The Lento Law Firm Defends Wisconsin CNA Registration
Wisconsin cities and towns like Milwaukee, Madison, Green Bay, Kenosha, Racine, and Appleton can be great locations to practice as a certified nursing assistant or CNA. Wisconsin offers a beautiful natural environment, abundant education, culture, arts, and entertainment, and a generally friendly and welcoming population. Wisconsin also offers great healthcare facilities like Aurora St. Luke's Medical Centre, Froedtert Hospital, Ascension SE Wisconsin Hospital, Marshfield Medical Centre, and HSHS St. Vincent Hospital, employing hundreds of CNAs. The state also has home health care agencies like Aurora at Home, SSM Health at Home, Horizon Home Care, Ascension at Home, and ProHealth Home Care, each employing many more CNAs for residential and facility care.
To enjoy your Wisconsin CNA practice, though, you need to maintain your Wisconsin CNA certification. Your employer must terminate your CNA employment if you suffer discipline resulting in your certification's suspension or revocation. Don't ignore the Wisconsin Department of Health Services notice of license disciplinary charges based on allegations of your professional misconduct as a CNA. Those disciplinary charges mean that you could lose your valuable Wisconsin CNA employment. Retain the Lento Law Firm's premier Professional License Defense Team to defend your Wisconsin CNA certification. Our attorneys are available to represent you in Milwaukee, Madison, Green Bay, Kenosha, Racine, Appleton, or any other Wisconsin location. Call 888.535.3686 or chat with us now for experienced attorney defense against Wisconsin CNA disciplinary charges.
Wisconsin Nurse Aide Registry Certification
Wisconsin certifies nursing assistants, nurse aides, or CNAs through its Department of Health Services rather than its Board of Nursing. Wisconsin Statutes Chapter 441 authorizes the Board of Nursing to license LPNs, RNs, and advanced practice nurses. But Wisconsin Statute Section 146.40 assigns the certification, regulation, and discipline of CNAs to the Department of Health Services. Section 146.40 specifically authorizes the Department to establish the Wisconsin Nurse Aide Registry and to promulgate rules consistent with the statute's requirements for nurse aide training, competency evaluation, and certification. The Department exercised that authority to promulgate rules governing CNAs at Chapter DHS 129. Wisconsin Administrative Rule DHS 129.09 forms the Nurse Aide Registry, while prior rules state the standards CNAs and their training programs must meet. If you don't hold a Wisconsin CNA certification, with your name in the Nurse Aide Registry in good standing, your Wisconsin employer should not be employing you in nursing assistant practice.
Wisconsin CNA Regulatory Authority
You must have met the Department's standards to obtain your Wisconsin CNA certification, and you must continue to meet those standards to retain your CNA license. As a Wisconsin CNA, you work in a closely regulated professional environment. Wisconsin Administrative Rule DHS 129.07 includes the following standards to which your CNA training program should have trained you, in which you must continue to demonstrate competency: interpersonal communication; social interaction; basic nursing skills including personal hygiene, body mechanics, medical terms and abbreviations, changes in behavior, nutrition, and hydration, walking and transferring techniques, infection control, temperature, pulse, and respiration monitoring, end-of-life care, and post-mortem care; personal care skills; restorative services; rights of clients; and dementias. You know the complexities and challenges of CNA practice. You have many standards and expectations to meet to retain your CNA certification.
Wisconsin CNA Disciplinary Authority
Wisconsin's Department of Health Services not only has the responsibility to certify and regulate nursing assistants or nurse aides. The Department also has the authority to discipline CNAs who fail to meet the Department's standards or who otherwise engage in professional misconduct. Wisconsin Statute Section 146.40 authorizes the department to discipline CNAs who commit patient or resident abuse or neglect or misappropriate their funds or property. The Department's Nurse Aide Misconduct Registry lists dozens of names of CNAs who have lost their certifications in the past year to discipline for patient or resident abuse or neglect or misappropriation of patient or resident funds or property. Wisconsin Administrative Code Chapter DHS 13 carries into effect the Department's statutory authority to discipline CNAs, defining the grounds and detailing the procedure for CNA discipline. Don't question the Department's authority to discipline you for CNA misconduct. Instead, let our attorneys help you make your best case to defend and defeat the disciplinary charges.
