South Carolina Attorney General Alan Wilson announced that his office’s Medicaid Fraud Control Unit (SCMFCU) arrested a 37-year-old woman for allegedly practicing medicine as a registered nurse without a license at seven nursing and assisted living facilities in Anderson, Greenville, and Pickens counties. She was arrested by SCMFCU investigators in Anderson County on October 24, 2022, Greenville County on October 25, 2022, and Pickens County on October 26, 2022. The charges against the woman include seven counts of Neglect of a Vulnerable Adult; five counts of Unlicensed Practice as a Registered Nurse; one count of Financial Identity Fraud to Obtain Employment; and one count of Obtaining Signature or Property Under False Pretenses, value $10,000 or more.
An investigation by the SCMFCU revealed that between January 15, 2020, and June 13, 2021, the woman allegedly used a State of Georgia Board of Nursing license number belonging to someone else to gain employment as a registered nurse in the seven facilities. At no time during this period did she have the certifications, qualifications, or training required of a registered nurse. By holding herself out as having credentials she did not possess, her conduct resulted in a failure to provide adequate medical care and services to vulnerable adults and presented a substantial risk of causing physical or mental injuries to the residents under her care.
Neglect of a Vulnerable Adult is a felony and, upon conviction, has a penalty of not more than five years imprisonment. Unlicensed Practice as a Registered Nurse is a Class C Misdemeanor and, upon conviction, has a penalty of imprisonment of not more than one year or a fine of not more than $50,000 dollars. Financial Identity Fraud is a felony and, upon conviction, has a penalty of a fine in the discretion of the court or imprisonment of not more than ten years, or both. Obtaining Signature or Property Under False Pretenses, value $10,000 or more is a felony and, upon conviction, has a fine of not more than $500 and imprisonment or not more than ten years.
Issue:
Healthcare settings are required to conduct extensive background checks on all employees. These should be comprehensive in order to ensure that each potential employee is qualified and permitted to be employed in a healthcare facility that receives government funds. Before an employee is officially hired into a position, a criminal background check and sex offender registry search must be completed, and the individual must be cleared in the databases. Additionally, an identification verification check, past employment history, education verification, and OIG’s List of Excluded Individuals and Entities (LEIE) check must be completed for all employment candidates. For positions that need certifications or licenses, verification of these credentials must be conducted and documented in the individual’s personnel file. After hire, it is essential that the databases are continually monitored to ensure that no current employee has recently been placed on an exclusion list or had a license or certification suspended or revoked. Routine monitoring will ensure that employees are legally permitted to practice healthcare in your facility.
Discussion Points:
- Review policies and procedures for verifying the status of professional licenses. Update as necessary.
- Train appropriate staff to follow protocols for verification of licenses and certifications of employees at the time of hire and on an ongoing basis to ensure that those licenses remain up-to-date and are unencumbered. Ensure that training is provided to licensed personnel about their responsibility to maintain an active license and to notify administration should their license be suspended, expire, or if they are added to the OIG’s LEIE. Document that these trainings occurred, and file the signed documents in each employee’s education file.
- Periodically audit to verify that the licensing and certifications of employees are valid and up to date. Immediately address any negative findings.
