Florida Bill to Expand Authority of Nurses Flatlines During 2014 Legislative Session

5 Indest-2008-2By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar   in Health Law

The 2014 Legislative Session ended May 2, 2014, with the death of an omnibus health bill. House Bill 7113 would have provided provisions to expand the power of nurse practitioners to work independently of physicians’ oversight. This extension of authority to nurses would no longer require them to contract with and pay a “supervising” physician. The bill died after being passed back and forth between the Florida House of Representatives and the Florida Senate numerous times. It could not be resuscitated or kept alive by artificial means.

Currently, Florida nurse practitioners must work under direct supervision of physicians. The bill would have changed the title of nurse practitioners or advanced registered nurse practitioners. These are registered nurses with post-college education, usually a Master’s degree. The denied change would have retitled these health professionals to advanced practice registered nurses (APRNs). The bill would have also provided nurses the authority to sign documents that currently require a physician’s signature. This would have included the ability to prescribe controlled substances.

There is a total of 17 states in the United States that have adopted similar bills allowing nurse practitioners to work independently of physicians as APRNs.

To read the entire article from Modern Healthcare, click here.

Conflicting Opinions of the Bill.

Proponents of expanding nurse practitioner autonomy argue that the bill would reduce health care costs in addition to solving a critical shortage of primary care physicians. Because of the high enrollment numbers associated with the Affordable Care Act (ACA), it is anticipated that the need for physicians and health care providers will dramatically increase. Supporters also argue that northerners will be accustom to treatment by nurse practitioners because states such as Connecticut and New York have passed similar bills. They will expect the same level of care when moving to Florida during the winter months.

Opponents of the bill, led by various medical associations, argue the dangers of allocating such power to nurses. They warn that nurses should not have access to prescribing controlled substances without a doctor’s supervision. This argument is defended by highlighting Florida’s constant struggles with high numbers of pill mill busts. The medical associations opposing the bill are passionate in preserving the practice of medicine for the physician. In the end, opponents were granted their wish.

To read more on House Bill 7113, click here for a previous blog.

Even though the bill did not pass this legislative session, we expect this will not be the end of the fight to allow nurse practitioners to work independently of physicians.

Contact Health Law Attorneys Experienced in Representing Nurses.

The Health Law Firm’s attorneys routinely represent registered nurses, nurse practitioners, advanced practice registered nurses, certified registered nurse anesthetists, midwives and licensed practical nurses in Department of Health (DOH) investigations, in appearances before the Board of Nursing in licensing matters and in many other legal matters. We represent nurses across the U.S., and throughout Florida.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Comments?

Is providing a trained nurse practitioner with greater authority to treat and prescribe really a controversial subject? How do you stand on the topic? What benefits or dangers could arise from providing nurses with greater independence? Please leave any thoughtful comments below.

Sources:

“Health Bill Dies in Florida Legislature.” Modern Healthcare. (May 3, 2014). From: http://www.modernhealthcare.com/article/20140503/INFO/305039930

About the Author:  George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law.  He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida, area.  www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone:  (407) 331-6620.

The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2014 The Health Law Firm. All rights reserved.

 

 

 

 

Florida Woman Uses Forged License to Practice Nursing

indest1By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A Florida woman allegedly used a fake state nursing license to pose as a nurse and then treat patients at their homes, according to the Lake County, Florida, Sheriff’s Office. The woman is accused of treating patients at least seven times, but the sheriff’s office stated there may be more victims. The fake nurse was arrested on September 27, 2013. She faces charges of working as a nurse without a license and using a forged state document.

To read the Orlando Sentinel article, click here.

This is not the woman’s first time in trouble with law enforcement. Earlier this year she was allegedly arrested for running an unlicensed assisted living facility (ALF), according to WFTV, the ABC affiliate in Orlando, Florida.

Used Another Nurse’s License Number to Dupe Employer.

According to the Orlando Sentinel, the fake nurse was hired at TLC Home Care Facilities in Leesburg, Florida, in May 2013, after presenting the forged nurse license to her employer. Part of the phony nurse’s job was to treat patients at their home, including administering blood pressure checks and dispensing medications.

An audit of TLC Home Care facilities by the Department of Health (DOH) uncovered that the phony nurse was allegedly using the same nursing license number as a woman with a similar name. The legitimate nurse actually works at St. Petersburg General Hospital.

Fake Nurse Previously Arrested for Similar Charges.

In December 2012, the same woman was arrested for scheming to defraud and criminal use of personal information, according to WFTV.

