The Lento Law Firm Defends Kentucky Nurse Aide Registration
Kentucky can be a great place to practice as a certified nursing assistant (CNA) or, as Kentucky calls it, a state registered nurse aide (SRNA). Kentucky's mostly temperate climate, beautiful landscape, and exciting and historic cities like Louisville, Lexington, Bowling Green, Owensboro, Covington, and Georgetown give CNAs an idyllic setting for nurse aide practice. Major hospitals like Norton Hospital, the University of Kentucky Albert B. Chandler Hospital, St. Elizabeth Edgewood Hospital, Baptist Health Louisville, and Owensboro Health Regional Hospital, each with their hundreds of patient beds, large staffs, and sophisticated medical services, offer CNAs hundreds of employment opportunities. Large home healthcare agencies like KentuckyOne Health's VNA Health at Home, Lifeline Health Care, Caretenders, Amedisys Home Health, and Kindred at Home multiply CNA opportunities across residential settings.
You must successfully defend your Kentucky nurse aide registration, though, to enjoy the abundant nursing assistant opportunities in the state. If you lose your Kentucky SRNA status in good standing, your Kentucky employer must terminate your nurse aide employment. Don't ignore the Kentucky Board of Nursing notice of license disciplinary charges alleging your professional misconduct as an SRNA or CNA. Disciplinary charges mean you risk losing your valuable Kentucky nurse aide employment. Retain the Lento Law Firm's premier Professional License Defense Team to defend your Kentucky nurse aide registration. Our attorneys are available to defend you in Louisville, Lexington, Bowling Green, Owensboro, Covington, Georgetown, and any other Kentucky location. Call 888.535.3686 or chat with us now to retain skilled attorney defense against Kentucky nurse aide disciplinary charges.
Kentucky Nurse Aide Registration
Kentucky's Board of Nursing has been registering and disciplining nurse aides since legislation took effect in 1990. Through a statutorily authorized interagency agreement with the Board of Nursing, Kentucky's Cabinet for Health and Family Services is responsible for the Nurse Aide Registry and the nurse aide training programs qualifying an aide for registration. 907 Kentucky Administrative Rule 1:450 authorizes the Cabinet to establish and operate Kentucky's Nurse Aide Registry, entering the names of only those nurse aides who complete the Cabinet's education, training, work experience, and competency evaluation requirements. Rule 1:450 also prohibits employers in the state from employing a nurse aide for more than four months without ensuring that the nurse aide has completed the Cabinet's registration. The Cabinet offers nurse aides a study guide for the competency evaluation necessary for registration. You met the Cabinet's requirements when first registering as a nurse aide in Kentucky. You must preserve your Nurse Aide Registry in good standing to maintain your Kentucky nurse aide employment.
Kentucky Nurse Aide Regulatory Authority
You must continue to meet the rules and standards of Kentucky's Board of Nursing and Cabinet for Health and Family Services to retain your SRNA registration and nurse aide employment. You work in a heavily regulated nursing assistant role. 907 Kentucky Administrative Rule 1:450 adopts the federal standards for nursing home care as standards for Kentucky nurse aides. Your Cabinet-approved nurse aide training and competency evaluation confirmed your ability to meet those nurse aide standards. Those standards require you to exhibit competent skill in many areas, including caring for dementia patients, personal care services, restorative services, end-of-life and post-mortem care, client rights, infection control, monitoring patient changes, assessing patient pulse, temperature, and respiration, patient nutrition and hydration, and body mechanics and transfer and ambulation skills. These standards form the basis against which the Cabinet measures whether you perform safely, competently, and compliantly as a state registered nurse aide (SRNA).
