In this chapter, the following terms have the meanings indicated. Terms Defined. “Active nursing practice” as used in Health Occupations Article, §8-312, Annotated Code of Maryland, means: The practice of registered nursing or licensed practical nursing as defined in Health Occupations Article, §8-101, Annotated Code of Maryland; Related nursing activities approved by the Board, including but not limited to a generic nursing education program, degree completion programs, or graduate programs within the last 5 years; and Completion of a generic nursing education program, degree completion program, or a graduate program within the last 5 years. “Advanced practice registered nurse” has the meaning stated in Health Occupations Article, §8-101, Annotated Code of Maryland. “Biennial renewal” means renewal of a license every 2 years in the licensee’s birth month. “Board” means the Maryland Board of Nursing. “Central Repository” means the Maryland Criminal Justice Information System Central Repository of the Department of Public Safety and Correctional Services. “Certified nursing assistant (CNA)” has the meaning stated in Health Occupations Article, §8-6A-01, Annotated Code of Maryland. “Continuing education” means planned, organized learning experiences designed to augment the knowledge, skill, and ability to enhance nursing practice and therefore improve health care delivered to the public. “Continuing education unit (CEU)” means 1 contact hour of 50—60 minutes. “Cosign” means a registered nurse verifies that: An activity was performed safely and accurately by the nursing graduate; and The documentation is complete and accurate. “Criminal history records check” means the performance of both a State criminal history check by the Central Repository, and a national criminal history check by the Federal Bureau of Investigation (FBI). “Criminal history records information” means information provided by the criminal history records check regarding an applicant's criminal arrests, charges, and convictions, and other dispositions of criminal charges. “Direct patient care” means healthcare activities that involve direct interaction between a healthcare professional and a patient. “Endorsement” means, for qualified applicants who have an unencumbered license from another state or country to practice registered nursing or licensed practical nursing, a waiver of the initial licensure requirement to take the national licensure examination in accordance with Health Occupations Article, §8-307, Annotated Code of Maryland. “English language competency examination” means an examination that tests an individual’s written and oral competency in the English language. Entry-level Registered Nursing Education Program. “Entry-level registered nursing education program” means a registered nursing education program that is the initial entry point for formal registered nursing education that, upon successful completion, qualifies an individual with no prior registered nursing education to obtain licensure as a registered nurse. “Entry-level registered nursing education program” does not include degree completion programs, including but not limited to: Associate of Applied Science Degree in Nursing to Baccalaureate of Science Degree in Nursing (AAS-BSN); Associate of Degree in Nursing to Baccalaureate of Science Degree in Nursing (ADN-BSN); Associate of Applied Science Degree in Nursing to Masters of Science Degree in Nursing (AAS-MSN); Associate Degree in Nursing to Masters of Science Degree in Nursing (ADN-MSN); Baccalaureate of Science Degree in Nursing to Masters of Science Degree in Nursing (BSN-MSN); Baccalaureate of Science Degree in Nursing to Doctor of Philosophy (BSN-PHD); Baccalaureate of Science Degree in Nursing to Doctor of Education (BSN-EDD); Baccalaureate of Science Degree in Nursing to Doctor of Nursing Practice (BSN-DNP); Masters of Science Degree in Nursing to Doctor of Philosophy (MSN-PHD); Masters of Science Degree in Nursing to Doctor of Education (MSN-EDD); Masters of Science Degree in Nursing to Doctor of Nursing Practice (MSN-DNP); or Masters of Science Degree in Nursing to Post Masters Certificate/Post Graduate Certificate. “Former licensee” means an individual who once had an active license with the Board who is no longer active. “Multistate licensure privilege” means an authorization to practice registered nursing or licensed practical nursing in Maryland that is granted to a registered nurse or licensed practical nurse who has an active multistate license issued by another state in accordance with the Nurse Licensure Compact. “NCLEX” means the National Council Licensure Examination for initial licensure as a registered nurse or licensed practical nurse. “Nursing assistant” means an individual certified by the Board as a certified nursing assistant. “Preceptor” means a registered nurse who meets the qualifications of faculty as described in Regulation .16 of this chapter. “Preceptorship” means an individualized refresher course approved by the Board and offered by an institution employing nurses which complies with Regulation .16 of this chapter. “Student” means a registered nurse or licensed practical nurse who is required to complete a refresher course in order to maintain or reestablish an active license. “Substantially equivalent” has the meaning stated in §§C and D of this regulation. “Volunteer” means a licensee who, at the time of licensure renewal, elects to receive a license which only allows the licensee to provide professional services without remuneration. “Written and oral competency in the English language” means the ability to demonstrate proficiency in listening, reading, speaking, and writing the English language. “Substantially equivalent” means a registered nursing or licensed practical nursing education program that: Contains theoretical learning experiences and related clinical learning experiences that include direct patient care within various settings consistent with program objectives, outcomes, or competencies conducted either concurrently with or after the theoretical learning experience; and Meets the curriculum requirements for Maryland schools of nursing at the time of the applicant’s graduation, including, but not limited to: The appropriate level of the graduate's intended scope of practice; Didactic and clinical learning experiences that are diverse and consistent with program objectives, outcomes, or competencies; Didactic and clinical instruction in nursing care of families and clients throughout the life span in a variety of care settings requiring nursing measures appropriate for: The maintenance or restoration