At Board of Nursing Hearing, Each Aggravating Factor Must be Supported by “Competent Substantial Evidence” or Discipline Is reversible on Appeal

The foregoing case summary was prepared by Mary F. Smallwood, Esquire, of The Administrative Law Section of The Florida Bar.

The Department of Health, Board of Nursing (“Board”) filed charges against Fernandez for administering medication to a person who was not his patient. The facts demonstrated that Fernandez had visited a friend in the hospital and administered a drug prescribed for one of his home health care patients. After an administrative hearing, the Board found that five aggravating circumstances justified an upward departure in the penalty provided for the Board’s guidelines to license revocation.

On appeal, the court reversed. While it found support for four of the aggravating circumstances cited by the Board, it held that one of the circumstances was not supported by competent substantial evidence. Specifically, the Board had determined that Fernandez’ actions had caused damage to the patient. The court found the only support for this determination was testimony in the hearing transcript that the court characterized as “speculation.” Since the court concluded that it was unclear whether the Board would have revoked Fernandez’ license absent the determination of damage to the patient, it reversed in part and remanded for the Board to reconsider the penalty without the unsupported aggravating circumstance.

Source:

Fernandez v. Department of Health, 120 So. 3d 117 (Fla. 4th DCA 2013) (Opinion filed August 14, 2013).

About the Author: The foregoing case summary was prepared by Mary F. Smallwood, Esquire, of The Administrative Law Section of The Florida Bar. It originally appeared in the Administrative Law Section Newsletter, Col. 36, No. 2 (Dec. 2013).

Florida Nurse Practitioners Fight for Autonomy

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

On February 18, 2014, a bill that would expand the authority of nurse practitioners and would allow some to practice independently of physicians was approved by the Florida House Select Committee on Health Care Workforce Innovations. Despite opposition from physician groups, the bill (PCB SCHCWI 14-01) was overwhelmingly approved 13 to 2. However, some of that support might be fleeting.

To read bill PCB SCHCWI 14-01, click here.

Details of the Bill.

Currently, nurse practitioners work under the supervision of physicians. This bill would change the title of what are usually called nurse practitioners, which are registered nurses who have post-college education, usually a master’s degree, to Advanced Practice Registered Nurses (APRNs). The bill would also apply to specialists, such as certified registered nurse anesthetists (CRNAs), certified nurse midwives and certified nurse practitioners.

These nurses would gain new powers under the bill, such as the ability to sign documents that now require a physician’s signature, and the opportunity to earn the title “Independent Advance Practice Registered Nurse” after a certain amount of training and experience. Nurse practitioners would no longer have to contract with and pay a “supervising” physician. Another controversial aspect of the bill is to allow these nurses to gain the authority to prescribe controlled substances. Currently, Florida is one of the few states that do not allow this.

Supporters and Opponents Cannot Agree.

Even though the vote drew bipartisan support, several committee members said their support was tentative, and that they wanted to see further debate and amendments.

According to Health News Florida, the President of the Florida Senate reported he opposes the House bill. Many physician groups, including the Florida Medical Association, agree. These groups point out that physicians receive years of additional training to provide care. They also raise the question why students would want to rack up huge amounts of debt to attend medical school if they could do much of the same work as nurse practitioners with less schooling.

Supporters state this bill will help increase access to primary care, particularly in rural areas. Nurse practitioners also state they already provide much of the care that physician groups bill for. It’s argued that similar laws are already in place in a majority of states around the country, according to The News Service of Florida. To read the entire article from The News Service of Florida, click here.

Expanded Scope of Practice for Nurse Practitioners Already Working in Other States.

According to Health News Florida, 23 other states already allow independent practice for nurse practitioners. Also, military services and the Veterans Administration Health System, already allow nurse practitioners to prescribe controlled drugs and allow independent practice. Florida is the only state that prohibits nurse practitioners from prescribing controlled substances.

According to Health News Florida, the issue is not expected to be considered during the upcoming Legislative session. Click here to read the entire Health News Florida article.

Be sure to check this blog regularly for updates to this story.

Contact Health Law Attorneys Experienced in Representing Nurses.