Kentucky Nurse Aide Disciplinary Authority
Kentucky's Nurse Aide Registry maintains two lists, one for registered nurse aides in good standing and the other for aides whose abuse or neglect of patients or residents, or misappropriation of their property, has revoked or suspended their registration. Kentucky's Cabinet for Health and Family Services enlists the state's Office of Inspector General (OIG) to investigate all allegations of abuse, neglect, or misappropriation of property made against a Kentucky SRNA. The Cabinet's Division of Administrative Hearings hears and decides disciplinary cases against registered nurse aides that proceed beyond investigation, determining whether the nurse aide's name should go into the abuse registry. 906 Kentucky Administrative Rule 1:100 authorizes the Cabinet to establish, maintain, and publish that abuse registry for employer and public review. The Cabinet thus has the state's authority to discipline you as a state registered nurse aide, effectively revoking your registration and ending your SRNA or CNA employment.
Kentucky Nurse Aide Disciplinary Sanctions
Many states expressly authorize their nursing board or other regulators of CNAs or nurse aides to impose a wide range of sanctions against the nurse aide, from a reprimand to probation, suspension, and revocation. Kentucky's regulatory scheme takes a different approach. 906 Kentucky Administrative Rule 1:100 indicates that the Cabinet for Health and Family Services is to enter the aide's name in the abuse registry if found to have committed abuse or to not place the aide's name in the abuse registry if not found to have committed abuse. Despite the all-or-nothing appearance of Kentucky's SRNA sanctions, the same rule permits an aide whose name is in the abuse registry to petition for its removal from the abuse registry after one year. One may also infer that OIG investigators and Cabinet disciplinary officials occasionally exercise some disciplinary discretion to warn, reprimand, educate, train, or provide for other remedial opportunities in at least some cases. Our attorneys may be able to help you negotiate for such relief.
Grounds for Kentucky Nurse Aide Discipline
Kentucky disciplinary officials must have grounds to discipline a state registered nurse aide, SRNA, or CNA. Those officials should not be making up disciplinary grounds as they go along. They should instead be applying the state's SRNA standards. 906 Kentucky Administrative Rule 1:100 defines the three grounds (1) abuse, (2) neglect, and (3) misappropriation on which disciplinary officials have the authority to enter a nurse aide on the Cabinet's abuse registry. As you consider those definitions and compare them to the grounds your notice of disciplinary action lists, also consider how our attorneys may be able to help you defend and defeat those charges.
Abuse as Grounds for Kentucky Nurse Aide Discipline
906 Kentucky Administrative Rule 1:100 defines abuse as "the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain, or mental anguish and includes physical abuse, verbal abuse, sexual abuse, and mental abuse." The mental state requirement of "willfulness" is significant. Rule 1:100 further defines "willful" as "the voluntary, conscious decision to do the act which the law forbids…." Some states do not impose that requirement, but Kentucky clearly does. Under the willfulness element, mistakes, errors in judgment, or omissions will not constitute abuse, no matter what harm they produce. "Willful infliction" generally means intentional, deliberate, or purposeful action in the nature of being immoral or even malicious. Proof of abuse thus requires disciplinary officials to muster evidence that you had the evil intention or design of doing the unlawful act that harmed the patient in one or more of the listed ways.
If you face such charges, our attorneys may be able to help you show that you did not have the required mental state. You may not have harmed, inflicted pain, or caused mental anguish at all. But if you did so, then your actions may have been unintentional. After all, competent nursing often necessarily inflicts some degree of discomfort or even anguish and pain, such as for wound care, personal hygiene, or even transfer in and out of bed. Abuse allegations are serious because of the implication of bad character that they carry. But we may be able to help you prove exonerating or mitigating circumstances that preserve your nurse aide registration.
Neglect as Grounds for Kentucky Nurse Aide Discipline
906 Kentucky Administrative Rule 1:100 defines neglect as "failure to provide goods or services that are necessary to avoid physical harm, mental anguish, or mental illness, but does not include a failure caused by factors beyond the control of the individual." Neglect differs from abuse in that neglect does not include an element of intent or willfulness. An error in judgment, careless omission, or another unintentional failure to serve the resident or patient could potentially result in neglect if, as a consequence, the resident or patient suffers physical harm, mental anguish, or mental illness. Failing to answer a patient's call for bathroom transfer resulting in soiled bedding and infection or burns; failing to turn a patient in bed, resulting in bed sores; and failing to provide adequate food or drink to avoid malnourishment or dehydration are examples of neglect.
