearing on the summary suspension within the twenty (20) day limit.

7.3. The Board shall conduct a hearing after imposing a summary suspension in the same manner as other disciplinary hearings.

W. Va. Code R. § 19-5-8 Conferences; Informal Disposition of Cases

8.1. At any time prior to the hearing or thereafter, the Board, its designee or its duly appointed hearing examiner may hold conferences for the following purposes:

8.1.a. To dispose of procedural requests, prehearing motions or similar matters;

8.1.b. To simplify or settle issues by consent of the parties; or,

8.1.c. To provide for the informal disposition of cases by stipulation or agreement.

8.2. The Board or its appointed hearing examiner may cause such conferences to be held on its own motion or by the request of a party.

8.3. The Board may also initiate or consider stipulation or agreement proposals with regard to the informal disposition of cases and may enter into such stipulations and/or agreements without conference.

W. Va. Code R. § 19-5-9 Depositions

9.1. Evidentiary depositions may be taken and read or otherwise included into evidence as in civil actions in the circuit courts of this state.

W. Va. Code R. § 19-5-10 Subpoenas

10.1. Subpoenas to compel the attendance of witnesses and subpoenas duces tecum to compel the production of documents may be issued by the Board, its Executive Secretary, its Assistant Executive Secretary, and by the hearing examiner appointed by the Board. Such subpoenas shall be issued pursuant to W. Va. Code 29A-5-1(b).

10.2. Written requests by a party for the issuance of subpoenas or subpoenas duces tecum as provided in subsection 10.1 of this section must be received by the Board no later than ten (10) days before a scheduled hearing. Any party requesting the issuance of subpoenas duces tecum shall see that they are properly served in accordance with W. Va. Code §29A-5-1(b).

W. Va. Code R. § 19-5-11 Orders

11.1. Any final order entered by the Board following a hearing conducted pursuant to these rules shall be made pursuant to the provisions of W. Va. Code §29A-5-3 and 30-1-8(d). Such orders shall be entered within forty-five (45) days following the submission of all documents and materials necessary for the proper disposition of the case, including transcripts, and shall contain findings of fact and conclusions of law.

11.2. The findings of fact and conclusions of law must be approved by a majority of the Board either by a poll or vote at a regular meeting, before a final order is entered. A copy of the final order approved by a majority of the Board shall be served upon the demanding or charged party and/or his attorney of record, if any, within five (5) days after entry by the Board by personal service or by registered or certified mail.

W. Va. Code R. § 19-5-12 Appeal

12.1. An appeal from any final order entered in accordance with these rules shall comply with the provisions of W. Va. Code §30-1-9 as well as W. Va. Code § 51-11-4(b)(4).

19CSR5

Series 07 Advanced Practice Registered Nurse Licensure Requirements

W. Va. Code R. § 19-7-1 General

1.1. Scope. -- This rule establishes the scope of the Advanced Practice Registered Nurse.

1.2. Authority. -- W. Va. §§30-7-1(a) and 30-7-4.

1.3. Filing Date. -- May 2, 2024.

1.4. Effective Date. -- May 2, 2024.

1.5. Sunset Date. This rule will terminate and have no further force or effect upon August 1, 2034.

W. Va. Code R. § 19-7-2 Definitions

2.1. Advanced Practice Registered Nurse (APRN) means a registered nurse who has acquired advanced clinical knowledge and skills preparing him or her to independently provide direct and indirect care to patients, who has completed a board approved graduate-level education program and who has passed a board approved national certification examination.

2.2. Certification or Recertification means a designation by a national certifying body recognized by the Board indicating the individual has completed the requirements necessary to earn such designation.

2.3. Unencumbered means a professional license has no current disciplinary action and no restrictions on practice through disciplinary action or other requirements.

W. Va. Code R. § 19-7-3 APRN Licensure

3.1. An applicant for initial licensure as an APRN shall meet the following requirements:

3.1.a. Submit to the Board the required fee as specified in §19-12 Fees, verification of licensure or eligibility for licensure as a registered nurse in this state and a completed advanced practice registered nurse (APRN) license application on forms provided by the board, that includes, at minimum, the following information:

3.1.a.1. Graduation from a graduate program accredited by a nurse accrediting body that is recognized by the U.S. Department of Education and/or the Council for Higher Education Accreditation (CHEA), or its successor organization as acceptable by the Board.

3.1.a.2. Verification of completion as evidenced by an official transcript with the official seal directly from a graduate program accredited by a nurse accrediting body that is recognized by the U.S. Department of Education and /or the Council for Higher Education Accreditation (CHEA) or its successor organization as acceptable by the Board. Said verification shall include documentation verifying the date of graduation, credential conferred, and number of clinical hours completed. On and after January 2, 2015 the verification shall include evidence of completion of 3 separate graduate level courses in advanced physiology and pathophysiology, advanced health assessment, and advanced pharmacology, which includes pharmacodynamics, pharmacokinetics and pharmacotherapeutics of all broad categories of agents, role and population focus of the education program, and evidence of meeting the standards of nursing education in this state.

3.1.a.3. Verification of successful completion of the appropriate APRN national certification examination in the APRN role and population focus congruent with educational preparation.

W. Va. Code R. § 19-7-4 Criteria for Evaluation of APRN Certification Programs

4.1. The board shall determine whether a certification program may be used as a requirement for licensure of APRNs based upon the following standards:

4.1.a. The program is national in the scope of its credentialing.

4.1.b. Conditions for taking the certification examination are consistent with standards of the testing community.

4.1.c. Education requirements are consistent with the requirements of the advanced practice roles of Nurse Anesthetist, Nurse Midwife, Clinical Nurse Specialist or Nurse Practitioner and population foci of Family/Individual Across the Lifespan, Adult-Gerontology, Neonatal, Pediatrics, Womens Health/Gender, Psychiatric Mental Health, and other advanced practice roles that are nationally and Board recognized.

4.1.d. The standard methodologies used are acceptable to the testing community, such as incumbent job analysis studies and logical job analysis studies.

4.2. Certification programs are accredited by a national accreditation body as acceptable by the Board.

4.3. The examination represents entry-level practice in the APRN role and population foci that are intended to ensure minimal competencies for practice at an advanced level of nursing.

4.4. The examination represents the knowledge, skills and abilities essential for the delivery of safe and effective advanced nursing care to patients.

4.5. Examination items are reviewed for content validity, cultural bias and correct scoring using an established mechanism, both before use and periodically.

4.6. Examinations are evaluated for psychometric performance.

4.7. The passing standard is established using acceptable psychometric methods and is reevaluated periodically.

4.8. Examination security is maintained through established procedures.

4.9. Certification is issued based upon passing the examination and meeting all certification requirements.

4.10. A retake policy is in place.

4.11. A certification maintenance program, which includes review of qualifications and continued competence, is in place.

4.12. Mechanisms are in place for communication to the Board for timely verification of an individuals certification status, changes in certification status, and changes in the certification program, including qualifications, test plan and scope of practice.

4.13. An evaluation process is in place to provide quality assurance in its certification program.

4.14. The Board shall maintain an updated, publicly accessible list of approved certification organizations.

W. Va. Code R. § 19-7-5 Application for Licensure by Endorsement for an APRN

5.1. An applicant for licensure by endorsement as an APRN in this state shall submit to the Board the required fee as specified in Series 12 Fees rule, verification of eligibility for license or privilege to practice as an APRN in another US state or territory and licensure as an RN in this state or as an RN in another National Licensure Compact (NLC) state and a completed an APRN license for endorsement application on forms provided by the board for APRN license that provides evidence the applicant meets the requirements of W. Va. Code §30-7-1.a. or evidence of the following information:

5.1.a. Graduation from a graduate program accredited by a nurse accrediting body that is recognized by the U.S.Department of Education and/or the Council for Higher Education Accreditation (CHEA), or its successor organization as acceptable by the Board.

5.1.b. Verification of completion as evidenced by official documentation directly from a graduate program accredited by a nursing accrediting body that is recognized by the U.S. Department of Education and/or the Council for Higher Education Accreditation (CHEA), or its successor as acceptable by the Board. Said verification shall include documentation verifying the date of graduation, credential conferred, and clinical hours completed. On and after January 1, 2015 the verification must include evidence of completion of 3 separate graduate level courses in advanced physiology and pathophysiology, advanced health assessment, advanced pharmacology, which includes pharmacodynamics, pharmacokinetics and pharmacotherapeutics of all broad categories of agents, role and population focus of the education program, and evidence of meeting the standards of nursing education in this state.

5.1.c. Demonstration of successful completion of approved APRN certification program by providing the following:

5.1.c.1. Current certification by a national certifying body in the APRN role and population focus appropriate to educational preparation.

5.1.c.2. Primary source verification of certification.

5.1.d. If the applicant has not been in clinical practice for more than the past 2 years, the applicant shall provide evidence of satisfactory completion of 24 contact hours, 12 in pharmacotherapeutics and 12 in the clinical management of patients, within the two years prior to applying for approval to practice.

5.1.e. If the applicant has not been in clinical practice for more than the past 5 years, the applicant shall provide:

5.1.e.1. Evidence of satisfactory completion of 45 contact hours of pharmacotherapeutics within the 2 years prior to application for approval to practice.

5.1.e.2. The applicant shall also successfully complete a refresher course or orientation program approved by the Board. An orientation shall:

5.1.e.2.a. Include the appropriate advanced practice role and population focus,

5.1.e.2.b. Be of sufficient length to satisfy the learning needs of the inactive advanced practice nurse and to assure that the advanced practice nurse meets the minimum standard for safe, competent care,

5.1.e.2.c. Cover the entire scope of the authorized advanced specialty area with content that will include, but not be limited to, that which is specified in Board guidelines, and,

5.1.e.2.d. Include a supervised clinical component by a qualified preceptor who is a graduate prepared health care provider with comparable practice focus and meets the following requirements:

5.1.e.2.d.1. Holds an active unencumbered license or privilege to practice,

5.1.e.2.d.2. Is in current practice in the advanced role and population foci, and,

5.1.e.2.d.3. Functions as a supervisor and teacher and evaluates the individuals performance in the clinical setting. 5.2 A temporary permit may be issued if an APRN endorsement applicant has submitted an APRN endorsement license application and fee per 19CSR12, holds an active APRN license from another US state or territory and an active West Virginia registered nurse license or NLC registered nurse license from another NLC state. The temporary permit is active until the official graduate transcript for APRN education conferring a graduation date and degree and official national certification verification is received in the Board office or 180 days whichever comes first. A temporary permit may only be issued one time and is nonrenewable.

W. Va. Code R. § 19-7-6 Application for Renewal of License as an APRN

6.1. An applicant for license renewal as an APRN shall submit to the Board the required fee for APRN license for renewal, as specified in rule §19-12 Fees; and a completed APRN license renewal application on forms provided by the board including the following:

6.1.a. Detailed explanation and supporting documentation for each affirmative answer to questions regarding the applicants background.

6.1.b. Evidence of completion of a minimum of 24 contact hours obtained within the most recent licensure renewal cycle; 12 hours in pharmacotherapeutics, 8 of which may be used for renewal and reinstatement of Limited Prescriptive Authority in accordance with WV19CSR8 and 12 hours in the clinical management of patients from an approved continuing education provider recognized by the Board. 12 hours may count toward the continuing education requirement for the registered nurse license according to WV19CSR11.

6.1.c. Evidence of current certification(s), or recertification as applicable, by a national professional certification organization that meets the requirements of the rule governing such programs.

6.2. An APRN who fails to renew the registered nurse license or privilege or is otherwise unable to legally practice as a registered nurse shall not practice as or use the title of APRN until:

6.2.a. A current active license has been issued by the board or a privilege is recognized by the board; and,

6.2.b. The APRN license has been reinstated.

6.3. An APRN shall provide evidence of current certification directly to the board by a recognized national certifying organization upon recertification and at the request of the board.

W. Va. Code R. § 19-7-7 Reinstatement of APRN License

7.1. To be eligible for reinstatement of the APRN license, the applicant shall meet all current requirements and submit:

7.1.a. A completed Application for Licensure as an APRN on forms provided by the board for APRN license;

7.1.b. The current reinstatement application fee for APRN license in rule §19-12 Fees; and,

7.1.c. Submit evidence of current certification or re-certification directly to the board by a recognized national certifying organization.

7.2. Refresher Course Requirement

7.2.a. An individual applying for licensure reinstatement and who has been out of practice for more than 5 years shall provide evidence of passing an APRN nursing refresher course approved by the Board or an extensive orientation which shall:

7.2.a.1. Include the appropriate advanced practice role and population focus;

7.2.a.2. Be of sufficient length to satisfy the learning needs of the inactive advanced practice nurse and to assure that the advanced practice nurse meets the minimum standard for safe, competent care;

7.2.a.3. Cover the entire scope of the authorized advanced specialty area with content that will include, but not be limited to, that which is specified in board guidelines; and,

7.2.a.4. Include a supervised clinical component by a qualified preceptor who may be a practicing physician or other licensed graduate prepared health care provider with comparable practice focus and meets the following requirements:

7.2.a.4.a. Holds an active unencumbered license as an APRN, practicing physician, or other licensed graduate prepared health care provider with comparable practice focus approved by the Board;

7.2.a.4.b. Is in current practice in the same advanced role and population foci; and

7.2.a.4.c. Functions as a supervisor and teacher and evaluates the individuals performance in the clinical setting.

7.3. An APRN may place his or her advanced practice registered nursing license on inactive by informing the Board in writing if he or she determines to no longer practice in this role. In order for the license to become active, the licensee must meet the reinstatement requirements contained in this rule.

W. Va. Code R. § 19-7-8 Titles and Abbreviations for APRNs

8.1. Each advanced practice registered nurse shall use the designation APRN and designated role title as a minimum for purposes of identification and documentation. When providing nursing care, the APRN shall wear clear identification that indicates his/her APRN designation.

W. Va. Code R. § 19-7-9 Postbasic program of Study and Clinical Experience Required for Licensure

9.1. Required Criteria for APRN Nursing Education Programs.

9.1.a. The board shall determine whether an APRN nursing education program meets the qualifications for the approval of a program based upon the following standards. The program shall:

9.1.a.1. Be established, ongoing, and organized program offered on a routine basis to an enrollee;

9.1.a.2. Be accredited or approved for the education of nurses by a recognized accreditation or approval body; or,

9.1.a.3. Be sponsored by a sponsoring organization, which shall hold the accreditation or approval for the education of nurses by a recognized accreditation or approval body;

9.1.a.4. Have a program design which prepares an enrollee to function in a role consistent with the advanced practice registered nursing designation;

9.1.a.5. Have a program design which includes purpose, philosophy, objectives, curriculum content, and plan to evaluate achievement of objectives and measurement of learning outcomes of students;

9.1.a.6. Have a designated faculty responsible for planning, development, implementation, and evaluation of curriculum and students;

9.1.a.7. Include didactic components that prepare the student to perform the additional acts delineated by the board and include at least pharmacology, advanced physical assessment, advanced pathophysiology, and clinical management of disease and differential diagnosis;

9.1.a.8. Include a supervised clinical experience that includes application of all the didactic components; and,

9.1.a.9. Upon successful completion, award a diploma or certificate.

9.2. If the applicant for licensure as an APRN completed a graduate degree of study after December 31, 2012, the applicant shall hold a graduate degree awarded by a college or university accredited by a nursing accrediting body that is recognized by the U.S. Department of Education and or the Council for Higher Education Accreditation (CHEA) or its successor organization as acceptable by the board.

9.3. If the applicant for licensure as an APRN completed a postbasic program of study before December 31, 2012, the program shall be evaluated by the board on an individual basis to determine if the program is acceptable to the board by sufficiently preparing a student for advanced practice registered nursing. Provided that the program was accredited by a nursing accrediting body that is recognized by the U.S.Department of Education and or the Council for Higher Education Accreditation (CHEA) or its successor organization as acceptable by the Board.

W. Va. Code R. § 19-7-10 National Certifying and Re-Certifying Organizations

10.1. A nationally established organization or agency which certifies registered nurses for advanced practice registered nursing shall be recognized by the board it is meets the following criteria:

10.1.a. The certifying body is an established national nursing organization or subdivision of this type of organization;

10.1.b. Eligibility requirements for certification are delineated;

10.1.c. Certification is offered in specialty areas of clinical practice consistent with the population focus;

10.1.d. Scope and standards of practice statements are established.

10.1.e. Mechanisms for determining continuing competency is established; and,

10.1.f. The certifying body is accredited by the American Board of Nursing Specialties or the National commission for Certifying Agencies.

10.2. In case of national recertification, any licensure suspension shall immediately be removed, and no further discipline may occur, if information is provided indicating that recertification has not lapsed.

W. Va. Code R. § 19-7-11 Practice Pending Licensure

11.1. A registered nurse who meets all the requirements for practice as an APRN, and who holds a registered nurse temporary license pending licensure by endorsement or a privilege to practice as a registered nurse, shall be authorized to practice as an APRN for a period of time not to exceed the expiration date of the temporary permit.