The Health Law Firm’s attorneys routinely represent registered nurses, nurse practitioners, advanced registered nurse practitioners, 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 http://www.TheHealthLawFirm.com.

Comments?

What are your thoughts on the bill? Do you think nurse practitioners should have more autonomy? Or do you believe nurse practitioners should be supervised by physicians? Please leave any thoughtful comments below.

Sources:

Saunders, Jim. “Nurse Practitioners Win First Round In Fight Over ‘Scope.’” The News Service of Florida. (February 22, 2014). From: http://www.theledger.com/article/20140222/NEWS/140229772/1374?Title=Nurse-Practitioners-Win-First-Round-In-Fight-Over-8216-Scope

Gentry, Carol. “Senate Pres.: No On Nurses’ Bill.” Health News Florida. (February 24, 2014). From: http://health.wusf.usf.edu/post/senate-pres-no-nurses-bill

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. http://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.

Other Options Must Be Considered Before Emergency Suspension Order Will Be Upheld

The forgoing case summary was prepared by Mary F. Smallwood, Esquire, of the Administrative Law Section of The Florida Bar.

The Department of Health (“DOH”) issued an emergency order suspending Burton’s license to practice nursing.

On appeal, the court quashed the emergency order. It held that DOH had failed to examine other disciplinary options available to it short of suspension. While recognizing DOH might be able to support license suspension as an appropriate penalty, it held that Burton was entitled to a hearing to contest the charges.

In the dissenting opinion, Judge Osterhaus cited numerous findings in the DOH order that supported suspension.

Source:

Burton v. Department of Health, 116 So. 3d 1285 (Fla. 1st DCA 2013) (Opinion filed July 24, 2013).

About the Author: The forgoing case summary was prepared by Mary F. Smallwood, Esquire, of the Administrative Law Section of The Florida Bar. It originally appeared in the Administrative Law Section newsletter, Vol. 35, No. 2 (Dec. 2013).

Nurses, No More Excuses: Get Personal Professional Liability Insurance Policy Now-Part 2

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

Nurses, I am writing this to strongly encourage you to purchase your own professional liability insurance policy. I have noticed many nurses fail to carry any insurance to protect one of their most precious assets, their nursing licenses. Yet such insurance is cheap and easy to obtain. Professional liability insurance will protect a nurse in the event of a lawsuit, and it may also pay legal defenses in the event of a complaint against a nurse’s license to practice or for other legal problems. If you already have nursing liability insurance, make sure it also pays all legal expenses incurred in defending a complaint against your license.

I’ve heard every excuse as to why a nurse does not have professional liability insurance. In this blog series, I am exploring many of those excuses. I want every nurse to understand the importance of buying personal professional liability insurance now, before it is too late.

This is part two of the series, click here to read part one.

Excuse: Professional Liability Insurance is Expensive.

All nurses should protect themselves by obtaining professional liability insurance. A good policy will provide medical malpractice and, very importantly, licensure protection coverage. The costs on these policies vary, but it is generally quite reasonable. It is common to find professional liability insurance that provides excellent coverage and excellent benefits for less than a dollar a day. We’ve seen policies cost as low as $10 to $15 a month. That is a small price to pay to protect your livelihood.

Excuse: Licensure Defense Coverage Is Not Necessary.

When you buy professional liability insurance, again, it is very important you make sure it includes legal defense coverage for professional licensing defense and other administrative proceedings in an amount of coverage of at least $25,000. If it does not, I recommend you purchase a “rider” or additional coverage from that insurer for a small additional premium.  Also, attempt to obtain “broad form coverage.” This will pay for your legal defense costs for other types of regulatory and administrative proceedings such as: a) an internal hospital/facility peer review proceeding; b) a Medicare or Medicaid audit or investigation; c) a Medicare medical quality assurance investigation or review; d) an EEOC discrimination or harassment complaint or investigation; e) an alleged HIPAA privacy violation; f) a hospital clinical privileges action (if you have privileges); g) action to exclude you from the Medicare or Medicaid Program; or h) action to suspend or revoke your DEA registration (if you have one).  There are some insurance companies that sell professional license defense and defense costs and expenses for other types of administrative proceedings as a stand-alone insurance policy.

