No evidence has emerged of harm to patients, officials say.


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Officials are scrambling to identify and stop several thousand nurses with fraudulent academic credentials from caring for patients. The effort follows a U.S. Department of Health and Human Services (HHS) investigation, Operation Nightingale, which uncovered a long-running scheme to sell fraudulent nursing diplomas and transcripts.


Between 2016 and 2021, several Florida nursing schools-including Siena College of Health, Sacred Heart International Institute, and Palm Beach School of Nursing-allegedly sold more than 7,600 fake credentials to aspiring nurses for $10,000 to $15,000 each. The schools have since closed and 25 people, most of them nursing school administrators and recruiters, have been arrested and charged with wire fraud, among other offenses.


The fake credentials enabled individuals to sit for the National Council Licensure Examination (NCLEX) for RNs and LPNs without completing the required coursework. According to a February 22 report in the online Becker's Hospital Review, approximately 37% of those who purchased fraudulent credentials passed the licensure exam, and many went on to secure employment at U.S. health care facilities. Prosecutors and officials in several states are tracking down these individuals through audits of enrollment and graduation records at the Florida schools alleged to have participated in the scheme.


Court documents initially identified Georgia, Maryland, New York, Ohio, and New Jersey as states where nurses with fraudulent credentials were working but additional states and the national Veterans Administration network have also launched investigations.


When criminal charges were announced in January, no evidence had been found of harm to patients, according to Omar Perez Aybar, special agent in charge of the HHS Office of the Inspector General. Some of the individuals with fraudulent credentials who scored passing grades on the NCLEX were LPNs looking to be RNs, while others were educated abroad and previously worked as nurses in their home countries.


"Nurses are hardworking and vital health care professionals, and there can be no shortcuts to meeting the qualifications for licensure or questions about the integrity of those who serve some of New York's most vulnerable populations," the New York State Education Department, which helped prosecutors locate nurses with suspicious credentials, said in a statement to AJN. "Our first priority is always public protection, and while we are aware of the nursing shortage that is gripping our health care system, we will continue to work with our partners in law enforcement to ensure that applicants for licensure have met the education requirements and are qualified to practice as a licensed practice nurse or registered professional nurse."


The New York investigation identified 903 nurses with degrees from schools associated with the scheme, though not all were participants in the fraud. To separate nurses who had legitimately completed coursework from those who purchased fake transcripts and diplomas, officials gave the nurses 14 days to prove they met the educational and training standards required to sit for the NCLEX. New York also paused the license applications of 2,352 students with credentials from the affected schools until their legitimacy could be verified. These actions were taken last February. New York officials did not respond to a request from AJN to update these findings, including whether license applications were still being held up.


At least 46 New Jersey nurses were barred from practice after state officials found that their credentials came from the involved institutions. According to reporting on March 9 by NorthJersey.com, the nurses will be eligible for reinstatement after proving to the state board of nursing that they completed the education and training required for licensure.


Washington State has rescinded the licenses of 17 people and denied license applications for four, the Delaware Board of Nursing annulled 26 licenses, the Georgia Board of Nursing asked 22 nurses to voluntarily surrender their licenses, and 23 Texas nurses face possible license revocations though they are continuing to work while their disciplinary cases are pending, according to reporting on March 1 by NBC Miami.


Federal officials say it is unlikely that the nurses who purchased fake credentials will face criminal charges.-Jennifer Fink, BSN, RN