Then in March 2013, the Florida Attorney General’s (AG) Medicaid Fraud Control Unit (MFCU) arrested her again for running an unlicensed ALF. According to WFTV, the woman billed residents for more than $55,000 worth of services in spite of the fact she was operating a facility without a state-required license.

Click here to watch WFTV’s report.

More Stories on Fake Physicians and Other Fraudulent Professionals to Come.

In the near future on this blog we will include additional articles on fake doctors and health professionals.

To see a recent blog a fake Florida pharmacist sentenced to prison, click here. To read a blog on a phony dentist in Miami, click here. You can also read the blog on a fake plastic surgeon in New York by clicking here.

Contact Health Law Attorneys Experienced in Representing Nurses.

The Health Law Firm’s attorneys routinely represent nurses in Department of Health (DOH) investigations, in appearances before the Board of Nursing in licensing matters and in many other legal matters. We represent nurses across the U.S., and throughout Florida.

To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Comments?

Do you think it is too easy to forge a health care professional’s license? Should the home health facility be punished for not doing a thorough background check? Please leave any thoughtful comments below.

Sources:

Comas, Martin. “Woman Used Forged Documents to Work as a Nurse, Deputies Say.” Orlando Sentinel. (September 27, 2013). From: http://www.orlandosentinel.com/news/local/breakingnews/os-woman-assumed-nurse-identity-20130927,0,395526.story

Hughes, Ryan. “Deputies: Woman Pretending to be Nurse has been in Trouble Before.” WFTV. (September 27, 2013). From: http://www.wftv.com/videos/news/deputies-woman-pretending-to-be-nurse-has-been-in/vCDXSX/
About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

 

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.

The American Nurses Association Breathes New Life Into The Nursing Code of Ethics For 2015

Headshot of attorney George IndestBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On a daily basis, the average nurse uses knowledge, training and ethical standards to make vital decisions regarding patient health. Nurses are required to quickly process simple and complex emergency situations, which leaves little room for second guessing. So, to help guide those in the profession, the American Nurses Association (ANA) created a Code of Ethics.

This Code is the structure that provides foundational standards and offers guidance to practicing nurses for various situations. It also sets the standards against which nursing performance can be judged. For the first time since 2001, the ANA has revised the Nursing Code of Ethics. The revised Code was released to the public on January 1, 2015.

Why Now?

The revised version of the Nursing Code of Ethics is geared to help nurses in a more modern practice environment. It addresses some of the more current issues, including confidentiality issues raised by social media, treatment for end-of-life care and the integration of social justice into health care policy as a whole. These guidelines need to be updated as conditions and society changes, and health care advances and presents new problems.

What Changes Were Made?

Provisions 1-3: These contain newly established guidelines on advocating for the patient, family and community, along with the need to exercise kindness and respect in all professional relationships.

Provisions 4-6: Contains new guidelines on delivering and maintaining competent care that includes self-respect and self-care, accountability, and responsibility to continue learning and growing personally and professionally.

Provisions 7-9: Sets forth broader health issues in the community and on a national and international level, along with the advancement of professional values, social policy and education.

The Nursing Code of Ethics is a reflection of the proud ethical heritage of nursing and serves as a guide and promise to society for all nurses now and into the future.

To view the complete revised Nursing Code of Ethics, click here.

Click here to find out more information on the American Nurses Association’s 2015 Year of Ethics

Comments?

What are your thoughts on the updates made to the code of ethics? Do you think it will help nurses identify components of real-world problems and analyze the situation effectively?

Contact Health Law Attorneys Experienced in Representing Nurses.

The Health Law Firm’s attorneys routinely represent nurses in Department of Health (DOH) investigations, Department of Justice (DOJ) investigations, in appearances before the Board of Nursing in licensing matters and in many other legal matters. We represent nurses across the U.S., and throughout Florida.

To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:

Howard, Cynthia. “2015: The Year of Nursing Ethics.” Nurse Together. (February 5, 2015). From: http://www.nursetogether.com/2015-the-year-of-nursing-ethics

Northeast Ohio Media Group Marketing Staff. “Year of Ethics Offers Nurses Guidance and Support Regarding Moral Decisions.” Cleveland.com. (April 15, 2015). From: http://blog.cleveland.com/university_hospitals_health_system_inc/2015/04/year_of_ethics_offers_nurses_g.html

American Nurses Association. “Code of Ethics for Nurses With Interpretive Statements.” (May 1, 2015). From: http://www.nursingworld.org/Mobile/Code-of-Ethics

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1999-2015 The Health Law Firm. All rights reserved.