of mental and physical health; Preventive, rehabilitative, and curative aspects of health care; Biophysical, psychosocial, cultural, and spiritual components of health and illness; and Professional issues content; and Didactic and clinical instructional content that includes, but is not limited to, the areas of: Medical and surgical nursing; Maternal and child health; Psychiatric nursing; and Geriatric nursing. “Substantially equivalent” does not mean a registered nurse or licensed practical nursing education program in another state or country that does not have a supervised clinical learning experience requirement. The fees listed in this regulation are not refundable. Licensure by examination fees are as follows: Registered nurse licensure — $187; Licensed practical nurse licensure — $187; and An examination fee for registered nurse and licensed practical nurse licensure shall be paid by the candidate directly to the testing service. Licensure by endorsement fees are as follows: Registered nurse licensure — $230; and Licensed practical nurse licensure — $230. Temporary registered nurse or licensed practical nurse licensure fee —$70. Advanced practice registered nurse certification fees are as follows: Initial advanced practice certification — $50; and Each additional initial advanced practice certification — $25. Specialty nursing practice certification fees are as follows: Initial forensic nurse examiner certification — $25; and Initial workers’ compensation medical case manager certification — $25. Biennial renewal fees are as follows: Renewal of a registered nurse license — $165; Renewal of a licensed practical nurse license — $165; Renewal of a registered nurse or licensed practical nurse volunteer license — $73; Renewal of an inactive license for a registered nurse or licensed practical nurse — $60; Renewal of each advanced practice registered nurse certification is in addition to the registered nurse license renewal fee and is — $10; and Renewal of certification for specialty nursing practices regulated by the Board is in addition to the registered nurse license renewal fee and is as follows: Forensic nurse examiner certification — $10; and Workers’ compensation medical case manager certification — $10. Health Care Practitioner User Fee. In addition to a license fee, each registered nurse shall pay a non-refundable health care practitioner user fee assessed by the Maryland Health Care Commission in accordance with Health-General Article, §19-111(b)(4), Annotated Code of Maryland. The health care practitioner user fee shall be: Included in the licensing fee paid to the Board; and Collected with the application for an initial or renewal license. The amount of the assessed health care practitioner user fee shall be double the amount of the annual health care practitioner user fee for biennial licensure. The Board shall: Account for the user fees; and Transfer the fees to the Maryland Health Care Commission on a quarterly basis. Nurse Practitioner Preceptorship Tax Credit Fund. This fee applies only to nurse practitioners. The Board shall assess a separate $15 fee for the renewal of a nurse practitioner, regardless of the number of certifications held by the nurse practitioner. The Board shall: Account for the fees collected under this section; and Transfer the fee to the Nurse Practitioner Preceptorship Tax Credit Fund. Other fees are as follows: Verification of licensure — $45; Copies of transcripts — $25; and Returned check fee —$30. Registered nurses or licensed practical nurses who hold a current active license in any other state or jurisdiction may render nursing care: For not more than 30 days, to an individual who is visiting the State for medical, educational, or personal reasons; For the purpose of the interstate transport and care of patients traveling to and from Maryland; and During an emergency situation. A registered nurse or licensed practical nurse who holds a multistate licensure privilege under the Nurse Licensure Compact may practice nursing in this State in accordance with the laws of this State. Nursing Graduate. A nursing graduate is a graduate of: A Board-approved registered nursing or licensed practical nursing education program; or An out-of-state nursing education program determined to be equivalent by the Board. A nursing graduate may practice as set forth in §C(5)—(7) of this regulation if: The nursing graduate has an application for a license pending before the Board; and One of the following circumstances exists: The nursing graduate has not taken the NCLEX examination; The nursing graduate has taken the NCLEX examination, but the results of the NCLEX examination are not yet known; The nursing graduate has taken and passed the NCLEX examination but is waiting for the completion of the criminal history records check; or The nursing graduate has taken and failed the NCLEX examination but has not failed the NCLEX examination more than one time within the 120 day period immediately following the submission of the application to the Board. A nursing graduate shall cease practice as a nursing graduate: No later than 120 days after the date the nursing graduate submitted an application to the Board; or Immediately if the nursing graduate fails the second NCLEX examination. If the nursing graduate fails the NCLEX examination, the nursing graduate may practice as a nursing assistant provided the individual obtains certification as a nursing assistant and practices according to COMAR 10.39.01. A nursing graduate shall: Practice only under the direct supervision of a registered nurse who is physically present on the unit to: Cosign medication transcription, medication administration, and nursing documentation; and Continually observe, assist, coordinate, evaluate, and monitor the nursing graduate; and Use the initials “NG” after the nursing graduate's name as credentials. After successful completion of an organized staff development program which includes an evaluation that the nursing graduate is competent and in compliance with §C(5) of this regulation, the nursing graduate may: Transcribe medication orders if: Written policies and procedures are available on the unit of care; and An organized staff development program which includes skill validation has been successfully completed by the nursing graduate; After competency has been validated by the facility: Administer medications and controlled substances; and Sign controlled substances sheets; Document in the medical record with the abbreviation “NG”; Perform patient assessments after the initial assessment or after the first assessment of the shift performed by the