If you face such charges, our attorneys may be able to help you show that you did not neglect the resident or patient, that you provided all necessary services, that others may have failed to do so, and that any failure on your part did not cause one of the listed harms. Residents and patients can suffer from many things other than neglect, including the natural course of their condition or disease. Disciplinary officials must prove that your alleged failure caused the harm when such proof could be difficult. Our attorneys may also be able to help you prove that factors beyond your control resulted in the failure in services and the harm, such as an excessive patient load, lack of suitable equipment or necessary supplies, and lack of supervision and support.
Misappropriation as Grounds for Kentucky Nurse Aide Discipline
906 Kentucky Administrative Rule 1:100 defines misappropriation of a resident's or patient's property as "the deliberate misplacement, exploitation, or wrongful, temporary or permanent use, of a resident's or patient's belongings or money without the resident's or patient's consent." Like the definition of abuse, this definition of misappropriation requires disciplinary officials to prove your deliberate, purposeful, knowing, or intentional wrong. If, for instance, you mistakenly took patient property that you believed to be your own, carried away a bag, or pushed away a cart that you did not know carried the patient's property, then you would not have committed misappropriation. Misappropriation would instead be more like theft, embezzlement, extortion, undue influence, coercion, or duress, all immoral wrongs inferring bad character.
If you face such charges, our attorneys may be able to show that you did not know of the disputed property and did not intend to move it away from the patient's or resident's reach. We may be able to help you show that the patient or resident requested and directed you to dispose of the property for their benefit rather than for your own gain. We may also be able to help you show that the patient or resident was demented, deluded, forgetful, or simply inaccurate in their observation and supposition of your wrong or that others with equal or greater access took the disputed property, not you.
Credentials Fraud as Grounds for Kentucky Nurse Aide Discipline
Another ground for discipline that Kentucky disciplinary officials will recognize, although not expressly included in the disciplinary Rule 1:100, is if the nurse aide misrepresents their credentials to obtain registration. Credentials fraud can include things like falsifying the training record, exaggerating your work experience or cheating on the competency evaluation, such as having someone else take the test for you. If you face such charges, our attorneys may be able to help you locate training records, work records, and study or testing records that prove your representations to be accurate and your credentials complete.
Criminal Conviction as Grounds for Kentucky Nurse Aide Discipline
Kentucky disciplinary officials will also recognize felony convictions and misdemeanor convictions involving moral turpitude as grounds for discipline, even though not expressly included in the disciplinary Rule 1:100. Disqualifying convictions can include violent crimes like sexual assault, aggravated assault, kidnapping, or unlawful restraint that indicate your unfitness for patient or resident safety. They can also include financial crimes like insurance or retail fraud, indicating your untrustworthiness with patient recordkeeping and property, or property crimes like arson, theft, and burglary, indicating that you might damage or destroy valuable employer or facility equipment. If you face such charges, our attorneys may be able to help you show that you were not convicted of a disqualifying crime or that your conviction was expunged or reversed. Your rehabilitation may also enable you to obtain a waiver and exemption.
Impaired Practice as Grounds for Kentucky Nurse Aide Discipline
Substance abuse and addiction are also common grounds that disciplinary officials allege in support of their abuse, neglect, or misappropriation charges. Disciplinary officials recognize, though, that nurse aides and other healthcare professionals can face unusual job stresses and the unusual temptation to self-medicate using their access to prescription medications. Those are some of the reasons why Kentucky offers some nurses the Kentucky Alternative Recovery Effort or KARE program. KARE participation can delay and divert disciplinary charges. But beware of KARE offers. The program generally requires the participating nurse to relinquish employment, placing their license, certification, or registration in jeopardy. Our attorneys can help you confirm whether a diversion offer is wise for you, whether you can negotiate better terms that retain your SRNA or CNA employment, or whether your best course is to defend and defeat the impaired practice charges.
