What the Nursing Board really cares about ..addiction, lies and convictions

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I had the opportunity to speak to a nursing school last week about the role of Ohio Board of Nursing. In preparing for the talk, I knew I would be asked “What is going to get me in trouble with the Nursing Board?”.  I have a pretty good idea of the types of actions that I regularly see investigated by the Board, but I also did a little research and reviewed the last few months’ list of disciplinary actions or proposed actions so I would be ready for this question.

I found, generally, the Nursing Board receives 3000 complaints each year. While the Board investigates all complaints, they only take action against approximately 600 nurses each year.

Half of the nurses disciplined or monitored by the Nursing Board involve cases of nurses who suffer from drug or alcohol abuse or dependency. (see my former post The Alternative Program for Chemically Dependent Nurses)   Many nurses voluntarily seek treatment and then are entitled to participation in the Board’s confidential monitoring program.

But, some nurses find themselves the subject of Board discipline after being found guilty of a DUI, or testing positive on a drug screen through their employer. Last month, the Nursing Board cited several nurses who tested positive at work for illegal street drugs or for medications for which they could not produce a valid prescription (ie. they had been given a prescription drug from a friend or family member)

In addition to actions against nurses who suffer from substance abuse, the Board also takes actions against nurses who have felony convictions and misdemeanors involving moral turpitude.  The Nursing Board recently cited nurses who had been charged with numerous crimes including: child endangering; Medicaid fraud; transporting or possessing a semi-automatic handgun; stealing narcotics; misdemeanor assault; illegal processing of drug documents; theft by deception, just to name a few.

The Board also takes action against nurses who have been disciplined by other state agencies (other state Nursing Boards) and they take actions against nurses for practicing outside of the scope of their license or for failing to disclose to the Board a disciplinary action or conviction from another agency or district (lies).

Most nurses are surprised to learn that the Nursing Board is genuinely concerned about conduct both at work and also outside of work. In addition to discipline related to practice, nurses can be subjected to disciplinary actions for “bad behavior” outside of the work setting. Nurses are routinely the subject of discipline by the Board for DUIs, assault, child abuse, neglect, passing a bad check and other crimes. As professionals, nurses are held to a high standard by the Board while at work and after work.

As always, if you have any questions about this post or the Ohio Board of Nursing in general, please feel free to email me at beth@collislaw.com or call me at 614-486-3909.

How to request a hearing with the Ohio Board of Nursing

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On November 20-22, 2013, the Ohio Board of Nursing met for its bi-monthly meeting. At that meeting, the Board voted to issue Notices of Opportunity for Hearing to over 80 nurses in Ohio.  The Notices either proposed to take a disciplinary action against a nurse for an alleged violation or Automatically or Immediately suspended certain nurses’  licenses based on an alleged violation of the Board’s laws and rules.  If you received a Notice of Opportunity for Hearing or a Notice of Suspension  from the Nursing Board, there are important deadlines, which if missed, can have significant consequences.

First, whether the allegations in the Notice are true or not, in order to preserve your right to a hearing, you must request a hearing in writing. The Notice contains instructions on how to request a hearing. It is imperative that you request a hearing in writing within 30 days of the mailing of the Notice to you (not from the date you receive the Notice)  If you do not request a hearing in writing within such period you will be prevented from providing any information or evidence on your behalf.   In the request for the hearing, you simply need to state “I am writing to request a hearing.”  It is also a good idea to follow-up with the Board via phone to ensure that they received your request for a hearing within the required time frame.

Then, you should consider hiring experienced legal counsel to defend you before the Board. The Nursing Board is represented by the Office of the Ohio Attorney General and also employs several in-house enforcement attorneys. In addition, all hearings are held before attorney hearing examiners. So, if you choose to represent yourself at a hearing, you may be the only non-attorney who participates in the hearing process. It’s your professional license at stake. It is important to find experienced counsel to assist in your defense.  Check out earlier posts where I provide guidance on how to hire experienced legal counsel to assist you.

As always, if you have any questions about this post or about the Ohio Board of Nursing in general, please feel free to contact me at 614-486-3909 or email me at beth@collislaw.com.

 

Ohio LPNs – time to renew your license!

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This month, Ohio LPNs will be mailed instructions by the Ohio Board of Nursing on how to renew their LPN license on-line.  The Board will mail the instructions to the address that you previously provided to the Board as your address of record. If you do not timely receive the instructions, you should contact the Board immediately.

