A patient is prepared for admission at a hospital
A patient is prepared for admission by emergency room nurses at Gulf Coast Medical Center in Fort Myers. As Florida hospitals see staffing shortages, problems persist with the pipeline of new nurses coming into the system. The state's pass rates on the national licensing exam for nurses continue to be the lowest in the nation.

Fewer than two-thirds of Florida nursing students passed the national licensing exam in 2022, according to a new report from the Florida Center for Nursing.

The National Council Licensure Examination is the final step for graduates to become licensed health care providers in a state that is desperate for nurses.

Nursing staffs at Florida hospitals have been plagued by high turnover and a large number of vacancies, with projections that the state will be short nearly 60,000 nurses by 2035. Yet Florida has had the lowest exam pass rate in the nation since 2017, according to Tampa Bay Times analysis.

Pass rates for registered nurses fell by 1 percentage point from 2021, dropping to 63.9%, the new report said. That’s far below the national average pass rate of 79.9% for first-time US-educated test-takers.

The rate for practical nurses — who are permitted to perform more limited health care duties — was 65.6%, up 3 percentage points from 2021. The national average pass rate for first-time U.S.-educated practical nurses was 79.9%.

“A persistent inability for employers to fill vacant nursing positions may result in decreased access to quality and safe nursing care for the people of Florida,” the Florida Center for Nursing warned in a news release.

RELATED: Florida’s nursing pipeline is broken as many would-be nurses fail their exams

The report comes on the heels of a recent revelation that three Florida nursing programs sold more than 7,600 fraudulent nursing degrees between 2016 and 2021.

Federal authorities charged 25 people from the South Florida schools — Siena College, Palm Beach School of Nursing and Sacred Heart International Institute — with selling the fraudulent diplomas for more than $114 million.

About 2,400 students from those schools eventually passed their licensing exams, federal officials said. Most passed the exam in New York, which does not limit the number of times an individual can take the test.

Nurses licensed in New York are allowed to practice in Florida and many other states.

Those who purchased a fake degree may lose their certification to practice nursing, but likely won’t be criminally charged, officials said.

“This is a travesty and a blow to the nursing workforce, specifically diminishing the trust and credibility of our profession,” said Dr. Rayna Letourneau, executive director of the Florida Center for Nursing, based in Tampa at the University of South Florida. “Nurses are trusted, ethical, hardworking, professionals that provide safe and quality care to our patients and our communities.”

It’s unclear why the three programs were allowed to operate for as long as they did.

The Florida Board of Nursing can place programs on probation if they fall below 10 percentage points of the national average pass rate for two years in a row. Programs that don’t improve can be terminated by the board.

Between 2016 to 2021, more than more than 2,100 students from the Palm Beach School of Nursing took the registered nursing exam, . In those years, the school never had a pass rate above 17% — well below the national average in every year, according to Tampa Bay Times analysis of licensure data.

Nearly 300 graduates from Siena and Sacred Heart took the practical nursing exam over the same period. Sacred Heart never had a pass rate above 40% and Siena never hit above 60%.

The rates at these and other private for-profit private schools, where only 52.7% of students passed the national nursing exam on average, are bringing down what might otherwise be a much better passing rate in Florida.

The problem is especially acute in the south and southeastern regions of the state, where for-profit schools had average pass rates under 45%.

The state’s public universities and colleges typically have among the highest pass rates in the state, with the biggest programs hovering above 90%. But even public programs saw a decline in pass rates in 2022 — falling to 79.8% on average.

It’s unclear why some schools and regions consistently underperform the rest of the state, Letourneau said, and the center’s next goal is to establish best practices that can be applied statewide.

Ian Hodgson is an education data reporter at the Tampa Bay Times, working in partnership with Open Campus.

Education data reporter for The Tampa Bay Times, in partnership with Open Campus.