registered nurse; and Perform and document routine procedures taught within the nursing graduate's generic nursing program, including but not limited to: Placing nasal gastric tubes; Performing urinary catheterizations; Applying sterile dressings; Performing blood sugar checks; and Obtaining specimens. A nursing graduate may not: Work without the physical presence of and direct supervision by a registered nurse; Refer to oneself or practice as a registered nurse (RN) or licensed practical nurse (LPN); Be considered a staff person for purposes of a staffing pattern; Accept charge responsibilities; or Perform initial patient assessment or the first patient assessment of a shift, develop patient plans of care, evaluate or document patient discharge, or independently administer medications or intravenous therapy. An applicant shall submit: A completed application to the Board on the form that the Board requires; To a criminal history records check (CHRC) in accordance with Health Occupations Article, §8–303, Annotated Code of Maryland; Written evidence satisfactory to the Board that the applicant has submitted to a CHRC as required by §A(2) of this regulation by submitting: Two sets of fingerprints, as required by the Central Repository and the FBI; and All fees required by the Central Repository and the FBI; Any documentation requested from the applicant by the Board including, but not limited to, official certified or true test court documents and a signed, dated explanation written by the applicant, regarding the facts and circumstances, outcome, and current status of any criminal history record information received by the Board: Under Health Occupations Article, §8-303, Annotated Code of Maryland; In an answer to a question on the Board’s application form; or From any other source; and Any additional documentation requested by the Board if the documentation received from the applicant under §A(4) this regulation is incomplete or insufficient. If an application is not complete when initially submitted to the Board by the applicant, the applicant shall have no longer than 12 months from the date the application is received by the Board to: Complete the application; and Provide all information and documents required in §A of this regulation. If an applicant fails to provide to the Board a complete application and any additional documentation requested by the Board in §A of this regulation within 12 months from the date the application is received by the Board, then the application: Shall be considered abandoned; and May be destroyed. Once an application is deemed abandoned under §C of this regulation, an individual seeking licensure shall: Submit a new application; Meet all of the requirements for licensure; and Pay the required fees that are in effect at the time of re-application. An applicant for the registered nurse licensure examination shall: Complete satisfactorily and meet all requirements for a diploma or degree from an entry-level registered nursing education program approved by the Board Have a diploma or degree from an entry-level registered nursing education program in another state, territory, or country determined by the Board to be substantially equivalent to the registered nursing education program approved in this State at the time of the applicant's graduation. An applicant for the licensed practical nurse licensure examination shall: Meet all requirements for a high school diploma or its equivalent and complete satisfactorily and meet all requirements for a diploma from: A licensed practical nursing education program approved by the Board; or A licensed practical nursing education program in any other state, territory, or country determined by the Board to be substantially equivalent to the licensed practical nursing education programs approved in this State at the time of the applicant's graduation; or Meet the requirements of §A of this regulation. Applicants for registered nurse licensure and licensed practical nurse licensure who take an English proficiency examination approved by the U.S. Department of Health and Human Services in order to demonstrate English language proficiency under Health Occupations Article, § 8-302(e), Annotated Code of Maryland, shall obtain the minimum passing scores for registered nurses and licensed practical nurses set by the Health Resources and Services Administration of the U.S. Department of Health and Human Services. An applicant whose entry-level registered nursing education program or licensed practical nursing education program was completed in another country shall have the applicant's transcript evaluated by the Commission on Graduates of Foreign Nursing Schools or a successor organization. An applicant shall: Comply with all of the requirements in Regulation .04A of this chapter; File and submit a completed application to the National Council of State Boards of Nursing on the form required; and Pay any required fees. Each application shall be signed by the nurse administrator of the school or program or an officer of the school to whom this responsibility has been designated. Applications may be signed before graduation and it shall be the responsibility of the person signing the application to submit written verification of program completion before the licensure examination. Applicants whose applications are complete and who, for any reason, fail to take the examination within 6 months shall be required to reapply and pay all fees. The authorization to test card shall be valid for a period of 6 months. If the applicant fails to complete the examination within that time frame the applicant is required to re-register and pay the NCLEX testing fee. Examinations shall be held at least once per year. The Board will participate with the National Council of State Boards of Nursing, Inc., in preparing and administering the National Council Licensure Examination for registered nurse and practical nurse licensure. The results of the NCLEX shall be reported as pass or fail. An authorization to test card shall be sent to each candidate that the Board determines to be eligible for the examination. Examination scores shall be released only to the candidate and to the school of nursing from which the candidate graduated, except on written authorization of the candidate. Candidates for Maryland licensure may write the licensure examination in any jurisdiction. Candidates applying for licensure in other jurisdictions may write the licensure examination in Maryland. An applicant with a disability may request modifications in examination materials or procedures. The applicant shall: Make the request