If you do not want to renew on-line, you may request to have a paper renewal form mailed to you. To be sent a paper renewal form:

  • send a written request to: Ohio Board of Nursing, 17 S. High Street, Suite 400, Columbus, Ohio 43215, attn: Renewal; or
  • fax a request to the Board at 614-466-0388, attn: Renewal;
  • or, email the Board at renewal@nursing.ohio.gov

Renewal applications received after July 1 will be assessed a $50.00 late fee. If you do not renew by August 31, the license will lapse.http://codes.ohio.gov/oac/4723-7-09

Whether you choose to renew online or to complete the paper renewal form, it is important that you take a few quiet minutes to complete the form on your own!   Allowing others to renew your license for you or not taking the time to carefully read and accurately and completely respond to the questions on the renewal can be a costly mistake.

By signing the renewal application you are certifying to the Nursing Board that all information contained in the application is correct and complete. The Nursing Board reviews all original applications for licensure and renewal applications very seriously and will take a disciplinary action against a licensee who fails to provide the Board with correct and complete information.

In addition, any questions in which you have to answer “yes” to will require you to provide a short written explanation. You should take time to provide a clear and careful response. Don’t minimize the incident or fail to take responsibility for your actions, as this could be to used as an aggravating factor if the Board chooses to impose a discipline.

The Nursing Board routinely suspends or revokes licensees who provide  a false response to a renewal question.  It is always better to provide clear, honest responses to the questions than to provide information that might be misleading or may lead to more questions by the Board.   If you do not understand a question, you may call the Nursing Board staff and ask  – however, the staff is unable to give legal advice.

As always, if you have any questions about this post or another question involving the Ohio Board of Nursing, feel free to email me at Beth@collislaw.com.

Taking medical “waste” for your own personal use is a felony

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The Ohio Board of Nursing may discipline a nurse for a wide range of violations from falsification on an application, practicing outside of the scope of their license or chemical substance impairment that prevents the nurse from providing safe nursing care, just to name a few.  However, few violations are more egregious than taking medication from a patient or documenting giving a patient a medication that was not given.  Even the most impaired nurse knows that they must always give their patients the medications that are prescribed to them.

However, many nurses “rationalize’ that they can take the medication waste that is not prescribed to a patient which is just going to be discarded. This is also faulty thinking. Anytime you take medications from a nursing home, hospital or patient, you are committing a crime and could be charged with a felony.  When medical facilities learn that medications are missing, usually the hospital pharmacist or hospital security are called in to conduct an investigation. Nurses can be asked to provide a urine drug screen and if the nurse tests positive for any prescription medication for which they do not have a valid prescription or an illegal street drug,  the results of the drug test are usually turned over to the local prosecutor and/or the Nursing Board. The police can charge the nurse with a variety of felonies including, theft of drugs, deception to obtain illegal drugs, or illegal processing of drug documents.

Some impaired nurses also use their knowledge on prescribing to call in an illegal prescription to a pharmacy. Pharmacists have been trained to keep an eye out for suspicious activities and will often call the “prescribing” physician to verify the prescription. Then, upon finding any irregularities in the prescription, the police will be called to arrest the nurse when she (or he) arrives at the pharmacy to pick up the medication.

Taking medical waste, documenting that you gave a patient a medication when you actually took it yourself or calling in a prescription to a pharmacy for your own personal use, can all lead to being charged with a felony in Ohio and suspension or revocation of your Ohio nursing license.

If you believe you are impaired, you should seek medical treatment immediately. For nurses who voluntarily seek treatment, you might also be eligible for the Ohio Board of Nursing Alternative Program for Impaired Nurses. http://66.161.141.164/oac/4723-6

As always, if you have any questions about this post or questions about the Ohio Board of Nursing in general, feel free to email me at Beth@collislaw.com or call me at 614-486-3909.

Nursing Board disciplinary actions are public and posted on the Board’s website

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I am often asked by nurses, if a disciplinary action taken by the Nursing Board against their license will be available to the public. The answer is Yes.  Under the Ohio Public Records law, R.C. 149.43, any official action taken by a governmental agency is a public record. http://codes.ohio.gov/orc/149.43

What does this mean? Prior to the internet, to obtain a public record from a governmental agency a written request for the document was required. You can still do that today.  Now, however, all Nursing Board disciplinary actions are posted on the Nursing Board’s website and are also listed in the back of the quarterly magazine Momentum, that is issued by the Nursing Board and mailed or emailed to every nurse in the state. http://www.nursing.ohio.gov/Publications.htm