Please, Please, Please Do NOT Talk to the Department of Health (DOH) Investigator

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Whether you are a nurse, physician, pharmacist or dentist, I beseech you: please do not talk to a Department of Health (DOH) investigator until you have talked to a health lawyer who is experienced with DOH investigations and board licensing complaints.  Do not answer or respond to even the most basic questions about where you work now, what your address is or if you know patient x, until consulting with counsel.

Admitting to the Simplest Facts May Harm You.

We are routinely consulted by nursing professionals and other healthcare providers for representation after they have discussed the case and after it is too late to undo the damage they have caused to themselves.  Often they do not understand the seriousness of the matter or the possible consequences, until it is too late. Admitting to even the most basic facts causes damage to any possible defense.

Administrative Licensure Investigations are “Quasi-Criminal.”

The vast majority of nurses and even most attorneys do not realize that DOH investigations concerning complaints against a nurse’s licences are considered to be “penal” or “quasi-criminal” proceedings.  This means the same laws and constitutional rights apply to them as apply to criminal investigations.  However, since they are also administrative proceedings and not strictly criminal proceedings, investigators do not need to advise you of your Miranda rights or tell you you have the right to remain silent, the right to an attorney, etc.

In any criminal investigation a good criminal defense attorney would always tell you “Do not talk to the investigator” and “Tell the investigator you have a lawyer.”

Investigators’ Techniques Try to Get You to not Consult a Lawyer.

DOH investigators, like police investigators, FBI investigators and other law enforcement officers, are well-trained in investigative techniques and how to get information out of suspects.  Often the approach used is to catch you by surprise before you even know there is an investigation and the investigation is of you.  Another technique used is to lull you into a false sense of security that the investigation is about someone or something else and not you.  Another investigative technique is to convince you that you need to “Tell your side of the story” so that the investigation is accurate.  Yet another is that “Things will go much better for you if you cooperate.”  None of these things are true.

However, if it is truly in your best interest to cooperate or to make a statement, after you consult with your attorney, your legal counsel will surely advise you to do this.  The investigator should not mind waiting until you consult your attorney.  However, many will go to extremes to convince you that you don’t need an attorney and shouldn’t get an attorneys.

Consult an Experienced Health Law Attorney.

The attorneys of The Health Law Firm are experienced in dealing with DOH investigators, AHCA surveyors, Drug Enforcement Administration (DEA) agents, FBI agents, police and sheriff’s office investigators, OIG special agents (S/As) and Medicaid Fraud Control Unit (MFCU) investigators.  Call or contact The Health Law Firm for legal advice before you talk to any investigator about any matter.

About the Author:  George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law.  He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida, area.  www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone:  (407) 331-6620.

Disclaimer: Please note that this article represents our opinions based on our many years of practice and experience in this area of health law. You may have a different opinion; you are welcome to it. This one is mine.

Note: This article is for informational purposes only; it is not legal advice.

How Can I Tell Whether or Not My Attorney Knows Anything about Florida Board of Nursing or Disciplinary Cases?

indest1By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Hiring an attorney can be intimidating and costly. However, hiring representation for a Florida Board of Nursing or disciplinary case is an investment in your future and career. An experienced attorney is indispensable for preparing and defending your case. But how do you know if your representation is knowledgeable in health law?

Below are some examples of what an experienced attorney will not say to a nurse about his or her Board of Nursing or disciplinary case. Remember, if you hear any of the advice below, the attorney most likely has limited or no experience in this area of legal practice.

1. Your attorney tells you that you can argue your case to the Board of Nursing.

Reason:

You cannot “argue your case” in front of the Board of Nursing. If you are at a hearing before the Board of Nursing, it is because you have requested an “informal hearing.”

If you have requested an “informal hearing” this means you do not dispute any of the facts alleged against you in the Department of Health (DOH) complaint. If you are not disputing the facts, this means you are agreeing that you are guilty. If you are at a hearing in front of the Board of Nursing, you will not be allowed to argue that you are not guilty, and you will not be allowed to call any witnesses or introduce any documents. You are only there for the purpose of determining how much punishment the Board will give you and this is based on guidelines that the Board has previously enacted.

2. If your attorney tells you that he or she does not intend to submit any information or documents for consideration by the Probable Cause Panel (PCP) of the Board of Nursing.