11.2. Authorization to practice pursuant to this section shall be the board acknowledging that the applicant has met all the requirements of this section by issuing an active temporary permit. An applicant may not practice until the temporary permit has been issued by the Board.

11.3. An individual authorized to practice pursuant to subsection (1) of this section may use the title APRN Applicant or APRN App.

W. Va. Code R. § 19-7-12 Certification or Recertification

12.1. An APRN shall maintain current certification or recertification from a national organization.

12.2. The APRN shall provide an official verification of current certification or recertification to the Board directly from the national certifying body before the expiration of the certification on file with the Board.

12.3. The board shall conduct an audit to verify that an APRN has met the requirements of the above section.

12.4. A nurse who fails to attain current, active certification or recertification from a national organization meeting the requirements of this rule for recognition by the Board or fails to submit to the Board evidence of such shall not practice or use the title of APRN until the requirements for certification have been met and evidence of current, active certification or recertification is submitted to the Board.

12.5. An APRN who is decertified by the appropriate national organization shall:

12.5.a. Notify the board of that fact; and,

12.5.b. Not practice as or use the title of APRN during the period of decertification.

W. Va. Code R. § 19-7-13 Application Validity

13.1. An application shall be valid for a period of 6 months from the date of submission to the board.

13.2. After 6 months from the date of application, the applicant shall be required to reapply.

W. Va. Code R. § 19-7-14 Discipline; Summary Suspension and Revocation of License

14.1. The board shall have the power to deny, revoke or suspend an APRN license or applied for in accordance with the provisions of this article, or any other Board law or rule, or to otherwise discipline a licensee or applicant upon proof that he or she has violated this article or any other Board law or rule.

14.2. An APRN license shall automatically and immediately be revoked if the registered professional nurse license is suspended or revoked.

14.3. A nurse practicing or identifying him or herself as an APRN who is not licensed as a registered nurse and as an APRN or whose practice is inconsistent with the role to which he or she has been designated, or an APRN who fails to renew the registered nurse license or recertify his or her national certification and provide the Board proof of such, and continues to practice as an APRN shall be subject to the boards disciplinary procedures and shall be subject to any other criminal and civil remedies afforded by law for practicing illegally.

14.4. If the Board finds that an APRN license was issued in error, such license shall be immediately revoked.

W. Va. Code R. § 19-7-15 Standards Related to the Advanced Practice Registered Nurse's Scope of Practice. 15.1 A license issued to an APRN by the Board of Registered Nurses shall authorize the APRN to perform nursing acts commensurate with their education, training, and experience and which they are competent to perform, consistent with the rules of the boards. Nursing acts include prescribing with Board approved prescriptive authority, and administering of controlled substances, prescription drugs, or medical devices. 15.2 An APRN shall provide only those services for which they have been prepared by their education, training, and experience and are competent to perform, consistent with sound nursing practice and that will protect the health and safety of the patient. This may occur in any health care setting, both hospital and outpatient in accordance with their practice notification

19CSR7

Series 12 Fees for Services Rendered by the Board

W. Va. Code R. § 19-12-1 General

1.1. Scope. -- This legislative Rule establishes the fees to be charged by the board for services rendered.

1.2. Authority. -- W. Va. §§ 30-7-4, 30-7-8a and 30-1-4.

1.3. Filing Date. -- May 2, 2024.

1.4. Effective Date. -- May 2, 2024.

1.5. Sunset Date. This rule will terminate and have no further force or effect upon August 1, 2034.

W. Va. Code R. § 19-12-2 Schedule of Fees for Services Rendered by the West Virginia Board of Registered Nurses

Fees collected by the board are not refundable.

2.1. Licensure Examination $70.00

2.2. Re-Examination $70.00

2.3. RN and APRN Endorsement into West Virginia (includes temporary permit) $125.00

2.4. RN and APRN Renewal of License (biennial) $90.00 $20.00 shall be deposited directly into a Fund designated for the Nurse Health Program.

2.5. RN and APRN Reinstatement of Inactive License $25.00

2.6. RN and APRN Reinstatement of Lapsed License $115.00

2.7. Transcripts $5.00

2.8. Insufficient Funds Penalty $25.00

2.9. Data Request (mailing addresses, reports, etc.) $350.00

2.10. Copy of Files $ 5.00 for the first page then $ .50 per page thereafter

2.11. APRN Initial Prescriptive Authority $125.00

2.12. APRN Prescriptive Authority Renewal (biennial) $125.00

2.13. APRN Prescriptive Authority Reinstatement $125.00

2.14. APRN License Verification to Another State $30.00

2.15. Continuing Education Provider Fee $100.00

2.16. Continuing Education Provider Maintenance Fee..$25.00

2.17. RN Conversion to Multi-State License...$7.00

2.18. Name Change...$10.00

2.19. New Prelicensure Nursing Education Program Application.....$50.00

2.20. RN and APRN Telehealth Registration (Initial and Renewal)..$100.00

2.21. APRN Initial License...$35.00 19CSR12 19CSR12

Registered Professional Nurses Registered Professional Nurses

Series 06 Open Meetings and Bylaws

W. Va. Code R. § 19-6-1 General

1.1. Scope. -- These rules establish general rules pertaining to regular meetings, special meetings and emergency meetings of the West Virginia Board of Examiners for Registered Professional Nurses and also sets forth certain bylaws of the Board.

1.2. Authority. -- W. Va. Code '6-9A-3 and '30-1-5

1.3. Filing Date. -- October 6, 2016

1.4. Effective Date. -- November 8, 2016

W. Va. Code R. § 19-6-2 Application And Enforcement

These procedural rules shall apply to the Board and any and all individuals desiring to attend or to address the West Virginia Board of Examiners for Registered Professional Nurses. The enforcement of these rules shall be vested with the Executive Secretary of the West Virginia Board of Examiners for Registered Professional Nurses.

W. Va. Code R. § 19-6-3 Definitions

3.1. "Board" - The West Virginia Board of Examiners for Registered Professional Nurses.

3.2. "Meeting" - The convening of a governing body of a public body for which a quorum is required.

3.3. "Quorum" - A majority of the constituent membership, including one officer.

W. Va. Code R. § 19-6-4 Regular Meetings: Notice Time, Place

4.1. The West Virginia Board of Examiners for Registered Professional Nurses shall meet in regular sessions during the months of October, March and June. The length of the meeting shall be determined by the amount of business to be addressed by the board. Special meeting dates shall be agreed upon by a majority of the board members. The first regular meeting after January 1, shall include an agenda item dates for regular meetings of the next fiscal year.

4.2. The executive secretary shall cause the notification of the public by filing a notice in accordance with West Virginia Law and Rules governing such practice. The notice shall contain the time, place and purpose of the meeting.

4.3. The board shall convene all regular meetings at a time designated by the Board.

4.4. The board shall convene all regular meetings at 101 Dee, Charleston, W.Va. 25311, unless otherwise changed by a majority vote of those board members present and voting.

4.5. The board may without notice, move the location of the meeting to accommodates members of the public who wish to attend such meeting in the event the meeting room is too small to accommodate such attendance.

4.6. All regular meetings shall be general meetings for the consideration of any and all matters which may properly come before the board.

4.7. The executive secretary shall send an Agenda and documents to be considered to all board members at least two weeks before the scheduled meeting or as soon before the meeting as possible.

4.8. The president of the board may cancel a meeting if a quorum cannot be convened or if there is not items of business to be conducted by the board.

W. Va. Code R. § 19-6-5 Special Meetings: Notice Required, Time, Place And Purpose

5.1. The Board may convene special meetings in accordance with the procedures established herein.

5.2. Special meetings of the board may be called by the president of the board, secretary or by two (2) board members upon written request to the secretary.

5.3. The executive secretary shall send to all members of the board, if possible, at least ten (10) days in advance of a special meeting, a written notice setting forth the time and place of such special meeting and the matter to be considered at such special meeting: Provided, That such written notice is not required if the time, place and matter for consideration has been fixed in a regular meeting.

5.4. The executive secretary, if possible, shall cause the notification of the public and news media by filing a notice of such special meeting at least ten (10) days in advance of such meeting with the Secretary of State. The notice shall contain the time, location, and purpose of meeting.

5.5. The provisions of this section shall not apply in the event of an emergency requiring immediate official action by the board.

W. Va. Code R. § 19-6-6 Proceeding To Be Open: Exceptions; Executive Session Permitted

6.1. Notwithstanding any other provisions of law or regulation all meetings of the board shall be open to the public, except as provided in the West Virginia Code.

6.2. The board reserves the right to executive sessions or closed meetings in accordance with those outlined in West Virginia.

W. Va. Code R. § 19-6-7 Minutes

7.1. The West Virginia Board of Examiners for Registered Professional Nurses shall provide for the preparation of written minutes of all of its meetings. All such minutes, other than the minutes of an executive session shall be available to the public within a reasonable time after the meeting and shall include the following information:

7.1.a. The date, time, and place of the meeting.

7.1.b. The name of each board member present or absent.

7.1.c. All motions, proposals, resolutions, orders ordinances and measures proposed and their disposition.

7.1.d. The results of all votes and, upon request of a member, the vote of each member by name.

W. Va. Code R. § 19-6-8 Quorum: Majority Vote Required; Vote By Proxy Prohibited

8.1. A majority, including one officer, of the board shall constitute a quorum.

8.2. The vote of a majority of all members present at any meeting of the board shall be necessary to take any action. The board may authorize the president to poll absent members by telephone regarding the release of a rule for public hearing if a quorum is not present.

8.3. Proxy voting is hereby prohibited.

W. Va. Code R. § 19-6-9 Records Of The Board To Be Public

All records of the board are public records except the exemptions as provided in West Virginia Code.

W. Va. Code R. § 19-6-10 Election Of Officers, Duties Of Officers

10.1. Officers The officers of this Board shall be a president and a secretary.

10.2. Elections of Officers.

The president and secretary shall be elected at the Annual meeting from its membership by a majority of the members.

10.3. Terms of Office.

The terms of the officers shall commence at the adjournment of the Annual meeting.

10.4. Vacancies.

In the event a president or secretary resigns or cannot complete the term a new election will be held to fill the office.

10.5. Duties of the Officers.

10.5.1. The President shall:

10.5.1.a. Preside at all meetings and conduct them by a formal order of business. In the event that the president is absent the secretary shall serve as president pro tem.

10.5.1.b. Appoint members to serve on committees as may be created and shall serve as an ex-officio member of all committees.

10.5.1.c. Retain the right to vote on all matters before the Board.

10.5.1.d. Perform such other functions as pertain to the office of the president.

10.5.2. The Secretary shall:

10.5.2.a. Also act as treasurer of the Board.

10.5.2.b. Assume functions at the discretion of the president.

10.5.2.c. Be responsible for the following unless these duties are delegated to an executive secretary.

10.5.2.c.1. Keep the records of all proceedings of the Board.

10.5.2.c.2. Preserve all papers, letters and transactions of the Board.

10.5.2.c.3. Have custody of the seal of the Board.

10.5.2.c.4. Send notices of time and place of all meetings.

10.5.2.c.5. Conduct the general correspondence of the Board.

10.5.2.c.6. Keep a register of the names and address of all nurses registered in West Virginia, which register shall be a public record.

10.5.2.c.7. Receive and account for monies received by the Board.

10.5.2.c.8. Deposit such monies in the State Treasury Special Account.

10.5.2.c.9. Certify to all expenses incurred by the Board and requisition warrants for their payment from the State Auditor.

10.5.2.c.10. Prepare an annual budget for the Board and submit to Finance and Administration for approval.

10.5.2.c.11. Shall be responsible to the Board for carrying out the routine duties of the office with the aid of such assistants as are appointed by the board.

W. Va. Code R. § 19-6-11 Resignation of Members

A board member wishing to resign should make the wish known by sending a letter to the Governor with a copy to the president of the board. A nurse board member should also send a copy to the West Virginia Nurses' Association.

W. Va. Code R. § 19-6-12 Committees

12.1. Ad Hoc Committee.

The president of the board has the right to appoint committees to perform such tasks as are deemed necessary by a simple majority of the board. Such appointments to committees is not limited to board members and may include such individuals who are determined will best serve a particular committee.

W. Va. Code R. § 19-6-13 Amendments to Procedural Policies

These policies may be amended by a majority vote of the board at any meeting for which written notice has been received accompanied by proposed changes at least ten (10) days in advance of the meeting.

W. Va. Code R. § 19-6-14 Parliamentary Authority

The rules contained in Roberts' Rules of Order Newly Revised shall govern the meetings of the Board in all cases where such rules are applicable and in which they are not inconsistent with these rules.

19CSR6

Series 08 Limited Prescriptive Authority for Nurses in Advanced Practice

W. Va. Code R. § 19-8-1 General

1.1. Scope. -- This rule establishes the requirements whereby the board authorizes qualified advanced practice registered nurses to prescribe prescription drugs in accordance with the provisions of W. Va. Code §30-7-15a, 15b, and 15c.

1.2. Authority. -- W. Va. Code §30-7-15a.

1.3. Filing Date. -- April 18, 2023.

1.4. Effective Date. -- April 24, 2023.

1.5. Sunset Date. – This rule shall terminate and have no further force or effect on August 1, 2033.

W. Va. Code R. § 19-8-2 Definitions

2.1. "Actively prescribe prescription medication" means the Advanced Practice Registered Nurse currently holds active prescriptive authority.

2.2. Advanced Practice Registered Nurse means a registered nurse who has acquired advanced clinical knowledge and skills preparing him or her to provide direct and indirect care to patients, as a certified nurse practitioner, certified nurse-midwife, certified registered nurse anesthetist, or clinical nurse specialist, who has completed a board-approved graduate-level education program and who has passed a board approved national certification examination.

W. Va. Code R. § 19-8-3 Application and Eligibility for Limited Prescriptive Authority

3.1. The board shall grant prescriptive authority to an advanced practice registered nurse applicant who meets all eligibility requirements specified in W. Va. Code 30-7-15b and the following:

3.1.a. Successfully complete an advanced pharmacotherapy graduate level course approved by the board of not less than 45 pharmacology contact hours;

3.1.b. Provide documentation of the use of pharmacotherapy in clinical practice in the education program;

3.1.c. Provide evidence of 15 graduate level pharmacology contact hours in advanced pharmacotherapy completed within 2 years prior to application for prescriptive authority;

3.1.d. Submit official graduate level transcripts or certificates documenting completion of pharmacology and pharmacotherapy course work.

3.1.e. The board may request courses documents if necessary to evaluate the pharmacology course content and objectives.

3.1.f. The advanced practice registered nurse shall submit a notarized application for prescriptive authority on forms provided by the Board with the following:

3.1.f.1. A fee set forth in the board’s Fees rule, 19CSR12.

3.1.f.2. When required, written verification of an agreement to a collaborative relationship with a licensed physician holding an unencumbered West Virginia license or with a licensed physician holding an unencumbered license from a contiguous state or the Veterans Administration for prescriptive practice on forms provided by the board containing the following:

3.1.f.2.A. Mutually agreed upon written guidelines or protocols for prescriptive authority as it applies to the advanced practice registered nurse’s clinical practice;

3.1.f.2.B. Statements describing the individual and shared responsibilities of the advanced practice registered nurse and the physician pursuant to the collaborative agreement between them;

3.1.f.2.C. A provision for the periodic and joint evaluation of the prescriptive practice; and,

3.1.f.2.D. A provision for the periodic and joint review and updating of the written guidelines or protocols.

3.1.f.2.E. Additional documentation at the request of the board.

3.1.f.3. The Advanced Practice Registered Nurse may have limited prescriptive authority without a collaborative agreement after meeting the following outlined requirements:

3.1.f.3.A. Have practiced at least three years in a documented collaborative relationship with prescriptive authority;

3.1.f.3.B. Be licensed in good standing with the board;

3.1.f.3.C. Submit a completed application on forms developed by the board and pay an application fee.

3.1.f.4. The Board will identify and maintain data designating those Advanced Practice Registered Nurses approved to prescribe without a collaborative agreement.

3.2. If the board obtains information that an applicant for prescriptive authority was previously addicted to or dependent upon alcohol or the use of controlled substances, the board may grant prescriptive authority with limitation. The limitations may include, but are not limited to, restricting the types of schedule drugs a nurse may prescribe.

3.3. The board shall forward a copy of the verified collaborative agreement specified in Subdivision 3.1.f.2. of this rule to the Board of Medicine or to the Board of Osteopathy, whichever is indicated.

3.4. Upon satisfactory evidence that the advanced practice registered nurse applicant has met all above requirements for prescriptive authority, the Board shall assign an identification number to that nurse.

3.5. The board shall notify the Board of Pharmacy of those advanced practice registered nurses who have been granted prescriptive authority, and shall also provide the prescriber's identification number and effective date of prescriptive authority.

