Board of Nursing has cleared hundreds of cases of questionable documentation for nurses

The Maryland Board of Nursing said it has cleared almost all of the 259 nurses and nursing applicants who may have obtained a Maryland license using fraudulent documents from a scheme revealed in Florida more than two years ago.

The board said that it found “no cause to take disciplinary action” against 205 of the Maryland cases linked to “Operation Nightingale,” a multistate investigation by federal officials in 2023 of a Florida-based wire fraud scheme that provided bogus documentation of nursing credentials.

The board did revoke the “privilege to practice in Maryland” for three nurses and voted to issue charges against seven others, who were referred to the Office of the Attorney General for prosecution. Three nurses voluntarily surrendered their licenses, another 12 applicants withdrew their applications for a registered nurse license in Maryland and the board voted to dispose of another three without taking action.

Those numbers were included in the board’s response to an Office of Legislative Audits report released last week that was a followup to a 2024 inquiry into several boards and commissions that oversee health care facilities or practitioners.

Among the findings of the report, which covered the period from September 2019 to July 2023, was that the agencies often failed to investigate complaints against licensees in a timely manner — a problem the auditors said could be due to staffing shortages during that period.

The report said that the 20 boards and commissions it studied had a total of 4,916 open cases as of February 2024, but that 3,051 of those had been open more than two years. The Board of Nursing, the largest by far of all the boards, had 2,411 cases that had been open more than two years, it said.

The auditors also reported in February 2024 that the nursing board could not provide documentation that it had investigated any of the 259 nurses whose names came up as part of Operation Nightingale — a claim the board disputed at the time, and again last week.

The board now says it is missing documentation for just 26 of those 259. While that is a significant improvement, the OLA report adds on to other audits that raise concerns in oversight and documentation of Board of Nursing and the Department of Health over several years.

The Operation Nightingale investigation became public in a January 2023 post from the U.S. Department of Health and Human Services Office of Inspector General. It said its investigation, along with the FBI and the U.S. Attorney’s Office, uncovered three Florida nursing schools tied to “bogus” nursing degree diplomas and transcripts that were sold to “aspiring” Registered Nurses (RN) and Licensed Practical/Vocational Nurse (LPN/VN) to qualify for the national nursing board exam.

“Upon successful completion of the board exam, the nursing applicants became eligible to obtain licensure in various states,” the HHS statement said. “Once licensed, the individuals were then able to obtain employment in the health care field. The overall scheme involved the distribution of more than 7,600 fake nursing diplomas and transcripts. These schools are now closed.”

Former U.S. Attorney for the Southern District of Florida Markenzy Lapointe said at the time that the wire fraud scheme “erodes public trust in our health care system.”

“Not only is this a public safety concern, it also tarnishes the reputation of nurses who actually complete the demanding clinical and course work required to obtain their professional licenses and employment,” Lapointe said in the 2023 statement.

The Maryland Board of Nursing was notified of 287 nurses or nursing applicants who may have received licensure with false credentials, with the expectation that the Maryland board would look into those cases. By February 2024, the board said it had reviewed most of those cases, even though the OLA said it lacked documentation at the time for that claim. At that time, 131 of those nurses had been working within the Maryland health system, the OLA said.

The Board of Nursing agreed that the audit’s findings were factual and has since located much of the missing documentation regarding those 259 nursing licenses — though documentation for 26 cases are still missing.

“Board of Nursing has located a substantial amount of the records documenting the work conducted to screen and process the 259 individuals who may have obtained licensure in Maryland using fraudulent credentials,” the board responded in the April audit report.

The board believes that it will resolve the outstanding 26 cases by July. The Board of Nursing has a list of the actions it has taken related to nursing licenses involved in Operation Nightingale.