Reason:

Many cases are dismissed by the Probable Cause Panel (PCP) and this is the easiest, most expedient, and least expensive way of winning your case. However, your presentation (written only) that is submitted to the PCP must be direct, concise, directly address the legal issues, and be well organized. It is not advisable to try to prepare this yourself. We often include affidavits from our own expert witnesses that have reviewed the case. If the PCP does not vote in favor of probable cause, the case is dismissed and closed. It is like it never happened. There is no record kept of the initial complaint.

The PCP of the Board of Nursing consists of between two and four members. Some of these can be laypersons with no experience in your area of healthcare. A majority has to vote and decide that there is probable cause. Therefore, if there are only two members, and you convince one that you did not do it, then there is no probable cause.

In my opinion, this is the best and quickest way to win your case, but you must know what you are doing. There are exceptions to every rule.

3. If your attorney tells you to meet with the DOH investigator or to give a statement (written or oral) to the investigator, especially without being present or preparing you.

Reason:

DOH investigators are similar to police. If you give them any statement, this can be used to prove the case against you. In most cases, you never want to do this. Although there may be a rare exception, we strongly advise the client against this in about 99% of the cases we handle.

Even if you believe that you are totally innocent, your former employer, the unhappy patient who reported you, or the DOH prosecuting attorney may be convinced that you are not innocent and recommend that charges are prosecuted against you. Exhibit 1 used against you at a hearing will be your own statement. The first witness the DOH prosecutor will call to testify will be you.

Be smart in such matters. Don’t think you can just explain the case away. Don’t give evidence that can be used against you. It is not required under Florida law, and you cannot be compelled to do this.

4. If your attorney says you should call and negotiate with the DOH attorney, or PRN/IPN case manager.

Reason:

As discussed above, anything you say can and will be used against you. This is one of the main reasons you should retain an experienced attorney: to act as a buffer between you and the legal system, to protect you, and shield you from mistakes you make that could hurt your defense.

Additionally, if your attorney is not much more familiar with the DOH and the PRN/IPN procedures than you are, then why have you hired him or her?

5. If your attorney tells you not to worry about the hearing, you can later appeal.

Reason:

Only about 20% of cases are won on appeal. On appeal, the Court of Appeal is limited to the record of the hearing that was held. You are not allowed to reargue the facts in an appeal. You are limited to arguing about legal errors that were made during the hearing. If you don’t know the law, you are unable to effectively appeal.

6. If your attorney tells you that he or she can represent you during the investigation but is unable to “try” your case at an administrative hearing.

Reason:

Representation only through the PCP hearing stage simply is not enough. An attorney should have sufficient knowledge, experience, and skill to represent you throughout the entire case. If he or she does not, and formal administrative charges are recommended by the PCP, you will then need to retain a completely new attorney who will need time, effort, and legal fees to learn your case in order to properly represent you.

Additionally only an attorney who has experience in litigation cases against the DOH and your professional board will have the credibility and experience to negotiate the most favorable deal for you if you later desire to settle the case.

Consult With An Experienced Health Law Attorney.

We routinely provide deposition coverage to registered nurses (RNs), advanced registered nurse practitioners (ARNPs), certified registered nurse anesthetists (CRNAs), licensed practical nurses (LPNs), nurse midwives and nurse practitioners and other health professionals being deposed in criminal cases, negligence cases, civil cases or disciplinary cases.

The lawyers of The Health Law Firm are experienced in both formal and informal administrative hearings and in representing registered nurses (RNs), advanced registered nurse practitioners (ARNPs), certified registered nurse anesthetists (CRNAs), licensed practical nurses (LPNs), nurse midwives and nurse practitioners in investigations at Board of Nursing hearings. Call now or visit our website www.TheHealthLawFirm.com.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2014 The Health Law Firm. All rights reserved.

Nurse: Please, Please, Please: Talk to an Attorney Before You Talk to an Investigator

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

In Florida, You DO NOT Have to Speak to an Investigator!

Despite mailing out hundreds of thousands of postcards and letters to physicians, nurses, dentists, pharmacists, and psychologists  throughout Florida, we continue to receive calls from new clients and from potential clients, after they have already spoken to and made critical harmful admissions against their own interests to investigators.  In Florida, you do not have any duty to cooperate with any investigator who is investigating you.  This extends to Department of Health (DOH) investigators (who are sometimes titled “Medical Quality Assurance Investigators” or “Medical Malpractice Investigators”), Drug Enforcement Administration (DEA) special agents, police officers, sheriff’s deputies, or criminal investigators of any type.

Investigators are NOT on Your Side.