for modifications in writing; Include in the request the following: The candidate's name; The date of the examination to be modified; A letter from the appropriate medical professional which: Confirms the disability; and Provides information describing the accommodations required; and A letter from the candidate's education program, indicating what modifications, if any, were granted by the program. Requests for modification and supporting documentation shall be received by the application deadline. An applicant who claims a speech impairment shall fulfill all requirements for application, and shall submit to the Board documentation of the applicant's impairment, from: An otolaryngologist who has current certification from the American Board of Otolaryngology; and A speech-language pathologist who has current certification from the American Speech-Language-Hearing Association. The Board shall require a speech-impaired applicant to prove the applicant's ability to communicate adequately with patients and other health care professionals by: Submitting letters from instructors in a nursing program, attesting to the applicant's ability to communicate in a professionally competent manner; and Meeting with the Board to demonstrate the manner in which communication with patients will occur. A speech-language pathologist or otolaryngologist may be asked to attend the meeting in an advisory capacity to the Board to aid in assessing an applicant's ability to communicate. A foreign-educated, speech-impaired applicant shall notify the Board before taking a Board-approved standardized test for competency in the English language. The Board shall attempt to locate a speech-language pathologist fluent in the applicant's native language to assess the impairment. A foreign-educated applicant who is in need of foreign accent reduction, but who has competency in the applicant’s native language, may obtain assistance from a bilingual speech-language pathologist before attempting to pass a test for competency in the English language. An applicant who holds an active, unencumbered license to practice registered nursing or practical nursing in another state, territory, or country is eligible for licensure without examination if the applicant: Complies with all of the requirements under Regulation .04A of this chapter; Pays the required fee; Meets one of the conditions in §B of this regulation; and Presents evidence of 1,000 hours of active nursing practice within the last 5 years or successful completion of a Board-approved refresher course or preceptor program. An applicant for licensure as a registered nurse by endorsement shall either: Hold a valid, unencumbered multistate license under the Nurse Licensure Compact; or Submit the following evidence directly to the Board from the appropriate authority: Verification that, at the time that applicant graduated from the nursing education program, the nursing education program was: Approved as a registered nursing or licensed practical nursing education program in that state, territory, or country; and Substantially equivalent to the education program approved in this State; Verification that the applicant passed one of the following licensure examinations under the laws of another state, territory, or country: If completed from 1952 to 1982, the “State Board Test Pool Examination — Registered Nurse or Practical Nurse”; If completed from 1982 to present, the “National Council Licensure Examination — Registered Nurse or Practical Nurse”; If completed before, 1952, the “National League for Nursing State-Constructed Board Examination, Registered Nurse or Practical Nurse”; or If completed before 1982, “Canadian Nurses Association Test Service Examination for Registered Nurses”; For applicants whose entry-level registered nursing education program or licensed practical nursing education program was completed in another country, a copy of an evaluation of the applicant's transcript by the Commission on Graduates of Foreign Nursing Schools or successor organization; and Except as provided in §D(1) of this regulation, proof of written and oral competency in the English language, in accordance with Health Occupations Article, § 8-302(e), Annotated Code of Maryland. An applicant for licensure as a registered nurse by endorsement who cannot provide the evidence required under §B(2) of this regulation may qualify for licensure if the applicant submits evidence, as required by the Board, that the applicant has: Completed satisfactorily and met all requirements for an associate or a baccalaureate degree in registered nursing from a college or university that, at the time of the applicant’s graduation, is: Accredited by a national or regional nursing accreditation agency that is recognized by the Secretary of the U.S. Department of Education or the Council for Higher Education Accreditation; and Approved by the board of nursing or other applicable state regulator in the state in which the program is located; and Completed a minimum of 1,000 hours of practice in direct patient care. English Language Competency Requirements for Endorsement. An applicant is not required to submit proof of English language competency if the applicant demonstrates that the applicant holds or has held a license to practice registered nursing or licensed practical nursing in another state if that state has an English language competency component for licensure or examination. Applicants for registered nurse licensure and licensed practical nurse licensure who take an English proficiency examination approved by the U.S. Department of Health and Human Services in order to demonstrate English language proficiency under Health Occupations Article, § 8-302(e), Annotated Code of Maryland, shall obtain the minimum passing scores for registered nurses and licensed practical nurses set by the Health Resources and Services Administration of the U.S. Department of Health and Human Services. Those applicants who cannot present evidence of 1,000 hours of active nursing practice within the last 5 years, or successful completion of a Board-approved refresher course or preceptor program, may apply for inactive license. An initial license shall be issued to each applicant passing the licensure examination or qualifying for licensure by endorsement provided that: The applicant meets all the requirements of this chapter; and The Board has: Received and reviewed the criminal history record information; and Approved the application. An initial license may not be issued for less than 90 days. An incorrect license issued as a result of a Board error will be corrected in the Board’s