A 36-year-old woman who impersonated a licensed nurse has been sentenced to 18 months in federal prison to be immediately followed by three years of supervised release. In addition to the prison sentence, a money judgement was entered against the defendant for $52,241.66. US Attorney Alamdar S. Hamdani made the announcement on May 17, 2024.
At the hearing, the court heard evidence that the defendant incorrectly took out stitches from a patient’s wound, leading to an infection. From 2017 until 2019, the defendant stole the identity of a licensed nurse and repeatedly and fraudulently presented the license and credentials of this licensed nurse at federally-funded Medicare and Medicaid providers throughout Laredo, Texas.
The defendant admitted that from January 2017 through December 2019, she impersonated a nurse and performed unlicensed work at multiple hospitals and home health companies in the Laredo area. At other home health agencies, she falsified patient records and failed to show up to work which left patients without needed care. She also obtained employment as nurse trainer in the federal-funded Job Corps program and was assigned to train future nurses.
Compliance Perspective
Issue
It is illegal to practice a health profession without a license or to use someone else’s license. Healthcare facilities that receive government funds are required to conduct comprehensive background checks on all employees. Before hiring, a criminal background check, sex offender registry search, identification verification, past employment history, education verification, and the Office of Inspector General’s (OIG) List of Excluded Individuals and Entities (LEIE) check must be completed. For positions that require certifications or licenses, verification of these credentials must be conducted and documented in the individual’s personnel file. After hire, databases must be continually monitored to ensure that no current employee has recently been placed on an exclusion list or had a license or certification suspended or revoked since the last check. Routine monitoring will ensure that employees are legally permitted to practice healthcare in your facility.
Discussion Points
- Review policies and procedures for verifying the status of professional licenses and monitoring the OIG’s LEIE. Update as necessary.
- Train appropriate staff to follow protocols for verification of licenses and certifications of employees at the time of hire and on an ongoing basis to ensure that those licenses remain up to date and are unencumbered. Ensure that training is provided to licensed personnel about their responsibility to maintain an active license and to notify administration should their license be suspended, expire, or if they are added to the OIG’s LEIE. Document that these trainings occurred, and file the signed documents in each employee’s education file.
- Periodically audit to verify that the licensing and certifications of employees are valid and up to date and that OIG LEIE checks are routinely conducted. In addition to background and licensure/certification checks, observe for the following: altered or forged driver’s license or insurance card; ID photo doesn’t match; physical description doesn’t match appearance; signature doesn’t match; inconsistent information between forms of ID and Company records; invalid social security number; address does not exist, is a PO Box, or does not match existing records; phone number is invalid, a pager, or an answering machine; failure to provide identifying information; inconsistent personal information compared to the Company record; and/or SSN is the same as provided by another Company individual. Immediately address any negative findings.
*This news alert has been prepared by Med-Net Concepts, LLC for informational purposes only and is not intended to provide legal advice.*