3.6. The advanced practice registered nurse shall file with the board any restrictions on prescriptive authority that are not imposed by W. Va. Code §60A-3-301 et seq., or this rule, but which are within the written collaborative agreement and the name of the collaborating physician for each advanced practice registered nurse on the approved list.

3.7. The advanced practice registered nurse with prescriptive authority who wishes to prescribe Schedules II through V drugs shall comply with federal Drug Enforcement Agency requirements prior to prescribing controlled substances.

3.8. The advanced practice registered nurse shall immediately file any and all of his or her Drug Enforcement Agency registrations and numbers with the board.

3.9. The board shall maintain a current record of all advanced practice registered nurses with Drug Enforcement Agency registrations and numbers.

3.10. Any information filed with the board under the provisions of this rule shall be available, upon request, to any pharmacist, regulatory agency or board or shall be made available pursuant to other state or federal law.

3.11. The APRN shall maintain with the board a current mailing and, if available, a current e-mail address.

W. Va. Code R. § 19-8-4 Renewal of Prescriptive Privileges

4.1. An applicant for renewal of prescriptive authority shall be licensed as an advanced practice registered nurse and shall:

4.1.a. Maintain an active, uninterrupted national certification as an advanced practice registered nurse and maintain this information on file in the Board Office.

4.1.b. Submit to the board all documentation evidencing national certification as an advanced practice registered nurse and subsequent, uninterrupted renewal of national certification thereof.

4.2. The board shall consider the national certification as an advanced practice registered nurse of a licensee to be lapsed where such licensee fails to renew his or her national certification prior to its expiration dates, or fails to provide to the board, at the office of the board, all proper documentation and evidence of an uninterrupted renewal of such national certification prior to its expiration date.

4.3. The applicant shall complete during the 2 years prior to renewal a minimum of 8 contact hours of pharmacology education that has been approved by the board which may be part of the same 12 contact hours of advanced pharmacotherapeutics submitted for the advanced practice registered nurse license renewal requirement.

4.4. The board shall renew prescriptive authority for advanced practice registered nurses biennially on a date determined by the Board.

4.5. The application must be notarized, and the fee set forth in the boards rule, Fees For Services Rendered by the board, 19CSR12 must accompany the application.

W. Va. Code R. § 19-8-5 Prescriptive authority for prescription drugs

5.1. The advanced practice registered nurse shall not prescribe from the following categories of drugs:

5.1.a. An advanced practice registered nurse may not prescribe a Schedule I controlled substance as provided in §60A-2-204 et seq. of this code;

5.1.b. An advanced practice registered nurse may prescribe up to a three-day supply of a Schedule II narcotic as provided in §60A-2-206 et seq. of this code; 5.1.c There are no other limitations on the prescribing authority of an advanced practice registered nurse, except as provided in §16-54-1 et seq. of this code.

5.2. Each prescription and subsequent refills given by the advanced practice registered nurse shall be entered on the patient's chart.

5.3. An advanced practice registered nurse who has been approved for prescriptive authority by the board may sign for, accept, and provide to patients samples of drugs received from a drug company representative.

5.4. The prescription authorized by an advanced practice registered nurse shall comply with the requirements of the West Virginia Board of Pharmacy, other applicable state and federal laws, rules and regulations all applicable standards of care; must be signed by the prescriber with the legal designation or the designated certification title of the prescriber and must include the prescribers identification number assigned by the board.

5.4.a. All prescriptions shall:

5.4.a.1. Meet all requirements issued by the Center for Medicare and Medicaid Services for a written prescription for controlled substances as required by Section 2002(b) of PL. 110-28 of the Iraq War Supplemental Appropriations Bill enacted by the United States Congress in 2007;

5.4.a.2. Contain six (6) quantity check-off boxes printed on the form and in the following quantities shall appear:

(1) 1-24;

(2) 25-49;

(3) 50-74;

(4) 75-100;

(5) 101-150; and (6) 151 and over:

Provided That, if the blank has the quantity prescribed electronically printed in both numeric and word format, then the quantity check-off boxes shall not be necessary;

5.4.a.3. Contain space for the prescriber to indicate the date of the prescription, the full name of the drug, the dosage, the route of administration and directions, for its use and number of refills, if any, or to indicate no refills;

5.4.a.4. Provide space for the patient’s name and address, and the prescribing practitioner’s signature;

5.4.a.5. Provide space for the preprinted, stamped, typed, or manually printed name, address and telephone number of the prescribing practitioner, and the practitioner’s DEA registration number and NPI number; Provided that, if a practitioner does not have authority to prescribe controlled substances, then no DEA number shall be required, and, instead, the following statement shall be printed: “No Controlled Substances Authority”;

5.4.a.6. Contain the following statement printed on the bottom of the prescription blank: "This prescription may be filled with a generically equivalent drug product unless the words 'Brand Medically Necessary' are written in the practitioner's own handwriting, on this prescription form."

5.4.b. An advanced practice registered nurse shall at the time of the initial prescription record in the patient record the plan for continued evaluation of the effectiveness of the controlled substances prescribed.

W. Va. Code R. § 19-8-6 Termination of Limited Prescriptive Privileges

6.1. The board may deny or revoke privileges for prescriptive authority if the applicant or licensee has not met conditions set forth in the law or this rule, or if the applicant has violated any part of W. Va. Code §30-7-1 et seq.

6.2. The board shall notify the Board of Pharmacy within 24 hours after the termination of, or a change in, an advanced practice registered nurse’s prescriptive authority.

6.3. If the board finds that the public health, safety and welfare requires emergency action and incorporates a finding to that effect into its order, the board shall order summary suspension of the prescriptive authority privilege pending proceedings for other action. The board shall promptly institute and determine further disciplinary action.

6.4. The board shall immediately terminate prescriptive authority of advanced practice registered nurse if disciplinary action has been taken against his or her license to practice registered professional nursing in accordance with W. Va. Code §30-7-11.

6.5. Prescriptive authority for the advanced practice registered nurse terminates immediately if either the license to practice registered professional nursing or the Advanced Practice Registered Nurse license in the State of West Virginia lapses.

6.6. Prescriptive authority is immediately and automatically terminated if national certification as an advanced practice registered nurse lapses or if the advanced practice registered nurse fails to provide the board evidence of current certification or re-certification of national certification before the expiration of the last certification on record with the board.

6.7. If authorization for prescriptive authority is not renewed by the expiration date which appears on the document issued by the board reflecting approval of prescriptive authority, the authority terminates immediately on the expiration date.

6.8. An advanced practice registered nurse shall not prescribe controlled substances for his or her personal use or for the use of members of his or her immediate family.

6.9. An advanced practice registered nurse shall not provide controlled substances or prescription drugs for other than therapeutic purposes.

6.10. An advanced practice registered nurse with prescriptive authority may not delegate the prescribing of drugs to any other person.

6.11. When applicable, prescriptive authorization shall be terminated if the advanced practice registered nurse has not filed a current verified collaborative agreement with the board. Upon dissolvement of a collaborative agreement, if there is no other current collaborative agreement the advanced practice registered nurse shall cease prescribing immediately, prescribing privileges will be terminated, and the advanced practice registered nurse shall have 60 days to provide the board a verified current collaborative agreement to reinstate the prescribing privilege, after 60 days a reinstatement application must be completed and submitted for reinstatement of the prescribing privilege.

W. Va. Code R. § 19-8-7 Reinstatement of Lapsed or Terminated Limited Prescriptive Privileges

7.1. An advanced practice registered nurse whose prescriptive authority has lapsed or been terminated for failing to maintain an active West Virginia license as a registered nurse or for failing to maintain or provide the Board proof of active national certification or recertification as an advanced practice registered nurse or failing to maintain prescriptive authority granted by the Board may have the prescriptive authority reinstated upon submission of the application for prescriptive authority with the required fee and a satisfactory explanation for the lapse or termination.

Series 09 Complaint Procedure

W. Va. Code R. § 19-9-1 General

1.1. Scope. -- This rule defines the role and authority of the board in investigation and resolution of disciplinary matters.

1.2. Authority. -- W. Va. Code §§30-1-4 and 30-7-4.

1.3. Filing Date. July 25, 2018.

1.4. Effective Date.- September 1, 2018.

W. Va. Code R. § 19-9-2 Definitions

2.1. The following words and phrases as used in this rule have the following meanings, unless the context otherwise requires:

2.1.a. "Board" means the West Virginia Board of Examiners for Registered Professional Nurses.

2.1.b. "Complaint" means any written, verbal, or other communication with the board or its representatives which indicates or tends to indicate that a licensee is acting or has acted in violation of W. Va. Code §§30-7-1 et seq. or 30-15-1 et seq., or rules governing the practice of registered professional nursing.

2.1.c. "Proof" means all types of evidence except testimony, including but not limited to records, documents, exhibits, concrete objects, laboratory or other tests, and the reports of results of examinations or laboratory or other tests.

2.1.d. "Testimony" means evidence given by a witness under oath or affirmation, including but not limited to oral statements, affidavits, or depositions.

W. Va. Code R. § 19-9-3 Complaint Procedures

3.1. The Board will accept a complaint from any individual against one or more licensees.

3.2. The complaint may be written or verbal. The Board may accept anonymous complaints if the complaint provides enough information to begin an investigation. The Board may provide a form for the purpose of completing a complaint. Complaints shall include the following:

3.2.a. name and address of the licensee against whom the complaint is being filed;

3.2.b. the alleged violation which prompted the complaint;

3.2.c. the date or dates of the incident prompting the complaint;

3.2.d. any supporting documents related to the alleged violation; and

3.2.e. the name, address and telephone numbers of any and all witnesses to the incident.

3.3. The Board shall maintain a log of all complaints, indicating date of receipt, license number of nurse against whom the complaint is filed and the name of the individual filing the complaint.

3.4. A registered professional nurse required to file a complaint with the Board in accordance with this rule or any other applicable state law or rule shall do so within thirty (30) days after their knowledge of the alleged violation.

3.5. Complainants are immune from liability for the allegations contained in their complaints filed with the Board unless the complaint is filed in bad faith or for a malicious purpose.

3.6. The Board or its representatives shall gather information necessary to determine the validity of the complaint. All necessary investigative techniques, including but not limited to, subpoenas and interviewing potential witnesses, may be utilized.

3.7. The complainant shall be sent an acknowledgment stating one or more of the following:

3.7.a. The allegations are being reviewed by the Board; or

3.7.b. The allegations are beyond the jurisdiction of the Board; or

3.7.c. More information is required in order to fully investigate the complaint.

3.8. The licensee shall be sent a Notice of Complaint containing the allegations. The licensee has fourteen (14) days to respond to the allegations. The licensee shall also be sent a copy of the complaint filed against his/her license and any supporting documents filed with the complaint.

3.9. Board staff shall review all information received, including subpoenaed information, and determine if further investigation is necessary, if disciplinary action is warranted or if the case needs to be referred to the Disciplinary Review Committee (DRC) for review and/or dismissal.

3.9.a. The DRC may dismiss a case, direct staff to further investigate the allegations or determine the disciplinary action that should be taken against the license.

3.10. Board staff may negotiate terms of consent agreements if probable cause for disciplinary action is warranted.

3.10.a. The DRC shall review all consent agreements for approval and signature; it can reject the consent agreement or request modifications to the consent agreement.

3.11. If the DRC rejects the consent agreement and the licensee rejects the DRCs modifications, if any, staff shall set the case for hearing.

3.12. If the licensee contests the allegations and refuses to enter into a consent agreement, Board staff shall set the case for hearing.

3.13. A licensee may request complaints that are dismissed by the DRC to be expunged from the licensees file after three (3) years if no other complaint is received against the same licensee within the three (3) year period.

W. Va. Code R. § 19-9-4 Investigation

4.1. Upon complaint or on its own initiative, the Board or its employees or designees may investigate conduct which is occurring or has occurred which would violate W. Va. Code §§30-7-1 et seq., 30-15-1 et seq., or rules governing the practice of registered professional nursing.

4.2. For the purposes of an investigation by the Board:

4.2.a. The executive secretary or assistant executive secretary may subpoena witnesses and documents and administer oaths;

4.2.b. The Board or its authorized agents may depose witnesses, take sworn statements and collect other evidence;

4.2.c. The Board may institute proceedings in the courts of this state to enforce its subpoenas for the production of witnesses and documents and its orders and to restrain and enjoin violations of W. Va. Code §§30-7-1 et seq., 30-15-1 et seq., or rules governing the practice of registered professional nursing;

4.2.d. The Board may review pertinent medical records during the course of its investigation, and shall remove patient identifying information from records which are introduced as evidence at any disciplinary hearing;

4.2.e. The Board, or its employees or designees within the limits of authority granted by the Board, may employ investigators, consultants and other employees as may be necessary to assist in an investigation;

4.2.f. All powers of the Board and its employees or designees may be exercised to investigate a matter, even if a hearing or disciplinary action does not result from the investigative findings.

W. Va. Code R. § 19-9-5 Disciplinary Action

5.1. The Board has the authority to deny, revoke, suspend, or otherwise discipline a licensee or applicant for licensure upon proof that the licensee or applicant for licensure has violated the provisions of W. Va. Code §§30-7-1 et seq.

5.1.a. The Board shall afford every person subject to disciplinary proceedings an opportunity for a hearing, as set forth in the Board's rule regarding Contested Case Hearing Procedure, 19 CSR 5;

5.1.b. If an applicant for licensure or a licensee fails to appear at a scheduled hearing or fails to reply to the notification of hearing, the charges specified may be taken as true and the Board may proceed with the disciplinary action;

5.1.c. Following a hearing before the Board or its hearing examiner, the Board will issue its decision on any disciplinary matter;

5.1.d. The Board may establish a committee that has the authority to resolve disciplinary matters through a formal consent agreement with a licensee, permitting the licensee to voluntarily agree to disciplinary action in lieu of a formal evidentiary hearing.

5.1.e. The Board or its authorized committee may take disciplinary action which includes, but is not limited to, the denial, suspension, or revocation of a license to practice as a registered professional nurse, or probation of a registered professional nursing license with terms to be met for continued practice, or the assessment of additional renewal, reinstatement, or administrative costs or fines against a licensee, or a combination of these or other actions. A licensee who fails to pay a fine or administrative cost assessed as part of disciplinary action or non-disciplinary action within the time period agreed upon between the parties, may be disciplined or may remain under the disciplinary terms until the fine and administrative costs are paid in full.

19CSR9

Series 10 Standards for Scope of Professional Nursing Practice

W. Va. Code R. § 19-10-1 General

1.1. Scope. -- This rule establishes standards of safe practice for the registered professional nurse, and serves as a guide for the board in evaluating nursing care to determine if it is safe and effective.

1.2. Authority. -- W. Va. Code § 30-7-4

1.3. Filing Date. -- April 10, 2019.

1.4. Effective Date. – April 10, 2019.

1.5. Sunset Date. This rule will terminate and have no further force or effect upon April 10, 2029.

W. Va. Code R. § 19-10-2 Standards Related to the Registered Professional Nurse's Scope of Practice

2.1. Standards related to Professional Accountability:

2.1.1. Practices within the legal boundaries for nursing through the scope of practice in W. Va. Code 30-7-1 et seq. and rules governing nursing.

2.1.2. Demonstrates honesty and integrity in nursing practice.

2.1.3. Bases nursing decision on nursing knowledge and skills, the needs of patients and registered professional nursing standards.

2.1.4. Accepts responsibility for judgements, individual nursing actions, competence, decisions and behavior in the course of nursing practice.

2.1.5. Maintains competence through ongoing learning and application of knowledge in registered professional nursing practice.

2.1.6. Reports violations of the acts or rules by self or other licensees.

2.2. Standards related to Scope of Practice.

2.2.1. Conducts a comprehensive nursing assessment.

2.2.2. Applies nursing knowledge based upon the biological, psychological and social aspects of the patients condition.

2.2.3. Detects faulty or missing patient information.

2.2.4. Plans nursing care and nursing interventions consistent with the patients overall health care plan.

2.2.5. Utilizes decision-making, critical thinking and clinical judgement to make independent decision and nursing diagnoses.

2.2.6. Seeks clarification of orders when needed.

2.2.7. Implements treatment and therapy, including medication administration and delegated medical and independent nursing functions.

2.2.8. Obtains orientation/training for competence when encountering new equipment and technology or unfamiliar care situations.

2.2.9. Demonstrates attentiveness and provides patient surveillance and monitoring.

2.2.10. Identifies changes in patients health status and comprehends clinical implications of patients signs, symptoms and changes as part of expected and unexpected patient course or emergent situation.

2.2.11. Evaluates the patients response to nursing care and other therapy, including patients response to interventions, need for alternative interventions, need to communicate and consult with other health team members and need to revise the plan of care.

2.2.1. Communicates and consults with other health team members including patient concerns and special needs, patient status and progress, patient response or lack of response to interventions and significant changes in patient condition.