data base at no charge to the licensee. A licensee who requests a change of name for a license shall: Make the request in writing on the form required by the Board; and Provide appropriate legal documentation supporting the change. The Board may issue a temporary license to an applicant who passed the licensure examination and is waiting for the criminal history records check to be completed or who is licensed as a registered nurse or licensed practical nurse in any other state provided that the applicant: Completes the required application; If licensed in another state, presents a copy of a current, active license in another state; Presents positive personal identification; Pays the required fee; and Provides written, verified evidence that the applicant has submitted to a criminal history records check in accordance with Health Occupations Article, §8-303, Annotated Code of Maryland. Except as provided in §§C and E of this regulation, temporary licenses expire 90 days after date of issuance and are not renewable. A temporary license may be extended for an additional 90 days if the applicant is waiting for the completion of the criminal history record information. The Board shall revoke a temporary license if the criminal history records check reveals that the applicant has been convicted of or pled guilty or nolo contendere to an act that would be cause for discipline under Health Occupations Article, §8-316(a), Annotated Code of Maryland. If an applicant does not meet the practice requirement in Regulation .10A(5) of this chapter, a temporary license may be extended every 90 days: Pending completion of the practice requirement; and Provided that the total length of the temporary license does not exceed 12 months from the original date of issuance. The Board shall renew the license of a licensee who meets all the requirements of Health Occupations Article, §8-312, Annotated Code of Maryland and of this chapter. The Board shall renew licenses biennially according to the following schedule: A registered nurse or licensed practical nurse with an odd-numbered birth year shall always renew in an odd-numbered year not later than the 28th day of the licensee’s birth month; and A registered nurse or licensed practical nurse with an even-numbered birth year shall always renew in an even-numbered year not later than the 28th day of the licensee’s birth month. At least 3 months before a license expires, the Board shall send the licensee a renewal notice by: First-class mail to the last known address of the licensee; or Electronic means to the last known electronic address of the licensee. It shall be the responsibility of the licensee to notify the Board if a renewal notice is not received. The Board cannot guarantee that renewal applications received later than 30 days before the expiration date will be processed before the expiration date. The Board shall issue a volunteer license to any registered nurse or licensed practical nurse who meets the licensure renewal requirements provided the licensee: Certifies to the Board that the licensee provides professional services only as a volunteer; Completes the required application; and Pays the required fee. Active Licensure Renewal. An individual applying for active licensure renewal shall show evidence of: 1,000 hours of active nursing practice within the 5 years immediately preceding the date of the renewal application; Satisfactory completion of all requirements for a diploma or degree from a Board-approved nursing education program within the 5 years immediately preceding the date of the renewal application; or Completion of 30 continuing education units (CEUs) within the 2 years immediately preceding the date of the renewal application. College or University Coursework. A renewal applicant may submit qualifying college or university coursework to fulfill the requirement under §G(1)(c) of this regulation. 15 CEUs shall be awarded for each semester hour completed of a qualifying college or university course. For the coursework to qualify: The college or university course shall be related to the renewal applicant’s nursing practice; and The renewal applicant shall receive a grade of C or higher, or the numeric equivalent in the course. An official transcript shall be acceptable as proof of completion of a qualifying college or university course. Continuing Education. Except as provided in §G(2) of this regulation, CEUs shall be approved by an entity listed in §H(5) of this regulation. CEUs used for the purpose of renewing a license are subject to random audits by the Board or the Board’s designee. CEUs that are used for the purpose of renewing a license shall be earned within the 2 years immediately preceding the date of the renewal application. The renewal applicant shall be responsible for: Ensuring that a CEU course, forum, or meeting has been approved for CEUs by one of the entities listed in §H(5) of this regulation; Retaining evidence of completed CEUs that are submitted for the purpose of renewing a license for 6 years after the license is renewed; and Producing evidence of completed CEUs for an audit by the Board or the board’s designee within 30 days of the request. The Board shall accept CEUs awarded or approved by: Area Health Education Centers (AHEC), including all local, state, and national centers; The American Nurses Association (ANA); The American Nurses Credentialing Center (ANCC); Professional organizations offering CEUs for the purpose of renewing a national certification for advanced practice registered nursing; A local, state, or national professional nursing association that provides educational programs; The Maryland Nurses Association (MNA); The National Council of State Boards of Nursing; and The National League for Nursing. CEUs may not be carried forward into the next renewal period. An individual applying for active licensure renewal who do not meet the requirements of §G of this regulation shall be required to successfully complete a Board-approved refresher program or Board-approved preceptorship program prior to renewal of the license. Tax Deficiencies. On a monthly basis, the Board shall notify the Office of the Comptroller of any licensee or certificate-holder: Whose license expires within the next 4-month period; and Whose identity has not previously been provided to the Office of the Comptroller. Upon notification by the Office of the Comptroller of any licensee or certificate-holder who is delinquent in the payment of undisputed taxes or unemployment insurance contributions, the Board shall notify the licensee or certificate-holder that renewal processing shall be delayed