Operation Nightingale Uncovers Alleged Fraud Scheme

Operation Nightingale has uncovered an alleged scheme that sold fraudulent nursing diplomas and transcripts to aspiring nurses. Federal and state authorities found three formally accredited nursing schools in Florida were involved. These schools have since been closed. This widespread activity involved the distribution of more than 7,600 fake documents, and 25 individuals across 5 states have been charged. These documents were bought by aspiring nurses, and in many cases, used to qualify to take state board of nursing exams. About one-third of these aspiring nurses successfully passed board examination and ultimately received state licensure, which enabled them to seek employment in healthcare.

Authorities have provided state boards of nursing with names of individuals who purchased the documents. Boards of nursing are now reviewing licenses, conducting investigations, and some licenses have been revoked. If your practice has hired a nurse with fraudulent credentials, what are your risks, and could you be a target of a negligent hiring claim? The Society for Human Resource Management (SHRM) defines negligent hiring as “a claim that can be made against an employer when an employee causes harm to others and the employer should have known of the individual's potential to cause harm but did not take steps to mitigate the risk.”[i] In this case, nurses were able to produce diplomas and transcripts. Even if an employer were to call the school for verification, they would have confirmed the potential employee as a student. Employers are expected to take reasonable steps upon hiring healthcare workers; and this includes license verification. Again, in this scenario these potential employees had a state sanctioned nursing license. Negligent hiring could be difficult to prove when employers in this situation took reasonable steps to confirm education and licensure. It would not be reasonable to expect that an employee held a fake transcript and degree and illegitimately passed the licensing exam.

What about negligent retention? Now that this activity is publicized, what is a practice or employer’s responsibility? According to SHRM, “Negligent retention occurs when an employer fails to take appropriate disciplinary action (i.e., termination) against an employee that the employer knew or should have known was unsuitable and the employee's actions cause harm to others.” [ii] Now that the schools in question have been identified, a review of nursing staff credentials is a reasonable expectation. Review nursing staff credentials, including school of nursing attended. When hiring, maintain a list of schools involved for future reference. Boards of nursing have been provided names and efforts to identify individuals with fraudulent credentials could be coordinated.

In a statement released by the National Council of State Boards of Nursing (NCSBN), “Nursing regulatory bodies in affected states have been investigating individual cases and are taking appropriate action, in accordance with their state laws and due process, that includes loss of license.”[iii] The full statement released by the NCSBN can be found here.

Patients have a right to receive care from well-qualified and competent staff. We suggest staff competency be assessed upon hire and at regular intervals. This could be at the time of annual review and upon learning a new skill. This competency should be documented and maintained in the employee’s personnel file. Sample skilled and unskilled competency forms can be found here.

[i] “Negligent Hiring,” SHRM. https://www.shrm.org/resourcesandtools/tools-and-samples/hr-glossary/pages/negligent-hiring.aspx#:~:text=What%20is%20negligent%20hiring%3F,%2C%20not%20hiring%20the%20individual). Accessed on February 6, 2023.

[ii] “Negligent Retention,” SHRMhttps://www.shrm.org/resourcesandtools/tools-and-samples/hr-glossary/pages/negligent-retention.aspxAccessed on February 6, 2023.

[iii] “The National Council of State Boards of Nursing (NCSBN) Statement on Operation Nightingale,” NCSBN. https://www.ncsbn.org/public-files/OperationNightengaleStatement.pdfAccessed on February 6, 2023.