2.2.13. Documents nursing care.

2.2.14. Revises care plan as needed.

2.2.15. Takes preventive measures to protect patient, others and self.

2.2.16. Provides comprehensive nursing and health care education in which the RPN assesses and analyzes educational needs of the learners, plans educational programs based on learning needs and teaching-learning principles, ensures implementation of an educational plan either directly or by delegating selected aspects of the education to other qualified persons and evaluates the education to meet the identified goals.

2.3. Standards for Patient Advocacy.

2.3.1. Respects the patients rights, concerns, decisions and dignity.

2.3.2. Identifies patient needs.

2.3.3. Attends to patient concerns or requests.

2.3.4. Promotes safe patient environment.

2.3.5. Communicates patient choices, concerns and special needs with other health team members regarding patient status and progress, response or lack of response to therapies, significant changes in patient condition.

2.3.6. Maintains appropriate professional boundaries.

2.3.7. Assumes responsibility for nurses own decision and actions.

2.4. Standards to Organize, Manage and Supervise the Practice of Nursing.

2.4.1. Assigns to another only those nursing measures that fall within that nurses scope of practice, education, experience and competence or unlicensed persons role description including assigning care within the RN scope of practice to other RNs, LPN within the LPN scope of practice based on the RNs assessment of the patient and LPNs ability and supervising , monitoring and evaluating the care assigned to an LPN.

2.4.2. Delegates to another only those nursing measures for which that person has the necessary skills and competence to accomplish safely. In maintaining accountability for the delegation, an RN shall ensure the:

2.4.2.1. Unlicensed assistive personnel (UAP) has the education, legal authority, and demonstrated competency to perform the delegated task.

2.4.2.2. Tasks delegated are consistent with the UAPs job description and can be safely performed according to clear, exact and unchanging directions.

2.4.2.3. Results of the task are reasonably predictable.

2.4.2.4. Task does not require assessment, interpretation or independent decision making during its performance or at completion.

2.4.2.5. Selected patient and circumstances of the delegation are such that delegation of the task poses minimal risk to the patient and the consequences of performing the task improperly are not life-threating.

2.4.2.6. Provides clear directions and guidelines regarding the delegated task or, for routine tasks on stable patients, verifies that the UAP follow each written facility policy or procedure when performing the delegated task.

2.4.2.7. Provides supervision and feedback to the UAP.

2.4.2.8. Observes and communicates the outcome of the delegated task.

2.4.3. Matches patient needs with personnel qualification, available resources and appropriate supervision.

2.4.4. Communicates directions and expectation for completion of the delegated task.

2.4.5. Supervises others to whom nursing activities are delegated or assigned by monitoring performance, progress and outcomes; assures documentation of the activity.

2.4.6. Provides follow-up on problems and intervenes when needed.

2.4.7. Evaluates the effectiveness of the delegation or assignment.

2.4.8. Intervenes when problems are identified, and revises plan of care as needed.

2.4.9. Retains professional accountability for nursing care provided.

2.4.10. Promotes a safe and therapeutic environment by providing appropriate monitoring and surveillance of the care environment, identifying unsafe care situation and correcting problems or referring problems to appropriate management level when needed.

2.4.11. Teaches and counsels patient and families regarding their health care regimen, which may include, but not limited to, general information about health and medical condition, specific procedures and wellness and prevention.

Series 11 Continuing Education and Competence

W. Va. Code R. § 19-11-1 General

1.1. Scope. -- This legislative rule establishes requirements for continuing education for re-licensure of registered professional nurses.

1.2. Authority. -- W. Va. Code §§30-7-4 and 30-1-4.

1.3. Filing Date. -- April 18, 2023.

1.4. Effective Date. -- April 24, 2023.

1.5. Sunset Provision. -- This rule shall terminate and have no further force or effect upon August 1, 2033.

W. Va. Code R. § 19-11-2 Definition of Terms

2.1. "Approved provider" means an individual, local, state, or national agency, organization or association recognized by the board to provide continuing education.

2.2. "Audit" means the selection of licensees for verification of satisfactory completion of continuing education requirements during a specified time period; or the selection of approved providers for verification of adherence to continuing education approved provider requirements during a specified time period.

2.3. "Continuing education" means those learning activities intended to build upon the educational and experiential basis of the registered professional nurse for the enhancement of practice, education, administration, research, or theory development to the end of improving the health of the public.

2.4. "College credit courses" means those courses offered by a recognized educational institution, and which may be approved as continuing education.

2.5. "Independent study" means a program of learning designed by an approved provider for the registered professional nurse who completes the program at his or her own pace, e.g., home study, programmed instruction.

W. Va. Code R. § 19-11-3 Continuing Education

3.1. Continuing education requirements for re-licensure.

3.1.1. A registered professional nurse with an active license to practice registered professional nursing in West Virginia shall complete twelve (12) contact hours of continuing education, as approved by this rule, every renewal period. A registered professional nurse shall attest to completion of continuing education activities with the board at the time he or she files an application for renewal of his or her license to practice registered professional nursing in West Virginia.

3.1.2. Each applicant for renewal of a license, if the license is currently active, or reinstatement of a license if a license is lapsed or in an inactive status, shall attest to completion of twelve (12) contact hours of continuing education during the reporting period prescribed in subdivision 3.1.1 of this rule. Units of measurement used for continuing education courses are as follows:

3.1.2.a. A contact hour is a unit of measurement that describes at least fifty (50) minutes of an approved, organized learning experience, either didactic or clinical experience;

3.1.2.b. One (1) successfully completed academic semester hour is equivalent to fifteen (15) contact hours of instruction; and

3.1.2.c. One (1) successfully completed academic quarter hour is equivalent to ten (10) contact hours of instruction.

3.1.3. The board shall not grant credit for identical continuing education activities submitted during any report period. Continuing education contact hours from a previous reporting period may not be used, nor shall contact hours be accumulated for use in a future reporting period.

3.2. Exceptions to continuing education requirements. The board shall exempt from the continuing education requirements a licensee who qualifies for exceptions set forth in this rule.

3.2.1. A licensee who obtains a license for the first time in West Virginia during a reporting period is exempt from the continuing education requirements for the entire reporting period.

3.2.2. A licensee who is a government employee working as a registered professional nurse outside the United States or who is serving on active duty with the military for more than three (3) months of any reporting period is exempt from the continuing education requirements for the entire reporting period. A licensee who claims this exception shall retain evidence of government service or active duty with the military and shall present the evidence to the board upon request.

3.2.3. The board may grant a waiver to a licensee who has a physical or mental disability or illness or hardship during all or a portion of the reporting period. A waiver provides for an extension of time or exception from some or all of the continuing education requirements. Any licensee may request an application for a waiver from the board. The board shall approve or deny an application for waiver after review of the application. The board shall not grant an exception from continuing education requirements for more than one (1) reporting period, as set forth in this rule.

3.3. Failure to meet requirements or exceptions to requirements. The board may take the following actions if a licensee fails to meet the continuing education requirements or the conditions for exceptions for continuing education requirements for renewal of licensure required by this rule.

3.3.1. The board may place the licensee on inactive status without penalty and may waive the continuing education requirements, providing the licensee notifies the board in writing of his or her desire to have the board place his or her license on inactive status before the last (business) day of the reporting period. This written notification must be submitted with the completed renewal application indicating the desire to place the license on inactive status. The board shall not charge a fee to place the license on inactive status.

3.3.2. The board shall lapse the license of any person who fails to notify the board, in writing, prior to the last (business) day of the reporting period that he or she wishes to place his or her license on the inactive status.

3.4. Reinstatement of a license from inactive or lapsed status. A person wishing to reinstate a license from an inactive status or from lapsed status shall comply with the following requirements. The person shall:

3.4.1. Make application for reinstatement of the license from an inactive status or lapsed status;

3.4.2. Meet the continuing education requirements as set forth in this rule; 3.4.3.

3.4.4. Submit legible copies of certificates of attendance or completion at continuing education programs, transcripts of courses taken, and other information as requested by the board.

3.5. Audit of licensees. The board may select any licensee who holds a current license to audit for compliance with continuing competence requirements.

3.5.1. To comply with the audit request from the board, a licensee shall submit legible copies of certificates of attendance at continuing education programs, transcripts of courses taken, and other information as requested by the board.

3.5.2. The licensee shall submit the required documents within thirty (30) days of the date he or she receives notification of the audit. The board may grant an extension of time for submission of the documents, on an individual basis, and in cases of hardship, providing the licensee makes a written request for an extension of time and provides justification for the request.

3.5.3. Licensees shall keep certificates of attendance at continuing education programs, , transcripts of courses, or documentation of other activities permitted by the Board, or shall keep evidence or documentation of compliance with the exceptions to continuing education requirements as stated in subsection 3.2. of this rule for a two (2) year period following submission of continuing education activities to the board.

3.5.4. The board shall notify the licensee of the satisfactory completion of the audit.

3.5.5. If a person fails to submit the audit information requested by the board or meet standards in subdivision 3.1.1. or 3.1.3. of this rule, the board shall not renew a license before the audit is completed.

3.5.6. The board shall take action as prescribed in the Board’s rule, Disciplinary Action, 19CSR9, against any licensee who submits false information to the board.

3.5.7. A licensee who fails to notify the board of a current mailing address is not absolved from the audit requirements. The board shall not renew a license before the audit is completed.

W. Va. Code R. § 19-11-4 Continuing Education Providers

4.1. The board may recognize as approved providers an agency which meets minimum provider standards as outlined in subsections 4.2. and 4.5. of this rule.

4.1.1. The board shall consider written requests to designate other individuals, local, state or national agencies, organizations and associates as approved providers.

4.1.2. The board shall maintain a current list of approved providers which shall be available to the public upon request. The board shall notify providers who fail to meet the minimum acceptable provider standards, in writing, of specific deficiencies and give them a limited period of time to correct deficiencies. The board may remove an approved provider who does not correct deficiencies within the specified time period from the list of approved providers.

4.1.3. The board recognizes the West Virginia nurses association or any other provider accredited by the American nurses credentialing center as an approved provider of continuing education programs for purposes of meeting the requirements of this rule.

4.2. Minimum standards for approved providers.

4.2.1. The duration of the activity shall be at least one (1) contact hour.

4.2.2. The provider shall prepare written objectives, in measurable terms, which describe what a licensee can expect to learn.

4.2.3. The program content shall relate to the program objectives.

4.2.4. The provider shall furnish to the participant the instructor's qualifications in the subject areas to be taught, in writing.

4.2.5. The provider shall establish a written method to determine whether the participant has achieved the stated objectives of the offering continuing education program. Methods may include but are not limited to self-evaluation check lists or tests.

4.2.6. The provider shall furnish a written statement of completion to each participant who completes each continuing education program. The statement shall be signed by the instructor or an individual designated by the instructor, and shall contain the following information: the name of the continuing education program, the number of contact hours, the date of the continuing education program, and the name of the participant.

4.2.7. The provider shall maintain a record of individuals who attend a continuing education program for a period of not less than three (3) years.

4.3. Independent study.

4.3.1. Independent study activities may include any learning activity as defined in subsection 2.6. of this rule that has been designed or planned as an individual study activity. This may include telecommunication activities such as educational television, video or audio events, and professional journal articles developed as continuing education programs and printed media units. These independent study activities are designed as programmed learning units meaning that there are educational objectives related to the content, and a mechanism to evaluate what has been learned.

4.3.2. Contact hour equivalents for approved independent study shall be based on contact hours awarded by the approved provider.

4.4. Continuing education subjects.

4.4.1. Continuing education programs shall reflect the educational needs of the licensee in order to meet the health care needs of the consumer and may consist of one or more of the following subject areas:

4.4.1.a. Professional nursing practice and special health care problems;

4.4.1.b. The biological, physical, social and behavioral sciences;

4.4.1.c. The legal aspects of professional nursing practice;

4.4.1.d. Management of health care personnel and patient care;

4.4.1.e. Teaching and learning process for health care personnel or for patients; and

4.4.1.f. Subjects relating to professional nursing practice which are required as part of a formal nursing program and which are more advanced than those completed for original licensure.

4.4.2. The licensee must have documentation that supports completion of twelve (12) continuing education credits from an approved source. The licensee may accomplish this by:

4.4.2.a. Completing twelve (12) hours of continuing education credits from an approved provider as defined in subsection 2.6. of this rule including Independent Study.

Series 13 Dialysis Technicians

W. Va. Code R. § 19-13-1 General

1.1.Scope. -- This legislative Rule establishes the general requirements for certification of and renewal and reinstatement of certification for dialysis technicians, delegation of acts by the registered professional nurse to dialysis technicians, discipline of dialysis technicians and for approval of dialysis technician training programs.

1.2.Authority. -- W. Va. Code §30-7C-4. 1.3.Filing Date. -- April 1, 2019. 1.4.Effective Date. – April 1, 2019.

1.5. Sunset Date. – This rule will terminate and have no further force or effect upon April 1, 2029.

W. Va. Code R. § 19-13-2 Definitions of Terms

2.1. “Board” means the West Virginia Board of Examiners for Registered Professional Nurses;

2.2. “Delegation” means the transfer of responsibility for the performance of a selected task or activity from a licensed physician or registered professional nurse authorized to perform the task or activity to an individual who does not have the statutory authority to perform the task or activity.

2.3. “Dialysis technician training program” means the three hundred twenty clock hours of instruction for hemodialysis care by dialysis technicians, including both classroom and supervised clinical components; and, approved out of state programs that meet the requirements of the board.

2.4. “Discontinue” means to cease or stop the treatment.

2.5. “Initiation of dialysis care” means appropriately preparing the dialysis machine and extra corporeal circuit for dialysis according to the physician order.

2.6. “Monitor” means to collect objective and subjective data and observe the dialysis patient for signs or symptoms of any change in physiological or psychosocial status or of complications related to dialysis, to check or regulate the performance of the machines used in performing dialysis, and to report any irregularity to the licensed physician or registered professional nurse as appropriate.

2.7. “Nurse administrator” means the registered professional nurse responsible for administering a board-approved dialysis technician training program;

2.8. “Preceptor” means a registered professional nurse or a dialysis technician with at least one (1) year of full time experience in providing dialysis care in the previous two (2) years.

2.9. “Site visit” means an announced or unannounced visit to a dialysis training program by a board representative to determine whether the program meets or maintains the minimum standards required by the board.

2.10. “Training Program” means a dialysis training program;

2.11. “Dialysis technician trainee” means an individual enrolled in an approved dialysis technician program.

W. Va. Code R. § 19-13-3 Standards for Delegation of Safe Dialysis Care

3.1. The dialysis technician shall provide hemodialysis in accordance with W. Va. Code § 30-7C-1 et seq. and the rules of the board which require the delegation of authority to the technician by a licensed physician or registered professional nurse.

3.2. The dialysis technician may not begin dialysis care until a registered professional nurse or physician has first assessed the patient upon entering the dialysis unit to assure that he or she is stable and then delegated dialysis care to the dialysis technician.;

3.3. The dialysis technician shall evaluate the patient pre-dialysis, including vital signs, volume assessment and evaluation of the vascular access, and report any abnormality to the responsible registered professional nurse or physician, who shall then further evaluate the patient problem before the dialysis technician proceeds with vascular access to begin the procedure.

3.4. The registered professional nurse may not delegate medication administration to the dialysis technician trainee until medication administration competencies have been validated.

3.5. The registered professional nurse who is delegating to the dialysis technician shall assure that:

3.5.a. The activity or task does not require the substantial, specialized knowledge, judgement, skill and decision making of a registered professional nurse;

3.5.b. The registered professional nurse has completed an assessment prior to delegating any nursing intervention in accordance with the standards outlined in the board’s rule, Standards for Professional Nursing Practice, 19CSR10;

3.5.c. The nurse administrator has validated the dialysis technician’s competency in performing the delegated task;

3.5.d. The registered professional nurse performs ongoing evaluation and assessment of the person receiving the care;

3.5.e. The staffing in the treatment facility provides for adequate supervision of the delegated tasks;

3.5.f. The dialysis technician maintains knowledge of the duties, responsibilities, and accountabilities of a dialysis technician and practices in accordance with the following:

3.5.f.1. The laws regulating the provision of dialysis care;

3.5.f.2. The rules of the board;

3.5.f.3. Any other applicable federal and state laws and rules; and,

3.5.f.4. Applicable standards .