You should buy this coverage now, when you don’t need it. Otherwise, when you do need it, it will be too late.

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 have personal professional liability coverage? Are you thinking about getting a personal policy now? Please leave any thoughtful comments below.

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.

Nurses, No More Excuses: Get a Personal Professional Liability Insurance Policy Now-Part 1

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

To protect yourself from automobile accidents, you carry auto liability insurance. To protect your home from fire, storms and other accidents, you carry homeowners’ insurance. However, I have noticed many nurses fail to carry any insurance to protect one of their most precious assets, their nursing licenses. Yet such insurance is cheap and easy to obtain. I cannot stress enough how important it is for a nurse to carry a personal professional liability insurance policy that covers any investigation, complaint or administrative hearing that might be filed or opened against a nurse’s license.

In my experience, I’ve heard every excuse as to why a nurse does not have a personal professional liability insurance policy. In this blog series, I am exploring those excuses. I want every nurse to understand the importance of buying personal professional liability insurance now, before it is too late.

Keep in mind that a great deal more nursing license complaints are filed against nurses than there are liability lawsuits.

Excuse: I Am a Good Nurse, I Don’t Need Professional Liability Insurance.

You may be a good nurse, but good nurses are the subject of lawsuits and complaints. All it takes is just one violation that gets reported to the DOH or BON, and the nurse is suddenly in a position of having his or her license investigated. The nurse then has to defend his or her actions to protect the integrity of his or her license, and possibly the ability to continue practicing.

The harsh reality is that legal representation is very expensive. Without insurance, even if the nurse is found to be not negligent, the nurse is still responsible for the attorney’s fees and expenses incurred during trial. However, professional liability insurance will protect the nurse in the event of a lawsuit, and it may also pay legal defenses in the event of a complaint against the nurse’s license to practice or for other legal problems.

Excuse: I am Covered By My Employer’s Insurance.

We hear this on a weekly basis. Many nurses mistakenly believe that their employer insures them for legal fees and costs associated with defending against licensure complaints, Emergency Suspension Orders (ESOs), Notices of Investigation, and Administrative Complaints. In the overwhelming majority of cases, this is false. Often it is the employer that files the complaint against the nurse that causes the investigation. If you are told your employer will cover you in such circumstances, ask for a letter in writing and signed by the employer stating that the employer will pay for your defense in any DOH or BON investigation or subsequent administrative proceedings that arise out of your employment. It is unlikely that you will get it.

When a nurse is “covered” under a hospital’s (you can substitute nursing home, clinic, etc., as applicable here) policy, that policy primarily protects the hospital’s interests. Therefore, this “coverage” extends only to those situations and occurrences where the hospital might have liability.

Check This Blog for More.

I will continue to explore excuses I hear from nurses as to why they do not have a personal professional liability insurance policy in later blogs.

It is my hope that after reading this you will look into purchasing your own professional liability insurance policy.

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 (BON) 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 have personal professional liability coverage? Are you thinking about getting a personal policy now? Please leave any thoughtful comments below.

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.

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.

Appealing Final Orders and Emergency Suspension Orders (ESOs) from the Florida Board of Nursing

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

The professional boards for licensed health professionals in Florida, such as the Board of Nursing, are all under the Florida Department of Health (DOH).  Each board is responsible for disciplinary actions and other matters regulating the professions under its authority.  The investigators and attorneys assigned for Board of Nursing matters all work for or are assigned to the DOH.  The Florida DOH is headed up by the Florida Surgeon General.  I think of the DOH as the umbrella agency over the professional boards or as a parent corporation which owns many subsidiary corporations.

Administrative Procedures Governing Investigations and Disciplinary Actions.

All agency actions, especially disciplinary actions and investigations, are governed by the Florida Administrative Procedure Act (APA), Chapter 120, Florida Statutes.  The Florida APA is modeled after the Federal Administrative Procedure Act.  However, in addition to the Florida APA, DOH investigations and hearings may also be governed by several different provisions of Chapter 456, Florida Statutes, a set of laws which govern all licensed health professionals.

