Certified Registered Nurse Anesthetists (CRNAs) are the unsung heroes of many healthcare systems in Louisiana, ensuring that residents can get the procedures and care they need. The Louisiana Legislature has written on the history of nurse anesthetists in Louisiana, which goes back over 100 years. Today, nurse anesthetists administer the majority of anesthetics in Louisiana and are the sole providers of these services in some clinics and areas. The Legislature has recognized that CRNAs are “safe, accessible, and cost-effective.”
CRNAs are experienced in patient care, with the AANA estimating that graduates of CRNA programs have an average of over 9,000 hours of clinical experience. But each year, some nurse anesthetists face accusations of unprofessional behavior or misconduct, and these allegations put their licenses and all those hours of training and work at risk.
In Louisiana, actions against nurses and advanced practice nurses are published. The most common allegations involve drug or alcohol abuse, convictions for drug offenses, and diversion of medications. Other common allegations are issues of competency and sexual misconduct.
If you are a CRNA in Louisiana facing a challenge to your license, you need the experienced team at the Lento Law Firm. The attorneys of the Lento Law Firm have vast experience in medical license defense and have represented many nurses, including advanced practice nurses. The earlier in the process that the Lento Law Firm Professional License Defense Team is involved, the better. Call the Lento Law Firm today at 888-535-3686 or provide your details online, and we will contact you.
Louisiana Board of Nursing Discipline Powers
The Louisiana Board of Nursing (the Board) handles all licensure issues for CRNAs in Louisiana and oversees all disciplinary cases. The Board has wide latitude to take action against a CRNA or any advanced practice nurse.
Disciplinary Actions by the Board
The Board may take the following disciplinary actions against a CRNA:
- Deny a License. Board may deny an initial license application.
- Formal Reprimand. Board may formally reprimand a CRNA.
- Limit a License. Board may limit the practice or license of a CRNA as a condition of retaining their license.
- Probate a license. Board may probate a license or place the CRNA on a type of probation under which they may continue to practice but under a set of conditions or terms.
- Suspend a license. Board may prohibit a CRNA from practicing for a period of time.
- Revoke a license. Board may rescind the license of a CRNA.
- Impose fines and assess costs. Board may fine the CRNA or assess the cost of discipline.
- Other Discipline. Board is given broad powers to discipline or sanction advanced practice nurses.
Nursys Database
This database allows the user to look up a nurse's disciplinary history. Louisiana is a member of the Nurse Licensure Compact (NLC) and reports all disciplinary actions into Nursys.
Please Note: Like any database, Nursys contains errors. If you are having issues with false information on Nursys, call the Lento Law Firm. We can help with these issues.
Other National Databases
The National Practitioner Database contains information on malpractice cases and disciplinary actions against medical providers. Advanced Practice Nurses, including CRNAs, are much more likely than other nurses to be placed into the National Practitioner Database.
With regard to all disciplinary databases, charges that originate in Louisiana are likely to affect licensure in other states. It is not possible to agree to or ignore charges in Louisiana and move your practice to another state. With the advent of national databases, CRNAs have no choice but to fight charges when and where they arise.
Grounds for Sanctions to CRNAs in Louisiana
In Louisiana, the following are possible grounds for sanctions on CRNAs:
- Fraud or deceit in licensing before the Board.
- Conviction of a crime which reflects an inability to safely practice nursing.
- Incompetence or unfitness.
- History of a lack of skill or safety because of drug or alcohol issues or physical or mental illness.
- Aiding another in violations of the Nurse Practice Act.
- Mental incompetence.
- The limitation, suspension, or revocation of a license in Louisiana or another state.
- Moral turpitude.
- Violation of the Nurse Practice Act.
Complaint Process
Step One: The Complaint
The Board will not take action on the complaint of a patient or other person or entity until the complaint is made in writing. If a complaint states a violation of the Nurse Practice Act, the Board may move to investigate the complaint or charge.
Step Two: Investigation
Board staff will investigate the complaint and will take witness statements. The Board has subpoena powers during an investigation—that is, they can order a witness to appear under the law.
During this state, the Board may choose to handle less serious allegations informally. This can be done in several ways:
- Disposition by Correspondence: The Board will write the Licensee and ask for a response to the allegations. If the Board is satisfied that no violation occurred, it will dismiss or drop the complaint.
- Disposition by Conference: The Board meets with the Licensee and asks for a response to the allegations. If the Board is satisfied that no violation occurred, it will dismiss or drop the complaint.
If, following the investigation, the Board believes a serious violation may have occurred, the Board will prepare a formal complaint and serve it on the licensee together with a notice of hearing time and date. This must happen at least 20 days prior to the scheduled hearing. The formal complaint is typically sent through some type of registered mail.
Step Three: Settlement Discussions
The Board and the licensee are allowed to negotiate an agreement on how to handle the complaint and charges. Most complaints before the Louisiana Board of Nursing are settled through a Consent Agreement or a Consent Order.