3.5.g. The dialysis technician shall demonstrate competence and accountability in all areas of dialysis care in which the dialysis technician is engaged. The dialysis technician shall:

3.5.g.1. Consistently perform all aspects of dialysis care according to acceptable standards;

3.5.g.2. Appropriately recognize, refer, or consult and intervene when a complication arises in conjunction with dialysis or when a change in patient status occurs;

3.5.g.3. Accurately maintain any patient record or any other documents prepared in the course of or in conjunction with the provision of dialysis care;

3.5.g.4. Implement measures to provide a safe environment for the patient;

3.5.g.5. Establish and maintain professional boundaries with each patient;

3.5.g.6. Not engage in behavior that causes or may cause physical, verbal, mental, or emotional abuse to a patient, or in behavior that may reasonably be interpreted as physical, verbal, mental or emotional abuse;

3.5.g.7. Not misappropriate a patient’s property, engage in behavior to seek or obtain personal gain at the patient’s expense, or engage in behavior that constitutes inappropriate involvement in a patient’s personal relationships. The patient is always presumed incapable of giving free, full, or informed consent to these behaviors;

3.5.g.8. Not engage in sexual misconduct or in conduct that may reasonably be interpreted as sexual or in any verbal behavior that is or may reasonably be interpreted as seductive or sexually demeaning to a patient. The patient is always presumed incapable of giving free, full or informed consent to these behaviors; and;

3.5.g.9. Treat each patient with courtesy, respect, and with full recognition of the dignity of each individual.

3.5.h. The dialysis technician shall timely:

3.5.h.1. Implement the prescribed dialysis care order for a patient, or clarify the order if the dialysis technician believes or should have reason to believe that the prescribed order is inaccurate, not properly authorized, not current or valid, harmful or potentially harmful to the patient, or contraindicated by other documented information. When clarifying the prescribed dialysis care order, the dialysis technician shall:

3.5.h.1.A. Timely consult with a physician or registered professional nurse; and,

3.5.h.1.B. Accurately, timely, and completely document and report to the appropriate practitioner all errors in or deviations from the prescribed dialysis care regimen; and

3.5.h.2. Initiate dialysis care after assuring that the equipment has been properly prepared and the environment is safe according to current state and federal requirements for dialysis facilities; and

3.5.i. The dialysis technician may not submit or cause to be submitted any false, misleading, or deceptive statements, information, or documentation to the board, to current employers, or to any future employers for positions requiring a certificate to practice dialysis care.

3.6. A dialysis technician employed in West Virginia through a temporary agency shall meet the requirements of this rule.

3.7. A registered professional nurse delegating inappropriately to a dialysis technician is subject to disciplinary action by the board.

W. Va. Code R. § 19-13-4 Standards for Medication Administration by a Dialysis Technician

4.1. A dialysis technician may administer the following medications if included in the dialysis prescription and delegated by the licensed physician or registered professional nurse:

4.1.a. Intradermal lidocaine or another single therapeutically equivalent local anesthetic for the purpose of initiating dialysis treatment;

4.1.b. Heparin or other single therapeutically equivalent anticoagulant to prime the pump, initiate treatment, or for administration throughout the treatment which may be done intravenously, peripherally via a fistula needle or in another clinically acceptable manner;

4.1.c. Intravenous normal saline;

4.1.d. Patient specific dialysate to which the dialysis technician may add only electrolytes; and

4.1.e. Oxygen, when the administration of the oxygen has been delegated to the dialysis technician by a registered professional nurse.

4.2. Except as provided by this rule, a dialysis technician may not administer any blood products or intravenous medications.

4.3. When administering the medications set forth in subsection 4.1 of this rule, the dialysis technician shall:

4.3.a. Assure that the right dose of the right medication is given to the right individual, through the right route of administration, at the right time, for the right reason;

4.3.b. Accurately and timely document the administration of the medication and notify the physician or licensed professional nurse of the patient's response to the medication as appropriate;

4.3.c. Consult with an appropriate licensed practitioner when the dialysis technician believes or should have reason to believe that a prescribed medication is inaccurate, not properly authorized, harmful or potentially harmful to a patient, or contraindicated by other documented information; and

4.3.d. Take any other action needed to assure the safety of the patient.

4.4. A dialysis technician shall administer the medications authorized by this rule only if the task has been delegated to the dialysis technician by a registered professional nurse or by a licensed physician in accordance with this rule.

4.5. The dialysis technician shall be under the direct supervision of a registered professional nurse or licensed physician when administering medications.

W. Va. Code R. § 19-13-5 Procedures for Obtaining Approval as a Dialysis Technician Training Program

5.1. The board shall approve dialysis technician training programs as follows:

5.1.a. A dialysis technician training program that seeks approval by the board shall submit to the board a completed application on a form specified by the board which includes the following:

5.1.a.1. Identifying information;

5.1.a.2. Information regarding administrative processes of the program;

5.1.a.3. A description of the record-keeping system to be used by the dialysis technician training program to assure accurate reporting to the board of individuals who have enrolled in and who did or did not successfully complete the dialysis technician training program;

5.1.a.4. A copy of the policies required by subsection 6.1.g. of this rule; and,

5.1.a.5. Any other information requested by the board; and,

5.1.b. Submit payment of a dialysis technician training program approval fee.

5.2. No more than one hundred sixty days (160) after receipt of a complete application for approval, the board shall either approve or disapprove the training program.

5.3. Approval shall continue for two (2) years if the program demonstrates that the standards set forth in this rule are met and maintained throughout the two-year approval period. The board may conduct additional site visits during each two-year approval period and at any other time the board considers necessary.

5.4. Dialysis technician training programs in existence on or before July 1, 2005, shall submit all items for the application for approval required by the board in this subsection on or before October 15, 2005.

5.5. Dialysis technician training programs in existence after July 1, 2005, shall submit all items for the application for approval required by the board in this subsection at least one hundred sixty (160) days prior to the beginning of the first day of the training program.

5.6. Any dialysis technician training program that fails to meet the initial requirements of the board has (3) months after notification of the deficiencies to provide the board with evidence of meeting the requirements and six (6) months to submit evidence of providing the additional required training to individuals who completed the program within the last twelve (12) months.

W. Va. Code R. § 19-13-6 Minimum Standards of a Dialysis Technician Training Programs

6.1. To be approved by the board, a dialysis technician training program shall meet and maintain the following standards and requirements:

6.1.a. The program shall be administered by a registered professional nurse who has:

6.1.a.1. A current, unencumbered, valid license in West Virginia to practice nursing as a registered professional nurse;

6.1.a.2. At least twenty-four (24) months experience in the practice of nursing as a registered professional nurse, of which at least twelve (12) months has been in the care of renal patients, with at least six (6) of those months in dialysis care, occurring within the last three years;

6.1.a.3. Education or experience in adult education, as supported by a portfolio submitted to the Board and,

6.1.a.4. A bachelors degree in nursing or a bachelors degree in education or a portfolio of skills and education evaluated and approved by the Board;

6.1.b. The nurse administrator shall:

6.1.b.1. Assure that the governing body of the training program establishes in writing the policies required by subdivision 6.1.g. of this rule; and,

6.1.b.2. Implement the policies as written;

6.1.c. The training program shall immediately notify the board in writing when the nurse administrator vacates the position or is replaced and provide the name and qualifications of the new or interim nurse administrator. A training program may not initiate a new class of dialysis technician trainees unless the new or interim nurse administrator meets the qualifications required by this rule.

6.1.d. The dialysis technician training program shall be taught by multidisciplinary faculty with expertise in the subject matter.

6.1.d.1. The training program shall provide the name, title, and credentials identifying the educational and professional qualifications of each instructor to the board.

6.1.d.2. The nurse administrator who is responsible for administering the program may use other health care professionals authorized to practice to assist in conducting classroom and clinical portions of the program if the other authorized health care professional relays information for which the professional has been educated and which is within the professional scope of practice as set forth in law.

6.1.d.3. The training program shall report a change in faculty to the board within thirty (30) days of the change;

6.1.e. Each training program shall develop written objectives for the training program which shall serve as the basis for planning, implementing and evaluating the program.

6.1.e.1. The objectives shall be developed by the training program faculty.

6.1.e.2. The training program objectives shall describe the knowledge and skills expected of the dialysis technician, and shall be consistent with the authorized functions of the dialysis technician.

6.1.e.3. The training program objectives shall be reviewed annually and revised as necessary by the nurse administrator;

6.1.f. The curriculum offered by the training program shall include both classroom and clinical instruction of at least three hundred twenty (320) clock hours in length and content which ensures sufficient preparation for safe and effective practice as a dialysis technician. Of the three hundred twenty (320) clock hours, at least one hundred sixty (160) clock hours shall be theoretical instruction with at least one hundred (100) hours face to face instruction in a classroom setting and a minimum of one hundred sixty (160) hours of supervised clinical experience. Supervised clinical experience shall provide opportunities for the student to apply theory and to achieve stated objectives in a patient care setting and shall include clinical learning experiences to develop the skills required by dialysis technicians to provide safe patient care. The registered professional nurse educator or clinical preceptor shall be physically present and accessible to the student when the student is in the patient care area.

6.1.f.1. Classroom instruction, which may be supported by audio visuals, shall include:

6.1.f.1.A. A review of the relevant laws and rules regulating the practice of a dialysis technician and appropriate program policies;

6.1.f.1.B. Renal anatomy and physiology;

6.1.f.1.C. Infection control, universal precautions, and Federal Regulations;

6.1.f.1.D. Basic chemistry of body fluids and electrolytes;

6.1.f.1.E. Manifestations of renal failure;

6.1.f.1.F. Basic laboratory values, including blood work and laboratory values related to dialysis;

6.1.f.1.G. Principles of dialysis;

6.1.f.1.H. Basic pharmacology of the drugs commonly used during dialysis;

6.1.f.1.I. Medication administration techniques specific to the drugs used in dialysis;

6.1.f.1.J. Management of the complications of dialysis and renal failure;

6.1.f.1.K. Principles related to vascular access;

6.1.f.1.L. The role of the dialysis technician in a dialysis setting including, but not limited to, legal and ethical considerations and concepts of delegation;

6.1.f.1.M. Water treatment relevant to dialysis;

6.1.f.1.N. Principles of patient education related to renal failure;

6.1.f.1.O. Principles of and requirements for documentation of hemodialysis care and interventions;

6.1.f.1.P. Communication and team work skills;

6.1.f.1.Q. Operation of dialysis delivery systems which includes the machines, dialysate, and dialyzer;

6.1.f.1.R. Principles of safe effective dialysis care;

6.1.f.1.S. Principles related to the nutritional considerations for patients receiving dialysis;

6.1.f.1.T. Psychosocial aspects of renal disease;

6.1.f.1.U. Principles of dialyzer reprocessing;

6.1.f.1.V. Principles for initiating, monitoring, and discontinuing dialysis; and,

6.1.f.1.W. Principles related to the adequacy of dialysis.

6.1.f.2. The program shall develop written tests for each unit in the curriculum, including a final test, and shall conduct a skills performance evaluation.

6.1.f.2.A. Examines may be administered by paper/pencil or by computer;

6.1.f.2.B. A score of eighty five percent (85%) or greater is required on each unit test with an opportunity to retake each unit test one time without additional instruction. If the student fails a unit test a second time, additional instruction is required before further testing is allowed.

6.1.f.3. Supervised clinical instruction shall:

6.1.f.3.A. Provide the dialysis technician trainee with the opportunity to practice the cognitive, psychomotor, and effective skills required for the safe performance of dialysis care by the dialysis technician;

6.1.f.3.B. Meet the learning needs of each trainee;

6.1.f.3.C. Meet the established program objectives or outcomes;

6.1.f.3.D. Be provided concurrently with the related classroom theory instruction;

6.1.f.3.E. Maintain a faculty to student ratio not to exceed one to four (1:4) in the clinical setting. A one to one (1:1) ratio is required for skills performance evaluation. The clinical preceptor to student ratio is one to two (1:2); and

6.1.f.3.F. Include a registered professional nurse or a dialysis technician preceptor with at least one (1) year of experience in providing dialysis care in the previous two (2) years;

6.1.g. The nurse administrator shall establish and adopt written program policies which address:

6.1.g.1. Criteria for trainee admission and continuation in the program which require, at a minimum, that each individual enrolled in the program has a high school diploma or equivalent, is at least eighteen (18) years of age and is able to safely perform the essential functions of a dialysis technician;

6.1.g.2. Criteria for trainee re-enrollment in the program;

6.1.g.3. Criteria for successful completion of the program;

6.1.g.4. A process for determining achievement of the skills required for the safe performance of dialysis care which shall include, at a minimum, written verification, signed by both a registered professional nurse and the trainee, that the trainee has been taught the required skills;

6.1.g.5. A process for maintaining trainee records. The records shall include, but not be limited to, the date the trainee began the program, the date the trainee completed the three hundred twenty (320) hour program, and the trainee’s competency check lists;

6.1.g.6. An accurate, timely process for notifying the board regarding enrollment and program completion which includes, but is not limited to, the following:

6.1.g.6.A. Requirements for successful completion of the training program shall be clearly specified. The requirements shall include demonstration of clinical competency and successful completion of a comprehensive, written final examination. The nurse administrator shall adopt a policy regarding a trainee who fails to successfully complete the training program. The statement of policy adopted by the training program shall include requirements that a person:

6.1.g.6.A.1. Shall not be enrolled in a training program more than two (2) times

6.1.g.6.A.2. Shall show continuing progress toward completion of the program; and

6.1.g.6.A.3. Who fails to successfully complete the program within twenty (20) calendar weeks shall cease functioning as a trainee until that person is reenrolled in a subsequent training program if that opportunity still exists;

6.1.g.6.B. At a minimum, the following records shall be maintained by the program:

6.1.g.6.B.1. The provider’s name and the date and site of the training program

6.1.g.6.B.2. The program code number issued by the board; and

6.1.g.6.B.3. A trainee roster, with a minimum of the trainee’s name, date of birth, Social Security number, and program completion date;

6.1.g.6.C. An individual who successfully completes the training program shall receive a certificate of completion that documents the following:

6.1.g.6.C.1. The name of the individual;

6.1.g.6.C.2. The title of the training program, date of completion, and location;

6.1.g.6.C.3. The provider’s name;

6.1.g.6.C.4. The dialysis technician training program code number issued by the board; and

6.1.g.6.C.5. The name and signature of the dialysis technician training program administrator;

6.1.g.6.D. The criteria required for making modifications in the dialysis technician training program or in the testing components of the dialysis technician training program to meet the learning needs of individual trainees who are re-enrolling or who have previous training or experience in dialysis care;

6.1.g.6.E. Those persons who have authority to notify the board regarding trainee enrollment, reenrollment, and completion of the dialysis technician training program; and,

6.1.g.6.F. A procedure for dealing with the unexpected vacancy of the nurse administrator;

6.1.h. When a decision is made to close a training program, the program shall notify the board in writing of the decision at least ninety (90) days prior to the anticipated closing date. The notice shall include the tentative date of closing; the location of the dialysis technician training program's records, including but not limited to, trainees' records; and the name and address of the custodian of the records;

6.1.i. If any changes are made to the training program previously approved by the board when a facility changes ownership, the training program may only be approved as a new program;

6.1.j. Records maintained shall include documentation of the following:

6.1.j.1. Each trainee enrolled in the program, including documentation of performance, and the date and reason the trainee withdrew or the date the trainee failed or completed the program;

6.1.j.2. Each individual teaching the dialysis technician training program, including qualifications and nursing experience;

6.1.j.3. The curriculum plan and revisions; and

6.1.j.4. Any test administered.

W. Va. Code R. § 19-13-7 Procedures for Obtaining Re-approval as a Dialysis Technician Training Program

7.1. A dialysis technician training program seeking reapproval by the board shall submit to the board ninety (90) days before the approval expires the following:

7.1.a. A reapproval application on a form specified by the board which includes, but is not limited to, verification that the program meets and has maintained the standards set forth in this rule;

7.1.b. Evidence of the completion of an evaluation of the curriculum and program standards for compliance with this rule to the board;

7.1.c. Payment of a program reapproval fee; and,

7.1.d. Any other information requested by the board.

7.2. The board may conduct site visits before reapproving a program.

7.2.a. The board shall provide written notification of the planned site visit to the dialysis technician training program seeking reapproval if additional information is needed. The notice shall specify a time frame for submission of the required information.

7.2.b. At a scheduled board meeting, the board shall review the completed application for reapproval, site visit information and all other documentation to determine compliance with this rule. The board shall reapprove a program when the program meets the requirements of this rule.

7.2.c. When a complete application for reapproval is submitted to the board in accordance with this rule, the on-site visit is completed and the board fails to make a determination before the program’s approval expires, the board shall issue a notice to the nurse administrator extending approval of the program until board action is taken on the reapproval application.

W. Va. Code R. § 19-13-8 Criteria for Probationary Approval

8.1. At any time, the board may give probationary approval to a dialysis training program or a training program seeking approval or reapproval when there is evidence of:

8.1.a. Noncompliance with the “minimum standards for approval of dialysis technician training programs” in subsection 6.5. of this rule.

8.1.b. Continuous disruptions in retaining qualified faculty or preceptors resulting in disorganization of the program and a breakdown of supervision and teaching of the program;

8.1.c. Noncompliance with the training program’s stated philosophy, objectives, policies and curriculum resulting in unsatisfactory student achievement; or,

8.1.d. Failure to provide clinical experiences or supervision necessary to meet the objectives of the training program.

8.2. Probationary approval shall be given in the following manner:

8.2.a. The board shall submit to the registered professional nurse responsible for administering the dialysis technician training program a written deficiency report which identifies the requirement(s) not met or maintained and shall include the date on which the board is to consider the deficiency report.