To see what is listed about you or another nurse on the Board’s website, interested persons can go to the link on the Nursing Board’s website to obtain information about a particular licensee, enter their name and they will be presented with a summary list of any discipline against that nurse.  A person can click on the “view documents” box (which is in bright yellow) and download the entire disciplinary record (copies of Citation letters, Consent Agreements, Adjudication Orders or any Court appeals documents).  To find information go to: https://license.ohio.gov/lookup/default.asp?division=86

Now, certainly any information about a medical diagnosis or medical condition that might have formed the basis of a disciplinary action is redacted and not included in the public record?  Sorry, that is not true. The documents are not redacted. All the information, including any medical diagnosis, criminal conviction, boundary violation, the factual and legal basis for the action and the disciplinary action taken against the licensee is all included in the public record on the Nursing Board’s website.

As a follow-up question, I am often asked whether the disciplinary action is taken off the website and out of the public record once the licensee completes any suspension or probation period? Unfortunately, no. Once a disciplinary action is taken, it is on the professionals’ “permanent record” and will not be sealed, removed or redacted.

The argument given for including all disciplinary actions of the Nursing Board in the public record is that consumers should be able to know if their medical professional has been the subject of discipline by the Nursing Board.

However, only proposed disciplinary actions and final actions (be it a Consent Agreement or Adjudication Order) are made public. Complaints submitted to the Nursing  Board and any Board investigations are confidential. Under the Nurse Practice Act, R.C. 4723.28 (I)(1) investigations of the Nursing Board are confidential and are not open for public disclosure. http://codes.ohio.gov/orc/4723.28  However, this restriction  also pertains to the licensee and their legal counsel. When a complaint is filed with the Nursing Board, the licensee may be notified of the general nature of the complaint, but they will not be provided with a copy of the complaint or even given the name of the person who filed the complaint.  This rule however does not prevent the Nursing Board from sharing any part of their investigation with other governmental agencies, such as a police department or another Board.

As always, if you have any questions about this post or would like me to address a particular question, feel free to email me at Beth@collislaw.com or call me at 614-486-3909.

Alternative Program for Chemically Dependent Nurses

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In Ohio, nurses who suffer from drug or alcohol addiction or abuse should immediately seek treatment at an authorized chemical dependency treatment facility.  However, nurses are often concerned about voluntarily seeking treatment because they do not know what effect, if any, treatment will have on their nursing license.

Fortunately, for Ohio nurses, the Ohio Board of Nursing has established the Alternative Program for Chemically Dependent Nurses.  This is a confidential program that allows eligible nurses to enter into a monitoring contract with the Nursing Board. Under the contract, the nurse is required to complete the recommendations of a treatment program, completely abstain from drugs and alcohol and submit to random drug screens generally for a period of five years.     A full outline of the program can be found at: http://codes.ohio.gov/oac/4723-6

Not all impaired nurses are eligible for the program. To be eligible, a nurse must hold a valid Ohio nursing license, submit an application for enrollment in the Board’s confidential program, submit to a chemical dependency assessment, and then follow all treatment recommendations. http://codes.ohio.gov/oac/4723-6-02 Eligible nurses may be required to place their nursing license on inactive status for six months at the beginning of treatment and they will be required to submit to random drug screens and attend weekly AA or NA meetings for five years.  This may seem like a long period of time to submit to monitoring, a chemically impaired nurse, is permitted to return to the practice of nursing while participating in the confidential program after six months of clean screens.

What can make a nurse ineligible for the program?  Nurses who are prescribed controlled substances by their physicians; who have a dual diagnosis with another medical or psychiatric condition; or who have completed drug and alcohol treatment two or more times in the past, may not be eligible for this program. http://codes.ohio.gov/oac/4723-6-02

The Alternative Program is confidential. If you are accepted, your participation will not be considered “discipline” by the Nursing Board. There will be no notation on the Board’s website that you are participating in the program and you will not be listed in the Nursing Board’s Momentum publication as a participant in this program. In addition, if you successfully complete the program, you will not be reported to the National Practitioner’s Data Bank . http://codes.ohio.gov/oac/4723-6-04

As always, if you have any questions, please feel free to email me at beth@collislaw.com or call me at 614-486-3909.

What to Consider When Hiring an Attorney

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When facing a disciplinary action before your state licensing board or when looking for assistance in applying for a license, it is important to find the right attorney to help you through this often cumbersome process. To make an informed decision, you should set an appointment and meet with the attorney in person to gauge the following:

Experience/Expertise: Experience in representing nurses before the Ohio Board of Nursing is a very important factor to consider. It is your professional license that is at stake. While you may have a good friend who is an attorney or a good professional relationship with a criminal defense counsel, often they do not have the experience or expertise to handle your defense before the Ohio Board of Nursing. In addition, many attorneys will claim to represent licensees before your licensing board. However, you should ask them what percentage of their practice is in the area of licensure defense. You also want to determine how many cases they have taken through the hearing process and on appeal. You don’t want your case to be the first case they have taken to a board hearing.

