TOPEKA, KS 66612-1230

Long Term Provider Application & Five Year Renewal

Individuals, organizations or agencies desiring long-term continuing nursing education providership status should complete and submit this application. Please review the following rules and regulations related to continuing nursing education in the Nurse Practice Act.:

65-1117 (a)

65-1119 (e)





Please review these instructions before completing the application.

1. Applications are to be submitted sixty (60) days prior to a Board meeting. Board meetings are scheduled during March, June, September and December of each year (Dates are posted on web site). Five year renewal notices will be mailed to providers with deadlines for the submission of their renewal application

2. The cover page must be completed and all attachments must be present.

3. The $200.00 application fee must be sent to KSBN before the initial providership application will be considered. The fee will not be returned even if the application is not approved. There is no fee for the five-year renewal.

4. The Policies and Procedures for the Providership must be placed in the corresponding text box. All supporting documents must be attached in pdf form after the policies and procedures page is completed.

5. The content should be organized in the order of the application criteria listed under "Regulation Description" on the attached form and the attachments labeled and numbered. All items listed under "regulation description" must be addressed.

6. Examples submitted in support of narrative statements must be referenced by page or appendix number and name of applicant

7. PDF attachments must be readable.


Approval of the Kansas State Board of Nursing (KSBN) Continuing Nursing Education (CNE) application is based on an in-depth analysis of the submitted information to best determine the applicant's capacity to offer continuing nursing education activities meeting the definition of CNE in accordance with KSBN CNE statutes and regulations.

Definition of CNE (from 65-1117 (a)) "Continuing nursing education means learning experiences intended to build upon the educational and experiential bases of the registered professional and licensed practice nurse for the enhancement of practice, education, administration, research or theory development to the end of improving the health of the public. "


The completed CNE providership application will be listed on the CNE Committee agenda for review at the next board meeting.

An electronic copy of the application and materials will be sent to designated CNE Committee members. The Education Specialist and the reviewers will evaluate the application for compliance with the CNE statutes and regulations. The reviewers will give their evaluative comments to the committee.

Following the board meeting, the Education Specialist will send written notification of the board's decision. If the application is approved, a provider number will be allocated.

Applications not approved or that have approval pending will receive written notification of requirements. Requirements must be submitted by the stated deadline for sufficient review prior to the upcoming board meeting. If application requirements are not met, notification will be given that the application process is considered abandoned. A new application and fee is required if the providership is still desired.


The providership renewal application will be listed on the next CNE Committee agenda for review.

The Education Specialist will review the renewal application for compliance with CNE statutes and regulations and make recommendations to the CNE Committee. Providers will be notified if the renewal application is incomplete or does not meet regulations and be given the opportunity to make corrections/additions prior to CNE Committee meeting.

Following the board meeting, the Education Specialist will send written notification of the board's decision.






Regulation Description

Additional information

60-9-107 b (1) (A)

Name and address of organization


60-9-107 b (1) (B)

Name and address of department or unit within the organization responsible for approving nursing continuing education


60-9-107 b (2)

60-9-107 c (1)

Name, education and experience of program coordinator responsible for CNE; The CNE coordinator must be a registered nurse with three years of clinical experience, baccalaureate degree and at least one year of experience developing and implementing educational offering;


Program Management Written Policies and Procedures

60-9-107 b (3) (A)

Process of assessing need and planning CNE

Include description of formal or informal needs assessment process, planning committees or advisory groups involved in the planning and evaluation of CNE and how the definition of CNE (65-1117(a)) is used to determine the content for CNE offerings.

60-9-107 b (3) (B)

Process for fee assessment

Include policy for refunds and insufficient fund checks if applicable

60-9-107 b (3) (C)

Process for advertisements or announcements,

Published information shall contain the following statement: (Name of Provider) is approved as a provider of continuing nursing education by the Kansas State Board of Nursing. This course offering is approved for ___contact hours applicable for RN, LPN, or LMHT relicensure. Kansas State Board of Nursing Provider Number: _____

Include a sample announcement/brochure

60-9-107 b (3) (D)

60-9-107 d

Process for offering approval:

  • Summary of planning
  • Behavioral Objectives (60-9-105 d)
  • Content which shall meet definition of CNE in KSA 65-1117(a)
  • Instructor's education and experience documenting knowledge/expertise,
  • current bibliography (books 10 yr, periodicals 5 yr)
  • offering evaluation that includes assessment of learner achievement of each objective, expertise of individual presenters.

