Nurse practitioners have an important job, and your dedication to the profession is evident through the arduous educational journey you took to reach your position. However, an anonymous complaint to the Virginia Board of Nursing has the potential to open a can of worms and unravel your hard work.
While nurse practitioners are subject to strict regulations, the messaging isn't always clear. The Virginia legislature has changed requirements for nurse practitioners to have full practice authority multiple times in the past decade. Is it fair for minor confusion regarding laws and regulations like this to have a future impact on your license?
The Lento Law Firm Professional License Defense Team knows Virginia licensing laws inside and out. We can help limit the negative ramifications of investigations into your license or appeal existing sanctions. If your license is at risk, call us at 888-535-3686 or reach out through our online form.
Who Can Discipline Nurse Practitioners in Virginia?
The authority to discipline and sanction nurse practitioners, along with other advanced practice registered nurses, rests with the Virginia Board of Nursing, overseen by the Virginia Department of Health Professions. The Enforcement Division of this department oversees initial investigations into misconduct, passing along info to the Board after the fact.
Disciplinary proceedings and investigations start in two primary ways. Usually, a complaint that someone files against you is the culprit. Other times, investigators may have reason to suspect misconduct without receiving this info directly through public complaints. If you are convicted of a felony, it can result in disciplinary action, though this process is often automatic and mandatory as opposed to an investigation.
Reasons for Disciplinary Action and Nurse Practitioner License Sanctions
You surely have many questions if you have just received notice of an investigation into your professional conduct. Your career may be at risk, and time is ticking until the Virginia Board of Nursing decides sanctions that can suspend or revoke your nurse practitioner license.
While you may not know precisely who filed a complaint against you or why this is happening, you need to respond to either address concerns or fight for your innocence. Common violations and acts of misconduct that can lead to disciplinary action include:
- Fraud and deceptive practices that benefit you at the expense of others, such as falsifying records and service bills.
- Substance abuse that affects your ability to practice safely. This can include both on-duty and off-duty substance use.
- Criminal convictions that affect your ability to work or require the automatic suspension of your license, such as certain felonies.
- Negligence leading to substandard levels of care for patients. The level of punishment will depend on the intent and severity of harm to patients.
- Breaking practice agreements for nurse practitioners who cannot work without collaboration with a physician.
- Failure to maintain patient confidentiality, whether intentional or accidental.
- Inappropriate relationships with patients, families of patients, colleagues, or subordinates.
Just because a written notice informs you of an investigation into your conduct doesn't mean the allegation is true. However, many different government workers have reviewed your case by the time you receive this letter. They believe the allegations have merit and warrant further investigation.
Don't delay contacting the Lento Law Firm when you learn of an investigation that can affect your license status. If the Board has already ordered sanctions, you have the right to appeal. You also have the legal right to legal counsel during the disciplinary process, and we can help defend your license at any point.
Potential Disciplinary Outcomes
Immediate license suspensions and revocations are some of the worst-case outcomes of an investigation, but that isn't always how the process unfolds. Potential actions the Board can take after an investigation include:
- No Sanction/Monetary Penalty: If your violation is minor or unintentional, the Board of Nursing may recommend a quick end to the disciplinary process by forgoing punishment or giving you a small fine.
- Reprimand/Advisory Letter: The Board may reprimand you through an official advisory letter to acknowledge a violation and signal the need for improved conduct. As the Board intends this as a corrective action, it will not typically affect your license. However, it may remain on your permanent professional record.
- Probation and Restrictions: For more serious violations, the Board can restrict your career while still allowing you to work. Common probationary conditions include additional training, regular reporting, and oversight of your work. Failure to meet these conditions can result in the suspension of your license and the inability to work as a nurse practitioner in Virginia.
- Immediate License Risks: The Board can immediately suspend or revoke your license if they deem the violation risky enough to endanger the public. They can also sanction your license after a formal hearing, though you have the right to plead your case and appeal the outcome.
Formal hearings carry high risks to your license. With one decision, the Board can remove your ability to work as a nurse practitioner in Virginia.
The Complex Disciplinary Process That Can Result in License Sanctions
Investigations into your actions and the resulting hearings and appeals can take a long time, and you need help to chart a path through them. An attorney can guide you through the process, starting when you are notified.
Complaints
Anyone wishing to file a complaint can complete a form and submit it electronically, by mail, or by fax. They can even submit a complaint anonymously, increasing the number of potentially bogus reports.
An intake analyst will make initial determinations to see if a violation exists, sending this recommendation forward for further review. Unless the Board decides that further investigation is warranted, they will drop false complaints against you and end the case.
Even if an intake analyst with the Department of Health Professions finds a possible violation, your license is not at immediate risk. They assign different priority levels to different violations, ranging from acts that pose immediate harm to the public to ones that cause minor inconvenience to patients. The consequences and speed at which the Board will act depend on the severity level of your violation.
Investigation
Investigations permit investigators to dig deeper into the violation. They can subpoena records, continue the initial work of interviews and evidence gathering, and work with law enforcement for violations of criminal law. The Board receives this report and uses it as the basis for continuing its disciplinary review.
Probable Cause Determination
The Board must have clear and convincing evidence of a violation before they take any action that affects your license. Even before they send you a notice and schedule informal hearings, a member of the Board must independently find probable cause that a violation exists.
As this determination adds one more set of eyes to your case, complaints at this part of the disciplinary chain are usually well-founded, even if only minor.
