Tuesday, September 29, 2015

Sunday Globe Special: Naughty Nurses

"State finds license fraud by 13 nurses; Raises broader fears on medical credentials" by Kay Lazar and Felice J. Freyer Globe Staff  September 13, 2015

Massachusetts regulators revoked or suspended the professional licenses of 13 nurses after discovering recently that the health care workers lied about having nursing degrees or being licensed in other states, health department documents show.

The action sparked questions about the background checks state regulators rely on to issue licenses to thousands of nurses and applicants in 10 other health fields, including pharmacists, psychologists, podiatrists, and optometrists.

More $tate incompetence, and could this also be tied into the meningitis murder scandal?

And the discovery raised the unsettling prospect that patients might have been treated by health care workers with fraudulent credentials, although regulators said there is no evidence so far linking the nurses to any patient safety or quality of care issues. 

The cover ip has already begun.

At least five of the nurses whose licenses were revoked had actually been working as nurses in Massachusetts, according to state documents. But health officials were unable to say where they had been employed.

The state health department said it has referred the apparent fraud cases to the FBI and the state attorney general’s office. A health department spokesman declined to say whether officials believe the cases are related, and a spokeswoman in the attorney general’s office declined comment.

The first hint of a problem emerged in late July when Nursys, a national database for verifying nurses’ licenses, notified the Massachusetts Department of Public Health of potential fraud committed by two women licensed in Massachusetts.

Those two nurses, identified by officials as Edna Tunis of Roslindale and Jesula Eustache of Milton, had applied for licenses in Oregon. But the Oregon State Board of Nursing rejected their applications after finding both women had falsely stated they had passed a national nursing licensure exam, completed a nursing education program, and met the nursing practice requirement.

The women also wrote in their Oregon applications that they were licensed in Massachusetts, which would have allowed them to avoid taking Oregon’s nursing examination under a system known as “reciprocity.” Most state nursing boards waive testing requirements if applicants are already licensed in another state, and both women had received Massachusetts licenses, Eustache in January and Tunis in May.

After being alerted to the Oregon cases, the Massachusetts Board of Registration in Nursing suspended both women’s licenses at an emergency meeting in early August. Tunis and Eustache admitted that when they sought licenses in Massachusetts, they falsely stated they had Alabama licenses, according to documents both signed in August.

The acknowledgment by the women of their fraudulent actions prompted members of the nursing board to wonder whether “a larger enterprise” had helped the nurses in their deception, according to minutes of that meeting.

Regulators embarked on a review of licenses recently granted to nurses who stated in their applications that they had licenses in other states. Investigators found 11 similar cases over the past year.

But after another instance emerged, dating to 2012, regulators extended their investigation of licences granted under reciprocity to 2010, according to the state health department. It was not clear whether any action was taken related to the 2012 case.

Last week, the Massachusetts nursing board suspended the licenses of seven nurses. Four others — Jeannot Maceus of Dorchester, Claudel Jean Baptiste of Brockton, Guerla M. Belony of Randoph, and Herold Philippe of Brockton — agreed to have their licenses revoked. They admitted to falsely stating they had licenses from other jurisdictions, including Puerto Rico, Louisiana, Hawaii, and Oklahoma.

“Upon learning about a problem with valid licenses, the Board of Registration in Nursing took decisive action to investigate and suspend the licenses of individuals who fraudulently represented that they were licensed in a reciprocating state,” Scott Zoback, spokesman for the state health department, said in a statement.

State officials suggest that the fraud may have been possible because each applicant claimed to have licenses from one of eight states that do not fully participate in the Nursys online database used to verify licenses.

So everyone will have to throw in with yet another database.

As a result, the company that Massachusetts employs to scour the backgrounds of nursing license applicants would have needed to search for paper records from those states.

That company, Professional Credentials Services of Nashville, also reviews applicants seeking Massachusetts licenses to work as chiropractors, occupational therapists, optometrists, pharmacists, pharmacy interns, pharmacy technicians, physical therapists, podiatrists, psychologists, and certified health officers.

Do you know who is treating you?

In the wake of the discovery about the nurses’ applications, the state health department said it is “currently evaluating” whether it will retain Professional Credentials Services for future work.

In the meantime, state regulators have asked Professional Credentials Services to immediately tighten its process for checking applicants’ backgrounds, particularly for those claiming a license from another state.

Attempts late Friday to reach Professional Credentials Services, and its chief executive, Mark Setash, were unsuccessful.

State regulators said three of the nurses had completed education programs to become licensed practical nurses, but had falsely indicated they had more advanced training. Others listed nursing degrees from fictitious schools, regulators said.

So they embellished the resume, so what? 

How do they not catch that? (Answer: not looking)



State greatly widens nurse licensing fraud investigation

Nursing licensing inquiry finds gap in process

Company that verified nursing licenses says it followed state’s directions

State reviews nursing licenses after fraud is found

Tufts Medical Center, SEIU local tangle over union drive 

I added that last link to remind myself to tell you what I feel regarding nurses, their treatment by the hospitals, and so on. 

I've stated here many times when a nursing strike comes about that you should GIVE THEM WHAT THEY WANT!! No patient wants an angry or unhappy nurse. That's not to say they will try to harm you; it is only to say as a patient I want them happy. Period, end of discussion.

