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Feds Charge 25 Nursing School Execs, Staff in Fake Diploma Scheme
January 30, 2023
UPDATED February 2, 2023 // Editor’s note: Georgia nurses are pushing back against a request by the Georgia Board of Nursing to voluntarily surrender their nursing licenses.
At least one state licensing agency is revoking nursing licenses allegedly obtained in a multistate fake diploma scheme.
The US Department of Justice recently announced charges against 25 owners, operators, and employees of three Florida nursing schools in a fraud scheme in which they sold as many as 7600 fake nursing degrees. The purchasers in the diploma scheme paid $10,000 to $15,000 for degrees and transcripts showing they’d received associates degrees, and some 2800 of the buyers passed the national nursing licensing exam to become registered nurses (RNs) and licensed practice nurses/vocational nurses (LPN/VNs) around the country, according to The New York Times.
Many of the degree recipients went on to work at hospitals, nursing homes, and Veterans Affairs medical centers, according to the US Attorney’s Office for the Southern District of Florida.
Several national nursing organizations cooperated with the investigation, and the Delaware Division of Professional Regulation already annulled 26 licenses, according to the Delaware Nurses Association. Other states are considering taking similar steps as they identify nurses with fake licenses, various news media reported. Those charged in the case were operating in five states, according to federal reports.
“We are deeply unsettled by this egregious act,” DNA President Stephanie McClellan, MSN, RN, CMSRN, said in the group’s press statement. “We want all Delaware nurses to be aware of this active issue and to speak up if there is a concern regarding capacity to practice safely by a colleague/peer,” she said.
The Oregon State Board of Nursing is also investigating at least a dozen nurses who may have paid for their degrees, according to a Portland CBS affiliate. The National Council of State Boards of Nursing said in a statement that it had helped authorities identify and monitor the individuals who allegedly provided the false degrees.
Nursing Community Reacts
News of the fraud scheme spread through the nursing community, including social media. “The recent report on falsified nursing school degrees is both heartbreaking and serves as an eye-opener,” Usha Menon, PhD, RN, FAAN, dean and health professor of the University of South Florida Health College of Nursing, tweeted. “There was enough of a need that prompted these bad actors to develop a scheme that could’ve endangered dozens of lives.”
Jennifer Mensik Kennedy, PhD, MBA, RN, the new president of the American Nurses Association, also weighed in. “The accusation that personnel at once-accredited nursing schools allegedly participated in this scheme is simply deplorable. These unlawful and unethical acts disparage the reputation of actual nurses everywhere who have rightfully earned [their titles] through their education, hard work, dedication and time.”
The false degrees and transcripts were issued by three once-accredited and now-shuttered nursing schools in South Florida: Palm Beach School of Nursing, Sacred Heart International Institute, and Sienna College. The alleged co-conspirators reportedly made $114 million from the scheme, which dates back to 2016, according to several news reports. Each defendant faces up to 20 years in prison.
Most LPN programs charge $10,000 to $15,000 to complete a program, Robert Rosseter, a spokesperson for the American Association of Colleges of Nursing (AACN), told Medscape Medical News. None were AACN members, and none were accredited by the Commission on Collegiate Nursing Education, which is AACN’s autonomous accrediting agency, Rosseter said. AACN membership is voluntary and is open to schools offering baccalaureate or higher degrees, he explained.
“What is disturbing about this investigation is that there are over 7600 people around the country with fraudulent nursing credentials who are potentially in critical health care roles treating patients,” Chad Yarbrough, acting special agent in charge for the FBI in Miami, said in the federal justice department release.
“Operation Nightingale” Based on Tip
The federal action, dubbed “Operation Nightingale” after the nursing pioneer Florence Nightingale, began in 2019. It was based on a tip related to a case in Maryland, according to Nurse.org.
That case ensnared Palm Beach School of Nursing owner Johanah Napoleon, who reportedly was selling fake degrees for
$6000 to $18000 each to two individuals in Maryland and Virginia. Napoleon was charged in 2021 and eventually pled guilty. The Florida Board of Nursing shut down the Palm Beach school in 2017 owing to its students’ low passing rate on the national licensing exam.
Two participants in the bigger scheme who had also worked with Napoleon, Geralda Adrien and Woosvelt Predestin, were indicted in 2021. Adrien owned private education companies for people who at aspired to be nurses, and Predestin was an employee. They were sentenced to 27 months in prison last year and helped the federal officials build the larger case.
The 25 individuals who were charged January 25 operated in Delaware, New York, New Jersey, Texas, and Florida.