Summary and Mandatory Suspensions
Members of the Board of Nursing may meet and take immediate action to suspend your license if they determine your conduct poses a substantial danger to the public. The Director of the Board of Nursing can also trigger a license suspension if you have felony convictions, a suspended license in another state or jurisdiction, or similar serious offenses.
Consent Orders
In most circumstances, you have the right to informal and formal hearings into your conduct violation. However, at different points in the process, the Board may offer a consent order to settle the case without further action. To benefit from a consent order, you must agree with and accept the facts, findings, and sanctions of the case up to that point.
The Board may also offer a confidential consent order for unintentional, minor misconduct that does not warrant a harsh punishment. Confidential consent orders benefit from not being public admissions of wrongdoing. However, the Board may consider these consent orders if you find yourself facing disciplinary action in the future.
The Board can offer consent orders whenever they want, and an attorney can negotiate with the Board to reduce fines or restrictions on your license before you agree to the order.
Advisory Letters
Unless you accept a consent order at a later date, an advisory letter is the last part of the process that allows you to avoid official disciplinary proceedings. While the Board may have concerns about your conduct, they simply suggest changes to behavior and do not punish you or suspend your license.
Informal Conferences
An informal conference will likely be the first time you meet with a member of the Board to discuss your accusations of misconduct. These public proceedings are intended to be quicker, cheaper, less adversarial, and less trial-like compared to formal hearings.
You have the right to see the evidence the Board uses to allege violations and provide your own explanations and evidence. Attorneys can also accompany you to informal hearings to assist or defend you.
If the Board members or those empowered by the Board to investigate your misconduct choose to exonerate you, the case is closed. However, Board members in informal hearings can still sanction you and restrict your license. You have the right to appeal their determination and argue your case in a formal hearing.
Formal Hearing
Formal hearings are the final step before resorting to circuit court appeals. Attorneys should accompany you to formal hearings, as they are more similar to court trials than public discussions about your conduct.
Reaching a formal hearing means you didn't get the desired result from every previous part of the process. Most cases, especially minor violations, are resolved before formal hearings.
Formal hearings can be costly, time-consuming, and extremely stressful. Your attorney from the Lento Law Firm Professional License Defense Team can provide further guidance on whether continuing with a formal hearing is worthwhile.
Your Rights to Appeal a Decision
Appealing a disciplinary decision is possible, but only if you are timely in your request and go through the proper channels. Accepting a consent order waives your rights to proceedings, but you can appeal the results of informal and formal hearings.
If you appeal the order of an informal conference, the Board will schedule a formal hearing. If you appeal the order of a formal hearing, you must appeal to the circuit court. Failing to appear at some informal conferences can cause you to lose the right to a formal hearing, forcing you to appeal directly to the circuit court.
If the Board of Nursing has already ordered sanctions to your license that limit your ability to work as a nurse practitioner, you might not have much time left to appeal the decision. Contact the Lento Law Firm Professional License Defense Team to learn about your options for appeal.
Do I Need an Attorney To Represent Me During Disciplinary Hearings?
Having an experienced lawyer represent you after the Board makes you aware of pending disciplinary action gives you the best chance of minimizing harm to your career. The Board recommends informing them of your intent to have an attorney represent you as soon as possible, as it allows clear communication between both sides.
At any point in the process, the Board may offer a consent order to you to skip lengthy disciplinary proceedings. Even if an attorney has not yet defended you during hearings, they can help negotiate a better consent order and provide guidance on whether this order is worth accepting.
Informal and formal hearings allow you to discuss the allegations with the Board and present yourself in the best light. Formal hearings are structured similarly to courtroom trials, and an attorney's experience affords more benefits than simply an understanding of licensing laws.
A formal hearing will contain opening statements, evidence presentation, witnesses, cross-examinations, testimonials, and closing arguments. Unless you are prepared to take on these responsibilities yourself, an attorney will be invaluable.
The Lento Law Firm Professional License Defense Team can help prepare a robust defense for formal hearings, assist in explaining your actions during informal proceedings, and guide you through the initial phases of consent orders and investigations.
The Lento Law Firm Serves Nurse Practitioners Throughout Virginia
Restrictions on your license limit your ability to work and provide for your family. Our Professional License Defense Team has worked extensively throughout Virginia, helping nurse practitioners working for large employers, including:
- Virginia Commonwealth University Medical Center – Richmond
- Inova Fairfax Medical Campus – Falls Church
- Sentara Norfolk General Hospital – Norfolk
- Carilion Roanoke Memorial Hospital – Roanoke
- University of Virginia Medical Center - Charlottesville
- Bon Secours St. Mary's Hospital – Richmond
- Henrico Doctors' Hospital – Richmond
- LewisGale Medical Center – Salem
- Mary Washington Hospital – Fredericksburg
- Riverside Regional Medical Center – Newport News
Your place of employment doesn't change our ability to support you as you fight to keep your license or limit the harm an accusation of misconduct can cause. Even if you don't see your employer on this list, the Lento Law Firm is here to help.
Contact the Lento Law Firm Today To Protect Your Nurse Practitioner License in Virginia
Virginia has a very long and complex process of investigating misconduct complaints against nurse practitioners. Waiting too long to respond to a notice means you have fewer opportunities and less time to argue your case before the Virginia Board of Nursing.
As soon as you receive written notice of investigations into your conduct, contact the Lento Law Firm at 888-535-3686 or through our website. Our Professional License Defense Team will fight to protect your rights and help you through Virginia's disciplinary process.
