Nurse fights licensing board’s findings of professional incompetence

An Iowa nurse is taking state regulators to court over their efforts to suspend her license due to professional incompetence.

Advanced Registered Nurse Practitioner Jennifer Penisten is seeking judicial review of a 90-day license suspension, arguing the Iowa Board of Nursing improperly relied on her alleged confessions rather than citing care issues involving specific patients.

State records indicate Penisten — identified in the lawsuit and in some board records as “Peniston” — was first licensed in Iowa in 2006 as a registered nurse. She is also a licensed advanced practice nurse prescriber in the state of Wisconsin.

According to the Iowa Board of Nursing, Penisten was previously disciplined by the board in 2021, at which time she entered into a settlement agreement to resolve charges of improperly prescribing, dispensing, administering or distributing drugs; prescribing, dispensing, or administering drugs to individuals who are not patients or are outside the licensee’s specialty area; and improper delegation of nursing services.

The board alleged Penisten, “without any formal training for the service, (was) acting as a supervisor to a registered nurse providing Botox and dermal fillers.” Penisten allegedly allowed the nurse to order Botox and dermal fillers under her prescriptive authority, did not see the patients which received Botox or dermal fillers, and did not provide direction to the nurse on the drug’s administration.

The board required Penisten to stop supervising nurses who administered Botox and dermal fillers until she received specified training and 4.6 hours of training in professional accountability and legal liability.

On Aug. 23, 2023, the Board received a complaint concerning intravenous therapy services provided by a company based in Iowa called IV Therapy.

Through its investigation, the board confirmed that Penisten was the medical director for IV Therapy from November 2021 through September 2022, and was also serving as the medical director for at least two other “medical spas” in Iowa and Wisconsin. Penisten had also been running an aesthetics practice, Vivid Life Spa, since November 2021, and served as the medical director of Vivid IV, according to the board.

The board alleges Penisten admitted she did not meet with all of the spas’ Botox and IV patients, either in person or virtually. The board alleges she admitted that she reviewed documentation submitted online by the patients, and then other nurses administered treatments with the use of her guidelines and a set of standing orders that were not patient specific.

Board cites past issues with Botox patients

In December 2024, based on its findings, the board charged Penisten with professional incompetence. After a hearing on the matter, the board concluded Penisten failed to adhere to the standards of practice for advanced registered nurse practitioners.

The board found that while Penisten served as a medical director at multiple businesses that provided Botox injections and IV infusions, she admitted that she didn’t meet with patients in person or virtually to establish a patient-provider relationship, and admitted she did not perform an initial assessment or establish a plan of care as required by state regulations.

“The board is concerned that despite previous discipline related to her failure to meet with Botox patients prior to treatment, (Penisten) has continued to engage in this practice,” the board said in imposing a 90-day license suspension.

The board also ordered that upon reinstatement of her license, Penisten cease and desist from serving as a medical director for a medical spa and that she refrain from overseeing the provision of medical spa services in any facility.

In her newly filed court petition seeking judicial review of the board’s actions, Penisten argues that “not a single patient or case was identified” during her hearing and the board instead relied upon “hearsay and vague and overly general ‘admissions’” that were attributed to her.

“The state’s evidence failed to assert a violation of any single patient or case handled by Nurse Penisten,” the petition alleges. “The state did not introduce a single patient file, nor did the peer reviewer actually review any patient or case.”

The Board of Nursing has yet to file a response to the petition.

Editor’s note: This story was originally published using the spelling of Jennifer Penisten’s last name as it appears in her lawsuit, “Peniston,” which is incorrect. The story has since been revised to use the correct spelling of Penisten’s last name.