Wisconsin CNA Disciplinary Sanctions
The above Wisconsin statutes and rules on the Department of Health Services certification, regulation, and discipline of the state's nursing assistants or nurse aides do not detail the permissible sanctions. The Board of Nursing rules in Wisconsin Administrative Code Chapter N 7 for the discipline of LPNs, RNs, and advanced practice nurses refer to license revocation, suspension, or reprimand. The Department of Health Services will likely impose the same broad range of potential sanctions against CNAs whom it finds to have violated the Department's rules and standards. But other sanctions or terms for resolution may also be possible, including remedial education or training, limits on practice, practice restricted to closer supervision, and reasonable accommodation of the CNA's disabilities.
Addressing Wisconsin CNA Disciplinary Sanctions
The point is that your certification's suspension or revocation, and your loss of CNA employment, are not a forgone conclusion accompanying the disciplinary charges. Charges are only allegations, not findings, even though evidence may support the allegations. Our attorneys may be able to help you defend and defeat the charges at a hearing or, better yet, negotiate an early favorable resolution that preserves your CNA certification while reassuring the Department that you can practice safely and competently.
Grounds for Wisconsin CNA Discipline
You've seen above that the Wisconsin Department of Health Services has the authority to discipline CNAs who commit abuse or neglect or who misappropriate patient or resident funds or property. Disciplinary officials must generally ground their charges in one or more of those grounds, as other Department rules and practices define them. Wisconsin Administrative Rule DHS 13.03 defines those three general grounds, (1) abuse, (2) neglect, and (3) misappropriation, as follows. As you consider those definitions and some other grounds that related law, rule, and regulation would also likely recognize, consider at the same time how our attorneys may be able to help you defend those specific charges.
Abuse as Grounds for Wisconsin CNA Discipline
Wisconsin law generally defines abuse as intentional, deliberate, or knowing wrongs rather than mistakes or carelessness. Wisconsin Administrative Rule DHS 13.03 states plainly that abuse "does not include an act or acts of mere inefficiency, unsatisfactory conduct or failure in good performance as the result of inability, incapacity, inadvertency, or ordinary negligence in isolated instances, or good faith errors in judgment or discretion." This limitation may give our attorneys a basis on which to defend you against abuse charges when you did no purposeful wrong. Otherwise, Wisconsin Administrative Rule DHS 13.03 defines abuse in the following several alternative ways:
- restraint, isolation, confinement, or other acts that cause or could reasonably be expected to cause pain or injury to a client or the death of a client
- restraint, isolation, confinement, or other acts that substantially disregard a client's rights or a caregiver's duties and obligations to a client;
- restraint, isolation, confinement, or other acts that cause or could reasonably be expected to cause mental or emotional damage to a client, including harm to the client's psychological or intellectual functioning exhibited by anxiety, depression, withdrawal, regression, outward aggressive behavior, agitation, or a fear of harm or death.
To qualify as abuse, Rule DHS 13.03 further states that the above acts must also be contrary to the employer's policies and procedures, not a part of the client's treatment plan, and done intentionally to cause harm. Abuse allegations can be difficult to defend because of the latter aspect that abuse involves intentionally causing harm. But if you face abuse charges of this type, our attorneys may be able to help you show that you did not commit the alleged acts or that your acts were consistent with your employer's policies, part of the individual's treatment plan, and done for therapeutic, protective, or self-defense or defense of others rather than to harm.
Sexual Contact as Grounds for Wisconsin CNA Discipline
Wisconsin Administrative Rule DHS 13.03 also defines abuse to include "acts of sexual intercourse or sexual contact by a caregiver and involving a client." Notice that the rule does not refer to consent. Even consensual sexual contact could lead to disciplinary charges. If you face such charges, our attorneys may be able to help you show that you did not commit the alleged acts or that the complainant misidentified you or is deluded or mistaken as to the nature of the conduct. Disciplinary officials generally recognize that residents and patients may suffer from dementia or other cognitive decline, making their reports suspect when contradicted by other reliable testimony and evidence.