60-9-107 b (3) (E)

60-9-107 e

Process for awarding contact hours: An approved provider may award any of the following:

  • contact hours as documented on an offering agenda for actual time attended, including partial credit for one or more contact hours
  • credit for fractions of hours over 30 minutes to be computed towards a contact hour
  • instructor credit, which shall be two contact hours for each hour of first-time presentation of an approved offering, excluding standardized prepared curriculum (e.g. ACLS, PALS, TNCC, ENPC, MANDT, etc)
  • independent study (60-9-105 (l)) credit based on time required to complete the offering as documented by the provider's pilot time test results
  • clinical hours

Include procedure for late arrival/early departure in reference to partial credit policy.

Contact hour means 50 total minutes of participation in a learning experience that meets the definition of CNE.
(60-9-105( j) )

Pilot testers should be representative of target audience; Contact hours may be determined using the time documented by pilot testers by:

  • totaling all time and dividing by number of testers, or
  • discard high and low times and average the time spent by the rest of the testers

60-9-107 b (3) (F)

60-9-107 f

60-9-107 g

Process for verifying participation and completion of the offering:

Documentation to verify that each participant attended offering

  • participants shall be required to sign a daily attendance roster
  • roster shall contain the provider's name, address, provider number and coordinator; the date and title of the offering and the presenter(s); the participant's name and license number, and the number of contact hours awarded

Documentation to verify completion of independent study offering, if applicable.

  • Documentation shall include information about the provider's name, address, provider number and coordinator; the title of the offering; the date on which the offering was completed; and the presenter(s); the participant's name and license number, and the number of contact hours awarded and either the completion of post test or return demonstration


  • Certificates of attendance shall be awarded to participants after completing an offering;
  • Each certificate shall be complete before distribution to participants;
  • each certificate shall contain the provider's name, address and provider number, title of the offering, date(s) of attendance, number of contact hours awarded and if applicable, the designation of any independent study or instructor contact hours awarded; signature of individual responsible for the providership, name and license number of the participant

Include a sample copy of the roster; may include additional participant information (i.e. address) if desired.

Include sample copy of verification of completion of independent study offering if applicable

Include a sample of copy of the certificate

60-9-107 b (3) (G)

60-9-107 h

Process for record keeping and record storage

  • For each offering the approved provider shall retain the following for two years: summary of the planning, copy of announcement/brochure, title and objectives, offering agenda or, for independent study, pilot time test results, bibliography, summary of participant evaluations; each instructor's education and experience; documentation to verify completion of the offering as specified in subsection (f).
  • Record storage system assure confidentiality and easy retrieval of records by authorized individuals

Include description of where files are kept

60-9-107 b (3) (H)

Process for notice of change of coordinator or required policies

  • the program coordinator shall notify the board in writing of any change of the individual responsible for the providership or required policies and procedures within 30 days

60-9-107 b (3) (I)

Total Program Evaluation

"a systematic process by which an approved provider analyzes outcomes of the overall continuing nursing education program in order to make subsequent decisions"(60-9-105 (s))

A sample plan is attached that can be modified to fit the needs of the organization. The total program evaluation plan can be developed in whatever format best fits your needs.

  • Include a sample copy of the total program evaluation

60-9-107 b (4)

60-9-107 i

Submit 2 proposed offerings:

  • A summary of the planning
  • Copy of the offering announcement or brochure
  • Title and behavioral objectives
  • Offering agenda or for independent study, pilot test results
  • Each instructor's education & experience
  • A current bibliography as specified in paragraph (d) (5); and
  • The offering evaluation form

Sample Total Program Evaluation

The total program evaluation plan should provide a systematic process for collecting and analyzing the data needed to determine if the providership is meeting the established policies and procedures. This is not an evaluation of individual education offerings.

The total program evaluation plan must evaluate the entire program:

Program administration program coordinator's responsibilities

Program management policies and procedures

Total Program Evaluation ability of the plan to measure the overall effectiveness of the CNE providership.

The total program evaluation is done at least annually and is reported in the annual report to KSBN. It may be presented as a narrative or a chart or in any format appropriate for the provider.



Resp. Person







Review job description



Assess need, planning

- written tool

- evaluation summaries


Review survey for appropriateness; were survey findings and identified needs from evaluation summaries used in program planning



Fee Assessment


Policy meets organization and customer needs





Review to be certain they reflect necessary information



Offering approval process


Review policies and compare to KSBN requirements



Awarding contact hours


Review agendas/pilot test results to verify contact hours awarded; review documentation of partial credit



Verifying participation/



Review rosters and certificates; compare to KSBN requirements



Record keeping


Audit contents of files for compliance with KSBN requirements



Notification of changes


Review procedures for changes reported to KSBN


Total Program Evaluation effectiveness


Review total program evaluation and compare contents to KSBN requirements