For example, Section 456.073, Florida Statutes, gives certain procedural steps that must be followed in investigations and probable cause hearings involving complaints against nurses and other health professionals.  Section 456.073(13), Florida Statutes, is a new section added several years ago that provides a six (6) year “statute of limitations” for many disciplinary matters;  but there are many exceptions to this.

Section 456.074, Florida Statutes, gives the Surgeon General the authority to issue emergency suspension orders (or ESOs) in certain cases.  Section 456.076, Florida Statutes, authorizes the establishment of treatment programs for impaired health professionals and offers some alternatives to disciplinary action.  To date, the only recognized programs are the Intervention Project for Nurses (IPN) (which covers all nursing professionals) and the Professionals Resource Network (PRN) (which covers almost all other health professionals).  Section 456.077, Florida Statutes, authorizes nondisciplinary citations for certain offenses.  Section 456.078, Florida Statutes, authorizes mediation for certain offenses.

Mistaken Advice Regarding Appeals.

We are often consulted by nurses after they have an emergency suspension orders (or ESOs) entered against them or after they have a Final Order for disciplinary action entered against them.  We often hear that they consulted an attorney who advised them at an earlier stage of the proceedings, after they received a letter from a DOH investigator advising that they were being investigated, to not worry about putting together or presenting any defense at that stage.  We often hear that they consulted an attorney who advised them not to dispute the charges at a formal administrative hearing or not to request a formal administrative hearing.  We are told that they have been mistakenly advised that they should just wait and file an appeal because they are more likely to win on appeal.

This is, of course, incorrect advice.  If you compare these proceedings to criminal investigations, would any competent attorney advise you to not worry about preparing for a trial or contesting the charges at a trial?  Would any competent attorney advise you to just wait until you are convicted, because you could then file an appeal?  No, of course not.  This is because appeals are based on legal defects in the proceedings and do not involve any presentation of new facts that are not already in the record.  Additionally, very few cases are reversed on appeal, whether criminal, civil or administrative in nature.  So why give up your best shots at winning a case:  presenting a good case of factual information and documents at the investigation level or disputing the charges at a formal hearing?

Don’t Try to Be Your Own Attorney on an Appellate Matter.

There are, of course, many valid legal grounds for appeals of ESOs and Final Orders.  However, you have to understand the law and the procedural rules that govern such matters in order to be able to identify them and argue them on appeal.  In addition, appellate law is a legal specialty of its own.  If you are not familiar with researching case law and writing legal briefs, you should not be attempting to appeal your own case.  Would you attempt to perform brain surgery on yourself?  If so, you should get your head examined.  The courts of appeal are far more exacting in their requirements than trial courts are.  See The Florida Rules of Appellate Procedure.  However, most Florida courts of appeal also have their own local rules which may apply to appeals.

Grounds for appeal of an ESO include that less restrictive means of protecting the public were available or that the conduct alleged does not meet the legal requirement for imposing such a suspension.  Grounds for appeal of a Final Order include that the punishment it gives exceeds the disciplinary guidelines that each board has and that proper procedures were not followed which deprived the respondent of his or her right to a fair hearing.  There are many other grounds which one who practices regularly before the Board will be able to identify and raise in an appeal.

In many cases, it would be completely useless to appeal an ESO.  You would just waste time and money by doing so, with little or no chance to win or have it reversed.  You might be far better off requesting an expedited formal hearing, to which you are entitled in an emergency suspension case, and get your case heard as soon as possible.  You need the advice and guidance of an experienced attorney to help you figure out what the best course of action is in your case.

Where to Appeal May Be an Issue.

The notice of appeal must be filed with the clerk of the DOH.  However, a copy must also be filed with the appropriate appellate court having jurisdiction.  The First District Court of Appeal in Tallahassee will have jurisdiction in almost all DOH and Agency for Health Care Administration (AHCA) appeals.  However, the District Court of Appeal which has jurisdiction over the county in which the respondent health professional resides will also have jurisdiction.  If the appellate case law of one of these is more favorable than the other, from a strategic viewpoint, it may be better to file in the one with the more favorable case law.

Alternative Actions to an Appeal May be Appropriate.

