February 21, 2024

A For-Profit Nursing College Is Trying To Take Root In Wisconsin. Here’s Why That’s Alarming.

A For-Profit Nursing College Is Trying To Take Root In Wisconsin. Here’s Why That’s Alarming.

More than a decade ago, a for-profit college chain opened an outpost in Milwaukee: Everest College, owned by Corinthian Colleges. Soon after, Corinthian became one of the most well-known and devastating examples of a for-profit college collapse — it shut down in 2015 mired in legal and regulatory challenges, overnight leaving about 16,000 students without an educational path

Everest operated in Milwaukee for only about three years, from 2010 to 2013, but the fallout of its own abrupt closure still reverberates. Students swayed by the institution’s aggressive marketing, which targeted low-income populations, took on ruinous debt, often unable to land jobs in their chosen field — if they finished at all. Even in the last couple of years, Everest students from the city have struggled to complete a degree elsewhere or qualify for other loans.

Against the backdrop of Everest’s tumultuous tenure, the arrival of another for-profit in Wisconsin — the Arizona College of Nursing — is stirring apprehension among consumer protection and education advocates. 

The college intends to open campuses in Milwaukee and Madison, by spring 2024 and spring 2025, respectively, in line with its rapid expansion over the last 10-plus years. However, accusations of fraud and mismanagement, akin to those seen at other for-profits, have plagued the Arizona College of Nursing, and its owner, Eduvision Inc.

In fact, the college’s main campus in Tempe remains on regulatory probation in Arizona after the school admitted to a few violations of state law in 2022. In one instance, it dismissed nearly three dozen faculty members, just two weeks or so before the fall 2021 semester began. This caused it to cancel almost 20 percent of clinical experiences between the end of August and mid-October in 2021 — a degree requirement — though the school asserted to state officials that students had all their clinical needs met that semester. 

The college’s woes extend beyond a single campus, however, and illustrate the dangers of the predatory for-profit model exploding in popularity in a field desperate for talent. 

High loan defaults, low graduation rate

A nursing shortage persists across the United States, which stress and burnout exacerbated in recent years. This dearth has sharpened states’ interests in cultivating nursing programs.

But before the emergence of state investments, for-profit nursing programs gained considerable traction over the past couple of decades.

A 2019 study published in the Journal of Nursing Regulation examined about 10 years of federal data, finding that for-profit nursing programs swelled by five fold, and their number of graduates by 14 fold. Some nursing programs are even hard to get into nowadays.

The Arizona College of Nursing’s growth coincided with the growth. In 2012, only Arizona College, a more generalized healthcare institution, existed with two campuses. The next year, Arizona College of Nursing launched, and today, the two schools have 20 campuses in a dozen states, according to the institution’s website.

Its bread-and-butter product appears to be a three-year bachelor’s in nursing, a truncated timeline from the usual four. But the program’s marketing is misleading, as students can finish in three years or less with an important caveat — they must have “qualified transfer credit,” which of course, they may lack. 

The college’s Wisconsin deal has been in progress for over a year, pending regulatory approvals. It hit a wall this month after a Milwaukee city planning commission declined to endorse it, which came amid pressure from a coalition of local activists.

The plans can still move forward, however.

As a part of seeking Wisconsin state approvals, the college in 2022 revealed some of its anemic student outcomes. 

Its nursing program’s accreditor, the Commission on Collegiate Nursing Education, requires a 70 percent completion rate.

But in 2021, the college’s completion rate was only 58 percent, which the college attributed to covid-19 pandemic problems, documents presented to the Wisconsin Board of Nursing show. But even before that, in 2019, the completion rate was 71 percent, barely passing the accreditor’s requirements.  

Public documents also show more than 21 percent of students on the Tempe campus defaulted on their federal loans in a three-year span, between Oct. 1, 2018, and Sept. 30, 2021. That’s much higher than the national three-year default rate for that period, which was was just above 2 percent. Only 60 percent of students who enrolled in the school in the 2016-17 academic year graduated, according to the most recently available federal data. 

