COMMONWEALTH of VIRGINIA. July 21, 2017

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COMMONWEALTH of VIRGINIA David E. Brown, D.C. Department ofhealth Professions www.dhp.virginia.gov Director Perimeter Center TEL (804) 367-4400 9960 Mayland Drive, Suite 300 FAX (804) 527-4475 Henrico, Virginia 23233-1463 Virginia Board of Nursing Board of Nursing (804) 367-4515 Jay P. Douglas, MSM, RN, CSAC, FRE Nurse Aide Registry (804) 367-4569 Executive Director FAX (804) 527-4455 July 21, 2017 Ann Underwood Smith, Ph.D., M.S.N., R.N., F.N.P., Program Director Piedmont Virginia Commtmity College Practical Nursing Education Program 501 College Drive Certified. Article. Numb'er - - _ Charlottesville, VA 22902 9414 7266 9904 2091 8746 33 RE: Case Number 179547. SENDERS REQORD Dear Dr. Smith: Enclosed is a certified true copy ofthe Order entered by the Virginia Board ofnursing following your infonnal conference. This Order will be forwarded to Tonya James, Compliance Case Manager for the Board of Nursing. Ms. James will monitor your compliance with the terms of the Order on behalf of the Board. Please direct all questions, documents, and correspondence related to your compliance with your Order to Ms. James at (804) 367-4536 or directly to her my Ihail at the Board of Nursing, Perimeter Center, 9960 Mayland Drive, Suite 300, Hemico, Virginia 23233-463. Ifyou object to this Order and desire a formal hearing before the Board, a written request must be received by the Board within 33 days from the date of service of the Order. Ifno written request is received by August 23, 2017, this Order will be final. Should you have any questions or concerns regarding this matter, please contact our office at (804) 367-4665. ~~in;welytf '4JM",R,- Q!i Power, R.N., J.D. Deputy Executive Director Virginia Board ofnursing JPP/dg Enclosure cc: Anne Joseph, Deputy Director, Administrative Proceedings Division Paula B. Saxby, R.N., Ph.D., Deputy Executive Director Charlette Ridout, R.N., M.S., Senior Nursing Education Consultant Tonya James, Compliance Case Manager Board of Audiology & Speech-Language Pathology- Board of Counseling - Board of Dentistry - Board of Funeral Directors & Embalmers Board of Long-Term Care Administrators - Board of Medicine - Board of Nursing - Board of Optometry - Board of Pharmacy Board of Physical Therapy - Board of Psychology - Board of Social Work - Board of Veterinary Medicine 700-1 Board of Health Professions

BEFORE THE VIRGINIA BOARD OF NURSING INRE: PIEDMONT VIRGINIA COMMUNITY COLLEGE PRACTICAL NURSING EDUCATION PROGRAM Program Code: US28203800 Case Number: 179547 RATIFICATION AND ORDER On July 18, 2017, a panel of the Board met to receive and act upon the Recommended Decision of the Education Special Conference Committee. Piedmont Virginia Community College Practical Nursing Education Program ("PVCC-PN") was not present nor represented by legal counsel. In consideration whereof, the Board of Nursing ACCEPTS the attached Recommended Findings of Fact and Conclusions of Law of the Education Special Conference Committee and ADOPTS the Recommended Order in its entirety. Pursuant to Virginia Code 54.1-2400.2, the signed original of this Order shall remain in the custody of the Department of Health Professions as a public record, and shall be made available for public inspection and copying upon request. Pursuant to Virginia Code 54.1-2400(10), PVCC-PN may, not later than 5:00 p.m., on August 23, 2017, notify Jay P. Douglas, Executive Director, Board of Nursing, 9960 Mayland Drive, Suite 300, Henrico, Virginia 23233, in writing that it desires a formal administrative hearing before the Board. Upon the filing with the Executive Director of a request for the hearing, this Order shall be vacated.

Page 2 of2 ENTERED AND MAILED ON: ~;)ls~µ;r1 This Order shall become final on August 23, 2017, unless a request for a formal administrative hearing is received as described above. Certified True Copy Byd tuv Virgi a Board Of Nursing

BEFORE THE VIRGINIA BOARD OF NURSING INRE: PIEDMONT VIRGINIA COMMUNITY COLLEGE PRACTICAL NURSING EDUCATION PROGRAM Program Code: US28203800 Case Number: 179547 REPORT AND RECOMMENDATION OF EDUCATION SPECIAL CONFERENCE COMMITTEE Jurisdiction and Procedural History Pursuant to Virginia Code 2.2-4019, 54.1-2400(10), and 54.1-3014, the Education Special Conference Committee ("Committee") of the Virginia Board of Nursing ("Board"), held an informal conference on July 12, 2017 in Henrico County, Virginia, to inquire into evidence that Piedmont Virginia Community College Practical Nursing Education Program ("PVCC-PN") may have violated certain laws and regulations governing the operation of practical nursing education programs in the Commonwealth of Virginia. Ann Underwood Smith, Ph.D., M.S.N., R.N., F.N.P., Program Director, appeared on behalf of PVCC-PN at this proceeding. The program was not represented by legal counsel. Upon consideration of the evidence, the Education Special Conference Committee makes the following Findings of Fact and Conclusions of Law and recommends that the Board adopt the following Order. Notice By letter dated June 13, 2017, the Board sent a Notice of Informal Conference ("Notice") to Dr. Smith notifying her that an informal conference would be held on July 12, 2017. The Notice was sent by certified and first class mail to the legal address ofrecord on file with the Board. )00-2