Furthermore, there may be more effective and less expensive methods of obtaining relief from an ESO or Final Order than an appeal.  If you are subject to an ESO, you have the right to an expedited hearing.  Sometimes this will result in quicker relief than appealing it.  If you are subject to a Final Order that has been issued in error or there was some mistake in the proceedings that led up to it, the Board may be inclined to reconsider the matter and amend it.  This would require you to file a motion for reconsideration with the Board itself.

Always Carry Professional Liability Insurance that Includes Licensure Defense Coverage.

We continue to recommend that all nursing personnel, especially those who work in hospitals, nursing homes or for agencies, carry your own professional liability insurance.  If you do purchase insurance, make sure it has professional license defense coverage that will pay for your legal defense in the event a complaint is filed against your nursing license.  Usually coverage of up to $25,000 comes with most good nursing liability policies.  There are many companies that sell such insurance for as little as $100 per year.  However, if you can get additional coverage, $50,000 is more likely to cover any foreseeable investigations, hearings and appeals.  Even higher limits can be purchased for a few dollars more from many insurance companies.

Seek Legal Advice and Prepare Your Defenses Early.

Always seek legal advice as soon as you suspect there may be a complaint of any kind or an investigation of any kind.  Don’t hide your head in the sand and think that the investigation could not possibly be about you.  Talk to an attorney before you talk to anyone else.  A good attorney will help to save you from making mistakes that could compromise a good legal defense.

Call the attorneys of The Health Law Firm to set up a consultation on any of the above issues. To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Comments?

Did you find this blog helpful? Please leave any thoughtful comments below.

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.

Nurses Need to Monitor Their Personal Nursys Profiles

CCS Blog LabelBy Carole C. Schriefer, R.N., J.D., The Health Law Firm and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Nurses, did you know that the status of your license and disciplinary actions taken against you are constantly being tracked by employers? It is actually relatively easy with the National Council of State Boards of Nursing (NCSBN) database, called Nursys. What’s even scarier is employers can sign up for an e-Notify option. This is an e-mail notification system that delivers real-time updates to employers about nurses. The Nursys’ e-Notify option is frequently used by hospitals and medical groups to regulate and screen employees. Click here to read a previous blog on Nursys.

It is imperative, as a nurse, you regulate your own profile regularly for discrepancies. You can do so by clicking here for the Nursys website.

Be Familiar with Nursys and the e-Notify Option.

Nursys is the only national database for license verification, discipline and practice privileges for registered nurses (RNs), licensed practical nurses (LPNs), practical nurses (PNs), certified nurse midwives (CNMs), certified nurse practitioners (CNPs), clinical nurse specialists (CNSs) and certified registered nurse anesthetists  (CRNAs). The data on Nursys comes directly from the Florida Board of Nursing and forty-six (46) other state nursing boards. The e-Notify option provides automatic email notifications of licensure status changes and discipline action changes to employers directly. Any institution that employs a nurse can track or check licensure and discipline information at any time.

Employers using Nursys have the ability to view and manage their institution’s nurse employees, including uploading nurse profiles, searching nurses by name, editing nurse information and viewing individual nurse reports.

Nursys Makes it Easy for Employers to Keep Tabs on Nurses.

According to the website, a nurse’s profile on Nursys contains:

-  the nurse’s name,
-  licensed jurisdiction,
-  license type
-  license number,
-  compact status (single state or multistate),
-  license original issue date,
-  license expiration date,
-  discipline against license, and
-  discipline against privilege to practice.

e-Notify will alert subscribers when then following changes are made to a nurse’s record:

-  license status,
-  license expirations, and
-  publicly available disciplinary and alert action and resolution.

Flaws in the Nursys Program.

If you have recently received discipline from the Florida Board of Nursing, or any other state board of nursing, it would be prudent to immediately check this website to verify that any information listed under your profile is accurate.  The website clearly states that it is the nurse’s responsibility to contact the board of nursing to update his or her information.

Our law firm has encountered errors on this database that our client contended caused him to lose employment opportunities. Be responsible for verifying the information on your personal profile.

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?

Did you know about Nursys? What do you think of the database? Do you monitor your profile? Please leave any thoughtful comments below.

