State Nursing Boards Delay Nursing Licenses Across the U.S. Even As COVID-19 Pandemic Continues

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

Staffing shortages at hospitals across the U.S. are worsening helped along by state boards and other licensing authorities taking months to process nursing licenses, a recent NPR survey claims. As a result, thousands of new nurses who want to help during the COVID-19 pandemic are reportedly getting sidelined by state bureaucratic red tape. Now, it’s resulted in a considerable backlog in nurses waiting for jobs.

State nursing boards are usually created and charged with safeguarding the public. But there are those who claim they have become an obstacle to ensuring public safety by preventing qualified nurses from getting into the workforce. A review of statistics from nursing boards shows that new applications are taking months to be reviewed and approved when basic vetting should take only weeks.

An Investigation Into Nursing Applications.

In 2021, National Public Radio (NPR) examined license applications and found that newly graduated nurses and those moving to new states often get sidelined by state bureaucracies for months, waiting for state approval to treat patients. This is occurring at a time of extreme nursing shortages and increased demand for nurses to work during a pandemic.

Of course, we may have those who want to challenge whether or not there is a pandemic still going on. But we feel that those nurses working in hospitals right now can tell us. We also believe that not enough time has passed since the last wave went over us to state that the pandemic has ended.

The Following are some key findings from NPR’s investigation:

1. How long is too long to wait for your license? Almost one (1) in ten (10) nurses issued new licenses last year waited six (6) months or longer, according to an analysis of licensing records from 32 states. More than a third of these 226,000 registered nurses and licensed practical nurses had to wait at least three (3) months. The processing time varies because each state has its own rules. Generally, state boards have to check a nurse’s education, run a criminal background check, and wait for new graduates to pass a national exam. This all does take time. However, some of the procedures, such as fingerprinting and background checks have speeded up tremendously over the past decade.

2. Applicants are stuck in license limbo. Some state nursing boards blame slow processing times on staff shortages, increased workloads, and remote work. California’s nursing board, for example, has just 47 people on staff handling tens of thousands of applications for licenses. That’s for a state with nearly a half-million RNs. To put it into more perspective, that works out to 10,000 nurses for each employee to assist.

3. When does the clock start? NPR’s investigation found that states often start the clock on processing times only after an application is marked complete. Some nurses NPR spoke with described scenarios where they spent weeks or longer arguing with the licensing authority that their applications were complete. In addition, many state boards don’t count that lost time when measuring how long it takes to process an application.

4. Some states aren’t part of any interstate agreement. Several large states have refused to join the Nurse Licensure Compact, which allows nurses to use licenses across state lines — sort of like a driver’s license lets you drive across state lines. One reason cited for this is that many nursing boards make most of their money, sometimes tens of millions of dollars, just from the licensing fees.

Overall, researchers found that one (1) in ten (10) nurses who received new licenses from nursing boards in 2021 waited six (6) months or longer. More than one-third of the nurses waited at least three (3) months. NPR reported: “[Nurses are] emotionally exhausted. They’re physically exhausted. We add to that the frustration of not being able to get your license,” Betsy Snook, BSN, RN, who is CEO of the Pennsylvania State Nurses Association, reportedly told NPR.

To learn some helpful tips if you are applying for your nursing license, click here to read my prior blog.

Contact Health Law Attorneys With Experience Handling Licensing Issues.

If you are applying for a nursing or health care license, have had a license suspended or revoked, or are facing imminent action against your license, it is imperative that you contact an experienced healthcare attorney to assist you in defending your career. Remember, your license is your livelihood, it is not recommended that you attempt to pursue these matters without the assistance of an attorney.

The Health Law Firm routinely represents nurses, physicians, dentists, medical groups, clinics, and other healthcare providers in personal and facility licensing issues.

To contact The Health Law Firm please call (407) 331-6620 or toll-free (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

“Nurses are waiting 6 months or more for licenses despite hospitals’ need for nurses.” Georgia Public Broadcasting. (March 10, 2022). Web.

Fast, Austin. “Nurses are waiting months for licenses as hospital staffing shortages spread.” NPR. (March 11, 2022). Web.

Gooch, Kelly. “Nurse license wait times complicating staffing shortages.” Becker’s Hospital Review. (March 11, 2022). Web.

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 Avenue, Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2022 The Health Law Firm. All rights reserved.

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More Reasons Not to Voluntarily Relinquish Your Professional License or Fail to Appeal an Exclusion Action

In the past, I have written articles and blogs on why a physician, nurse, dentist, psychologist, pharmacist, mental health counselor or other licensed health professional should never agree to voluntarily relinquish his or her license after any notice of a possible investigation being opened.  This is treated the same as if the state licensing agency had revoked that license for cause.  This applies even if the license is in another state, is inactive, or has expired.

The consequences of this include the action that will surely follow from the Office of the Inspector General (OIG) of the Department of Health and Human Services (HHS) to exclude that professional from the Medicare Program.  Of course, this exclusion means any federal health care program, including participation in TRICARE/CHAMPUS, Veterans Administration (VA) program, Public Health Service (PHS) programs, Indian Health Service programs, U.S. Postal Service (USPS) health programs, and the state Medicaid program. 

However, 42 C.F.R. § 1001.2006 requires that that the Department of Health and Human Services (HHS) provide notice of a health professional’s exclusion from the Medicare Program to, among others:

 (1)  Medicare beneficiaries;

 (2)  The public;

 (3)  Any entity in which the excluded individual is known to be serving as an employee, administrator, operator, or in which the individual is serving in any other capacity and is receiving payment for providing services;

 (4)  State Medicaid Fraud Control Units;

 (5)  Utilization and Quality Control Quality Improvement Organizations;

 (6)  Hospitals, skilled nursing facilities, home health agencies and health maintenance organizations;

 (7)  Medical societies and other professional organizations;

 (8) Contractors, health care prepayment plans, private insurance companies and other affected agencies and organizations;

 (9)  The National Practitioner Data Bank.

