When the Ohio Board of Nursing can automatically suspend a license

The Nurse Practice Act in the State of Ohio (R.C. 4723) sets out certain instances when the Nursing Board can take a disciplinary action against a nurse. In most instances, the Nursing Board will issue a Notice of Opportunity for Hearing to the nurse that addresses the allegations against the nurse, note the Code section that the nurse is alleged to have violated, and offer the nurse an opportunity to request a hearing prior to the Nursing Board issuing any sanction against a nurse.

However, in instances when the Nursing Board believes that allowing the nurse to continue to practice presents danger of “immediate and serious harm to the public,” the Nursing Board can suspend the license prior to offering the nurse a hearing. In previous blog posts, I have noted instances when a nurse has been convicted of a serious crime (aggravated murder, murder, gross sexual imposition, etc.) in which the Nursing Board automatically suspended a license prior to offering the nurse a hearing.

The Nursing Board has automatically suspended a nursing license prior to offering the nurse a hearing though in less seriously instances. For example, if a nurse is under probation with the Nursing Board and subject to terms in an Adjudication Order or Consent Agreement and violates any terms of the Agreement the Nursing Board will automatically suspended their nursing license prior to offering them a hearing. Violations of Consent Agreements (such as testing positive on a random drug test or failing to notify the Nursing Board of their employment) has triggered an automatically suspension.

Once the license has been automatically suspended, the nurse can request a hearing and present evidence in their defense. However, during the hearing process or while negotiating terms of an Amended Consent Agreement, the nurse’s license remains suspended. It is imperative when entering into any Consent Agreement with the Nursing Board that the nurse understands the terms of the Consent Agreement, because failure to comply with the terms, limitations or conditions of the Consent Agreement can result in an automatic suspension of their nursing license.

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

Ohio RNs and APNs, time to renew your license!

If you are licensed as a Registered Nurse or Advanced Practice Nurse in the State of Ohio it is time to renew your professional license.

As part of its electronic renewal system, the Ohio Nursing Board assigns each nurse a unique User ID and Password.  You can access this information through the Board’s website at:https://license.ohio.gov/lookup/password.asp

You can save money by renewing your license before July 1, 2015.  Registered nurses who renew before July 1, 2015, must pay Sixty Five Dollars ($65.00).  After July 1, 2015, the cost goes up to One Hundred Fifteen Dollars ($115.00).

Advanced practice nurses (APRN) must renew their RN license and each of their Certificates of Authority (COA).  Before July 1, 2015, the renewal fee is Eighty Five Dollars ($85.00) for each COA.  After July 1, 2015, the renewal fee goes up to One Hundred Thirty Five Dollars ($135.00) for each COA.

APRNs with prescriptive authority must renew their RN license, their COA, and their Certificate to Prescribe (CTP).  The renewal fee for the Certificate to Prescribe (CTP) is Fifty Dollars ($50.00) through August 31, 2015.

APRN’s must provide the name and address of their collaborating physician as part of the renewal process.

Maintaining an Active nursing license is your responsibility. Failure to renew your RN license, COA, and CTP (as applicable to you) by August 31, 2015 will result in your RN license, COA, and/or CTP to automatically lapse.  Practicing under a lapsed license, COA, and/or CTP is a disciplinable offense.

As always, if you have any questions about this post or the Ohio Board of Nursing in general, please feel free to contact one of the attorneys at Collis, Smiles and Collis, LLC at 614-486-3909. You may also look for more information at http://www.collislaw.com.

When should you self report to the Ohio Board of Nursing?

In certain instances, it may be beneficial to self-report to the Nursing Board, even if not required by law.  How and when should this be done?  There are no simple answers.

In Ohio, the Nursing Board can take a disciplinary action against a nurse who has been convicted of a felony, a misdemeanor committed in the practice of nursing and a misdemeanor involving a “crime of moral turpitude”.  Many crimes fit under the definition of a “moral turpitude”, such as assault charges, domestic violence, sexual imposition, child abuse, neglect, just to name a few.

The Nursing Board is also always on the lookout for nurses who are impaired in their ability to practice because they suffer from drug, alcohol or mental health issues.  The Nursing Board is authorized to take a disciplinary action against a nurse who is unable to practice according to acceptable and prevailing standards of safe nursing care without appropriate treatment, monitoring, or supervision.