About the Authors: Carole C. Schriefer is a nurse-attorney with 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, Altamonte Springs, Florida 32714, Phone:  (407) 331-6620.

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.

Think You Have Professional Liability Insurance Through Your Employer? Think Again, Nurse!

00034_RT8By Joanne Kenna, R.N., J.D., The Health Law Firm

Not a week goes by without a call coming into the firm from a nurse whose license is under investigation for some reason or another.  The nurse is generally dumbfounded that this has happened.  “But I’m a good nurse.  I never thought this could happen to me,” is the sad refrain.

Very often the nurse is correct.  He/she is a clinically good nurse.  Often there has never been any prior problem or any question of this.  But all it takes is one instance, just one violation that gets reported to the Department of Health (DOH), and the nurse is suddenly in the position of having his/her license investigated.  The nurse then has to defend his/her actions to protect the integrity of his/her license, and possibly even his/her ability to continue practicing, against the allegations of the violation.

Employer’s Insurance Coverage Protects the Employer, Not You.

Normally when a licensure investigation is initiated, the nurse is upset and angry, and is determined to do whatever is necessary to protect his/her license.  At this point the intelligent  nurse will usually start making telephone call(s) to seek legal advice and counsel.  Then comes the harsh reality.  Obtaining good legal services is expensive.  It can be very expensive.  Inevitably the question is put to the nurse as to whether he/she has insurance.  All too often the nurse responds that his/her insurance is (or more often at this point, was) through his/her employer.

Then more reality hits.   Often the nurse has already been terminated from employment by this point.  So, no insurance.  Even if the nurse is still employed, the nurse quickly finds out that the coverage he/she believed existed, and often was led by the employer to believe existed, is not really a policy for the nurse at all.  The nurse is “covered” under the hospital’s (you can substitute nursing home, clinic, etc., as applicable here) policy really only to protect the hospital’s interests.  Therefore, this “coverage” extends only to those situations and occurrences where the hospital might have liability.  (And even in that case the nurse should be wary because it is really the hospital’s interests that are being protected by the policy.   Where the nurse’s interests happen to be aligned with the hospital’s, all is good.  But where they are not, well, the hospital has coverage and its interests will be protected; as for the nurse, he/she is on his/her own).

What you should know is that the hospital’s insurance coverage is there to protect the hospital – - period.

Protect Your Nursing License with a Personal Professional Liability Insurance Policy.

You should also recognize that no nurse is immune from a professional liability claim.  No matter how conscientious and clinically competent the nurse may be, the potential for a professional licensure action always exists.   Day after day nurses forego legal representation when they are under licensure investigation because legal representation is unaffordable for them.  While some nurses get lucky and will have a good outcome in spite of this, many others will not.  The very idea of gambling with your nursing license that took so much effort to earn and is the key to your future earning capacity, is not only risky, it is downright foolish.

The truth of the matter is that all nurses should protect themselves by obtaining a personal professional liability insurance policy.  A good policy will provide medical malpractice and, very importantly, licensure protection coverage.  The cost on these policies varies, but it is generally quite affordable, often costing little more that $10 – $15 a month.

Licensure protection coverage provides the nurse with the ability to obtain competent legal representation from an attorney or a law firm that is familiar with handling licensure investigations and the disciplinary actions that can ensue from them.  Good policies will provide $10,000 – $25,000, and even more for legal expense.  Having this money available at the time it is needed allows the nurse to focus on his/her defense and provides the nurse the opportunity to pursue this defense all the way through the administrative process.  All too often the alternative is having the limited available funds dictate the nurse’s acceptance of an undesired resolution to the matter.

Be Smart, Get Professional Insurance Before it is Too Late.

So, if your independently wealthy, you can continue practicing without much concern about how you will be able to afford legal services for licensure defense if and when that becomes necessary.  If though you are not, and your answer to the question of whether you have insurance would be that you do through your employer, now is the time to start thinking about changing that.  Tomorrow just might be too late.

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 have personal professional liability coverage? Are you thinking about getting it now? Please leave any thoughtful comments below.

About the Author: Joanne Kenna is a nurse-attorney with 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, Altamonte Springs, Florida 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.