After service of the complaint and notice of hearing, the Board counsel will often serve a drafted Settlement Agreement on the licensee. The licensee is not required to sign, but if they do, the Consent Agreement or Order is binding. The Consent Order will often involve an agreement to undergo certain conditions, such as drug or alcohol evaluation or treatment, or probation and monitoring.
At this stage of negotiation, it is vitally important to have counsel. Your attorney will be able to advise you on whether you should accept a negotiated settlement or sign a consent order. If you have had the opportunity to consult an experienced attorney, you will not have lingering doubts and questions as to whether a settlement was in your best interests. Please note that consent orders and other stipulated settlement agreements are reported to Nursys.
If the parties are unable to agree to a settlement, the matter will proceed to a hearing.
Step Four: Board of Nursing Hearing
The Executive Director of the Board will send out a Notice of Hearing with the original complaint/charge. The Executive Director will select a hearing panel of 3 or more Board members to hear the case. If the Executive Director fails to do this, the hearing must be before at least a quorum of the Board.
The panel will have a number of powers:
- The panel may subpoena witnesses.
- The panel may compel the production of documents—that is, they may order a provider or clinic (or someone else) to produce copies of certain documents.
- The panel may put witnesses under oath.
- The panel may issue subpoenas on behalf of the licensee.
- The panel must allow the licensee to cross-examine witnesses.
- The panel must loosely follow certain rules of evidence.
- The panel must accommodate the attorney of the licensee.
The Hearing will appear very much like an informal trial, with the parties taking turns presenting evidence. The Board will issue a Decision and Order.
Step Five: Appeal
If this is not successful, the licensee may appeal to the Louisiana courts.
Step Six: Compliance
Depending on the nature of the settlement or the Board's decision, you may have to submit to ongoing oversight of your compliance with the Board's order.
Order of Hearing Proceeding
Many people wonder if a Hearing before the Board of Nursing is like a trial. It is, in a sense, in that there is a hearing officer as a presiding official and a prosecutor in the Board's legal counsel. However, the rules of evidence are more relaxed and informal. Typically, this is the order of such a Hearing:
- The Board will make an opening statement outlining the substance of the complaint/charge.
- The CRNA licensee will now make an opening statement outlining their response to the complaint.
- The Board's legal counsel will present evidence and call witnesses.
- The Board may question the witnesses presented by legal counsel.
- The CRNA or their attorney will cross-examine witnesses.
- The CRNA licensee will present evidence and testimony of witnesses.
- The Board may question these witnesses.
- Board legal counsel may cross-examine witnesses presented by licensee.
- Board legal counsel may present a rebuttal to this evidence.
- Licensee may rebut any evidence presented by the Board's legal counsel.
- Each side may make a closing statement.
- The Board panel will discuss this privately and will issue a Final Order.
Surrendering a License
If you are considering voluntarily surrendering your license, please contact the Lento Law Firm Team first. CRNAs may hope that they will be able to practice in another state in which they hold a license, or they may wish to avoid public exposure or embarrassment. But voluntary surrender of a license when facing accusations is most often not effective and not a good decision for two reasons:
- Report to Nursys: The voluntary surrender of a license must be reported to Nursys. It is likely that any other state in which a CRNA holds a license will learn of the complaint/charge in Louisiana.
- OIG List of Excluded Individuals: If a CRNA surrenders their license in the face of charges, there is a significant chance that the voluntary surrender will be reported to the HHS Office of Inspector General (OIG) List of Excluded Individuals. Inclusion on this list will prevent a provider from working at any facility that receives Medicare or Medicaid funding. This limitation will effectively exclude the listee from working in almost any healthcare facility in any capacity.
Whatever you have been accused of, the Lento Law Firm Team can advise you and assist in presenting a defense. Do not give up the license you worked so hard to achieve—call us, and we can help.
Why You Should Hire the Lento Law Firm Team
The Lento Law Firm Professional License Defense Team is made up of some of the most experienced in the country. They have represented countless medical professionals, including doctors, APRNs, and CRNAs.
Whether you are working in New Orleans, Shreveport, Baton Rouge, Lafayette, or any other area of Louisiana, the Lento Law Firm can represent you in defending your Louisiana CRNA license.
How Does the Lento Law Firm Defend You?
The Lento Law Firm Professional License Defense Team will be with you every step of the way as we defend your license and reputation. The Lento Law Firm will:
- Review the complaint or charge and advise you on how best to proceed.
- Represent you during the investigation and seek early dismissal of the complaint.
- Advise you on how to handle settlement negotiations and when a Consent Order might be in your best interests.
- Represent you at the Hearing, including opening and closing statements, examination of witnesses, cross-examination of agency witnesses, and all other hearing tasks.
- Advise you on appeals and attempt to have any discipline reduced.
- Assist you with any ongoing compliance issues.
If you have begun this process without counsel, the Lento Law Firm can still help, but it is imperative to call and begin the process of hiring counsel. The Lento Law Firm's Professional License Defense Team will lead the defense of your license. Call us today at 888-535-3686 or submit your details online, and we will contact you.
