Fraudulent Nursing Diplomas: Protect Your Organization

In January 2023, the U.S. Department of Health and Human Services Office of the Inspector General and the Department of Justice filed criminal charges against several individuals in connection with a fraudulent nursing diploma scheme nicknamed “Operation Nightingale.” The indictments, which were filed in the U.S. District Court for the Southern District of Florida, alleged that the defendants operated nursing schools that sold bogus diplomas and transcripts. These documents enabled purchasers to sit for nursing board exams and obtain licenses to practice as registered and licensed practical nurses. From 2016 to 2023, the schools distributed more than 7,600 fraudulent nursing diplomas. While some attendees completed the programs and training necessary to receive a diploma, the vast majority did not. 

Schools involved in the alleged scheme included: 

• Siena College of Health II LLC.
• Med-Life Institute WPB LLC.
• Palm Beach School of Nursing LLC.
• Quisqueya School of Nursing LLC d/b/a Sunshine Academy.
• Quisqueya Health Care Academy LLC.
• Sacred Heart International Institute Inc.
• Florida College of Health LLC.

While these schools no longer operate, state nursing boards nationwide are working with federal prosecutors to understand how the scheme impacts their respective states. Nurses who obtained diplomas or transcripts from the schools now face possible revocation, suspension, or investigation of their licenses. Organizations that unwittingly employ nurses with fraudulently obtained licenses may be exposing patients to harm and the organization to liability by allowing potentially unqualified nurses to provide patient care.

Risk Recommendations

Although hospitals and clinics are facing unprecedented staffing shortages, unqualified nurses pose a threat to patient safety and can expose an organization to liability. Consider the following when crafting your organizational response to “Operation Nightingale”:

• Keep current. State nursing boards are currently investigating and acting against individuals who received fraudulent credentials. In some cases, boards are denying, revoking, or suspending licenses pending investigation. Frequently check the nursing board website(s) in your area for the status of investigations and findings.
• Review employment files. Work with your human resources department and compliance personnel to review employment files for nurses hired during the relevant periods, and determine whether they graduated from any of the above-listed schools. If so, ensure that those individuals are still licensed to practice nursing in your state. Consult an attorney and/or your human resources representative to determine next steps.
• Review patient care. Develop a process for auditing records of patients who received care from graduates of the above-listed schools. Determine if substandard care harmed any patients. Work with your risk management professional to track, investigate, and respond to quality-of-care concerns according to organizational policies.

Enhance your credentialing process. Take this opportunity to review and revise your credentialing and competency assessment processes for nursing. Ensure that policies require regular license status review and the consistent, thorough verification and documentation of general/unit-specific competencies at the time of hire and yearly thereafter.