Other Grounds for Kentucky Nurse Aide Discipline
Kentucky disciplinary officials may recognize other common grounds for nurse aide disciplinary charges. If you breach patient or resident confidences, such as by sharing confidential medical information with the patient's family members or friends, you may face discipline, although our attorneys may be able to show that you disclosed only non-confidential information or disclosed information only to other care providers who needed to know. If you act unprofessionally in the course of your duties, such as by disrespecting and disobeying your supervisor or directing physicians, you may face discipline, although our attorneys may be able to show that allegedly insubordinate acts were, instead reasonable efforts to seek guidance and direction. If you have a mental or physical disability interfering with your safe and competent practice, you may face discipline, although in this instance, you may also be able to show that your employer should have accommodated your disability or that your disability did not affect patient care.
Kentucky Nurse Aide Disciplinary Procedures
The procedures through which you can contest your SRNA or CNA disciplinary charges can be critical to your successful outcome. Our attorneys can help you invoke those procedures wisely and strategically in ways that help disciplinary officials understand and appreciate your skills and commitment to safe and competent nurse aide practice.
Preliminary Determination of Kentucky Nurse Aide Misconduct
906 Kentucky Administrative Rule 1:100 states the Cabinet for Health and Family Services nurse aide disciplinary procedures. When Cabinet disciplinary officials receive a complaint, the Cabinet's investigator visits the facility, interviews witnesses, and examines records to draw a preliminary conclusion on whether the nurse aide committed abuse, neglect, or misappropriation. The investigator may contact the nurse aide under investigation or may not. If the investigator concludes that the nurse aide violated rules and standards, then disciplinary officials notify the nurse aide within ten days of the report's completion. The notice must inform the nurse aide of the aide's right to request a hearing. If, instead, the nurse aide accepts the findings, then the Cabinet imposes the sanction, ordinarily entry of the aide's name in the abuse registry.
Formal Hearing on Kentucky Nurse Aide Misconduct
If, instead, the nurse aide found to have committed abuse, neglect, or misappropriation disagrees, then the nurse aide may request a formal hearing. 906 Kentucky Administrative Rule 1:100 also calls that request an appeal, although the request obtains the suspect aide's first formal opportunity to respond to the charges and preliminary determination. The nurse aide may present witnesses and exhibits, and cross-examine the state's witnesses, at the formal hearing. The hearing officer makes a determination that the nurse aide may then, if the decision is adverse, appeal to the full Cabinet for review. If the Cabinet affirms the finding and sanction of entry in the abuse registry, the nurse aide has a limited court appeal under the state's Administrative Procedure Act.
Role of Defense Counsel in Kentucky Nurse Aide Misconduct Proceedings
Kentucky administrative rules permit you to retain and rely on the representation of our skilled and experienced Professional License Defense Team attorneys. Our attorneys can help you gather and present evidence at the investigation stage that may head off a preliminary determination of your wrongdoing. Our attorneys can also help you invoke a formal hearing to challenge the preliminary determination if it is adverse. Our attorneys can research and draft your hearing brief, present your witnesses and exhibits at the hearing, and cross-examine opposing witnesses to expose weaknesses in the other side's case. Our attorneys can also appeal any adverse decision to the full Cabinet for review and, if necessary, seek further court review. Don't expect to rely on yourself or on unqualified local criminal defense counsel. Administrative hearing rules and procedures differ from civil or criminal court.
Nationwide Stakes of Kentucky Nurse Aide Discipline
Kentucky recognizes SRNA reciprocity, meaning that your Kentucky nurse aide registration is good by endorsement in other states reciprocating with Kentucky. But that right also means that if you lose your Kentucky nurse aide registration to an abuse registry entry, then you'll lose the right to practice by endorsement in other states. Fight your Kentucky nurse aide disciplinary charges now, or you may lose your ability to obtain nurse aide or nursing assistant certification in other states.
Premier Kentucky Nurse Aide Defense Representation
The Lento Law Firm's premier Professional License Defense Team is available in Louisville, Lexington, Bowling Green, Owensboro, Covington, Georgetown, and any other Kentucky location to defend your nurse aide registration against disciplinary charges. Hundreds of professionals nationwide have trusted the Lento Law Firm to obtain the best possible outcome to disciplinary charges. Call 888.535.3686 or chat with us now.