until the Office of the Comptroller verifies that the licensee or certificate-holder has made arrangements for payment of the undisputed taxes or unemployment insurance contributions that are satisfactory to the unit responsible for collection. Upon notification by the Office of the Comptroller that the licensee or certificate-holder has made satisfactory arrangements for payment of the undisputed taxes or unemployment insurance contributions, and where the licensee or certificate-holder is otherwise qualified for licensure, the Board shall renew the license or certificate. Along with the renewal notice in accordance with §C of this regulation, the Board shall: Notify every renewal applicant who is required to have a criminal history records check in the selected birth month; and Send the renewal applicant instructions for downloading and completing the documents needed to submit to a criminal history records check. If a renewal applicant is out of the state, the Board shall mail a packet to the applicant with the required documents and instructions for completing the documents. Upon notification by the Board that a criminal history records check is required before a license can be renewed, a renewal applicant shall comply with all of the requirements under Regulation .04A of this chapter. Criminal history record checks for renewal applicants shall be scheduled according to the licensee's birth month as follows: In 2025 — all applicants with an August or September birth month; In 2026 — all applicants with a September or October birth month; In 2027 — all applicants with an October or November birth month; In 2028 — all applicants with a November or December birth month; In 2029 — all applicants with a December or January birth month; In 2030 — all applicants with a January or February birth month; In 2031 — all applicants with a February or March birth month; In 2032 — all applicants with a March or April birth month; In 2033 — all applicants with an April or May birth month; In 2034 — all applicants with a May or June birth month; In 2035 — all applicants with a June or July birth month; and In 2036 — all applicants with a July or August birth month. For renewal applicants who are required to submit to a criminal history records check, the Board may not renew a license without written documentation that the applicant has submitted to a criminal history record check in accordance with Health Occupations Article, §8-303, Annotated Code of Maryland. The Board shall place the license of any registered nurse or licensed practical nurse on inactive status if the licensee: Has not satisfactorily completed 1,000 hours of active nursing practice or graduated from an approved nursing program within the 5-year period immediately preceding the date of anticipated renewal or chooses inactive status; Completes the biennial application for inactive status; and Pays all fees. A licensee on inactive status may not practice nursing in this State. However, a registered nurse on inactive status may use the title “registered nurse”, and a practical nurse on inactive status may use the title “licensed practical nurse”. A licensee on inactive status may apply for an active status license provided that the licensee: Meets the renewal requirements of Health Occupations Article, §8-312, Annotated Code of Maryland; and Submits to the Board: The required application; and Written, verified evidence that the licensee has submitted to a criminal history records check in accordance with Regulation .13 of this chapter by: Submitting two sets of fingerprints required by the Central Repository and the FBI; and Paying all fees required by the Central Repository and the FBI. An additional fee may not be charged to change from inactive to active status. A license expires on the 28th day of the licensee's birth month. A licensee has a 30-day grace period beyond the expiration date of a license to renew a license. Refresher courses and preceptor programs, as defined in Regulation .01B of this chapter, shall be approved by the Board before their implementation and at least every 5 years after that. The registered nurse curriculum shall: Have a minimum of 80 theory hours, 60 clinical hours, and 8 hours of a classroom laboratory training before the on-site clinical experience; Include the following content areas: The nursing process; Management and delegation of patient care; Documentation and information management; Pharmacology, including calculation; Nursing care of patients with alterations in body systems; Emergency procedures; Disaster response; and Professional responsibilities, which include, but are not limited to, the following: Trends in nursing and the health care system; Legal aspects of nursing; and Development and initiation of patient and community health education. The practical nurse curriculum shall: Have a minimum of 60 theory hours, 60 on-site clinical hours, and 8 hours of a classroom laboratory training before the on-site clinical experience; Include the following content areas: The nursing process with the licensed practical nurse as a contributor; Provision and delegation of patient care under the supervision of a registered nurse; Documentation and information management; Pharmacology, including calculations; Nursing care of patients with common health problems; Emergency procedures; Disaster response; and Professional responsibilities, which include, but are not limited to, the following: Trends in nursing; Legal aspects of nursing; and Contribution to patient health teaching. The organization and utilization of curriculum materials shall be based on accepted educational principles. Faculty Qualifications. Faculty shall: Be a registered nurse as defined in Health Occupations Article, §8-101, Annotated Code of Maryland; and Have a baccalaureate degree in nursing. A minimum of 3 years of clinical and teaching experience is recommended. Faculty shall: Plan, implement, evaluate, and revise the educational program. Select and evaluate clinical facilities used to achieve program objectives. Develop and utilize: Written examinations to measure achievement of program objectives. An evaluation tool to measure achievement of clinical competencies. The clinical competencies shall be based upon the registered nurse and licensed practical nurse standards of practice. A mechanism for student evaluation of the course. Students shall complete theoretical instruction either before or concurrent with clinical instruction. All program requirements including required clinical hours shall be completed within 12 months of the starting date of the refresher course. Clinical facilities