State nursing board should do more to protect public, audit says
A state licensing board should do more to protect West Virginia residents from bad nurses, because “the potential for public harm is substantial,” according to an audit released Tuesday.
The Legislative Auditor’s office found that the West Virginia Board of Medical Examiners for Registered Nurses failed to properly investigate a complaint about three nurses who allegedly falsified medical records and defrauded Medicare while working at a pain clinic.
The RN board also allowed at least four nurses to return to practice, even though they repeatedly failed drug tests while in substance abuse programs, according to the audit.
Auditors determined that the nurses’ board was slow to respond to complaints about registered nurses.
“The findings ... give the impression that the board leans more toward protecting the professionals [nurses] at the expense of protecting the public,” the audit concluded.
Laura Rhodes, the RN board’s executive director, disputed sections of the report Tuesday, saying auditors reached some conclusions based on “factual errors.”
“We stand behind our discipline process, and we’re confident it protects the public,” Rhodes said after the audit was released Tuesday at a legislative interim meeting in Clarksburg.
In 2010, the RN board received a report from the state Board of Medicine about nurses who allegedly wrote illegal prescriptions for painkillers, according to the audit. However, the nursing board never filed complaints against the nurses or started a formal investigation. The nurses had worked for a doctor convicted on federal charges for prescription fraud.
“The court records supplied by the Board of Medicine clearly state that the nurses at the [pain] clinic were involved in illegal activities,” the audit states.
Rhodes said the RN board reviewed records and spoke to the U.S. Attorney’s Office about the case.
“We went to the courthouse to see if there were any charges, and there were no documents indicating a conviction or any wrongdoing by these nurses,” Rhodes said. “There was nothing to charge them with.”
The RN board also tracked down the nurses and spoke with their lawyers, Rhodes said. There were no grounds to file complaints, she said.
“We did many things to follow up on that,” Rhodes said. “It was not ignored. It just ended up there was not anything to do.”
The audit also criticized the RN board for allowing nurses who failed drug tests -- or skipped drug screenings -- to keep their licenses. The nurses were taking part in substance-abuse recovery programs.
“The relatively permissive handling of these licensees [nurses] does expose the public to nurses who may have questionable decision-making abilities due to impairment,” according to the audit.
Rhodes said some of the nurses cited by the audit never had their licenses reinstated - or forgot to call about their drug screenings.
“There are some factual errors in those cases presented [by the audit],” she said.
The RN board closely monitors every nurse in the recovery program, Rhodes said.
“We make sure everything is in order before they’re permitted an opportunity to pay a fine and return to work,” Rhodes said. “The people being monitored by the board certainly don’t find the board to be lenient. Actually, it is the opposite.”
Legislative auditors also found that the RN board took a year and a half or more to resolve about 16 percent of complaints filed against registered nurses in recent years. The board receives about 300 complaints a year. West Virginia has more than 30,000 registered nurses.
“The board’s complaint process shows signs of lacking appropriate and timely responses,” the audit states. “The board’s actions have resulted in licensees [nurses] continuing to practice after repeatedly violating consent agreements while allowing licensees to effectively ignore public complaints.”
Rhodes acknowledged it’s often difficult to track down nurses who have complaints filed against them. Some nurses never respond to the complaints. Others frequently move from place to place.
The RN board takes its mandate to protect the public and evaluate complaints against nurses “seriously,” Rhodes said.
“There isn’t anything in the law that says you can take somebody’s livelihood because they’re not responding,” she said. “We have to exhaust all of our remedies.”
Reach Eric Eyre at email@example.com, 304-348-4869 or follow @EricEyre on Twitter.