Let me state this as succinctly and clearly as possible.  If you are being investigated, you will not be better off making a statement.  You will not be better off explaining your side of the story.  The investigator is not your friend.  The investigator is not on your side.  All you are doing is falling for a trick and helping the government to make a case against you.

You have a right under the U.S. Constitution to not make any statement that may be used against you.  This is so important that in criminal cases government investigators are required to advise you of this by reciting to you your Miranda rights.

However, in cases where you might have your medical license revoked or have your nursing license revoked or have your DEA number revoked or lose your Medicare provider status or your Medicaid provider status, the investigator is not required to advise you of your rights.

In a criminal case, there may be ways to have your statement thrown out.  However, in a professional licensing case or other administrative case, it may be too late to avoid the damage.  You may be the best witness the government has and you may be the only witness the government needs to prove ths case against you.

In the case where you could receive a $100 criminal fine, the investigators are required to read you your constitutional Miranda rights and to be sure that you understand them before you make a statement.  However, in a case where you can lose your professional license, where you could lose your livelihood and ability to make a living, where you could lose everything you have worked so hard to obtain, they are not required to do this.  You must protect yourself.

Many health professionals, when confronted by an investigator, who will usually call at a very inconvenient time (to catch you by surprise) and will usually flash a badge (to intimidate you), will refuse to acknowledge the seriousness of the matter and will fall for the bait to “tell their side of the story.”  This can be fatal to your defense and fatal to your license.

Admitting to Anything Can Ruin Your Defense.

In the absence of a statement by the suspect (in this case, let’s assume this is YOU), the government may have a very difficult time of proving that you have committed any offense.  It may have other witnesses (who may not be around at the time of any hearing or trial).  It may have a lot of physical evidence or documents.  But it may be impossible for the government investigators to make any link between you and the evidence, unless you help the investigators do this.  You would be surprised at how many health professionals believe that they can just talk their way out of the situation;  in reality, they are just giving evidence that is used to make the case against them.

Any evidence at all, just admitting that you were there, admitting that the documents are yours, admitting that the patient was yours, admitting that you worked at the clinic, admitting that you wrote the prescription, admitting that the property is yours, admitting that you were on duty at the time, admitting that you have taken a drug, admitting that you signed the form, can be a crucial piece of evidence that could not otherwise be proven without your own testimony.

Remember, this is the investigators’ job and profession.  This is what they do full time, every day.  And they are very good at it.  They are 1,000 times better at getting you to admit the crucial elements of a disciplinary infraction than you are in “talking your way out of it.”  They will not be convinced by any excuses you make.  They do not have to be. They will not be the ones making the final decision against you.  Theirs is the job of putting together the case against you.  You will help them by talking to them, explaining why your decisions are correct, explaining why what you did is excusable, etc.  It will not work.  You will merely be giving them enough rope to hang you with.

How to Determine the Purpose of the Investigation.

Hint: If it is a Medicaid Fraud Control Unit (MFCU) special agent (investigator), you are probably under investigation for Medicaid fraud.

Hint: If it is an “auditor,” “surveyor” or “investigator” from an agency or company with “integrity” or “program integrity” in its name, they are probably investigating you for “lack of integrity,” i.e., false claims or fraud.

Hint: If it is a Drug Enforcement Administration (DEA) special agent (investigator) they are probably investigating you to prosecute you or to revoke your DEA registration for drug or prescribing violations.

Hint: If it is an Office of the Inspector General (OIG) special agent (investigator), you are probably under investigation for Medicare fraud or Medicare false claims.

Hint: If it is a Department of Health Quality Assurance Investigator or Medical Malpractice Investigator, they are probably only investigating possible disciplinary action against your license that could result in large administrative fines or revocation of your license.

You Cannot Outsmart the Investigator.

Do not believe for a second that you are smarter than the investigator.  Do not believe for a second that you will convince the investigator (or anyone else) that there is a legal or medical justification for what you did or what they allege.  If it were as simple as that, then why would there be an investigation and why would you be the one being investigated?

Additionally, do not believe for a second that you can lie your way out of it, either.  Remember, if the government cannot prove the basic offense that it is investigating against you, it may be able to prove that you have committed perjury or lied to an investigator.  In the case of a federal official or a federal investigation, merely making a false statement (oral or written) to an investigator is a criminal act.  This is what Martha Stewart and many others have served time for in federal prisons.

These investigators are lied to all the time.  They are usually better at detecting lies than a polygraph expert is.  Furthermore, in most cases, you will be the very last person to be interviewed.  Therefore, they will already know just about everything that can be used against you.  If your statement contradicts in any way what others have told them, they will know you are the one who is lying.  However, knowing something or suspecting something does not mean it will be something that can be proven in court or in an administrative hearing.