When you renew your nursing license, you must disclose to the Nursing Board any convictions that you received since your last renewal.  You must also disclose to the Nursing Board if you have been diagnosed with a substance abuse, dependency, or mental health issue which impairs your ability to practice.  However, as you only renew your license every two years, there are instances where you may want to self-report a conviction or diagnosis to the Nursing Board PRIOR to the time you are to renew your license.  However, WHEN to self-report, WHAT information should be reported, and WHAT supporting documents or information you should provide to the Nursing Board all depend on the individual facts and circumstances in your case.

Therefore, before you self-report to the Nursing Board, you should consider seeking experienced legal counsel to assist you to determine WHEN is the best time to self-report and to make sure you provide correct and complete information to the Nursing Board.

As always, if you have any questions about this post or the Ohio Board of Nursing in general, please feel free to contact one of the attorneys at Collis, Smiles and Collis, LLC at 614-486-3909. You may also look for more information at http://www.collislaw.com.
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Ohio Nursing Board imposes Permanent Practice Restrictions

In our practice at Collis, Smiles and Collis, we have the privilege of representing not only Nurses before the Ohio Board of Nursing but also other professionals before their licensure Boards.  This has given us the opportunity to see how various licensure Boards in Ohio handle disciplinary matters.

Each licensure Board in Ohio has its own rules and regulations and has the authority to take any action including but not limited to revocation, suspension, and/or probation of a license.  Under Ohio Revised Code Chapter 119, licensees in Ohio are entitled to an administrative hearing, which allows the licensee to introduce evidence in their defense.

Despite the similar due process that is afforded to most licensees facing a disciplinary action in Ohio, we have seen that many licensure Boards in Ohio (Nursing Board, Medical Board, Psychology Board, Board of Education, Counselor, Social Work and Marriage and Family Therapist Board) impose very different sanctions, despite the relatively similar nature of the offense.

In our experience, we have seen that, generally, licensure Boards in Ohio can be more strict/punitive than licensure Boards in other States in terms of sanctions.

Even within Ohio, based on our experience, the Ohio Board of Nursing imposes permanent practice restrictions on its licensees to a far greater extent than other licensure Boards in Ohio.  Generally, a permanent practice restriction limits a Nurse’s ability to work in the following settings: hospice, home health, as an independent provider for an Ohio agency, as a private duty nurse, as a volunteer, as well as any position involving management of nursing or supervision or evaluation of nursing practice, including but not limited to Director of Nursing, Assistant Director of Nursing, or Nursing Supervisor.  In certain instances, the Ohio Board of Nursing will include language in a Consent Agreement or Order that allows a Nurse to request on a case-by-case basis approval to work in an otherwise restricted position, however, such requests are given close scrutiny and are often denied.

Permanent practice restrictions are often imposed in cases in which a Nurse has been convicted of a crime, found to be addicted to drugs or alcohol, or where a Nurse has practiced below the standard of care.  In certain cases, the Ohio Board of Nursing imposes practice restrictions that prohibit a Nurse from working in any position that would require a Nurse to have oversight or control over financial dealings.

Permanent practice restrictions place a significant hardship on a Nurse’s employment opportunities.  Although we have seen Nurses with permanent practice restrictions on their license obtain employment, permanent practice restrictions create an enormous hurdle to overcome in terms of obtaining meaningful employment because, in our experience, many employers will simply not consider any Nurse who has permanent practice restrictions on their license.

Historically, it has been our experience that the Ohio Board of Nursing imposed permanent practice restrictions on a Nurse in cases where the facts of a case fully justified doing so based on significant practice or impairment issues, or in cases where a Nurse had been repeatedly disciplined.  Presently, however, we are seeing the Ohio Board of Nursing impose permanent practice restrictions on Nurses in greater numbers and on their first disciplinary action.

While there are cases in which permanent practice restrictions are justified to protect the public, obtaining the advice of experienced legal counsel before you sign a Consent Agreement containing permanent practice restrictions or before undertaking to represent yourself at an Administrative Hearing (which could result in a Ohio Nursing Board Order imposing permanent practice restrictions) is recommended.

As always, if you have any questions about this post or the Ohio Nursing Board in general, please feel free to contact one of the attorneys at Collis, Smiles & Collis, LLC at 614-486-3909 or email Beth@collislaw.com

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It’s important to have an Experienced Attorney for your Nursing license defense

Nurses often report to us that they are concerned that they will appear to the Nursing Board to be “hiding something” or trying to be uncooperative if they have an attorney represent them before the Ohio Board of Nursing in a disciplinary case or at a Hearing.

Nothing could be further from the truth.

Obtaining experienced legal counsel to help a nurse through the Nursing Board’s disciplinary process can be beneficial for the Nurse to understand the process and to assist the Nurse with resolution of their case.