shall provide sufficient opportunities to meet the learning objectives of the refresher course. The faculty/student ratio may not exceed 1:10 in the clinical area. The Board shall reinstate the license of a former licensee who has failed to renew the license for any reason if the former licensee meets the renewal requirements. After January 1, 2010, an applicant for reinstatement who has failed to renew the applicant's license for a period of 1 year or more shall submit to a criminal history records check before the license is reinstated. Temporary License. The Board shall issue a temporary license to a former licensee who: Applies for reinstatement in accordance with Health Occupations Article, §8-313, Annotated Code of Maryland; Meets the renewal requirements of Health Occupations Article, §8-312, Annotated Code of Maryland; and Is awaiting the completion of the criminal history records check. The temporary license issued pursuant to §C(1) of this regulation is effective until the earlier of 90 days after the date of issue or the date the Board issues an active license. If a program is thought to be in violation of this chapter, the following steps shall be taken: The Board shall notify the program of the regulations it is violating; The program shall submit a plan with a proposed time frame for correcting the violations; The plan shall be due within 30 days of receipt of notification of the violations; The Board's professional staff may, at the request of the Board, visit the program; After receipt of the plan, the Board shall provide the program with a reasonable time frame within which to correct the violations; and Upon expiration of the time period for correcting violations, a member of the Board's staff shall visit the program to determine if the school is in compliance with the regulations, and report to the Board. If the program does not correct the violations within the time frame established by the Board, the Board: Shall notify the program that it has not corrected violations in a reasonable time and schedule a hearing in accordance with the Administrative Procedure Act; and If, after a hearing, determines that the program or preceptorship is in violation of the regulations, may place a program on either conditional approval or remove it from the approved list of programs. If the Board places the program on conditional approval, the Board may request that a program suspend admission of students. A program placed on conditional approval shall remain in that status until the Board determines it has complied with the regulations. Unless authorized to practice as a nursing graduate under this chapter, an individual may not use the words “nursing graduate”, the abbreviation “NG”, or any other title, symbol, abbreviation, sign, card, device, or other representation with the intent to represent that the individual practices as a nursing graduate. Health Occupations Article, §§1-213, 1–230, 8-101, 8-201, 8-205, 8-206, 8-301—8-315, 8-6A-05(a), 8-701, 8-7A-01, Article 1116(b)(2), and 8-703; Tax-General Article, §§10-738 and 10-739(b)(1); Annotated Code of Maryland; Ch. 486, Acts of 2012; Chs. 281 and 282, Acts of 2013; Chs. 385 and 386, Acts of 2016; and Chs. 234 and 234, Acts of 2017 Effective date: Regulation .01B, C amended effective May 5, 1978 (5:9 Md. R. 684) Regulation .02A amended effective January 7, 1976 (3:1 Md. R. 40) Regulation .02B, F amended effective October 13, 1976 (13:21 Md. R. 1206) Regulation .02G amended effective May 14, 1975 (2:10 Md. R. 752) Regulation .05 amended effective January 7, 1976 (3:1 Md. R. 40) Regulation .08 repealed effective March 23, 1979 (6:6 Md. R. 512) Regulations .01—.07 renumbered as Regulations .02, .03, .04, .05, .07, .08, and .09, respectively Regulation .01 adopted effective March 23, 1979 (6:6 Md. R. 512) Regulation .02A, C, E, G, H amended effective March 23, 1979 (6:6 Md. R. 512) Regulation .02B, C amended effective June 29, 1979 (6:13 Md. R. 1128) Regulations .03A—F, H and .05A amended effective March 23, 1979 (6:6 Md. R. 512) Regulation .06 adopted effective March 23, 1979 (6:6 Md. R. 512) Regulations .08A, C and .09 amended effective March 23, 1979 (6:6 Md. R. 512) Regulations .01—.09 repealed effective August 11, 1986 (13:16 Md. R. 1827) Regulations .01—.11 adopted effective August 11, 1986 (13:16 Md. R. 1827) Regulations .01—.06 amended as an emergency provision effective April 11, 1994 (21:9 Md. R. 744); amended permanently effective August 15, 1994 (21:16 Md. R. 1384) Regulation .01B amended effective December 11, 1989 (16:24 Md. R. 2620); May 10, 1993 (20:9 Md. R. 779) Regulation .02A amended effective December 11, 1989 (16:24 Md. R. 2620); October 1, 1990 (17:19 Md. R. 2321); May 10, 1993 (20:9 Md. R. 779) Regulation .02A amended as an emergency provision effective July 1, 1991 (18:14 Md. R. 1606); adopted permanently effective January 2, 1992 (18:25 Md. R. 2751) Regulation .02A amended as an emergency provision effective October 27, 1995 (22:23 Md. R. 1795); amended permanently effective February 12, 1996 (23:3 Md. R. 169) Regulation .02A amended as an emergency provision effective November 14, 1997 (24:25 Md. R. 1717); amended permanently effective March 9, 1998 (25:5 Md. R. 369) Regulation .02A amended as an emergency provision effective August 2, 1999 (26:17 Md. R. 1314); amended permanently effective November 15, 1999 (26:23 Md. R. 1777) Regulation .04D adopted effective November 8, 1993 (20:22 Md. R. 1707) Regulation .06G amended as an emergency provision effective November 1, 1987 (14:23 Md. R. 2412); adopted permanently effective March 1, 1988 (15:3 Md. R. 304) Regulation .06G amended effective May 10, 1993 (20:9 Md. R. 779) Regulation .07 amended effective October 1, 1990 (17:19 Md. R. 2321); May 10, 1993 (20:9 Md. R. 779) Regulation .07A amended effective December 11, 1989 (16:24 Md. R. 2620); November 8, 1993 (20:22 Md. R. 1707) Regulation .08E adopted effective October 1, 1990 (17:19 Md. R. 2321) Regulation .09 amended as an emergency provision effective October 27, 1995 (22:23 Md. R. 1795); amended permanently effective February 12, 1996 (23:3 Md. R. 169) Regulation .09C amended effective May 10, 1993 (20:9 Md. R. 779) Regulation .10 amended effective December 11, 1989 (16:24 Md. R. 2620) Regulation .10D amended and H adopted effective October 1, 1990 (17:19 Md. R. 2321) Regulation .10I adopted effective May 10, 1993 (20:9 Md. R. 779) Regulation .11 recodified to Regulation .12 and new Regulation .11 adopted effective December 11, 1989 (16:24 Md. R. 2620) Regulation .13 adopted effective December 11, 1989 (16:24 Md. R. 2620) Regulations .14 and .15 adopted effective