Consult an Attorney Before You Do or Say Anything.

It is much better to make no statement at all.  Blame it on your attorney.  Tell the investigator that your attorney will kill you if you were to talk to the investigator without your attorney being there ahead of time.  “Speak to my attorney.”  “My attorney can help you, I can’t.”

All you have to do is state “I must talk to my lawyer before I say anything.”  “I will have my lawyer contact you.”  “I cannot say anything until I talk to my lawyer.”  “I want a lawyer.”

If you are not the one being investigated, then there is no good reason why the investigator would want you to make a statement before you consulted with your attorney.  What is the rush?

Then you must also avoid the old trick of the investigator telling you “If you don’t have anything to hide, why would you need a lawyer?”  Please don’t fall for this trick, either.  This is America.  Smart people and rich people spend a lot of money on attorneys and other professionals to represent them and advise them.  There is a good reason why they do this.

Far too often the health professional only calls us after he has given a statement.  This is usually too late to avoid much of the damage that will have been be caused.

Everything above applies to oral statements or written statements.  Do not make either.  Contact a lawyer as soon as possible, preferably before making any statement, no matter how simple, defensive, self-serving or innocuous you may think it to be.

Think of this as an intelligence test.  Are you smart enough to follow this guidance and avoid this type of mistake?

Contact Health Law Attorneys Experienced with Investigations of Health Professionals Today.

The attorneys of The Health Law Firm provide legal representation to physicians, nurses, nurse practitioners, CRNAs, dentists, pharmacists, psychologists and other health providers in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Medicare investigations, Medicaid investigations and other types of investigations of health professionals and providers.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

About the Author:  George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law.  He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida, area.  www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone:  (407) 331-6620.

Your Professional Nursing License May Be Your Most Valuable Asset; Insure It!

5 Indest-2008-2By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Suppose you had an item that you really wanted but was very expensive.  Suppose this item cost you $80,000.  Perhaps you took out a loan in order to pay for the item.

Suppose in addition to paying $80,000 you also had to work for four years and contribute four years of your labor to help pay for the item.  For this example, let’s assume your four years of labor is equivalent to an additional $80,000.  Once you can afford the item, you will have invested the equivalent of $160,000 for it.

In order to protect this expensive item, would you insure it?  If this item produced additional income for you, would you insure it?  After considering the price tag of the item, and knowing you have achieved something few others ever do, would you insure it for its full value?

I think almost everyone would answer yes to the questions above.  I certainly would, and I expect you would too.

Yet, I am constantly contacted by nurses who have worked hard for many years, have paid tens of thousands of dollars in tuition, fees, books, and who have sacrificed in order to obtain a nursing degree and nursing license.  Yet, they have not purchased insurance to protect their hard earned licenses.

I am baffled at the number of nurses who come to us in serious trouble because a complaint has been filed against them by a former employer, vengeful co-worker, unhappy patient (or patient’s family), or disgruntled former spouse, boyfriend, girlfriend, etc.  Often the issues are complex.  The legal procedures surrounding administrative complaints and administrative hearings are certainly complicated and confusing.  Yet they do not have the savings to hire an experienced attorney to defend them, and they do not have insurance to cover their defense.

I’m not speaking of professional liability insurance when I am writing this.  I am speaking of insurance to cover your legal defense expenses in the event a complaint is filed against you, jeopardizing your nursing license.  A nursing license with discipline on it is like an old antique painting with a big hole in it; its value is greatly diminished.  A nursing license with disciplinary action is worth a lot less than one that is unblemished.  It is not as marketable as one with no damage on it.

In my experience, nurses are far more likely to have a complaint filed against them resulting in an investigation for possible discipline against their licenses than they are to have a professional liability suit filed against them.  That is why I say that you should purchase nursing liability insurance because of the professional licensure defense coverage it provides;  not because it pays in the event of a law suit.

Furthermore, given that most popular nursing liability insurance (e.g., Nurses Service Organization (NSO) Insurance, CPH & Associates Insurance) is very inexpensive (as little as $10 a month), it is foolish not to be insured.  You have an extremely valuable asset that could easily produce $2 million in income during your lifetime.  Don’t you think a hundred dollars a year is worth paying to help protect it?

This is why I stress buying nursing liability insurance.  Buy it now!  Be sure you are covered for at least $25,000 in professional license defense expense coverage and preferably more, if you can get it.  Buy two policies if necessary.  But buy it!  If you don’t, when you really need it, it will be too late.  You may lose that valuable asset you worked so hard to get.