Traveling Nurses Must Have Appropriate Professional Liability Insurance

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

We are often asked what we consider to be the biggest problem that a nurse has in defending herself in a complaint against her license.  In our opinion, it is not having the financial resources to retain the services of an experienced attorney to defend her.  Because of this, we believe that any nurse, especially traveling nurses working at a hospital, skilled nursing facility, home health agency, assisted living facility, medical group, or any other organization must have her own personal professional liability policy that provides ample insurance coverage for professional license defense expenses.

Most Complaints Made Against Nurses are Filed by Employers.

In our experience, most of the complaints filed against nurse professionals come from employers.  In many cases, a patient will complain to the employer and the employer will file the complaint.  In others, the employer initiates the complaint because of substandard performance, documentation problems, allegations of theft or drug diversion, allegations of falsification of documents or records, etc.  When this happens, in most cases the employer terminates the nurse.  This is why we say that a nurse must have her own professional liability insurance policy.

We see a great many more complaints filed against a nurse’s license that she then must defend, than we ever see civil claims for damages.

Many nurses work under the incorrect assumption that they are “insured” by their employer or their agency or that their employer’s or agency’s insurance covers them.  This is a fallacy, especially when it comes to defending against a complaint made against one’s nursing license.  If your employer or agency is the one that files the complaint against you, you don’t really think that your employer or agency is going to cover the legal expenses associated with your defense, do you?

Some hospitals and health organizations are notorious about firing nurses who have any discrepancies in drug counts or who have documentation errors.  This often results in a complaint to the Department of Health (DOH) against the nurse’s license.

Furthermore, we are all aware of the phenomenon with the traveling nurse, the person who is no longer there, getting all of the blame for any problem or incident that come up.  The ones that are still at the facility, the ones who are conducting the investigation on the incident, are far less likely to find blame with their friends and colleagues who are still there.

Just when you need it the most, you may find yourself out of a job, with no income, and no money to pay for a legal defense.  This may ultimately lead to your losing your nursing license and your ability to ever work as a health professional again.

If You Don’t Have Personal Professional Liability Insurance-Get It.

Professional liability insurance policies for nurses are very cheap.  Often policies are only about ten dollars a month.  Usual limits of coverage for this small premium payment are one million dollars of coverage for civil suits and $25,000 or more coverage for professional license defense.

But wait, it is not as simple as just purchasing the first professional liability insurance policy you find.  Many professional liability insurance policies do not offer license defense coverage.  Or, if they do, it is limited to only complaints where there is also the threat that a patient is going to sue for money.  Still others provide such low limits of coverage for license defense expenses (e.g., $5,000 or $10,000) that it is not worth the money paid for it, while others do not allow you to choose your own attorney.

Insurance Companies We Recommend.

We usually tout insurance companies such as that provided by Nurses Service Organization (NSO) and Healthcare Professionals Service Organization (HPSO) as providing great bang for the buck.  But here lately, we’ve been seeing (and hearing) more and more about CPH & Associates insurance.  Not only does it provide one million dollars in coverage if you are sued in a civil court, but it also provides up to $35,000 in coverage for professional license defense.  Additionally, for a very small additional payment, with CPH & Associates Insurance you can increase that coverage to $100,000 for professional license defense.  The other company we hear good things about is Lloyd’s of London.

If you have a complaint filed against your nursing license and you have to prove your innocence through a formal administrative hearing (trial), this can be very, very expensive.  Additionally, if you lose at this level, you may have to appeal the results to a higher court.  These expenses can easily cost $75,000, even if you win.  And you are not ever assured that you will get any of this money paid back to you, even if you are innocent and you win the case.  Inexpensive insurance coverage is the only thing that makes since.  Buy it!

In Conclusion.

We urge all nurses, especially traveling nurses, to purchase and maintain their own personal professional liability insurance policy.  It’s tax deductible.  But check to make sure you have coverage for professional license defense, even when there is no claim for damages expected from a patient.  Additionally, pay the extra premium to purchase a higher limit of coverage for professional license defense cases, or buy a second insurance policy for this additional coverage.

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 have personal professional liability insurance? Will you consider purchasing a personal policy now? Please leave any thoughtful comments below.

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.