Nurses are often surprised to learn that if they proceed to a Hearing without their own legal counsel, in most cases, they will be the ONLY nurse in the Hearing room.  At the Hearing, the Nursing Board is represented by their own attorney from the Office of the Ohio Attorney General, who is assigned to prosecute the case on behalf of the Nursing Board.  In certain instances, a representative of the Nursing Board, who is also an attorney, will also appear at the Hearing on behalf of the Nursing Board.  The Hearing is conducted in front of a Hearing Examiner, who is also an attorney.  If the Nurse does not have their own legal counsel at the Hearing, the Nurse will be at the unfortunate disadvantage of having to present their case on their own without the benefit of their own independent legal counsel.

In some cases, nurses are offered a Consent Agreement, which is an agreed upon Contract which outlines disciplinary terms in lieu of proceeding to a Hearing. Consent Agreement are drafted and negotiated by the Board’s lawyers. If the Nurse does not have their own legal counsel negotiating the Consent Agreement, the Nurse will be at the unfortunate disadvantage of having to negotiation with the Board’s attorney a binding Contract without the benefit of having their own independent legal counsel to be able to more fully consider whether the Consent Agreement being offered is in their best interest..

Your worked hard for your Nursing license. The Nursing Board has its own lawyers.  Representing yourself at Hearing or in negotiating a Consent Agreement could result in the Nurse taking an action not in their best interest or agreeing to a disciplinary term they did not understand. An nursing license defense attorney with experience in these matters can help the Nurse understand the process and assist the Nurse with resolution of their case.

As always, if you have any questions about this post or about the Ohio Board of Nursing in general, please contact one of the attorneys at Collis, Smiles &Collis, LLC at 614-486-3909 or email me at beth@collislaw.com.

 

Be honest when filing an application or renewal with Ohio Board of Nursing

Honesty is always the best policy when working with the Ohio Board of Nursing.

Professionals should know that before submitting information to a licensing authority the information must be accurate. Whether it is submitting the responses on an initial application for a license, or answering the questions on the bi-annual renewal of a license, the responses must be truthful.

However, I am often asked, “how will the Board know if I answer a question on my renewal application or original application incorrectly?” We never know how the Board may be notified of a violation of their laws and rules. Complaints to the Nursing Board can be anonymous, and the complainant is immune from liability (absent a finding of bad faith in their report). This means that you can be reported to the Board without your knowledge and you will never been provided with a copy of the complaint or the name of the complainant. (O.R.C. 4723.28(H) and (I)(1))

You may have a neighbor, employer or co-worker file a complaint against you with the Board alleging that you had a DUI that you failed to disclose to the Board or violated a section of the Ohio Nurse Practice Act. If you have reported this infraction on your application and/or on your renewal, it goes a long way to possibly having the investigation closed with no disciplinary action. However, if the Board goes back and pulls your application or renewal form and finds that you failed to disclose this information to the Board, the Board has the authority under O.R.C. 4723.28(A) to take an action against your license for providing false or fraudulent information to the Board.

Even without a formal complaint, the Board has the authority to open its own investigation if it learns of a violation of the Nurse Practice Act. If a Board investigator reads a news article about a nurse who has been charged with a DUI or is admitted into a diversion program by the Court, these types of actions can lead the investigator to open an investigation against the nurse. (Please note, that the nurse does not need to self report convictions or violations to the Board until the time of renewal of the license. However, on the renewal application responses need to be truthful and accurate.)

So, when applying for a license or completing a renewal application never ask yourself,”how will the Board ever find out?” The question you should ask yourself is, “what is the right answer and how can I best provide that information to the Board.”

While I encourage nurses to be honest with the Board, I always encourage the nurse to seek experienced legal counsel to assist them if they have any questions about how to respond to specific questions or if they are called to attend a meeting with a Board investigator.

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

Alcohol Prohibitions – Be Aware of the Things You Eat and Drink As Well As the Products You Use and the Medications You Take

In alcohol impairment cases before the Ohio Board Of Nursing resulting in Consent Agreements, the Alternative Program, Board Orders, or otherwise requiring nurses to undergo screening for alcohol, nurses are typically required (among other things) to abstain completely from the use of alcohol or any products containing alcohol.

It is critically important to avoid beverages, foods, hygienic and beauty products, household products, over the counter medications, and prescription medications which contain alcohol.

BEVERAGES: Beverages, including but not limited to, distilled spirits, beer, ale, malt beverages, wine, and cider contain alcohol.  Additionally, beverages such as Communion Wine or beverages labeled “Non-Alcoholic” or “NA” also can contain alcohol.

