Breaking Compliance News Blog

Fake Nurses: A Compliance Nightmare

Posted by Scott Gima on 5/24/17 6:45 AM

On April 18, 2017, a woman was arrested in St. Louis, MO and is facing federal charges of health care fraud and identify theft after working as an agency nurse in the intensive care unit and geriatric psych unit at a local hospital for three months. The woman is accused of working as a nurse, despite lacking a nursing license or degree in any state.

The Red Flags

In March 2017, this individual applied for a job with a nurse staffing company in Chicago. As reported in the St. Louis Post-Dispatch, the co-owner of the firm found the following problems with her employment application:

  • She failed a basic ICU skills test
  • She reported a New Mexico nursing license, but her social security number did not match any nursing license in New Mexico
  • The copy of her nursing license looked like it was copied and pasted with incorrect numbers and formatting as well as crooked text

Separate criminal charges have also been filed against the woman in New Mexico, where the authorities claim she was hired as a nursing instructor at the Brown Mackie College School of Nursing in 2015 – despite not having a nursing degree or license.

Don’t Let This Happen to You

How does an individual who is not a licensed nurse get hired as 1) a hospital ICU nurse and 2) a school of nursing instructor? This mistake was easily found by the Chicago staffing company which tried to verify her credentials with the state.

License verification is a necessary procedure for all new hires. This requires independent verification with the state – never rely on documentation provided by applicants or staff. Verification should also occur on a monthly basis. Many state license boards publish monthly lists of professionals whose licensed have been disciplined, suspended or revoked. Someone in the HR or Compliance departments should be reviewing this list to see if any staff or contractors are listed. HR and Compliance should also collaborate to audit these procedures periodically to make sure these simple steps are being completed.

Finally, staffing agencies should be thoroughly addressed. If your company uses temporary or agency staff, be confident that the agency(ies) are properly vetting the individuals they send to work in your organization. You are billing Medicare and Medicaid for their work, and exposing your patients to these individuals, after all. The agency’s duty to screen their staff can be addressed by contract. The provider can – and should – also audit the agency to verify that screening occurs. Finally, it is wise for providers to also conduct screens of agency or temporary staff whenever feasible.

stg sig.jpg

MCS_Photo_Signature.jpg

compliance risk assessment annual review 

 

Topics: Compliance Basics, Excluded Providers

    Privacy Policy           Terms of Use