Fake Nurse Pleads Guilty to Wire Fraud, Healthcare Fraud, and Identity Theft

A woman, previously convicted as a felon, was recently sentenced in a Tennessee U. S. District Court to 51 months in prison followed by three years of supervised release for practicing a profession without a license, wire fraud, healthcare fraud, and using another person’s identity to commit federal and state offenses.

The imposter, who had no nursing degree or license, began working in East Tennessee as a registered nurse in September 2012. She obtained license numbers of real nurses with similar first names and then created phony aliases and used the license numbers to pose as an actual nurse and to apply for employment positions. Through her scheme, she obtained employment with at least eight (8) healthcare providers between September 2012 and November 2018.  During the six-year period, she worked in a variety of nursing settings that included nursing homes, rehabilitation and assisted living facilities, a doctor’s office, and home health agencies.

Her imposter status gave her access to real patients, and she rendered actual medical care to numerous patients, including dispensing medications, obtaining invasive access to patient’s bodies, and becoming privy to patients’ sensitive private medical information.  Due to her lack of qualifications, she created a serious risk of injury, and even death, to patients she was treating. The risk manifested itself by her performing procedures she was unqualified to perform, not performing needed procedures she recognized she was not qualified to perform, and failing to chart and document patient care in an appropriate fashion. According to the written plea agreement, at least one patient required re-admittance and a three-day hospital stay due to the imposter’s inept care.

Compliance Perspective

Employing persons as registered nurses whose licensing and training have not been verified and who have also been convicted of criminal felonies which could be discovered by thorough employee screening prior to allowing those persons to provide care to residents may result in placing residents in immediate jeopardy, and may be considered provision of substandard quality of care, in violation of state and federal regulations.

Discussion Points:

  • Review policies and procedures regarding requirements for verification of licensure, education, experience, and possible criminal behavior for all nurses and aides prior to employment.
  • Train staff who are responsible to perform employee screening regarding the need for careful and thorough verification of each individual’s identity and license number, and to check for criminal convictions and exclusion from Medicare through review of the OIG’s List of Excluded Individuals and Entities at https://exclusions.oig.hhs.gov. All staff should be trained in how to report any employee who they suspect may be unlicensed or have a criminal background to their supervisor or through the facility’s Hotline.
  • Periodically audit to ensure that all employees requiring licensure and/or certification have been checked periodically to verify that their licenses and certifications are valid and current.

STAYING ON TOP OF EMPLOYEE CHECKS