FOODS: Foods prepared with cooking wine, sherry, wine vinegar, soy sauce and items containing flavoring extracts (such as vanilla extract), can contain alcohol.  Additionally, certain cooking sprays contain alcohol.

HYGENIC AND BEAUTY PRODUCTS: Certain hygienic and beauty products can contain alcohol, including but not limited to certain:

Perfumes, colognes, and after shaves

Lotions and balms

Body sprays and mists

Makeup removers

Hand sanitizers

Antiperspirants

Deodorants

Mouthwashes

Hair Products

Cosmetics

HOUSEHOLD PRODUCTS: Certain household products can contain alcohol, including but not limited to certain:

Antibacterial products including antibacterial gel, dishwashing liquid and hand soap

Cleaners

Detergents

Dishwashing liquids

Air fresheners

Insect repellents

Disinfectant sprays

Sanitizing wipes

Liquid bandages

OVER THE COUNTER MEDICATIONS: Certain over the counter medications can contain alcohol, including but not limited to certain:

Cough suppressants

Expectorants

Nasal decongestants

Oral antiseptics

Anti-asthmatics

Antihistamines

Bronchodilators

Decongestants

Mouthwashes and gargles

Laxatives

Analgesics

Supplement

Vitamins

Anti-diarrheas

PRESCRIPTION MEDICATIONS: Certain prescription medications, including but not limited to certain asthma inhalers, contain alcohol or ethanol.

CONSULT YOUR PHYSICIAN: If you are unsure whether a particular food, beverage, product, or medication contains alcohol, read the label and consult your physician prior to eating, drinking, using, or taking it.

This article provides general guidance and is not a substitute for the advice of your physician.

As always, if you have any questions about the Ohio Board of Nursing or this post, please feel free to call one of the attorneys at Collis, Smiles and Collis at 614-486-3909 or check out our website at http://www.collislaw.com.

Ohio Nursing Board Investigations of Nurses during Inpatient or Intensive Outpatient Treatment

Tackling addiction to drugs or alcohol is a difficult decision to make and a lifelong challenge to maintain. It is important that you make this decision without jeopardizing your professional license.

Frequently, a nurse will enter a drug or alcohol rehabilitation program due to employer discipline or termination from employment. In certain instances, both the Nursing Board and law enforcement will be notified about the employment action.

Because of its responsibility for patient safety, the Nursing Board can and should take these situations very seriously. Nursing Board investigators frequently contact nurses who are participating in intensive rehabilitation programs to question them about their addiction and employment issues. As part of the investigatory process, nurses are often requested to place their license on inactive status as a “sign of cooperation with the Board investigation” or as a “good faith commitment to their sobriety”.

There are certain times when going on inactive status is the right choice. It allows the nurse time to obtain treatment and often provides more time for the Nursing Board investigation, which gives the nurse more time to strengthen his or her sobriety. In certain instances, a nurse can also be given credit by the Nursing Board for the period of time during which the nurse was on inactive status towards any period of license suspension imposed by the Nursing Board in a disciplinary action.

However, prior to making the decision to go on inactive status, a nurse should make sure they are in the correct mental or emotional state.  Going on inactive status is a very serious decision.  When a nurse is in treatment, quality of thought may not be at its best and, as with other important family or career matters, it is often not the best time to be making serious, long lasting decisions. A nurse should also be aware that the Nursing Board can impose significant requirements on a nurse in order to have a license reinstated, including but not limited to undergoing evaluation and/or treatment for drugs or alcohol or psychological condition, successfully completing negative urinalysis for a period of time determined by the Board, completing additional continuing education, and/or completing a practice improvement plan. Each situation is different and will be handled on a case by case basis by the Nursing Board.

Once the intensive portion of the treatment program is completed, there will be time to decide whether to communicate with a Nursing Board investigator and/or whether to voluntarily do anything regarding the status of your license. Such decisions should be made with a clear mind and after a careful consideration of the facts in your case. The recommendations of experienced nursing license defense legal counsel can be of assistance.

As always, if you have any questions about the Ohio Board of Nursing or this post, please feel free to call one of the attorneys at Collis, Smiles and Collis at 614-486-3909 or check out our website at http://www.collislaw.com.

Nursing Board discipline .. when to take the deal

Each year, hundreds of nurses face a possible disciplinary action by the Ohio Board of Nursing.  Sanctions can include a reprimand, probation, suspension, license limitations, and even license revocation.  In many cases, the nurse is offered a Consent Agreement, which is similar to a plea bargain in a criminal case, in which the nurse can agree to the terms of discipline.  I am often asked by my clients, “Should I accept the Consent Agreement or should I reject the offer and proceed to a Hearing?”