May 10, 1993 (20:9 Md. R. 779) Chapter revised effective April 30, 2001 (28:8 Md. R. 760) Regulation .01B amended effective March 1, 2004 (31:4 Md. R. 316) Regulation .01B amended as an emergency provision effective January 2, 2007 (34:4 Md. R. 397); amended permanently effective May 7, 2007 (34:9 Md. R. 825) Regulation .01B amended effective September 22, 2008 (35:19 Md. R. 1717) Regulation .01C adopted effective September 22, 2008 (35:19 Md. R. 1717) Regulation .02 repealed and new Regulation .02 adopted effective April 1, 2013 (40:6 Md. R. 474) Regulation .02A amended effective September 3, 2001 (28:17 Md. R. 1556); August 27, 2007 (34:17 Md. R. 1508) Regulation .03 amended effective March 1, 2004 (31:4 Md. R. 316) Regulation .03A amended effective September 22, 2008 (35:19 Md. R. 1717) Regulation .04 amended effective September 22, 2008 (35:19 Md. R. 1717) Regulation .04B amended effective September 3, 2001 (28:17 Md. R. 1556) Regulation .05 amended effective March 1, 2004 (31:4 Md. R. 316); September 27, 2004 (31:19 Md. R. 1433) Regulation .05A amended as an emergency provision effective January 2, 2007 (34:4 Md. R. 397); amended permanently effective May 7, 2007 (34:9 Md. R. 825) Regulation .05D amended effective September 22, 2008 (35:19 Md. R. 1717) Regulation .05I adopted as an emergency provision effective January 2, 2007 (34:4 Md. R. 397); amended permanently effective May 7, 2007 (34:9 Md. R. 825) Regulation .09A amended as an emergency provision effective January 2, 2007 (34:4 Md. R. 397); amended permanently effective May 7, 2007 (34:9 Md. R. 825) Regulation .09A amended effective January 6, 2014 (40:26 Md. R. 2164) Regulation .09D adopted as an emergency provision effective January 2, 2007 (34:4 Md. R. 397); amended permanently effective May 7, 2007 (34:9 Md. R. 825) Regulation .11 amended as an emergency provision effective January 2, 2007 (34:4 Md. R. 397); amended permanently effective May 7, 2007 (34:9 Md. R. 825) Regulation .11 amended effective April 19, 2010 (37:8 Md. R. 617) Regulation .12 amended effective April 1, 2013 (40:6 Md. R. 474) Regulation .12F, G amended effective April 24, 2006 (33:8 Md. R. 733) Regulation .12H adopted effective October 11, 2004 (31:20 Md. R. 1485) Regulation .12I, J, K adopted as an emergency provision effective January 2, 2007 (34:4 Md. R. 397); amended permanently effective May 7, 2007 (34:9 Md. R. 825) Regulation .12I amended effective April 19, 2010 (37:8 Md. R. 617) Regulation .12I-1, I-2, J-1 adopted effective April 19, 2010 (37:8 Md. R. 617) Regulation .12I-1 amended effective June 13, 2011 (38:12 Md. R. 705) Regulation .13 amended as an emergency provision effective January 2, 2007 (34:4 Md. R. 397); amended permanently effective May 7, 2007 (34:9 Md. R. 825) Regulation .13A amended effective April 24, 2006 (33:8 Md. R. 733) Regulation .13C amended effective January 6, 2014 (40:26 Md. R. 2164) Regulation .15 amended effective April 24, 2006 (33:8 Md. R. 733) Regulation .16 amended effective April 19, 2010 (37:8 Md. R. 617) Regulation .17C amended effective March 1, 2004 (31:4 Md. R. 316) Chapter revised effective February 13, 2017 (44:3 Md. R. 189) Regulation .01B amended effective July 2, 2018 (45:13 Md. R. 667); June 17, 2019 (46:12 Md. R. 544); August 23, 2021 (48:17 Md. R. 669); Regulation .01B amended as an emergency provision effective January 4, 2022 (49:4 Md. R. 297); emergency status expired effective July 3, 2022 Regulation .01B amended as an emergency provision effective September 7, 2022 (49:21 Md. R. 940); emergency status expired effective March 5, 2023 Regulation .01B amended as an emergency provision effective May 4, 2023 (50:10 Md. R. 405); emergency status expired effective October 31, 2023 Regulation .01B amended as an emergency provision effective August 26, 2025 (52:20 Md. R. 999); amended permanently effective October 13, 2025 (52:20 Md. R. 1001) Regulation .01B amended effective April 27, 2026 (53:8 Md. R. 356 Regulation .01D adopted effective August 23, 2021 (48:17 Md. R. 669) Regulation .02 amended effective January 29, 2018 (45:2 Md. R. 69); July 1, 2025 (52:10 Md. R. 436) Regulation .03 amended effective July 2, 2018 (45:13 Md. R. 667) Regulation .03A, C amended as an emergency provision effective January 4, 2022 (49:4 Md. R. 297); emergency status expired effective July 3, 2022 Regulation .03C amended as an emergency provision effective September 7, 2022 (49:21 Md. R. 940); emergency status expired effective March 5, 2023; Regulation .03C amended as an emergency provision effective May 4, 2023 (50:10 Md. R. 405); emergency status expired effective October 31, 2023 Regulation .03C amended as an emergency provision effective August 26, 2025 (52:20 Md. R. 999); amended permanently effective October 13, 2025 (52:20 Md. R. 1001) Regulation .05 amended effective July 2, 2018 (45:13 Md. R. 667); April 27, 2026 (53:8 Md. R. 356) Regulation .05C amended effective August 23, 2021 (48:17 Md. R. 669) Regulation .05C amended as an emergency provision effective October 6, 2023 (50:22 Md. R. 972); emergency status expired effective April 3, 2024 Regulation .05C amended effective June 24, 2024 (51:12 Md. R. 619) Regulation .06F repealed effective July 2, 2018 (45:13 Md. R. 667) Regulation .09D, F amended effective July 2, 2018 (45:13 Md. RR. 667) Regulation .10 amended effective August 28, 2017 (44:17 Md. R. 835); July 2, 2018 (45:13 Md. R. 667); August 23, 2021 (48:17 Md. R. 669); April 27, 2026 (53:8 Md. R. 356) Regulation .11 amended effective July 2, 2018 (45:13 Md. R. 667) Regulation .12 amended effective July 2, 2018 (45:13 Md. R. 667) Regulation .13 amended effective July 2, 2018 (45:13 Md. R. 667); June 17, 2019 (46:12 Md. R. 544) Regulation .13N amended as an emergency provision effective June 24, 2025 (52:15 Md. R. 810); amended permanently effective August 18, 2025 (52:16 Md. R. 846) Regulation .14 amended effective July 2, 2018 (45:13 Md. R. 667) Regulation .15B amended effective July 2, 2018 (45:13 Md. R. 667) Regulation .16E amended effective July 2, 2018 (45:13 Md. R. 667) Regulation .17C adopted as an emergency provision effective January 4, 2022 (49:4 Md. R. 297); emergency status expired effective July 3, 2022 Regulation .17C adopted as an emergency provision effective September 7, 2022 (49:21 Md. R. 940); emergency status expired effective March 5, 2023 Regulation .17C amended as an emergency provision effective May 4, 2023 (50:10 Md. R. 405); emergency status expired effective October 31, 2023 Regulation .17C adopted as an emergency provision effective August 26, 2025 (52:20 Md. R. 999); adopted permanently effective October 13, 2025 (52:20 Md. R. 1001)