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Download Approved Provider Forms

Approved Provider Unit

Approved provider status is recognition by INA of an agency or organization’s capacity to award contact hours for continuing nursing education activities, planned, implemented and evaluated by the organization within a three-year period. An agency or organization seeking approved provider status must have applied for and attained approval for three (3) single educational activities in accordance with the current criteria within at least the last twelve months.

Ineligibility of Commercial Entities
 As of August 31, 2009 per the ANCC Accreditation Program, a provider is ineligible for approval if it is a commercial interest. Commercial Interest (definition): An entity that produces, markets, sells or distributes healthcare goods or services consumed by or used on patients or that is owned or controlled by an entity that does the same.  
 
Please consult with the Continuing Education Approver Unit (CEAU) at kani@illinoisnurses.com for clarification regarding eligibility.
 
Ineligibility of Multiple Region Providers
As of August 31, 2009 per the ANCC Accreditation Program, Organizations that:

  • Conducted more than 50% of their educational activities in the previous calendar year to nurses in multiple regions (using the DHHS regions: www.hhs.gov/about/regions/)  must apply for accreditation as a provider unit to the national accrediting body – ANCC Accreditation Program.

 
However, organizations that: 

  • Targeted 50% or less of their activities in the previous calendar year to nurses in multiple regions

                  -OR-

  • Conducted any number of activities in a single state or region (or a state contiguous to that region

 
MAY apply or continue to apply to the INA Continuing Education Approver Unit for approved provider unit status.  Please consult with the Continuing Education Approver Unit at kani@illinoisnurses.com for clarification regarding eligibility.

 

 Provider Materials to Download:

 Reference Material for Approved Provider Status

Directions for Completing & Submitting an Application for Provider Status

Fee Schedule

Provider Unit Criteria Manual- Administrative Section

Provider Unit Criteria Manual- Educational Design Section


Forms for Provider Units

Provider Unit Application

Provider Unit's Main Documentation Form

Provider Unit Addendum for an Independent Study

Provider Unit Biographical Data Form

Provider Unit Certificate

Provider Unit Educational Activity Overview Form

Agenda

Biographical Data Forms- Planners & Presenters

Conflict of Interest Forms

Evaluation Form- Live Presentation

Independent Study- Evaluation Form

Sponsorship Declaration Form

Provider Unit Evaluation Plan

Additional Resources

Sample Co-Providership Agreement

Sample Sponsorship Agreement

Sample Disclosure Statement

Writing Content and Objectives on the Educational Activity Overview Form

Acceptable Verbs Used on the Educational Activity Overview Form

Category of Evaluation Definitions

Standards for Commercial Support and Disclosure

Mergener Formula- a method to calculate independent study hours

 

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