It is important to first note that whether the nurse enters into a Consent Agreement or proceeds to a Hearing, the Board will issue a final Order against the nurse and that the Order and the sanction imposed against the nurse is a public record which will be on the Board’s website, reported to the National Practitioner Data Bank and www.nursys.com, and published in the Nursing Board’s quarterly magazine, Momentum.

There are pros and cons to accepting a negotiated Consent Agreement.  By entering into a Consent Agreement, the nurse often has the ability to negotiate what factual information concerning the disciplinary action will be included in the Consent Agreement.  Because a disciplinary action is open and available to the public, being able to negotiate the wording of the Consent Agreement is important.  Additionally, the nurse can often negotiate WHEN the sanction will take place or when they will start the conditions for reinstatement of their license (if their license is suspended).  Also, the nurse avoids the stress, expense, and uncertainty of a Hearing.  If a nurse proceeds to a Hearing, nurse has no ability to negotiate the factual summary that is included in the Order or negotiate the sanction to be imposed. The Board has the sole discretion to issue any sanction as noted above.

However, there can be drawbacks to accepting a Consent Agreement. Consent Agreements are negotiated by only one Board member.  In negotiating a Consent Agreement, the nurse waives their right to a Hearing and often regrets not having their “day in court” to tell their “side of the story.”

In determining whether to negotiate a Consent Agreement or proceed to a Hearing, the nurse should consider all options and potential outcomes. These options and potential outcomes, as well as the nurse’s final decision, should be carefully considered, taking into account how the Board has handled similar cases in the past.  Whether through a Consent Agreement or a Hearing, the sanction that is imposed in each case depends on the individual facts and circumstances of the matter.

As always, if you have any questions related to this post or the Ohio Board of Nursing in general, please feel free to contact one of the attorneys at Collis, Smiles in Collis, LLC at 614-386-3909 or email me at beth@collislaw.com

Permanent Practice Restrictions on Nursing Licenses

For violations of the Nurse Practice Act in Ohio, the Nursing Board can impose a range of sanctions against a nurse which can include (but are not limited to) any of the following sanctions: revocation, suspension, reprimand, temporary or permanent practice restrictions.

Prior to the Board imposing a sanction against a nurse’s license, the Board is required to provide the nurse with a written Notice of the alleged violation and an opportunity to request a hearing.  If the nurse properly and timely requests a hearing, the nurse can attempt to negotiate a Consent Agreement with the Board (similar to a plea bargain in a criminal case) or they are entitled to a hearing where the Board would be required to prove the alleged violation of the Nurse Practice Act.

The sanction that the Board imposes in each case is strictly dependent on the individual facts and circumstances that gave rise to the alleged violation.  However, in most cases, the Board attempts to impose similar sanctions on similar cases.

Many nurses are surprised that in addition to a suspension of a nursing license, in many instances the Board will impose temporary or even permanent practice restrictions on the nurse’s license.  The restrictions generally limit the nurse’s ability to pass narcotics or to work in certain settings such as home care or home hospice, through an agency, as an independent provider, as a volunteer or to contract individually with a patient.  The Board also typically restricts the nurse’s ability to work as a nurse manager, DON, ADON or nursing supervisor.

If the Board places temporary practice restrictions on a nurse’s license, typically the restrictions will be lifted when the period of suspension and probation ends.  However, in certain serious cases, the Board will impose permanent practice restrictions that will permanently bar the nurse from working in certain settings. Occasionally, the Board will include a statement that says that the practice restrictions are permanent “unless otherwise approved by the Board.”  This specific language allows the Board to lift a permanent restriction in certain circumstances and for certain specific positions.

If a nurse has a permanent practice restriction on their license without the “unless otherwise approved” language, the permanent practice restrictions can NEVER be lifted.  This is generally reserved for the most serious violations of the Nurse Practice Act, generally resulting from cases of significant impairment (drug or alcohol abuse) by the nurse.

Nurses are often disappointed that they may complete a period of suspension or probation but still have permanent limitations on their license.  While the Board is one of only a few professional licensing agencies that will impose permanent restrictions on a professional license, it is a routine practice of the Board and is even imposed against a nurse who may have never been disciplined by the Board in the past.

As always, if you have any questions about this post or the Ohio Board of Nursing in general, please feel free to contact one of the attorneys at Collis, Smiles and Collis, LLC or email me at beth@collislaw.com