As a licensed nurse practitioner (NP) in Hawaii, you have paid a huge price to get to this point in your career--including years of specialized education, years of practical experience, and years building your career itself. You now play a crucial role in Hawaii's healthcare system by alleviating some of the workload from physicians and providing essential care to patients.
This is why it can be so particularly distressing to learn that a complaint has been filed against you, prompting an investigation by the Hawaii Board of Nursing for alleged misconduct.
It is a difficult but unfortunate reality for licensed healthcare professionals across the country: after all you've worked for, a single complaint could potentially derail your career. Whether you work in Hilo, Honolulu, or Lahaiuna, without your nurse practitioner's license, you effectively have no career. Should the Board find evidence to corroborate the complaint against you--even if the evidence is misleading or incomplete--you could face various sanctions, including the potential revocation of your license. Additionally, any disciplinary action could adversely affect your ability to practice not only in Hawaii but also in other states, as such sanctions are reported to Nursys, the nationwide database used by licensing boards and healthcare facilities to verify credentials.
Suffice it to say that if you're in this situation, you must take action now to protect your career, both now and in the future. Fortunately, by acting swiftly and engaging an experienced professional license defense attorney, you can significantly improve your chances of resolving the complaint and safeguarding your license. The Professional License Defense Team at the Lento Law Firm has extensive experience assisting NPs across the country. We are committed to working diligently on your behalf to secure the best possible outcome. To schedule a consultation, contact the Lento Law Firm today at 888-535-3686 or use our online form.
How Licensed Nurse Practitioners Are Regulated in Hawaii
In the State of Hawaii, Chapter 457 of the Hawaii Revised Statutes sets the standards and regulations for the licensing, conduct, and discipline of licensed nurses in Hawaii. Nurse practitioners fall into the category of Advanced Practice Registered Nurses (APRNs) and require separate licensing in the state. The Hawaii Board of Nursing holds the authority to issue licenses, investigate complaints, and administer disciplinary actions when necessary.
The regulatory structure governing professional licensure in Hawaii is somewhat complex, and if you're accused of misconduct, your case may wind through several agencies during the disciplinary process. These include:
- Department of Commerce and Consumer Affairs (DCCA): This is the overarching government agency overseeing all aspects of business regulation, professional licensure, and consumer protection within the State of Hawaii.
- Division of Professional and Vocational Licensing (PVL): This division functions under the DCCA and is responsible for the licensure, regulation, and enforcement of professional licenses in Hawaii. The PVL supervises 25 licensing boards statewide, including the Hawaii Board of Nursing.
- Board of Nursing: Operating under the PVL, the Board of Nursing licenses and regulates RNs, LPNs, and APRNs in the state.
- Regulated Industries Complaints Office (RICO): RICO is the agency that receives and investigates complaints against professional licensees in Hawaii. If a nurse practitioner is accused of misconduct, this office typically conducts an investigation to substantiate the complaint.
- Office of Administrative Hearings (OAH): This agency conducts administrative hearings for all divisions within the DCCA, including the PVL. If you're unable to resolve the complaint with the Board of Nursing, this department will oversee your formal hearing.
It is important to understand that any action taken against your license becomes a matter of public record, accessible online and searchable by patients, employers, and other state medical boards. The best way to protect your interests and minimize these consequences is by engaging a professional licensed defense attorney as soon as possible. The team at the Lento Law Firm has extensive experience with these matters and can help you navigate successfully through all steps of the disciplinary process to obtain the best possible resolution.
Board of Nursing Disciplinary Measures
By state law, the Board of Nursing is authorized to impose disciplinary actions (or "sanctions") on NPs and other nursing professionals whom they determine have violated state regulations and standards of practice. The Board makes this determination based on the preponderance of the evidence standard rather than guilt beyond a reasonable doubt. If the Board finds you have committed misconduct, they may impose one or more of the following penalties:
- Reprimand: A formal warning from the Board, documented on your record but not restricting your license.
- Fines: A monetary penalty might be imposed.
- Practice Restrictions: The Board has the authority to limit your working conditions or prohibit you from performing specific tasks.
- Diversion Program: If substance abuse or addiction was a contributing factor in the misconduct, the Board may offer to allow you to participate in a state-approved diversion program as a condition for keeping your license.
- License Suspension: This prevents you from practicing as a nurse or NP in Hawaii for a specified or indefinite period.
- License Revocation: The Board may permanently revoke your license, barring you from working as a nurse or nurse practitioner in Hawaii in the future.
Allegations That Could Threaten Your NP License
Most allegations that could result in losing your license involve violations of state nursing standards or general breaches of public trust. Common violations include, but are not limited to:
- Patient Abuse or Neglect: Allegations of physical, verbal, sexual, or mental abuse of a patient can jeopardize your license, as can any behavior that unnecessarily endangers a patient.
- Sexual Misconduct: Inappropriate sexual behavior with a patient can lead to license suspension or revocation. Romantic relationships between nurse practitioners and their patients are also deemed highly unethical and can result in loss of license.
- Drug Mismanagement or Misuse: Any deviation from proper medication administration rules, such as diverting medications intended for patients, drug abuse, poor inventory management, or unauthorized or falsified prescriptions, can result in disciplinary measures.
- Fraud: Fraudulent practices, such as altering patient records, exaggerating qualifications, or "upcoding" insurance claims, can lead to license revocation.