8.2.b. Within thirty (30) days after receipt of the deficiency report, the registered professional nurse responsible for administering the dialysis technician training program shall submit to the board a written response to the report setting forth evidence that the dialysis technician training program is meeting and maintaining each minimum standard identified in the report as not being met or maintained.

8.2.c. Based on the deficiency report, the dialysis technician training program’s response to the report, if any, and any other relevant evidence, the board may grant approval, continue approval, or deny or withdraw approval of the program.

W. Va. Code R. § 19-13-9 Criteria for Denial or Withdrawal of Approval

9.1. The board may deny approval of a training program when a program fails to meet the “minimum standards for approval of dialysis technician training programs” contained in this rule. The board shall provide written notice detailing the reasons to the registered professional nurse responsible for administering the program.

9.2. The board may withdraw approval of a training program if the program fails to correct deficiencies resulting in noncompliance with the “minimum standards for approval of dialysis technician training programs.”

9.3. If the training program fails to meet the “minimum standards for approval of dialysis technician training programs” it shall be removed from the list of board approved dialysis technician training programs.

W. Va. Code R. § 19-13-10 Requirements for Approval of a Testing Organization That Conducts an Examination of a Dialysis Technician

10.1. To be approved by the board, a testing organization that conducts an examination of a dialysis technician shall:

10.1.a. Be national in the scope of its testing and credentialing;

10.1.b. Maintain files for each applicant who passes the organization’s examination for dialysis technicians;

10.1.c. Issue a certificate to each individual who passes the organization's examination for dialysis technicians;

10.1.d. Periodically conduct an analysis of the tasks, role delineation, skills, and knowledge required of a dialysis technician and revise the examination as needed to reflect the findings of the analysis;

10.1.e. Require work experience in dialysis care before the candidate is allowed to take the examination;

10.1.f. Provide a mechanism for assuring the security of the examination;

10.1.g. Not be affiliated in any way with a provider of dialysis care or with a dialysis technician training program;

10.1.h. Include on the examination, material which comprehensively tests the following:

10.1.h.1. Patient care activities which include, at a minimum, collection of objective and subjective data about the patient's condition; the patient's response to dialysis; and appropriate interventions when complications arise in conjunction with dialysis;

10.1.h.2. Principles of dialysis delivery systems including machine technology which include, at a minimum, operation of the machines used in dialysis; machine set-up; and machine evaluation;

10.1.h.3. Principles of water treatment systems which include, at a minimum, system components and design; maintenance; monitoring; and evaluation of the system;

10.1.h.4. Principles of dialyzer reprocessing which include, at a minimum, reprocessing procedures; testing; and evaluation; and

10.1.h.5. Responsibilities of the dialysis technician in respect to documentation, continuing education, and professional development.

10.2. The board may also require a testing organization to demonstrate that the test administered by the organization is psychometrically sound.

10.3. A testing organization seeking approval by the board shall submit to the board a completed application which includes the information required by the board to determine whether the organization meets the requirements set forth in subsection10.1. of this rule. The board shall verify compliance of each testing organization with the criteria contained in subsection 10.1. of this rule.

10.4. The board shall verify continued compliance of each testing organization with the criteria contained in subsection 10.1. of this rule.

10.5. The board shall issue a written notification to each testing organization that is approved by the board.

10.6. The board shall make available a list of approved testing organizations that meet the requirements of subsection 10.1. of this rule

10.7. The board may discontinue approval of a testing organization that does not meet the criteria contained in subsection 10.1 of this rule.

W. Va. Code R. § 19-13-11 Board Approved Testing Organizations for Dialysis Technicians

The successful completion of a national certifying examination shall be the final step of the dialysis technician’s training program. In order for a dialysis technician to become a West Virginia Certified Dialysis Technician he or she must pass a certifying examination offered by one of the following approved organizations:

11.1. The Board of Nephrology Examiner Nursing Technology (BONENT) ;

11.2. The National Nephrology Certification Organization (NNCO) Professional; and

11.3. The Nephrology Nursing Certification Commission (NNCC).

W. Va. Code R. § 19-13-12 Fees

12.1. Dialysis technician training program initial approval fee which applies to each site where training occurs, including all clinical experiences $1000.00

12.2. Dialysis technician training program reapproval fee $800.00

12.3. Dialysis technician training program reinstatement fee $1,000.00

12.4. Return check fee $20.00 Approval of the program is voided if resolution of the outstanding fees is not made in the required time frame.

12.5. Fee for subsequent review and approval of a training program when a change has been required by a change in board policy or rules, not to exceed $250.00

12.6. Fee for periodic evaluation of a training program, not to exceed $2,000.00

12.7. Initial application for dialysis technician certification fee $200.00

12.8. Dialysis Technician Renewal fee $100.00

12.9. Dialysis Technician Reinstatement fee $200.00

12.10. All fees are nonrefundable.

W. Va. Code R. § 19-13-13 Reporting Responsibility of Dialysis Centers. 13.1 Dialysis Centers shall provide a list of all dialysis technicians employed by the center on or before July 1 of every year on documents provided by the board. The report is due to the board on July 15 of every year. The board may provide these documents by electronic means. The report shall include documentation attesting to the dialysis technician’s competencies to perform in the role of dialysis technician

W. Va. Code R. § 19-13-14 Application for Certification; Temporary Permit and Endorsement of Certification

14.1. An individual who applies to be credentialed as a dialysis technician shall:

14.1.a. File with the board the completed “Application for Dialysis Technician Credential”, within the deadlines and according to all instructions including remittance of the required fee on forms by the Board. The individual shall submit the application at least thirty (30) days prior to the date the applicant wishes to take the examination. Payment shall be in the form established by the West Virginia Board of Examiners for Registered Professional Nurses. Application fees are not refundable;

14.1.b. Have completed a board approved dialysis technician training program, unless otherwise excepted by the law governing this rule;

14.1.c. The applicant shall submit to a state and a national electronic criminal history records check for the purpose of determining whether the applicant has been charged with, indicted for, or convicted of a crime that may have bearing upon the applicant’s fitness to hold a license.

14.1.c.1. The criminal history records checks shall be based on fingerprints submitted to the West Virginia State Police or its assigned agent for forwarding to the Federal Bureau of Investigation.

14.1.c.2. The applicant shall meet all requirements necessary to accomplish the state and national criminal history record check, including:

14.1.c.2.A. Submitting fingerprints for the purposes set forth in this subsection; and,

14.1.c.2.B. Authorizing the board, the West Virginia State Police and the Federal Bureau of Investigation to use all records submitted and produced for the purpose of screening the applicant for a license.

14.1.c.2.C. Paying for actual costs of the fingerprinting and criminal history record check.

14.1.d. The criminal history records required by this paragraph must have been completed within the twelve (12) months immediately before the application is filed with the board.

14.1.e. The board may require the applicant to obtain an electronic criminal history records check from a similar agency in the state of the technician or applicant’s residence, if outside of West Virginia.

14.1.f. Should criminal offenses be reported on an applicant’s criminal history record check, the board will consider the nature, severity, and recency of offenses, as well as rehabilitation and other factors on a case by case basis for licensure. To be qualified for certification, the results of the criminal history records checks must be verified by a source acceptable to the board other than the applicant.

14.1.g. The board may deny certification to any applicant who fails or refuses to submit the criminal history records checks required by this subsection.

14.1.h. The results of the state and national criminal history record check may not be released to or by a private entity except:

14.1.h.1. To the individual who is the subject of the criminal history record check;

14.1.h.2. With the written authorization of the individual who is the subject of the criminal history record check; or

14.1.h.3. Pursuant to a court order.

14.1.i. The criminal history record check and related records are not public records for the purposes of chapter twenty-nine-b of this code.

14.1.j. Have submitted to the board directly from the board approved training program a sealed verification of completion indicating the date of completion of the dialysis training program; and

14.1.k. Provide to the board a certified copy of the court record of any conviction from any jurisdiction, except for traffic-related misdemeanors (other than DUI) and a letter of explanation that addresses each conviction.

14.2. The board may issue a temporary permit to an applicant who files a completed “Application for Credential” following completion of a board approved training program. The temporary permit is effective from the date of issuance until three (3) days following receipt by the applicant and the board of the results of the first written certification examination or after 18 months whichever is sooner. A temporary permit may be renewed one time for an additional 18 months from the renewal date unless the board revokes the temporary permit prior to its expiration, under the following circumstances: The national certification has lapsed, and a dialysis technician is required to work to qualify for recertification. The board may revoke the temporary permit prior to its expiration.

14.3. The holder of a temporary permit is subject to all provisions of West Virginia Code § 30-7C-1 et seq. and all other relevant provisions of the West Virginia Code and rules promulgated by the board.

14.4. An applicant for certification who fails to attain a passing score on the certification examination shall, upon notification of examination results, immediately return any temporary permit to the office of the board.

14.5. An individual who repeats the certification shall complete the application for certification as specified in this rule.

14.6. Individuals employed and working as dialysis technicians prior to July 1, 2005 may continue to do so provided they:

14.6.a. Meet the requirements of WV Code §30-7C-3 et seq.;

14.6.b. Complete and submit an application to the board along with all required documents and fees; and

14.6.c. Meet with the board upon request.

14.7. On or before July 1, 2006, an individual who has successfully completed an approved dialysis technician training program and who was working on or before July 1, 2005, as a dialysis technician trainee in a dialysis facility, and whose administrative registered professional nurse in charge acknowledges that he or she is competent to perform the delegated duties and practices in accordance with the laws regulating the provision of dialysis care, the rules of the board and any other applicable federal and state laws and rules, shall be considered as having met the requirements of subdivision (4), subsection (a) of W. Va. Code § 30-7C-3 for the purposes of being certified by the board as a dialysis technician and shall:

14.7.a. Submit an application and all required documents and related fees; and

14.7.b. Meet with the board upon request.

14.8. Individuals certified as a dialysis technician in another state or territory may apply for West Virginia certification by endorsement. The applicant shall provide:

14.8.a. Evidence directly from the dialysis training program of completion of a program that meets the board’s requirements for an approved dialysis training program in West Virginia;

14.8.b. Evidence from the original state and other states in which the applicant has been a dialysis technician that the certification in that state is in good standing;

14.8.c. Evidence that the applicant passed a national certification exam approved by the board. The evidence shall be provided directly from the certification body;

14.8.d. A completed competency verification form;

14.8.e. The results of a local and Federal criminal background check completed with the previous six (6) months; and,

14.8.f. Payment of the required fee.

W. Va. Code R. § 19-13-15 Renewal of Certification; Request for inactive status and Reinstatement of Certification

15.1. Dialysis technician certifications expire on June 30 of each year. The deadline for receipt of the renewal application and fee is thirty days after receipt of the renewal application from the board.

15.2. A dialysis technician who is not practicing, and has no disciplinary action pending against his or her certification, may request his or her name be entered on the inactive list by the executive director of the board by completing the renewal application furnished by the board and indicating his or her desire to be placed on inactive status. The board shall then designate the certificate holder’s records "inactive". No fee is required for inactive status and no certificate is issued. The board may provide the inactive certificate holder, upon application, payment of the current reinstatement fee, and an active national certification, a certificate to practice in West Virginia. The board may inquire into activities and events during the term of the inactive period.

15.3. If a certificate holder fails to renew his or her certification before the current certification expires, the certification shall lapse and the holder must make application for reinstatement and submit the required reinstatement fee. The board may inquire into activities and events during the term of the lapsed period.

W. Va. Code R. § 19-13-16 Discipline of a Dialysis Technician

16.1. Conduct, including, but not limited to the following, if proven by a preponderance of evidence, constitutes professional misconduct and the applicant or dialysis technician is subject to disciplinary action pursuant to W. Va. Code §30-7C-10(c). The applicant or dialysis technician:

16.1.a. failed to adhere to common and current standards for dialysis care, including but not limited to standards established by national professional organizations, dialysis research, dialysis education, or the board;

16.1.b. failed to adhere to established standards in the practice setting to safeguard patient care;

16.1.c. knowingly committed an act which could adversely affect the physical or psychological welfare of a patient;

16.1.d. abandoned patients by terminating responsibility for nursing care, intervention, or observation without properly notifying appropriate personnel and ensuring the safety of patients;

16.1.e. practiced or offered to practice beyond the scope permitted by law or accepted and performed professional responsibilities that the dialysis technician knows or has reason to know that he or she is not certified, qualified, or competent to perform;

16.1.f. impersonated another certified dialysis technician;

16.1.g. permitted another person to use the dialysis technician's certification for any purpose;

16.1.h. permitted, aided, or abetted an unlicensed, uncertified, or unregistered person to perform activities requiring a license, certificate, or registration;

16.1.i. delegated or assigned responsibilities to another person when the dialysis technician delegating the responsibilities knows or has reason to know that person is not qualified by training, experience or certification to perform them;

16.1.j. practiced as a dialysis technician while his or her certification is suspended, lapsed, or inactive;

16.1.k. failed to comply with terms and conditions imposed by the board based upon previous disciplinary action of the board;

16.1.l. practiced as a dialysis technician while the ability to safely and effectively practice is compromised by alcohol or drugs;

16.1.m. is addicted to a controlled substance;

16.1.n. is a chronic or persistent alcoholic;

16.1.o. engaged in dishonorable, unethical or unprofessional conduct of a character likely to deceive, defraud or harm the public or any member of the public;

16.1.p. practiced as a dialysis technician while the ability to safely and effectively practice was compromised by physical or mental disability;

16.1.q. refused or failed to report for a physical or mental examination, including but not limited to laboratory or other tests, requested by the board;

16.1.r. provided false or incorrect information to an employer or potential employer regarding the status of certification, or failed to inform an employer or potential employer of a change in the status of a certification;

16.1.s. knowingly falsified an application for employment;

16.1.t. knowingly provided false information regarding completion of educational programs;

16.1.u. falsified patient records or intentionally charted incorrectly;

16.1.v. improperly, incompletely, or illegibly documented the delivery of care, including but not limited to treatment or medication;

16.1.w. knowingly made or filed a false report;

16.1.x. knowingly or negligently failed to file a report or record required by state or federal law;

16.1.y. willfully impeded or obstructed the filing of a report or record required by state or federal law;

16.1.z. induced another person to file a false report or obstructed the filing of a report required by state or federal law;

16.1.aa. failed to report to the board within thirty (30) days, knowledge of a violation by a dialysis technician of W. Va. Code §30-7C-1 et seq., this rule, any other applicable state law or rule or any applicable federal law or regulation;

16.1.bb. failed to report through proper channels a violation of any applicable state law or rule, any applicable federal law or regulation or the incompetent, unethical, illegal, or impaired practice of another person who provided health care;

16.1.cc. impeded or obstructed an investigation by the board by failing to comply or respond to requests for action or information;

16.1.dd. violated any provision of W. Va. Code §30-7C-1 et seq., or rules governing the practice of the dialysis technician, or a rule or order of the board, or failed to comply with a subpoena or subpoena duces tecum issued by the board;

16.1.ee. failed to register or notify the board of any changes of name or mailing address;

16.1.ff. failed to accept certified mail from the board, when mailed to the dialysis technician’s last address on record in the board’s office;

16.1.gg. failed to disclose to the board a criminal conviction in any jurisdiction;

16.1.hh. was convicted of a misdemeanor or felony which involved fraud, deceit, a breach of trust, or physical harm or endangerment to others, or acts that bear directly on the qualifications or ability of the dialysis technician to practice dialysis care;.

16.1.ii. failed to disclose information when required by the board concerning treatment or counseling for substance abuse, or participation in any peer assistance program;

16.1.jj. provided false information on any application, or any other document submitted to the board;

16.1.kk. misappropriated medications, supplies, or personal items of a patient or employer;

16.1.ll. self-administered or otherwise took into his or her body any prescription drug in any way not in accordance with a legal, valid prescription or used any illicit drug;

16.1.mm. is listed on the nurse aide abuse registry in this state or any other state, territory, jurisdiction or foreign nation;

16.1.nn. physically or verbally abused, or failed to provide adequate protection or safety for an incapacitated individual in the context of a dialysis technician-patient/client relationship;

16.1.oo. used the dialysis technician-patient/client relationship to exploit a patient or client;

16.1.pp. engaged a patient or client in sexual activity or became romantically involved with a patient or client while still responsible for the care of that patient or client;

16.1.qq. failed to maintain appropriate professional boundaries in the dialysis technician-patient/client relationship;

16.1.rr. failed to report that his or her authority to practice as a dialysis technician in any other state, territory, jurisdiction or foreign nation was revoked, suspended, restricted or limited, or otherwise acted against, that he or she was subjected to any other disciplinary action by the credentialing or certifying authority, or that he or she was denied certification or credentialing in any other state, territory, jurisdiction, or foreign nation;

16.1.ss. practiced as a dialysis technician by way of telecommunications or otherwise, in any other state, territory, jurisdiction, or foreign nation, without the authority from that state, territory, jurisdiction or foreign nation to do so and not in accordance with the law of that state, territory jurisdiction, or foreign nation; or

16.1.tt. was found guilty for improper professional practice or professional misconduct by a duly authorized professional disciplinary agency or licensing or certifying or credentialing body or board in this or another state or territory, where the conduct upon which the finding was based would, if committed in this state, constitute professional misconduct under the laws of this state, may serve as a basis for disciplinary action by this board.