Harassment as Grounds for Wisconsin CNA Discipline
Wisconsin Administrative Rule DHS 13.03 also defines abuse to include "a course of conduct or repeated acts by a caregiver which serve no legitimate purpose and which, when done with intent to harass, intimidate, humiliate, threaten or frighten a client, causes or could reasonably be expected to cause the client to be harassed, intimidated, humiliated, threatened or frightened." If you face such charges, our attorneys may be able to show that you did not commit a series of repeated acts, that you had no intention to harm your patient or resident, and that your patient or resident, in fact, suffered no harm because of your actions. We may also be able to show that whatever actions the individual alleges were, in fact, a part of a therapeutic regimen and not harassing.
Neglect as Grounds for Wisconsin CNA Discipline
Wisconsin Administrative Rule DHS 13.03 also addresses neglect as grounds for CNA discipline. Under Rule DHS 13.03's definition, neglect is "an intentional omission or intentional course of conduct by a caregiver or nonclient resident, including but not limited to restraint, isolation or confinement, that is contrary to the entity's policies and procedures, is not part of the client's treatment plan and, through substantial carelessness or negligence, does any of the following":
- causes or could reasonably be expected to cause pain or injury to a client or the death of a client;
- substantially disregards a client's rights … or a caregiver's duties and obligations to a client; or
- causes or could reasonably be expected to cause mental or emotional damage to a client, including harm to the client's psychological or intellectual functioning that is exhibited by anxiety, depression, withdrawal, regression, outward behavior, agitation, fear of harm or death, or a combination of these behaviors.
Rule DHS 13.03's above definition for neglect makes clear that you must intend the neglectful act or omission, making neglect a deliberate rather than merely careless wrong. Rule DHS 13.03 emphasizes the intent element by stating that neglect does not include "permissible restraint, isolation or confinement implemented by order of a court or as permitted by statute" or "acts of mere inefficiency, unsatisfactory conduct or failure in good performance as the result of inability, incapacity, inadvertency or ordinary negligence in isolated instances, or good faith errors in judgment or discretion." If you face such charges, our attorneys may thus be able to show that you did not intend any patient harm or neglect, were not neglectful, and were following treatment plans and employer policies for the patient's benefit. Allegations of neglect may also be unreliable or due to the action of others.
Misappropriation as Grounds for Wisconsin CNA Discipline
Wisconsin Administrative Rule DHS 13.03 also addresses misappropriation as a third and final ground for discipline. Rule DHS 13.03 defines misappropriation to mean any of the following:
- the intentional taking, carrying away, using, transferring, concealing or retaining possession of a client's movable property without the client's consent and with the intent to deprive the client of possession of the property;
- obtaining property of a client by intentionally deceiving the client with a false representation which is known to be false, made with the intent to defraud, and which does defraud the person to whom it is made;
- having possession or custody of another's money as safekeeper of that money but intentionally using, transferring, concealing, or retaining possession of the money without the owner's consent, contrary to his or her authority, and with the intent to convert it to one's own use or to the use of any other person except the owner; or
- intentionally using or attempting to use personal identifying information or an individual's birth certificate or financial transaction card to obtain credit, money, goods, services or anything else of value without the authorization or consent of the individual and by representing that he or she is the individual or is acting with the authorization or consent of the individual.
CNAs practicing in residential settings can have unusual, unguarded access to resident money, credit cards, jewelry, and other things of value. They may also have sway and influence over a resident that they can abuse for their own benefit. But disciplinary officials generally also know that dementia patients and others with cognitive decline or impairment can be unreliable reporters, especially as to allegedly missing property. If you face such charges, our attorneys may be able to help you show that the patient or resident complaining of your misappropriation was deluded or mistaken as to the existence, location, or disposition of the property, that you took no property, or that others with equal or greater access did so rather than you.