Personality/Compatibility/Accessibility: Meet and interview the attorney before you decide to hire them. Do they seem knowledgeable about the investigative or disciplinary process? Did they take the time to meet with you, answer your questions and explain the disciplinary process to you? Do you think the attorney understands your individual circumstances? Do you feel welcome to pick up the phone or to email the attorney with questions and concerns?

Costs/Accounting of fees: You should have a frank discussion with your attorney and make sure you understand their fees and how the fees are to be paid. Does the firm take credit cards? Do they charge late fees or interest on late balances? Does the firm send you a monthly statement that outlines the time spent on your case that month and any fees/expenses charged to you? If you deposit money in the firm’s IOLTA trust account are you sent a monthly accounting of your money on retainer? Before entering into any relationship with an attorney you should have a clear understanding of their fees and should receive a regular accounting of any fees or expenses for which you will be charged.

As always, if you have any questions, please feel free to contact me at: beth@collislaw.com

Ohio Board of Nursing complaints – what can happen?

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The Nursing Board receives hundreds of complaints each year.  The Board is required to conduct some investigation on all complaints. Some investigations are closed with no disciplinary action taken against the nurse. However, in many cases the investigation can lead to criminal charges or to a suspension of a nurse’s RN or LPN license.  It is important to be proactive to have the investigation closed.  If the Nursing Board closes its investigation, no public record is created.

The process:

You may be contacted by a Nursing Board investigator at your home or place of employment. You do not have to speak with the investigator immediately. It is important to have legal counsel present whenever speaking with a Board investigator.   At the completion of the investigation, if the Board finds no violation or that there is a minor violation of their laws and rules, often they close the investigation. http://www.nursing.ohio.gov/PDFS/Discipline/BoardPolMinorVio4723.pdf

What if the Nursing Board finds a substantial violation?

If the Board does not close its investigation, in many cases the Board will offer the nurse a Consent Agreement that will implement some discipline such as a Reprimand, Suspension or Probation of their nursing license. Or, the Board may offer the nurse a right to a hearing.  However, all discipline issued by the Nursing Board will be placed on the Nursing Board website and will become a part of your permanent professional record.

So, before rushing off to speak with or provide a statement to the Nursing Board or criminal investigator, it is important to seek experienced legal counsel to assist you as any information provided to the investigator can and will be used against you by your licensing board.

 

What do I do when contacted by a Nursing Board Investigator?

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In my practice I receive calls each week from nervous and frightened nurses who have been contacted either by telephone or letter from a Nursing Board or even Pharmacy Board investigator.  The question I am always asked is:

Do I have to talk with the investigator?

First, never speak with investigators without competent legal counsel. Anything you tell an investigator can be used in a disciplinary action against you by your licensing board and/or by the police in a criminal investigation.

Depending on the facts in your case, sometimes I advise clients to speak with investigators or to provide a written statement to their licensing board regarding an alleged complaint. However, I never have my clients meet with investigators without legal counsel and I never allow my clients to submit written statement that I have not had a chance to review.

Also, don’t allow the investigator to set the timing for when you will respond to them. I am often contacted by nurses who have been contacted by an investigator from the Ohio Board of Nursing and advised that they need to meet with the investigator or submit a written statement to the investigator within 24 or 48 hours.  These deadlines or almost always negotiable. Do not allow the investigator to rush you into providing them with the statement until you have had a chance to meet with legal counsel.

Hello Ohio Nurses!

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Hi, in my practice as an attorney I exclusively represent professionals before their state licensing boards in Ohio.  As a former Ohio Assistant Attorney General, I am familiar with the disciplinary process of Boards such as the State Medical Board of Ohio, Ohio Board of Nursing, Ohio Board of Pharmacy, Ohio Chiropractic Board and many, many more licensing agencies.

I regularly help applicants apply for a professional license in Ohio or wade through the disciplinary process. I have started this blog to answer many of the common questions that I receive in my practice on a weekly basis from nurses throughout Ohio. Such as, “should I apply for a license in Ohio if I have a criminal conviction on my record?” “what will happen with my professional license if I get a DUI?” “what should I do if contacted by a board or criminal investigator?”. I hope over  the next few months to answer many of your questions.