Also, up until this month, the college touted publicly that its pass rate for the National Council Licensure Examination, or NCLEX, is higher than the national average. Students must pass this to secure their nursing license. 

But that claim — that in 2022, across its campuses the NCLEX pass rate was nearly 85 percent, compared to the national rate of about 83 percent — has now been scrubbed from its website

An 85 percent pass rate is also hardly a feat. In Arizona, for instance, most institutions in 2023 had a pass rate higher than 90 percent for registered nurses taking the exam. The lowest pass rate that year, at roughly 71 percent, was Aspen University — another for-profit college. The 2019 study also found lower NCLEX pass rates among for-profit nursing schools nationally.

Troubles in another state

The college’s weak student outcomes are concerning enough, but it was the institution’s troubles on its Tempe campus that slowed an arrangement to open a Connecticut location.

In May 2022, Arizona regulators agreed to put the college on a 36-month probation after they found the institution had dismissed instructors without master’s degrees shortly before the start of the fall 2021 semester. The school said this was to comply with a requirement from its accreditor, the Accrediting Bureau for Health Education Schools, that its educators teaching bachelor’s courses needed a masters degree.

“Managers leading the campus had previously agreed to replace the instructors by July 2021 and even after ample time, unfortunately failed to do so,” the school wrote in a public letter to the Connecticut Board of Examiners for Nursing.

The campus’ provost continued to admit students, despite fears about lacking the staff to maintain clinical work, that agreement said. The college had also tripped up in monitoring clinical time, including once when students were left unsupervised for a half an hour while an instructor went to lunch. 

Connecticut’s nursing board in September 2022 revoked part of their earlier approvals for the college’s campus in Hartford, griping the institution wasn’t transparent about the Arizona agreement.

The school didn’t seem to think it was hiding anything. School officials wrote to the board they “would have notified you if it was relevant, if it was required by regulation, or if there was a request regarding” the agreement.

Ultimately, the Hartford campus opened after locking down board approval in January 2023. The college’s agreement with the Connecticut board is missing in public documents, but according to a local news report, it said the state and college had a “desire to avoid litigation.”

This language, coupled with the fact the board worked with the attorney general’s office on the deal, implied the institution threatened to sue. 

A lawsuit alleging fraud

In Texas, it was the college that faced a lawsuit.

In 2022, more than 20 Arizona College of Nursing students filed a lawsuit against owner Eduvision Inc, alleging the school was committing fraud and violating the Texas Deceptive Trade Practices Act. They accused the school of overcharging them for the classes and jacking up the difficulty in their programs in an attempt to fail them, including by testing them on subjects they never learned.

Those students also alleged the college didn’t distribute federal pandemic relief money to which they were legally entitled. 

The college denied the accusations in court filings, and the case stalled, partially because as part of enrolling, the students agreed to enter into arbitration for such litigation, but they did not start the process of doing so. 

Still, these incidents add up. Students might benefit from avoiding a for-profit institution with shoddy outcomes and that’s under the shadow of lawsuits, and consider other programs, including through nonprofit institutions, community colleges or regional publics, which also tend to have lower costs but better outcomes. Apprenticeships are also an option and actually share many qualities with pre-licensure nursing degrees. 

These offer paid, on-site job learning that help familiarize students with the field in a practical way. These are key experiences, especially considering NCLEX is just a written exam, so students don’t need to demonstrate such skills for a license. 

And apprenticeships mitigate that significant risk associated with for-profits — the burden of debt, as witnessed in Milwaukee following the fall of Everest College and Corinthian. These are the debts that continue to haunt individuals, underscoring the enduring repercussions of their for-profit education.

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Jeremy Bauer-Wolf is the investigations manager on the higher education program at New America. Starting now, he will be cross-posting pieces on Republic Report.