- Criminal Convictions: Being found guilty of a felony or any other crime of moral turpitude can render you ineligible to maintain a nurse practitioner license in Hawaii.
The Disciplinary Process for Nurse Practitioners in Hawaii
The DCCA oversees a uniform regulatory framework for investigating complaints and penalizing misconduct among all licensed professions. As a nurse practitioner operating in Hawaii, if you are implicated in professional misconduct, your case will move through the following stages.
Complaint
Disciplinary proceedings typically begin with a formal complaint lodged against a practitioner with the DCCA. Complaints can be filed by any member of the public but are most frequently submitted by patients, patients' families, peers, other medical professionals, insurance companies, and others.
Investigation
Upon receipt and preliminary assessment of the complaint by the DCCA, it is handed over to the Regulatory Industries Complaints Office (RICO). An investigator is assigned to gather facts and search for evidence supporting the allegations. This stage can span several months and may involve interviews with the complainant and any witnesses, soliciting a written response from you, issuing subpoenas for documents, and conducting site inspections, among other activities.
Settlement Agreement
If the evidence against you is compelling, the Board may propose a settlement agreement negotiation with you in lieu of a formal hearing. This binding agreement means you essentially admit to wrongdoing and willingly accept the Board's disciplinary recommendations. While this may not be suitable for everyone, and any penalties might still become public record, it offers an opportunity for your attorney to negotiate for leniency and a more favorable outcome, ideally one that either enables you to retain your license or provides a path toward reinstatement. The Lento Law Firm Team can negotiate for the most advantageous settlement terms if this is deemed the best course of action.
Formal Hearing
If a settlement cannot be reached (or none is offered), the case is referred to the Office of Administrative Hearings (OAH), where a formal hearing is scheduled. The Board presents its case and evidence against you, and you (preferably via an attorney) present your arguments and evidence refuting the complaint. Once the arguments and evidence are presented, the hearing officer submits their findings and recommendations to the Board.
Final Disposition
The Board, after considering the recommendations and findings made at the hearing, makes the final decision and personally informs you of the disciplinary actions to be taken. These actions can range from a formal reprimand to license restrictions or even complete revocation of your license to practice.
Areas We Serve in Hawaii
The Lento Law Firm assists nurse practitioners throughout the Hawaiian Islands who may be facing challenges to their licenses. Understandably, most of our clients live and work in the state's larger population centers where the need for care and employment opportunities are the greatest.
Honolulu
Located in Oahu, Honolulu is not only Hawaii's state capital and largest city, but it also serves as a crucial hub for healthcare on the islands. Rightly so, considering two-thirds of the state's total population live in or near Honolulu. While the city proper is home to 350,000 permanent residents, the surrounding metropolitan area has a population of more than one million. Renowned for its beautiful beaches, such as Waikiki, historic sites like Pearl Harbor, and verdant landscapes, Honolulu offers a unique blend of urban and natural attractions. The city is served by several major healthcare systems, including Hawaii Pacific Health, The Queens Health System, and Kuakini Health System.
Hilo
Serving as the county seat of Hawaii County, Hilo is the largest town on the Big Island and the second-largest in Hawaii. With a population of approximately 47,000 people, Hilo offers a more laid-back and slower pace than Honolulu while still providing ample healthcare facilities and systems. Some of these include Hawaii Health Systems Corporation (HHSC) East Hawaii Region, which operates Hilo Medical Center, and Hawaii Island Community Health, which offers comprehensive primary and specialty care services to underserved populations.
Kahului
Located on Maui, Kahului is the island's primary retail and commercial center. With a population of approximately 27,000 residents, Kahului offers a laid-back island atmosphere with a bustling economy. Its central location on Maui makes it an ideal location for healthcare providers, such as Maui Health System, which operates Maui Memorial Medical Center, Kula Hospital, and Lanai Community Hospital. Additionally, Kahului also has several private practices and clinics providing various medical specialties.
Kailua-Kona
As the center of commerce and tourism on the west coast of the Big Island, Kailua-Kona is home to a diverse population of approximately 21,000 residents. This area is widely known for its pristine beaches and watersports, including snorkeling, scuba diving, and fishing. The main healthcare providers in the area include Kona Community Hospital, which is part of HHSC's West Hawaii Region, and North Hawaii Community Hospital.
Why You Need Legal Representation, and How We Can Help
As an NP practicing in Hawaii, you are at an inherent disadvantage as soon as a complaint is filed against you, as there is no guaranteed presumption of innocence. The Board's primary responsibility is to ensure public safety, and they have the authority to impose discipline on nurse practitioners based merely on a preponderance of the evidence. Therefore, negotiating on your own behalf is not advisable, as anything you say in your defense could potentially be used against you.
The Professional License Defense Team at the Lento Law Firm can significantly improve your chances of retaining your NP license while also minimizing the impact of any other sanctions or penalties. We will review the facts and evidence, evaluate the strength of the complaint against you, gather witnesses to support you, build a body of evidence in your favor, and work to negotiate the most favorable terms of resolution with the Board.
Whether the allegations against you arise from a misunderstanding, an honest mistake, a lapse in judgment, or a vindictive false accusation, you have worked too hard to build your career to have it jeopardized by unfair actions by the Board. Take steps now to protect your career and your future. To schedule a consultation, call the Lento Law Firm at 888-535-3686 or fill out our confidential online form.