 (10)  Other Departmental operating divisions, Federal agencies, and other agencies or organizations, as appropriate.

One should think not twice but three times before voluntarily relinquishing a health professional license of any kind, medical license, nursing license, psychology license, pharmacy license, social work license, mental health counselor license, or any other, once there is some notice that an investigation has commenced or that a complaint has been received.

For more information please visit our website at www.TheHealthLawFirm.com.

Adverse Consequences of Discipline Against Your Nursing License

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

If the Florida Department of Health (DOH) takes discipline against your Florida nursing license, this will have many significant consequences.

Investigation and Discipline of Other State Licenses.

The discipline will be reported to every other state in which you have a license and similar investigations will be opened by those states.

Many states also have laws similar to those of Florida which require you to report discipline yourself to the other state in which you are licensed. Sometimes this is very short, 15 or 30 days, for example. Check the other state’s laws to be sure.

Discipline Against Other Types of Licenses.

If you have other types of health professional licenses, such as a massage therapist (LMT) license, emergency medical technician (EMT) license, mental health counselor license (LMHC), advance registered nurse practitioner (ARNP) license, acupuncture physician (A.P.) license, etc., it is most likely that an investigation will be opened against the other license. This may result in discipline against your other license.

Discipline Will be Reported to the National Practitioner Data Bank.

Additionally, any discipline against your Florida nursing license will be reported to the National Practitioner Data Bank (NPDB), as well as other reporting organizations. You may also face action to exclude you from the Medicare Program by the Office of the Inspector General (OIG). If this occurs, it will be virtually impossible for you to get a job anywhere, especially in a hospital or facility.

Possible Loss of Certification.

In addition, if you are certified in a specialty, your certification organization may revoke or not renew your certification. It may also have rules requiring you to report disciplinary action.

Loss of Employment Opportunities.

Many health facilities, insurers, hospitals and other employers have policies against hiring nursing professionals with discipline on their licenses. Regardless of what an employer or supervisor might orally tell you, company policy, whether formal (written) or informal, may cause you to be terminated as an employee.

Buy Insurance to Cover License Investigation Legal Defense Expenses: It’s Cheap.

Most nursing malpractice insurance policies are very inexpensive and provide excellent coverage. Most contain insurance coverage that will pay for an attorney and other legal defense expenses if you are being investigated or charged with a licensure offense. Buy this. You should have at least $25,000 in coverage for such investigations and administrative proceedings. $50,000 in coverage would be better, even if you must pay extra or buy additional coverage.

If you are innocent of the charges alleged against you, a fully contested formal administrative hearing (trial) could easily cost $50,000. If you can’t afford to pay this amount yourself, you may have to give up your rights to proof of your innocence or guilt. Buy insurance to cover such unfortunate circumstances.

Obtain an Experienced Health Law Attorney Immediately After Receiving Any Notification of an Investigation from the Department of Health.

If the DOH is investigating you, you will receive a letter stating that an investigation has been opened by the DOH for discipline against your license. Do not speak with or make any statement to any DOH investigator (for more on this, see our previous blog post). Instead, immediately obtain an experienced health law attorney to represent you throughout the investigation and disciplinary proceedings.

Contact Health Law Attorneys Experienced in Board of Nursing Cases.

The Health Law Firm’s attorneys routinely represent nurses in Department of Health Investigations, before the Board of Nursing, in appearances before the Board of Nursing in licensing matters, and in 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.

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.

Florida Nurse Accused of Abusing Patient

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

A Florida State Hospital licensed practical nurse (LPN) has been arrested and charged with one count of abuse of a disabled adult at the facility. The nurse was arrested on a felony warrant by the Attorney General’s Medicaid Fraud Control Unit (MFCU). The arrest was announced by the Florida Attorney General on June 29, 2012.

Nurse Accused of Abusing Patient During Medication Administration.

The nurse allegedly struck a disabled woman at the mental health facility, while trying to administer medication. The nurse attempted to administer medications to the patient by holding her nose closed in an attempt to force her mouth open, slapping her across the face, and pulling the patient’s hair, according to the charges filed.

The nurse has been charged with one count of abuse of a disabled adult, which is a third degree felony. If convicted she faces up to five years in prison and a $5,000 fine.

Medicaid Fraud Control Unit (MFCU) Conducted Investigation.

Investigators with the Medicaid Fraud Control Unit (MFCU) received information regarding the alleged abuse from the Florida Department of Children and Families’ (DCF) Adult Protective Services Program. The Calhoun County Sheriff’s Office assisted in the arrest. The case will be prosecuted by the State Attorney’s Office for the Second Judicial Circuit of Florida.

Contact Health Law Attorneys Experienced in Representing Nurses.

The Health Law Firm’s attorneys routinely represent nurses in Department of Health investigations, before the Board of Nursing, in appearances before the Board of Nursing in licensing matters, and in 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:

Lucas, John. “Attorney General Pam Bondi Announces Arrest of Nurse for Abusing a Disabled Adult at Florida State Hospital.” Florida Office of the Attorney General. (June 29, 2012). Press Release. From: http://www.myfloridalegal.com/newsrel.nsf/newsreleases/AF6292E44D8579B685257A2C0069ED2D

WCTV. “Nurse at Florida State Hospital Arrested for Abuse.” WCTV.com. (June 29, 2012). From: http://www.wctv.tv/home/headlines/Nurse_at_Florida_State_Hospital_Arrested_for_Abuse_160893645.html

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.

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