16.2. Upon a finding of probable cause that a basis for disciplinary action exists, the board may require a dialysis technician or a person applying for certification to practice as a dialysis technician in this state to submit to a physical or psychological examination by a practitioner approved by the board. Any individual who applies for or accepts the privilege of practicing as a dialysis technician in this state is considered to have given consent to submit to all such examinations when requested to do so in writing by the board and to have waived all objections to the admissibility of the testimony or examination report of any examining practitioner on the ground that the testimony or report is a privileged communication. If an applicant or dialysis technician fails or refuses to submit to any examination under circumstances which the board finds are not beyond his or her control, that failure is prima facie evidence of his or her inability to practice as a dialysis technician competently and in accordance with accepted standards for professional practice. A dialysis technician or person applying for certification as a dialysis technician who is adversely affected by this provision may request a hearing within thirty days of any action taken by the board.

16.3. Based on the nature of the complaint filed against a technician or of the information received about an applicant, the board may require the technician or applicant to request and submit to the board the results of a state and national electronic criminal history records check by the State Police.

16.3.a. The technician or applicant under investigation shall furnish to the State Police a full set of fingerprints and any additional information required to complete the criminal history records check.

16.3.b. The technician or applicant under investigation is responsible for any fees required by the State Police in order to complete the criminal history records check.

16.3.c. The board may require the technician or applicant to obtain an electronic criminal history records check from a similar agency in the state of the technician or applicant’s residence, if outside of West Virginia.

16.3.d. Instead of requiring the technician or applicant under investigation to apply directly to the State Police for the criminal history records checks, the board may contract with a private vendor to provide the services required in this subsection.

16.3.e. The board may deny certification or take disciplinary action against any technician or applicant who fails or refuses to submit the criminal history records checks required by this subsection.

16.4. If the board finds that public health, safety and welfare requires emergency action and incorporates a finding to that effect into its order, the board shall order summary suspension of a certification pending proceedings for revocation of the certification or other action. The board shall promptly institute and determine further disciplinary action.

16.5. In addition to the disciplinary actions provided in W. Va. Code §30-7C-10, the board may also levy fines and assess administrative costs in accordance W. Va. Code §30-1-8.

Series 14 Practitioner Requirements for Accessing the West Virginia Controlled Substances Monitoring Program Database

W. Va. Code R. § 19-14-1 General

1.1. Scope. -- W. Va. Code §60A-9-5A(a) provides that all practitioners who prescribe or dispense Schedule II, III, IV or V controlled substances shall register with the Controlled Substances Monitoring Program and obtain and maintain online or other electronic access to the program database: Provided , That compliance with the provisions of this subsection must be accomplished within 30 days of the practitioner obtaining a new license: Provided, however, That the Board of Pharmacy may renew a practitioner’s license without proof that the practitioner meet the requirements of this subsection. W. Va. Code §60A-9-5A(b) provides that all persons with prescriptive or dispensing authority and in possession of a valid Drug Enforcement Administration registration identification number and who are licensed by the Board of Registered Nurses upon initially prescribing or dispensing any pain-relieving substance for a patient, any Schedule II controlled substance, any opioid or any benzodiazepine to a patient who is not suffering from a terminal illness, and at least annually thereafter should the practitioner or dispenser continue to treat the patient with a controlled substance, shall access the West Virginia Controlled Substances Monitoring Program Database for information regarding specific patients. The information obtained from accessing the West Virginia Controlled Substances Monitoring Program Database for the patient shall be documented in the patient’s medical record maintained by a private prescriber or any inpatient facility licensed pursuant to the provisions of Chapter 16 of this code. A pain-relieving controlled substance shall be defined as set forth in §30-3A-1 of this code. W. Va. Code §60A-9-5A(b) provides that emergency and legislative rules are to be promulgated to effectuate the provisions of W. Va. Code §60A-9-5A.

1.2. Authority. -- W. Va. Code §60A-9-5A(c)

1.3. Filing Date. -- April 18, 2023.

1.4. Effective Date. -- April 24, 2023. 1.5 Sunset Provision. -- This rule shall terminate and have no further force or effect upon August 1, 2033.

W. Va. Code R. § 19-14-2 Definitions

2.1. As used in this rule, the following words and terms have the following meaning:

2.1.a. "Administering” means the direct application of a drug to the body of a patient by injection, inhalation, ingestion or any other means by a registered professional nurse with valid prescribing privileges.

2.1.b. “Authorized agent” means an individual, who is an employee of any of the covered persons or entities permitted to have access to the central repository who is specifically designated by the Advanced Practice Registered Nurse with prescriptive privileges to access the central repository on behalf of the covered person or entity.

2.1.c. "Board” means the West Virginia Board for Registered Nurses as described at W. Va. Code §30-7-1 et seq.

2.1.d. “Chronic nonmalignant pain” means pain that has persisted after reasonable medical efforts have been made to relieve the pain or cure its cause and that has continued, either continuously or episodically, for longer than 3 continuous months. For purposes of this rule, “chronic nonmalignant pain” does not include pain associated with a terminal condition or illness or with a progressive disease that, in the normal course of progression, may reasonably be expected to result in a terminal condition or illness.

2.1.e. "Controlled substance” means a drug that is classified by federal or state law in Schedules I, II, Ill, IV or V, as defined in W. Va. Code §60A-2-204 through 212.

2.1.f. "Course of treatment" means the period of time necessary to effect a cure for an acute disease, or the period of time from one office visit until the next scheduled or anticipated office visit for a chronic disease.

2.1.g. "CSMP" means the West Virginia Controlled Substances Monitoring Program repository and database.

2.1.h. “DEA registration identification number” means the federal Drug Enforcement Administration registration identification number issued to a practitioner.

2.1.i. "Dispensing” means the preparation and delivery of a drug to an ultimate user by or pursuant to a lawful order of a practitioner, including the prescribing, packaging, labeling, administering or compounding necessary to prepare the drug for that delivery.

2.1.j. "Medical records" means records including the medical history and physical examination; diagnostic, therapeutic and laboratory results; evaluations and consultations; treatment objectives; discussion of risks and benefits; informed consent; treatments; medications (including date, type, dosage and quantity provided); instructions and agreements; and periodic reviews.

2.1.k. "Opioid" means natural and semi-synthetic derivatives of the opium poppy, as well as similar synthetic compounds that have analgesic or pain-relieving properties because of their effects in the central nervous system. These include, but are not limited to, codeine, morphine, hydromorphone, hydrocodone, oxycodone, methadone, and fentanyl.

2.1.l. "Pain-relieving controlled substance” means, but is not limited to, an opioid or other drug classified as a Schedule II through V controlled substance and recognized as effective for pain relief and excludes any drug that has no accepted medical use in the United States or lacks accepted safety for use in treatment under medical supervision including, but not limited to, any drug classified as a Schedule I controlled substance.

2.1.m. "Patient” means a person presenting himself or herself for treatment who is not considered by the practitioner as suffering from a terminal illness.

2.1.n. "Practitioner" means a registered professional nurse licensed pursuant to the provisions of The Nurse Practice Act W. Va. Code §30-7-1 et seq. who possesses a valid DEA registration identification.

2.1.o. "Provision” means prescribing or administering.

2.1.p. "Terminal illness” means an incurable or irreversible condition as diagnosed by the attending physician or a qualified physician for which the administration of life-prolonging intervention will serve only to prolong the dying process.

W. Va. Code R. § 19-14-3 General Rules for Practitioners for Patients Not Suffering From a Terminal Illness

3.1. Prior to the initial provision of any pain-relieving controlled substance as part of a course of treatment for chronic nonmalignant pain to any patient not considered by a practitioner to be suffering from a terminal illness, a practitioner shall apply for and receive capability to access the CSMP for purposes of compliance with this rule.

3.2. Prior to the initial provision of a pain-relieving controlled substance as part of a course of treatment for chronic nonmalignant pain to a patient not considered by the current practitioner to be suffering from a terminal illness, a current practitioner, or the practitioner’s authorized agent, is required to access the CSMP to determine whether the patient has obtained any controlled substance reported to the CSMP from any source other than the current practitioner within the 12 month period immediately preceding the visit of the patient to the current practitioner.

3.3. Upon accessing the CSMP prior to the initial provision of a pain-relieving controlled substance as part of a course of treatment for chronic nonmalignant pain, the access and any controlled substances reported to the CSMP within the 12 month period immediately preceding the visit of the patient shall be then promptly documented in the patient's medical record, with rationale for provision of the pain-relieving controlled substance by the current practitioner with a paper or electronic copy of the CSMP accessed report maintained in the patient medical record.

3.4. After the initial provision of a pain-relieving controlled substance as part of a course of treatment for chronic nonmalignant pain, should the patient continue as a patient with the current practitioner, and the current practitioner continues to provide pain-relieving controlled substances as part of a course of treatment for chronic, nonmalignant pain, the CSMP shall be accessed by the current practitioner, or the practitioner’s authorized agent, at least annually to determine whether the patient has obtained any controlled substances reported to the CSMP from any source other than the current practitioner within the 12 month period immediately preceding the access. The access and any controlled substances from any other source other than the current practitioner reported to the CSMP -within such 12 months immediately preceding the access shall be then promptly documented in the patient's medical record, with rationale for continuing provision of the pain-relieving substance by the current practitioner, with a paper or electronic copy of the CSMP accessed report maintained in the patient medical record.

3.5. Nothing herein prohibits the CSMP from being accessed for a specific patient more frequently than annually by the current practitioner, or the practitioner’s authorized agent; however, upon any such additional access of the CSMP, controlled substances reported to the CSMP from any source other than the current practitioner shall be promptly documented in the patient's medical record, with rationale for provision of the pain-relieving controlled substance by the current practitioner, with a paper or electronic copy of the CSMP accessed report maintained in the patient medical record.

3.6. Accessing the CSMP must occur prior to the provision of the controlled substance Provided, that if there is an equipment failure, electricity outage or other disaster or event that renders review of the CSMP impossible prior to provision of the required controlled substances and it is determined by the practitioner that providing a controlled substance is medically necessary, this determination of medical necessity shall be documented in the medical record and the controlled substance may be provided in a limited amount. The circumstances preventing the access to the CSMP prior to provision of the controlled substance shall be documented in the patient’s medical record, and immediately upon having access restored the CSMP report shall be accessed, documented as described in this rule and the practitioner shall adjust patient care as needed.

W. Va. Code R. § 19-14-4 Other Legal Authority

4.1. Practitioners shall comply with all other applicable federal and state laws, rules, and regulations.

W. Va. Code R. § 19-14-5 Discipline

5.1. Any practitioner who fails to comply with this rule 19CSR14 is subject to board disciplinary proceedings for failing to perform any statutory or legal obligation placed upon the practitioner and unprofessional, unethical, and dishonorable conduct, pursuant to W. Va. Code §30-7-11 and 19CSR3.

Series 15 Request for Waiver of Initial Licensing Fees for Certain Individuals

W. Va. Code R. § 19-15-1 General

1.1. Scope. -- This rule establishes procedures for waiving the initial licensing fee for low income individuals and military personnel and their spouses.

1.2. Authority. -- W. Va. Code §30-7-4 and 30-1-23.

1.3. Filing Date. – May 1, 2020.

1.4. Effective Date. – May 1, 2020.

1.5. Sunset Provision. -- This rule shall terminate and have no further force or effect on May 1, 2030.

W. Va. Code R. § 19-15-2 Definitions

2.1. “Board” means the West Virginia Board of Examiners for Registered Professional Nurses.

2.2. “RN-LIW” means the Registered Nurse Low Income Waiver form used to request a waiver of the initial licensing fee for low income individuals, as authorized in W.Va. Code §30-1-23;

2.3. “Initial license” means an individual applying for a license in West Virginia sought for the first time; 2.4 "Local labor market" means every county in West Virginia, and any county outside of West Virginia if any portion of that county is within fifty miles of the border of West Virginia, pursuant to W.Va. Code §21-1C-2;

2.5. “Low-income individual” means an individual in the local labor market as defined in §21-1C-2, whose household adjusted gross income is below 130 percent of the federal poverty line. This term also includes any person enrolled in a state or federal public assistance program including, but not limited to, the Temporary Assistance for Needy Families Program, Medicaid, or the Supplemental Nutrition Assistance Program;

2.6. “Military families” means any person who serves as an active member of the armed forces of the United States, the National Guard, or a reserve component as described in 38 U. S. C. §101, honorably discharged veterans of those forces, and their spouses. This term also includes surviving spouses of deceased service members who have not remarried; and

2.7. “RN-MFW” means the Registered Nurse Military Family Waiver form used to request a waiver of the initial licensing fee for military service members and their spouses as described in §30-1-23.

W. Va. Code R. § 19-15-3 Request for Waiver of Initial Licensure Fees

3.1. An applicant seeking a low income or military family waiver of the initial licensing fee shall apply for licensure to the Board and provide the required documentation.

3.2. The Board shall provide the waiver form and instructions on what documentation is necessary to submit with the license application requesting the low income or military family initial licensing fee waiver.

3.3. An applicant shall submit all required documentation to the Board and upon the submission of a complete application, the Board shall review the waiver form and issue a decision within 30 days of receipt of the completed application.

3.4. The Board may issue a license to an applicant who meets the requirements of W. Va. Code §30-7-1 et seq., the rules promulgated by the Board, and the Board shall waive the initial licensing fee for an applicant that meets the requirement of “low-income individuals” or “military families” as defined in W.Va. Code §30-1-23.

W. Va. Code R. § 19-15-4 Required Documentation for Waiver of Initial Licensure Fees

4.1. Individuals requesting a waiver of initial licensure fees for low income or military service personnel and their spouses, shall submit with the application for licensure the initial licensure waiver RN-LIW or RN-MFW form and the appropriate documentation as specified in this section.

4.2. To establish low income eligibility for the initial licensing fee waiver, an applicant shall submit to the Board evidence that the adjusted gross income of the household of the applicant is below 130% of the federal poverty level by submitting a Federal Tax Return or documentation of eligibility for:

4.2.1. Temporary Assistance for Needy Families Program;

4.2.2. Medicaid; or

4.2.3. Supplemental Nutrition Assistance Program;

4.3. To establish military family eligibility for the initial licensing fee waiver, an applicant shall submit to the Board proof of qualifying military service and proof of eligibility as a qualifying spouse or surviving spouse, as follows:

4.3.1. A service members DD-214 form;

4.3.2. A service members NGB-22 form;

4.3.3. A service members DD-1300 form; or

4.3.4. A copy of their current military orders; and

4.3.5. A copy of the marriage certificate with the qualifying service member and, where applicable, the death certificate of the service member if the surviving spouse is requesting the military family waiver.

4.4. Honorably discharged applicants shall submit a completed application, and a DD-214 form or an NGB-22 form showing the applicant has been an honorably discharged from military service.

Series 16 Telehealth Practice; Requirements; Definitions

W. Va. Code R. § 19-16-1 General

1.1. Scope. -- This rule establishes procedures for the practice of telehealth by a registered nurse or advanced practice registered nurse.

1.2. Authority. -- W. Va. Code §30-1-26 et seq.

1.3. Filing Date. -- April 18, 2023.

1.4. Effective Date. -- April 24, 2023.

1.5. Sunset Provision. -- This rule shall terminate and have no further force or effect upon August 1, 2033.

W. Va. Code R. § 19-16-2 Definitions

2.1. “Board” means the West Virginia Board of Examiners for Registered Professional Nurses, established in W. Va. Code §30-7-3.

2.2. “Distant site” means the telehealth site where the health care practitioner is seeing the patient at a distance.

2.3. “Established patient” means a patient who has received professional services, face-to-face, from, from a Registered Nurse or Advanced Practice Registered Nurse within the past three years.

2.4. “Good standing” means a license that:

2.4.1. Is not currently revoked, suspended, or subject to probationary period or a practice restriction or limitation;

2.4.2. Was not surrendered while under or to avoid an investigation or disciplinary action; or

2.4.3. Was not revoked, suspended, or subject to a probationary period or a practice restriction or limitation at the time the license expired, lapsed, terminated, or was cancelled.

2.5. “Health care practitioner” or “practitioner” means a registered professional nurse or advanced practice registered nurse.

2.6. “Interstate telehealth registration” or registration” means an authorization to practice as a registered professional nurse or advanced practice registered nurse regulated for the limited purpose of providing interstate telehealth services within the registrant’s scope of practice.

