A West Virginia audit of the Board of Examiners for Registered Professional Nurses, published in August, noted several weaknesses, particularly concerning the Board's process of resolving complaints and administering disciplinary action. The review also cites issues with the board's complaint process and the board's website. PERD found that in 3 of the 81 cases sampled, the board allowed months to go by without receiving responses from licensees to complaints and a consent order.
“The board’s complaint process shows signs of lacking appropriate and timely responses,” the audit states. “The board’s actions have resulted in licensees [nurses] continuing to practice after repeatedly violating consent agreements while allowing licensees to effectively ignore public complaints.”
According to the audit, the Board did not fully investigate a complaint from another board. The Legislative Auditor reviewed a complaint received by the Board that was not part of the sample of 81 complaints. The Board of Medicine (BOM) provided PERD with court records indicating that a physician and three Advanced Practice Registered Nurses (APRNs) operated a pain clinic where the APRNs wrote prescriptions for narcotics utilizing the physician’s Drug Enforcement Agency (DEA) identification number instead of their own.
The physician was not present in the clinic and observed patient charts from his home several counties away. The physician was investigated and charged with several crimes, to which he pled guilty. The board received this information, but did not begin the formal complaint process as it should have.
In another case, the Board offered a licensee a consent order in April 2009, but the licensee failed to respond. Only after nine months did the Board send a consent order again, according to the report.
Another peculiarity, the audit notes, is the fact the board requires complaints to be notarized. This is deemed unnecessary since it does not “add any additional layer of protection for the public.”
The report also recommended that the board’s website be made more “user-friendly and transparent.” For instance, the auditors note that users cannot submit a complaint notice online and contact information is not easily accessible through the site.
The audit makes 11 recommendations to improve complaint handling, including:
- Responding more stringently to nurses who “repeatedly violate or relapse while they are in a substance-abuse program.” The auditor recommends higher fines and monitoring agreements for repeat offenders.
- Timeliness in resolving complaints and taking action when complainants do not respond to consent orders or complaints.
- Hiring additional nurse investigators;
- Improvements to the website to increase user-friendliness and transparency.