Looks like some are resorting to other means:

"Mass. General to pay $2.3 million over drug thefts" by Travis Andersen Globe Staff   September 28, 2015

Massachusetts General Hospital will pay a record $2.3 million settlement to the federal government to resolve allegations that its lax control over the facility’s drug supply allowed employees to steal thousands of pain pills, authorities said on Monday.

I'm seeing the gateway to the opioid crisis!

“Diversion of these drugs feeds addiction, contributes to potential illegal drug sales, and fuels the opioid epidemic that has had a devastating effect on the Commonwealth,” US Attorney Carmen M. Ortiz said in a statement. “We commend MGH for disclosing and addressing its diversion problems and for taking steps to ameliorate future diversion by hospital personnel.”

Ortiz’s office said the settlement is the largest amount ever paid for a case involving alleged drug diversion, or the use of substances for nonmedical purposes, at a hospital.

According to the settlement agreement, one nurse identified as J.S. stole 14,492 pills, and a second nurse, identified as J.Z. 1, pilfered 1,429 tablets.

The thefts occurred between October 2011 and April 2015, and most of the pills were the prescription painkiller oxycodone, officials said.

“MGH did not discover J.S.’s actions until she had been stealing for an entire year — even though she sometimes appeared high to co-workers and other times was seen falling asleep at work,” the agreement said. “MGH failed to report these diversions to DEA [Drug Enforcement Administration] within one business day as required” under federal law.

Ortiz’s office said authorities began investigating the matter in 2013, after the hospital informed the DEA that two nurses had stolen large amounts of controlled substances.

In a written statement, Mass. General said drug diversion is a challenge for the health care industry nationwide, and that hospital officials are “confident that no patients were harmed by this misconduct and that all patients in need were given the drugs they were prescribed.”

“We are committed to ensuring that this does not happen again in the future,” Mass. General said, adding that the pill count discrepancies represented less than 1 percent of the total drugs dispensed during the relevant period at the hospital.

Then it really can't be much of a problem, or this nation is awash in pills. 

Cui bono?

Ortiz’s office said Mass. General has developed a detailed plan to strengthen controls over its drug supply, including the “establishment of an internal drug diversion team; the creation of a full-time drug diversion compliance officer position; mandatory training of all staff with access to controlled substances, including on how to identify the signs and symptoms of substance abuse.”

The plan also includes “enhanced diversion monitoring by supervisors and management; annual external audits to ensure compliance with [federal law]; and increased physical controls of controlled substances, including limiting and monitoring access to automated dispensing machines through fingerprint identification,” prosecutors said.


You know there’s a problem when the guy who is supposed to be in charge has a bag of crack on his desk for no apparent reason.” 

That was where?

Additional instances of drug misconduct cited in court papers included a doctor, identified as E.P., repeatedly prescribing medications to patients without seeing them or maintaining medical records, and nurses identified as M.B., M.M., and R.C., who stole substances.

Court papers indicate that R.C. “had a substance abuse issue off and on for the past twelve years.

“He was found sleeping at work, unsteady on his feet, and with slurred speech. He admitted diverting Dilaudid, a Schedule II drug, and injecting himself at work.”

The settlement did not indicate whether any of the employees cited for misconduct were fired or charged criminally, and neither the hospital nor Ortiz’s office would elaborate.

According to court records, E.P., the doctor, surrendered his federal license to prescribe drugs in 2014.

The ince$tous relation$hips with pharmaceuticals have nothing to do with it, I'm sure.

The hospital said in its statement that all employees referenced in court papers were reported to the state Board of Registration in Medicine, which oversees doctors, or the Board of Registration in Nursing and “offered treatment for their addiction.”

“Employees who successfully complete treatment may return to their clinical work under increased supervision, including random drug tests,” Mass. General said.

Michael J. Ferguson, who heads the New England Division of the Drug Enforcement Administration, said in a statement that his agency is “committed to investigating hospitals that are not in compliance with the Controlled Substances Act.”

“The diversion of prescription pain killers, in this case oxycodone, contributes to the widespread abuse of opiates, is the gateway to heroin addiction, and is devastating our communities,” he said.

And yet the PTB seem all bunged up over medical marijuana.


Related: Cleaning Up in Connecticut 

Another unsolved crime flushed down the memory hole.

Also see:

Nursing home faulted anew

State identifies nursing homes cited for misleading Alzheimer's ads

State cites nursing homes for misleading ads on Alzheimer’s care

You don't want to end up in one of those, not in Massachusetts.


"The state’s highest court has ordered a new trial for a Gardner man charged with raping a high school girl at a party at his home, saying the testimony of a state lab chemist was hearsay and should not have been admitted as evidence. Clauzell Jones was sentenced to up to 12 years in prison in 2011, after a jury found him guilty of providing alcohol to the girl in October 2008 and then raping her. Jones, 39 at the time, said the sexual contact was consensual. Jones argued on appeal that the trial judge erred in allowing the prosecution to introduce expert testimony through a State Police chemist who was not present when the alleged victim’s ‘‘rape kit’’ examination was performed by a nurse."

Also seeBrigham and Women’s gears up for a contract battle as nurses union worries about pay, safety

Startup website matches nurses with patient needs

Did you do a license check?