2.7. “Interstate telehealth registrant” or “Registrant” means a registered professional nurse or advanced practice registered nurse issued an interstate telehealth registration by the Board.

2.8. “Interstate telehealth services” means the provision of telehealth services to a patient located in West Virginia by a registered nurse or advanced practice registered nurse located in any other state or commonwealth of the United States.

2.9. “Licensee” means:

2.9.1. A registered professional nurse who has been granted a license to practice nursing pursuant to W. Va. Code § 30-7-1 et seq.;

2.9.2. An advanced practice registered nurse who has been granted a license to practice nursing pursuant to W. Va. Code § 30-7-1 et seq.;

2.10. “Originating site” means the location where the patient is located, whether or not accompanied by a health care practitioner, at the time services are provided by a health care practitioner through telehealth, including, but not limited to, a health care practitioner’s office, hospital, critical access hospital, rural health clinic, federally qualified health center, a patient’s home, and other nonmedical environments such as school-based health centers, university-based health centers, or the work location of a patient.

2.11. “Professional license” means a license to practice nursing in any state or commonwealth of the United States.

2.12. “Remote patient monitoring services” means the delivery of home health services using telecommunications technology to enhance the delivery of home health care, including monitoring of clinical patient data such as weight, blood pressure, pulse, pulse oximetry, blood glucose, and other condition-specific data; medication adherence monitoring; and interactive video conferencing with or without digital image upload.

2.13. “Telehealth services” means the use of synchronous or asynchronous telecommunications technology or audio only telephone calls by a registered nurse or advanced practice registered nurse to provide health care services, including, but not limited to, assessment, diagnosis, consultation, treatment, and monitoring of a patient; transfer of medical data; patient and professional health-related education; public health services; and health administration. The term does not include internet questionnaires, e-mail messages, or facsimile transmissions.

2.14. “Telehealth provider” means a licensee or registrant who provides health care services using telemedicine technologies to patients in West Virginia.

2.15. “Telemedicine technologies” means technologies and devices which enable secure communications and information exchange in the practice of telemedicine, and typically involve the application of secure real-time audio/video conferencing or similar secure video services, remote monitoring or “store and forward digital image technology”, or audio only telephone calls to provide or support health care delivery by replicating the interaction of a traditional in-person provider and a patient.

2.16. “Virtual telehealth” means a new patient or follow-up patient for acute care that does not require chronic management or scheduled medications.

2.17. “Nurse Portal on Board’s website” means the set of related webpages operated by or on behalf of the West Virginia Board of Examiners for Registered Professional Nurses located at the domain name wvrnboard.wv.gov, or at any successor domain name published by the Board.

W. Va. Code R. § 19-16-3 Telehealth Practice Requirements

3.1. The telehealth practice of registered nursing or advanced practice registered nursing occurs where the client is physically located at the time the telehealth technologies are used.

3.2. A health care practitioner may not provide telehealth services to patients in West Virginia unless the practitioner is:

3.2.1. Licensed by the Board; or

3.2.2. Practicing on the privilege of a multi-state Registered Nurse license in West Virginia; or

3.2.3. Registered with the Board pursuant to this rule.

3.3. A person currently licensed as a registered nurse or advanced practice registered nurse in this state is not subject to registration but shall practice telehealth in accordance with the provisions of this section and the rules promulgated by the West Virginia Board of Examiners of Registered Professional Nurses thereunder.

3.4. A registered nurse or advanced practice registered nurse who is not licensed in West Virginia may provide interstate telehealth services to patients located at an originating site in West Virginia from a distant site, within the practitioner’s scope of practice, if the practitioner holds an interstate telehealth registration issued by the Board.

3.5. An interstate telehealth registration does not authorize a registered nurse or advanced practice registered nurse:

3.5.1. To practice from a physical location or distant site within this state; or

3.5.2. To provide telehealth services to a patient in the State of West Virginia from an international distant site.

W. Va. Code R. § 19-16-4 Interstate Telehealth Registration Eligibility; Invalidation and Reinstatement

4.1. A registered nurse or advanced practice registered nurse who is not licensed in West Virginia or practicing on a multistate Registered Nurse practice privilege many only provide telehealth services pursuant to this rule if the nurse is eligible for an interstate telehealth registration.

4.2. A registered nurse or advanced practice registered nurse is eligible for an interstate telehealth registration issued by the Board if all the following requirements are continuously met:

4.2.1. The practitioner holds a valid, active registered nurse or advanced practice registered nurse license issued by another state licensing authority or board that is not in the Nurse Licensure Compact;

4.2.2. The practitioner is licensed in good standing in all states in which the practitioner is licensed;

4.2.3. The practitioner is not the subject of an administrative complaint which is currently pending before another state licensing authority or board; and

4.2.4. The practitioner is not currently under investigation by another state licensing authority or board.

4.3. A registered nurse or advanced practice registered nurse may not apply for an initial registration or renew a registration unless the eligibility requirements set forth in subsection 4.2 are met.

4.4. The Board shall decline to issue or renew an interstate telehealth registration to any applicant who does not meet all the eligibility requirements.

4.5. Registrants must continue to maintain eligibility at all times to continue to practice pursuant to an interstate telehealth registration.

4.6. An interstate telehealth registration issued by the Board shall invalidate upon a registrant’s loss of eligibility.

4.7. A registrant whose interstate telehealth registration is invalid due to a loss of eligibility may apply for registration reinstatement upon regaining eligibility.

4.8. A registered nurse or advanced practice registered nurse who is ineligible to apply for, receive or maintain an interstate telehealth registration is not automatically disqualified from or ineligible for a professional license issued by the Board.

W. Va. Code R. § 19-16-5 Interstate Telehealth Registration Application, Renewal and Expiration

5.1. An eligible registered nurse or advanced practice registered nurse who is not licensed in West Virginia may apply for an interstate telehealth registration with the Board.

5.2. The Board shall issue an interstate telehealth registration to a registered nurse or advanced practice registered nurse who:

5.2.1. Meets all eligibility requirements for an interstate telehealth registration set forth above in Section 4 of this rule; and

5.2.2. Submits a complete application for an interstate telehealth registration, including all required documentation and verifications, which is accompanied by the appropriate fee.

5.3. An application for an interstate telehealth registration shall be completed in the Nurse Portal provided by the Board, which is available on the Board’s website. An interstate telehealth registration application must be accompanied by payment of a nonrefundable application fee as set forth herein:

5.3.1. The initial and renewal registration fee for registered nurse or advanced practice registered nurse is $100.

5.4. The Board will not consider an application or decide upon the issuance of an interstate telehealth registration until the complete application, including all third-party documentation and/or verification, is on file with the Board and the Board has had at least ten business days to review the application. These applications will be processed in order of receipt.

5.5. Applicants must provide the following information in association with an application for an interstate telehealth registration:

5.5.1. The applicant must have submitted a verification of licensure from the state in which he or she was originally licensed and the state in which he or she is currently employed if it is different than the original state of licensure. If these boards participate in the licensure verification system maintained by the National Council of State Boards of Nursing, the applicant shall follow the process of verification to another state in accordance with the procedures set in place for that system.

5.5.2. The advanced practice registered nurse applicant must have submitted primary source verification of certification/recertification of successful completion of the appropriate APRN national certification examination in the APRN role and population focus congruent with educational preparation. The certifying body is accredited by the American Board of Nursing Specialties or the National commission for Certifying Agencies.

5.5.3. Information concerning whether the applicant:

5.5.3.a. Has any limitations, restrictions or conditions placed upon a professional license by any licensing board;

5.5.3.b. Has had a professional license revoked, suspended or placed on probation;

5.5.3.c. Has had disciplinary action taken against a professional license in any jurisdiction; or

5.5.3.d. Is currently under investigation or subject to an administrative complaint in any jurisdiction related to professional conduct or professional licensure.

5.6. Ineligible applications shall be declined. Complete applications without discrepant information may be approved without presentation to the Board. Any registration application that contains discrepant information concerning the applicant may be presented to the Discipline Review Committee for review and recommendation to the Board.

5.7. Registrants shall maintain complete and up-to-date contact information, including a current email address, with the Board. Registrants are required to update all categories of contact information collected by the Board within 10 business days of any change to the information previously provided.

5.8. Registrants shall immediately notify the Board, in writing via their Nurse Portal, of any restrictions placed on the registrant’s professional license(s) in any state or jurisdiction.

5.9. An interstate telehealth registration is valid for a period of up to one year, and automatically expires on the 31st day of October unless the registrant renews the registration.

5.10. An interstate telehealth registration may be renewed annually during the renewal period established by the Board if the registrant remains eligible and meets all of the requirements for renewal.

5.11. A registrant may renew an interstate telehealth registration issued by the Board if the registrant:

5.11.1. Meets all eligibility requirements for an interstate telehealth registration as set forth in section 4 of this rule.

5.11.2. Submits a complete application for registration renewal accompanied by the appropriate renewal fee; and

5.11.3. Certifies compliance with all continuing education requirements associated with the registrant’s current professional licenses.

5.12. The Board shall decline to renew a registration if the renewal applicant is ineligible.

5.13. The Board shall publish the renewal period and renewal application on its website and shall provide email notice via Nursys e-Notify of the renewal to the registrants’ email address of record with the Board. Registrants are responsible for registering for Nursys e-Notify and submitting a renewal application by the deadline.

5.14. Communications and notifications regarding the renewal process will be provided to the registrant via email in their Nurse Portal. Failure of the registrant to receive or review a renewal notification does not justify the provision of interstate telehealth services after registration expiration.

5.15. If a registration automatically expires, the former registrant may reapply. If registration is granted, the Board shall reactivate the registration and reissue the practitioner’s original registration number.

W. Va. Code R. § 19-16-6 Establishment of the Practitioner-Patient Relationship

6.1. A practitioner-patient relationship may be established through:

6.1.1. An in-person patient encounter;

6.1.2. Telemedicine technologies which incorporate interactive audio using store and forward technology, real-time videoconferencing, or similar secure video services during the initial provider-patient encounter; or

6.1.3. Audio-only calls or conversations that occur in real time.

6.2. While real-time audio-only communications may be utilized to establish the practitioner-patient relationship, patient communication though audio-visual communication is preferable, if available or possible. Real-time audio-only communications may not be utilized when its use does not conform to the standard of care.

6.3. The practitioner-patient relationship may not be established through text-based communications such as email, internet questionnaires, text-based messaging, or other written forms of communication.

6.4. After a practitioner-patient relationship has been established, a practitioner may utilize any telemedicine technology that meets the standard of care and is appropriate for the patient presentation.

6.5. This rule does not prohibit the use of text-based communications for:

6.5.1. Responding to a call for existing patients;

6.5.2. Providing cross coverage for a practitioner who has established a practitioner-patient relationship with the patient through an in-person encounter; or

6.5.3. Providing assistance in the event of an emergency.

W. Va. Code R. § 19-16-7 Standard of Care, Delivery of Telehealth Services and Medical Records

7.1. A telehealth provider has the duty to practice in a manner consistent with:

7.1.1. The provider’s scope of practice;

7.1.2. The professional conduct standards established in this state for the provider’s profession; and

7.1.3. The standard of care applicable to the provider’s practice.

7.2. The standard of care for the provision of health care services is the same for health care services provided in-person and health care services provided via telemedicine technologies.

7.3. A telehealth provider’s selection of telemedicine technologies for a patient encounter must permit the provider to meet the standard of care for the patient’s particular health issue and presentation. Treatment, including issuing a prescription, if the nurse has prescriptive authority, based solely on an online questionnaire, does not conform to the standard of care.

7.4. Nothing in this rule requires a practitioner to use telemedicine technologies to treat a patient if the practitioner, in his or her discretion determines that an in-person encounter is required.

7.5. A telehealth provider shall:

7.5.1. Verify the identify and location of the patient;

7.5.2. Provide the patient with confirmation of the identity and professional qualifications of the telehealth provider;

7.5.3. Provide the patient with the physical location and contact information for the telehealth provider;

7.5.4. Establish or maintain a provider-patient relationship that conforms to the scope of practice, professional conduct standards, and standard of care;

7.5.5. Determine whether telemedicine technologies are appropriate for the patient’s presentation of a specific health issue;

7.5.6. Obtain the patient’s consent to receive telehealth services;

7.5.7. Conduct all appropriate evaluations and history of the patient consistent with the standard of care for in-person treatment of the patient’s health condition; and

7.5.8. Create and maintain health care records for the patient which justify the course of treatment, and which verify compliance with the requirements of this section.

7.6. A telehealth provider shall maintain a patient medical record for each patient for whom telehealth services are provided. The patient record shall be accessible to the provider and the patient and maintained consistent with the laws and legislative rules governing patient health care records. All laws governing the confidentiality of health care information and governing patient access to medical records shall apply to records of telehealth encounters.

7.7. A telehealth provider solely providing services using telemedicine technologies shall make a patient’s medical record easily available to the patient, and subject to the patient’s consent, to any identified care provider of the patient.

7.8. Upon request of the Board, a telehealth provider shall provide the Board with the identity of, and address for, the custodian of records of any company, service, platform or entity through which the telehealth provider practices while treating patients at originating sites in West Virginia.

W. Va. Code R. § 19-16-8 APRN Prescribing Authority and Limitations

8.1. When prescribing to a patient via telemedicine, a telehealth provider shall prescribe within the prescriptive authority as set forth within the provisions of W. Va. Code § 60A-9-5a and the requirements set forth in §30-7-15a, 15b, and 15c and 19 CSR 08.

8.2. Telehealth providers who prescribe any medication listed in Schedules II though V of the Uniform Controlled Substance Act pursuant to a telehealth encounter with a patient at an originating site in West Virginia shall:

8.2.1. Obtain and maintain online or other electronic access to the CSMP;

8.2.2. Comply with all preconditions to prescribing identified in W. Va. Code § 60A-9-5a and the requirements set forth in 19 CSR 08;

8.2.3. Maintain a record of the controlled substance prescribed and the diagnosis or basis for the prescription in the patient medical record;

8.2.4. Comply with all prescribing protocols and prescribing limitations established in the Opioid Reduction Act, W. Va. Code § 16-54-1 et seq;

8.2.5. Comply with all state and federal laws which govern the prescribing of controlled substances.

8.3. A telehealth provider may not, based solely upon a telemedicine encounter, prescribe any drug with the intent of causing an abortion.

W. Va. Code R. § 19-16-9 Complaint and Disciplinary Procedures for Interstate Telehealth Registrants

9.1. By registering with the Board to provide interstate telehealth services to patients in this state, a health care practitioner is subject to:

9.1.1. All state laws regarding the registrant’s profession in this state;

9.1.2. The state judicial system;

9.1.3. All professional conduct rules and standards incorporated into W.Va. Code § 30-7-1 et seq.; and 19 CSR 03; and

9.1.4. The jurisdiction of the Board, including the Board’s complaint, investigation, and hearing process.

9.2. In circumstances where a registration is not declined or invalidated due to uncontested ineligibility, the complaint and disciplinary process and procedures, and appeal rights set forth in the contested case hearing procedure, W. Va. Code §29A-5-1 et seq., W. Va. Code 30-7-11, and in the Board’s procedural rules 19 CSR 5, Contested Case Hearing Procedure, and 19 CSR 9, Complaint Procedure, also apply to interstate telehealth registrants.

W. Va. Code R. § 19-16-10 Registration Denial, Professional Conduct, and Discipline

10.1. The Board shall deny an application for an interstate telehealth registration, or a registration renewal, to any applicant who is ineligible based upon the criteria set forth in W. Va. Code § 30-7-1 et seq. or section 4 of this rule.

10.2. In circumstances where a registration is not declined or invalidate due to ineligibility, the Board may discipline a registered nurse and advanced practice registered nurse registered by the Board who, after a hearing, has been adjudicated by the Board as unqualified due to any of the following reasons

10.2.1. Engaging in professional misconduct as outlined in WV Code 30-7-1 et. seq., 19 CSR 03 or section 04 of this rule may subject a registered nurse or advanced practice registered nurse to disciplinary action and or fines by the West Virginia Board of Examiners for Registered Professional Nurses.

10.2.2. Failure to immediately notify the Board of any restrictions placed on the registrant’s professional license in any state or jurisdiction.

10.3. If the Board determines that an eligible registrant is otherwise unqualified, the Board may enter an order imposing any limitation, restriction or other disciplinary measure set forth in W. Va. Code § 30-3-14(j) and/or 19 CSR 03.

10.4. In addition to the complaint, investigation and disciplinary processes available in this state, the Board may elect to report or refer any complaint or allegation of professional misconduct by a registrant to the registrant’s professional licensing boards.

W. Va. Code R. § 19-16-11 Required Records

11.1. The Board shall provide each interstate telehealth practitioner registered written verification of registration via their Nurse Portal and registration expiration via email through the e-Notify system of Nursys®.

11.2. The Board shall provide verification of practitioners who are registered with the Board as interstate telehealth practitioners and shall publish that information for each registrant on its website at wvrn.boardsofnursing.org/licenselookup.