Schemes Lured Immigrants
In the scheme involving Siena College, some of the individuals acted as recruiters to direct nurses who were looking for employment to the school, where they allegedly would then pay for an RN or LPN/VN degree. The recipients of the false documents then used them to obtain jobs, including at a hospital in Georgia and a Veterans Affairs medical center in Maryland, according to one indictment. The president of Siena and her co-conspirators sold more than 2000 fake diplomas, according to charging documents.
At the Palm Beach College of Nursing, individuals at various nursing prep and education programs allegedly helped others obtain fake degrees and transcripts, which were then used to pass RN and LPN/VN licensing exams in states that included Massachusetts, New Jersey, New York, and Ohio, according to the indictment.
Some individuals then secured employment with a nursing home in Ohio, a home health agency for pediatric patients in Massachusetts, and skilled nursing facilities in New York and New Jersey.
Prosecutors allege that the president of Sacred Heart International Institute and two other co-conspirators sold 588 fake diplomas.
The FBI said that some of the aspiring nurses who were talked into buying the degrees were LPNs who wanted to become RNs and that most of those lured into the scheme were from South Florida’s Haitian American immigrant community, Nurse.org reported.
Alicia Ault is a Saint Petersburg, Florida-based freelance journalist whose work has appeared in publications including JAMA and Smithsonian.com. You can find her on Twitter @aliciaault.
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Lead image: Seventyfourimages/Dreamstime
Medscape Medical News © 2023
1. You are working on an unit and overhear your colleague say that she purchased her diploma from one of the schools discussed in the article above. How would you respond?
2. Discuss how the American Nurse’s Association 18 Standards of Practice may influence your response.
3. Discuss ethical principles and which ethical principle may impact your response.
REPLY TO THIS TWO STUDENT WRITE UP
Jacqueline Vargas posted Feb 7, 2023 8:19 PM
1. I think I wouldn’t tell them anything directly, but I would immediately go tell management of everything I have overheard so they can take the appropriate steps to approach the nurse and manage a situation like this with the patients’ safety as a priority.
2. Ethics, advocacy, respectful and equitable practice, and quality of practice influence my response the most. By communicating this with management I am acting as the patients advocate because I am looking out for their best interest. They deserve the best quality of care possible from their nurse and someone who has bypassed schooling and got their diploma in a fraudulent way isn’t someone who can give that type of care.
3. There are four main ethical principals autonomy, beneficence, justice, and non-maleficence. They are guidelines that remind nurses to treat their patients with respect and equitably while providing privacy. Non-maleficence impacts my response. I don’t wish to do or cause any intentional harm on anyone and if I kept quiet and didn’t inform anybody of what I had overheard I am intentionally doing harm to the patients. The nurse who is caring for them doesn’t have the proper education and skills sets to have other people’s lives in their hands.
Nayeli Ferrer posted Feb 7, 2023 8:22 PM
1. I would kindly tell my colleague that what he/she did was wrong and that he/she should report it to our manager. I will also tell my colleague that she/he is putting the patient’s safety in danger since she did not finish nursing school and did not do hands-on practical skills. Nursing requires more than just paper knowledge. After I have spoken with her/him, I will report what I heard to our manager so they can make their decisions on the matter.
2. The American Nurse’s Association 18 Standards of Practice may have influenced my response since it outlines and describes a competent level of care for registered nurses to follow. It requires the nurse to be able to analyze the data gathered during the assessment phase, to determine potential or actual diagnoses. My colleague did not attend any clinicals or had skills lab, so she does not know how to properly assess a patient and that puts the patient’s safety in danger. The ANA also requires nurses to demonstrate and contribute to a high quality of care and without attending nursing school you do not acquire the knowledge and skills learned to be able to provide excellent quality of care. A nurse can’t provide quality nursing care without having basic nursing knowledge and skills.
3. There are 7 ethical principles in nursing which include accountability, accepting responsibility for one’s own actions; justice, and fairness. Nurses must be fair when they distribute care; nonmaleficence, doing no harm. Harm can be intentional or unintentional; autonomy, the patient has the right to reject or accept all treatments; beneficence, doing good and the right thing for the patient; fidelity, keeping one’s promises; and veracity, being completely truthful with patients.
All ethical principles are important, but the one that impacted my response the most was nonmaleficence because that means that you as a healthcare professional must do no harm to the patient. My colleague with no experience in the clinical setting is putting patient safety in danger. Maybe my colleague doesn’t know how to properly care for some of her assigned patients and because she’s afraid they might question her about where she got her diploma from, etc., she/he prefers to stay quiet and just try her best to take care of her patients for the rest of her/his shift.
Jecker N. S. (1997). Principles and methods of ethical decision making in critical care nursing. Critical care nursing clinics of North America, 9(1), 29–33.