Page 2 of 4 Recommended Findings offact and Conclusions of Law I. Piedmont Virginia Community College Practical Nursing Education Program was granted approval to operate a practical nursing education program on November 3, 2009. The program was placed on conditional approval on March 15, 2015, following two years ofnclex passage rates for first-time test takers below 80%. By Order entered May 27, 2016 ("Board's Order"), the program was continued on conditional approval subject to certain terms and conditions. 2. Tenn No.!(a) of the Board's Order required PVCC-PN to have an NCLEX-PN passage rate for first-time test takers for Calendar Year 2016 of 80% or above. Tenn No. l(c) of the Board's Order required PVCC-PN to comply with the Board's regulations for maintaining an approved practical nursing education program. 3. PVCC-PNviolated 18 VAC 90-20-132(A)(l), (10), and (11) and 18 VAC 90-20-151 of the Regulations Governing the Practice of Nursing (currently found at 18 VAC 90-27-140(A)(l), (10), and (11) and 18 VAC 90-27-210 of the Regulations for Nursing Education Programs, effective February 24, 2017) and Term Numbers l(a) and l(c) ofthe Board's Order in that the pass rate for firsttime test takers of the NCLEX-PN for Calendar Year 2016 was 70.54 %. Calendar Year 2016 was the fourth year in which PVCC-PN's NCLEX pass rate for first-time test takers was below 80%. 4. Dr. Smith stated that she believed that the low passage rate was because many students tended to wait for several months before taking the NCLEX-PN. The class that graduated in December 2016 were strongly encouraged to take the exam shortly after graduating. As of July 10, 2017 all but one of the students who graduated in December 2016 had taken the examination and all but two who took the exam had passed. Three students who graduated in prior years also took the examination for the first time. As of July 10, 2017, the year-to-date passage rate for first time test-takers in Calendar Year 2017 was 90.48%.

Page 3 of 4 5. Dr. Smith also stated that the program has implemented nearly all of the changes outlined in its NCLEX improvement plan. Financial constraints and timing had prevented the program from fully implementing the changes sooner. The most helpful changes, in addition to facilitating students' taking the NCLEX soon after graduation, have been a mentoring program, more accurate methods for evaluating students' progress, more interactive classroom projects to strengthen students' critical thinking skills and the connection between theory and clinical practice, and working more closely with employers and the program's advisory board. There are two dedicated full-time faculty members and one part-time instructor. The college's educational foundation has set funds aside to assist students in paying for the NCLEX and licensing fees. Dr. Sinith stated that she believes these improvements are sustainable over time. 6. Only one class of 20 is admitted per year, each January. There are 15 students currently in the program. They are scheduled to graduate at the end of December 2017. The attrition rate for the 2016 cohort was 15%. The employment rate in the community for PVCC-PN's graduates is 100% within 12 months ofgraduation. Recommended Order Based on the foregoing Findings of Fact and Conclusions of Law, the Education Special Conference Committee recommends that the Board issue an Order as follows: I. PVCC-PN shall remain on conditional approval under the following terms and conditions: a. PVCC-PN's NCLEX passage rate for first-time test takers for Calendar Year 2017 shall be 80% or above. b. The passage rate for first-time test taking graduates of the December 2017 class shall be 80% or above.

Page 4 of4 c. PVCC-PN shall provide a copy of this Order to all current and prospective students, all faculty members, and the Dean of the College. Further, PVCC-PN shall publish this Order on its website. d. PVCC-PN shall comply with all the Board's regulations for maintaining an approved practical nursing education program in Virginia. 2. Any violation of the terms and conditions of this Order or any law or regulation affecting the operation of nursing education programs in the Commonwealth of Virginia may constitute grounds for the withdrawal ofapproval ofpvcc-pn, and an administrative proceeding shall be convened to determine whether such approval shall be withdrawn. 3. Upon review of compliance with the terms and conditions of this Order, the Board will further consider PVCC-PN's approval status, which may require its appearance before a Committee of the Board. Upon receipt of evidence of PVCC-PN's full compliance with all terms and conditions of this Order, the Committee, at its discretion, may waive PVCC-PN's appearance before the Committee and may conduct an administrative review of this matter to determine restoring PVCC-PN's full approval status to operate a practical nursing education program without restriction, unless there is a pending investigation or unresolved allegation involving a violation oflaw or regulation. Reviewed and detennined to be consistent with the Education Informal Conference Committee's Decision rj)~1?. Y /,IV fa.:b Paula B. Saxby, RN., Ph.D. Deputy Executive Director, Vlfginia Board of Nursing JOl).2 Certified True Copy By...!C,4,::.:.:...:.::...-:-~--:- Virgin