By Scott Travis

Florida’s efforts to address a nursing shortage led to a boom in nursing schools, but many of their graduates can’t pass the state exams that will allow them to practice.

Last year, more than a third of Florida's nursing programs failed to meet a state requirement that at least 70 percent of their graduates pass a state licensing exam. In some schools, no students passed the state test.

Most of the problems center on unaccredited programs that have opened since 2009, when the state relaxed the requirements for opening a new school. At that time, the state projected a shortage of 50,000 nurses by 2025, yet universities and community colleges were turning down students because they lacked space.

The Legislature, believing the State Board of Nursing was too stringent in approving new programs, changed the rules so the board could only reject applicants in extreme cases.

Supporters say the effort is working. Today, there are 380 nursing programs in the state, more than twice that of 2009. And last year, 8,874 Floridians passed the registered nurse licensing exam on the first try, compared to about 6,000 the year before the law was enacted.

But others worry that 86 of the state's nursing programs had passing rates below the state requirements.

"It's not a good solution if you don't have quality programs," said Willa Fuller, executive director of an advocacy group.

She worries that even if graduates from poor-performing schools pass the nursing exam, they may not be adequately prepared.

"It's a risk to public safety if people are graduating from programs and are not qualified," she said. "It's also a victimization of those going into the programs who go into debt, and it's a financial impact on the country because of lot of them are getting loans and taxpayer money."

Florida's overall passage rates for students graduating with an associate's degree in nursing has dropped from 86 percent in 2009 to 76 percent last year.

Schools that fail to meet the passing rate requirement for two years in a row are placed on probation, and if they don't improve a year later, the state Board of Nursing has the authority to close them.

Most of the schools in danger are newer for-profit schools, although some long-established state-run schools could be affected, including the Belle Glade campus of Palm Beach State College and Florida A&M University in Tallahassee.

Many of the programs with dismal passing rates are in South Florida including: Censa Miami Institute in Hialeah Gardens (12 percent); Dade Medical College in Hollywood (18 percent); Med-Life Institute in West Palm Beach (18 percent); and Hope College of Arts & Sciences in Pompano Beach (20 percent).

As of June, 13 schools with poor passage rates have closed or shut down their nursing programs, according to the report, and several others have closed since then.

Dade Medical College shut down all six of its campuses in Miami, Hollywood and Jacksonville on Friday. Brown Mackie College in Miramar recently stopped enrolling new students in its associate degree in nursing program, but will continue to teach those already enrolled.

"We are disappointed in the pass rates....and, together with the state Board of Nursing, are committed to making things right," said Chris Hardman, a spokesman for Brown Mackie. "We've made significant administrative and academic changes at the school to ensure that our students are provided with a quality education that prepares them for professional practice in their chosen field."

Rep. Jason Brodeur, R-Sanford, who chairs the House's Health and Human Services Committee, said the state is now requiring that nursing programs become accredited by 2019 and is considering legislation to ensure that the operators of failing schools don't reopen under a new name.

"If you have a school where most students don't pass the exam, the market should reward them with having nobody going there," Brodeur said. "Rather than have the government prop up a school for many years, if you have a school that continues to fail, they have to go out of business."

Curtis Austin, executive director of the Florida Association of Postsecondary Schools and Colleges, which represents many of the newer schools, said the schools are doing the job they are supposed to do.

"We focus on what the goal was, which was to be able to produce more nurses, and we're doing that," Austin said.

Exactly how much of an impact this increase in nurses is having on the workforce remains unclear. The 50,000 nurse shortage projection was made prior to the recession, and many nurses close to retirement age stayed on longer than anticipated. The need today is for experienced nurses, and because there are so many new nursing graduates to choose from, many employers are picking ones from more established nursing schools, Fuller said.

Others say that while hospitals may prefer more experienced nurses, there aren't enough to replace those who leave the profession, and these new nurses will become experienced over time.

"Right now our most critical need is getting nurses into the marketplace and the private sector is doing it a lot faster than the government could," Brodeur said.