Comments?

Have you dragged your feet in purchasing professional liability insurance? If so, why? Did reading this blog change your mind? Please leave any thoughtful comments below.

Contact Health Law Attorneys Experienced in Representing Nurses.

The Health Law Firm’s attorneys routinely represent registered nurses, nurse practitioners, advanced practice registered nurses, certified registered nurse anesthetists, midwives and licensed practical nurses in Department of Health (DOH) investigations, in appearances before the Board of Nursing in licensing matters and in many other legal matters. We represent nurses across the U.S., and throughout Florida.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2014 The Health Law Firm. All rights reserved.

Florida Registered Nurses Finalize Union Agreement with HCA

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Registered nurses at ten HCA hospitals in Florida have reached a collective bargaining agreement with the hospital chain. After negotiating for over a year, National Nurses United–a union for registered nurses–announced that it finalized the agreement with HCA on May 7, 2012.

The agreement affects over 3,000 Florida registered nurses at HCA hospitals. It will be effective for three years.

According to National Nurses United, Florida HCA management has agreed to establish a committee of elected nurses at each hospital to make recommendations on improving patient care. The contract also protects nurses against forced overtime and provides for a new wage system based on experience.

Milestone for Florida Nurses.

This collective bargaining agreement is a milestone for Florida nurses. It provides some degree of security and assurances of fairness to nurses before they can be terminated. Internal grievance procedures will have to be complied with by the employing hospital which will no longer be able to arbitrarily terminate a nurse.

Unionization Means Written Contract for Nurses.

This also means that nurses employed by the hospital will now have a written contract and will have contractual rights. Most nurses work as “at will employees” without a contract. This allows them to be fired for any (non-discriminatory) reason or no reason at all. This will prevent that from happening from now on.

This also has an advantage even for those nurses who are not union members. The labor contract will apply to them, too, giving them contract rights, as well.

Union Representative.

Although the union believes that the RNs covered by the new agreement will greatly benefit from it, there are often problems that arise from union negotiations that may not be initially apparent.

For example, the nurse employee will have the right to have a union representative present at any disciplinary proceedings, interviews, or investigations by the hospital employer. A nurse may feel that having a union representative present will ensure that his or her legal interests are protected. However, this is not always the case. A union representative will generally not do anything to jeopardize the union’s relationship with the employer. Additionally, the union representative is not a lawyer and often will not be able to provide legal strategy, legal advice, or good defenses to the nurse.

Union reps should never be mistaken for legal counsel. They will likely have no legal background and are not a substitute for an attorney.

Nurses Unfairly Accused of Diverting Narcotics.

This firm has heard from a number of nurses employed by hospitals across the state and regularly represents them. Often we are contacted by nurses who state that they are unfairly and incorrectly accused of diverting narcotics from patients or pilfering them from Pyxis, Diebold or ther brands of automated pharmacy dispensing systems. Many of these have been terminated by their employers even though their drug tests came back negative or they passed a polygraph examination (lie detector test).

When nurses are unionized and have contractual rights, this helps to end unfair and arbitrary terminations. Such abuses by hospital employers cause nurses to decide to vote in favor of unionization.

Contact Health Law Attorneys Experienced with Nursing Issues Today.

The attorneys of The Health Law Firm provide legal representation to nurses, nurse practitioners, and CRNAs in investigations, contract negotiations, licensing issues and at Board of Nursing hearings.  They also advise nurses wrongfully accused of diverting drugs and those wrongfully terminated from employment.  Its attorneys represent nurses in DOH investigations, Board of Nursing cases and administrative hearings.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources Include:

Dymond, Richard. “Nurses Win First Bargaining Contract with HCA’s Blake, Doctor’s Hospital.” Bradenton Herald. (May 8, 2012). From
http://www.bradenton.com/2012/05/08/4029914/nurses-win-first-bargaining-contract.html

Peters Smith, Barbara. Registered Nurses Reach Labor Agreement with 10 Florida Hospitals.” Herald-Tribune. (May 7, 2012). From
http://health.heraldtribune.com/2012/05/07/registered-nurses-reach-labor-agreement-with-10-florida-hospitals/

About the Author:  George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law.  He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida, area.  www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone:  (407) 331-6620.