Credentials Fraud as Grounds for Wisconsin CNA Discipline
While the above abuse, neglect, and misappropriation grounds are the ones to which Wisconsin Administrative Rule DHS 13.03 expressly refers, you may face other disciplinary charges on the grounds that the Department of Health Services construes from other provisions. Credentials fraud is one common ground for discipline. Credentials fraud can involve misrepresenting your education, training, or work experience, cheating on a competency evaluation, or lying about criminal convictions or professional discipline when completing an application or renewal form. If you face such charges, our attorneys may be able to show from coursework, work records, or other testimony or exhibits that your representations were accurate and that you have the knowledge, skills, and experience necessary to retain your CNA certification.
Criminal Conviction as Grounds for Wisconsin CNA Discipline
Criminal convictions are also common grounds for CNA discipline. Felony convictions and misdemeanor convictions involving moral turpitude are the usual disqualifying convictions. Those crimes may include assault, sexual assault, kidnapping, and similar violent crimes indicating a potential for abuse, insurance or retail fraud indicating unreliable financial and legal reporting, or arson, theft, or other property crimes indicating a propensity for misappropriation. If you face such charges, our attorneys may be able to help you show that you suffered no such conviction, the court has expunged or reversed the conviction, or you are rehabilitated such that officials should consider a waiver and exemption.
Recordkeeping Issues as Grounds for Wisconsin CNA Discipline
CNAs can face recordkeeping issues when submitting false patient records, time records, and activity reports used for patient care or Medicare or insurance billing. If you face such charges, our attorneys may be able to help you show the accuracy of your records, that others were responsible for any false entries, that you were acting on the reasonable instruction of your supervisor, or that your recordkeeping inadequacies had to do with a lack of training or an excessive workload mitigating and excusing any wrong.
Impaired Practice as Grounds for Wisconsin CNA Discipline
CNAs can also face disciplinary charges for working while intoxicated or under the influence of impairing drugs. Disciplinary officials generally appreciate, though, that nurses may be prone to substance abuse and addiction. Wisconsin's Department of Safety and Professional Services thus offers a Professional Assistance Program, somewhat like the Wisconsin Nurses Association's Peer Assistance Program, for professionals seeking recovery services and to avoid discipline. Consult our attorneys before entering into any consent agreement for recovery referral. Do not agree to a referral that requires you to relinquish your CNA certification without consulting us because, depending on the agreement's terms, you might not get your certification back.
Other Grounds for Wisconsin CNA Discipline
Other common grounds for CNA disciplinary charges include performing while under an impairing mental or physical disability, confidentiality breaches, unprofessional practices such as insubordination and failure to follow supervisor orders, and general incompetence in practice. If you face charges not supported by statutory or regulatory authority, our attorneys may be able to help you show that the disciplinary officials lack the authority to pursue them. We may also be able to help you show that you did not commit the alleged acts or that other circumstances, such as the employer's failure to train, supervise, and equip you excused or mitigate your alleged misconduct.
Wisconsin CNA Disciplinary Procedures
Wisconsin Administrative Rule DHS 13.05 states the procedures that Wisconsin's Department of Health Services follows to pursue discipline against a CNA. Our attorneys can help you invoke those procedures to their greatest protective effect. The Department takes complaints of CNA wrongdoing from anyone, investigating those complaints to see whether they have merit. The Department will notify you if it believes that you may have committed misconduct. The Department's investigation should include gathering your information and records. The Department will then notify you of its decision. If you disagree, you must request a hearing in the form of an appeal, which will be your first opportunity to formally present your witnesses and exhibits and to challenge the Department's evidence. Our attorneys have the skills and experience to represent you throughout this process, from investigation to appeal and even beyond if necessary.
Nationwide Stakes of Wisconsin CNA Discipline
Because Wisconsin recognizes CNA reciprocity, discipline that you suffer in Wisconsin could cause you to lose your ability to practice as a nursing assistant in any other state by endorsement. Fight your charges now in Wisconsin, even if you plan to move to another state for future CNA practice. Otherwise, you may not be able to practice anywhere else.
Premier Wisconsin CNA Defense Representation
The Lento Law Firm's premier Professional License Defense Team is available in Milwaukee, Madison, Green Bay, Kenosha, Racine, Appleton, and any other Wisconsin location to defend your CNA certification against disciplinary charges. Hundreds of professionals nationwide have wisely trusted the Lento Law Firm for their best outcome. Call 888.535.3686 or chat with us now.