Join Us for Florida Laws and the Nurse: New Licensure Requirement

Join Joanne Kenna nurse attorney with The Health Law Firm and the Greater Orlando Chapter of the American Association of Legal Nurse Consultants for:

FLORIDA LAWS AND THE NURSE – NEW LICENSURE REQUIREMENT:  Keep Your Patients Safe and Protect Your Nursing License

PROGRAM OBJECTIVES

The purpose of this is course is to provide nurses with knowledge of the Florida Laws and Rules that govern the practice of nursing in Florida, while meeting the 2015 requirement for Florida nurse licensure and renewal; and to provide valuable information regarding the structure and purpose of the Florida Board of Nursing Disciplinary Process and how to protect your nursing license by providing excellence in nursing care.

Upon completion of this course, you will be able to:

  • Describe the purpose and provisions of the Health Professions and Occupations Statue, the Florida Nurse Practice Act and Florida Health Professions Regulations;
  • Describe nursing standards of practice and identify deviations in standards;
  • List the steps in the Florida Nursing Disciplinary Process;
  • List specific sources of nursing practice that have high potential for putting a nursing license at risk of discipline.
  • Describe resources and procedures to protect your nursing license and respond to disciplinary action by the Florida Board of Nursing.

Beginning with the biennium ending in 2015, each Florida Nursing licensee must complete a two hour course on the laws and rules that govern the practice of nursing in Florida.  This program is approved by the Board of Nursing to meet the requirement.

SPEAKERS FOR THIS PROGRAM ARE:

ATTORNEY JOANNE KENNA, RN, JD is an attorney, whose practice encompasses most aspects of health law and nursing law, including the representation of health care providers in professional licensing and credentialing matters, professional board representation, administrative hearings, contracts, licensure issues, corporate matters, transactional matters and litigation.  Ms. Kenna received her juris doctorate degree from Stetson University College of Law.  She has an extensive legal background including medical malpractice defense and nursing home defense.  Prior to law school, Ms. Kenna’s nursing career included at the University of Chicago Hospitals and Clinics included being the head nurse of the cardiac critical care units, a cardiac nursing instructor and cardiac nursing consultant.  She brings a vast amount of experience and expertise to her role in health law.

JUDY A. YOUNG, RN, MSN, MHL is a nurse with over 38 years experience, 20 of which were served in the US Air Force.  Judy is the owner of Florida Legal Nurse Experts, LLC, and works as an independent Legal Nurse Consultant.  Judy’s LNC experience includes defense of mass torts / product liability; expert witness for both plaintiff and defense; and behind the scenes LNC roles for both plaintiff and defense firms.  She currently does medical malpractice defense work.  She also remains clinically active in critical care.  In addition to decades of critical care experience, Judy has been a nursing school director and instructor, and has experience in nursing administration and flight nursing.  She has a master’s degree in nursing from University of Oklahoma, and a master’s degree in health law, from the Sheppard Broad Law Center, Nova Southeastern University, Ft. Lauderdale, FL.

WHEN: October 28, 2014 – Social (light food) & Networking – 5:30 – 5:45 PM; Chapter Update Meeting 5:45 – 6:00 PM; and Education Program 6:00 – 8:00 PM.

CONTINUING EDUCATION CREDITS: 2.0 contact hours, as part of the total hours of continuing education required for initial licensure and biennial renewal, FL Administrative Code 64B9-5.011.  Approved by The Greater Orlando Chapter AALNC, FL Board of Nursing Continuing Education Provider #: 50-13.  LNCCs – This topic qualifies as contact hours that can be applied toward LNCC certification renewal.  If you are submitting this program as contact hours on application for LNCC renewal, report these hours on the application as nursing contact hours.

WHERE:  PLEASE NOTE NEW LOCATION!!!  We are now holding our Greater Orlando Chapter AALNC Meetings at University of Central Florida (UCF).  The street address is UCF Continuing Education, Innovative Center, 3280 Progress Drive, Suite 700, Orlando, FL 32826,  Room 722.

REGISTRATION:  If you plan to attend the meeting in person, PLEASE RSVP by contacting:  info@orlandoaalnc.org.  If you are a guest, please provide your name, address and FL nursing license number for continuing education credit and course completion certificates.

**NEW REGISTRATION INFORMATION:  Members and guests will be able to attend the program in person or “virtually” by logging in online.  Registration to attend the meeting online, will be completed through UCF Continuing Education.  Information regarding the online registration process will be sent ASAP.  The program will also be available for online attendance at any time after the live meeting.

FEES: The meeting / program is free to all Greater Orlando Chapter Members.  There will be a fee for guests:  $25.00 for in person attendance.  Virtual (online) attendance is also free for members, and $25.00 for guests.

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