The US Department of Justice and Department of Health and Human Services Office of Inspector General have identified a wire fraud scheme to sell false and fraudulent nursing degree diplomas and transcripts. Coined as Operation Nightingale, the scheme has resulted in the distribution of more than 7,600 fake nursing diplomas and transcripts obtained from accredited Florida-based nursing schools to registered nurse (RN) and licensed practical nurse/vocational nurse (LPN/VN) candidates.
On May 15, 2023, five of the co-conspirators charged in the Southern District of Florida pleaded guilty to wire fraud conspiracy for their alleged participation in the scheme. The defendants are set for sentencing on July 27 and each face up to 20 years in prison. During the plea hearings, four of the five defendants admitted to soliciting and recruiting individuals seeking nursing credentials, as well as creating and distributing the false credentials.
The Federal Bureau of Investigation (FBI) and US Department of Health and Human Services (HHS) now estimate that the approximately 7,600 students involved in the scheme paid a total of $114 million for fake credentials—paying between $10,000 for a licensed practical nurse degree and $17,000 for a registered nurse diploma. Among these students were victims and those who knew the diplomas were fake. Approximately one third passed their respective state licenses exams.
Since the initial enforcement sweep was announced, many nursing boards have investigated licensed nurses who may have participated in the scheme. On May 8, the Pennsylvania Board of Nursing sent notices to 18 nurses, providing them 30 days to contest the allegations that they submitted fraudulent credentials when applying to the Board.
The Maryland Board of Nursing website maintains a running list of the Board orders issued as a result of Operation Nightingale, so far having suspended or revoked at least 45 fraudulently obtained licenses. Many additional nursing boards across the country, from Georgia to Washington state, have also identified several of their own licensees that may be involved with the scheme.
As of May 30, 2023, there have been no reports of patient harm by a nurse with fraudulent credentials, and no students from the schools associated with the scheme have been criminally charged.
To date, the schools associated with the scheme are Siena College, Palm Beach School of Nursing, and Sacred Heart International Institute (each now closed), as well as Quisqueya School of Nursing LLC, Quisqueya Health Care Academy LLC, Sunshine Academy, and Florida College of Health. It is reported that additional organizations may be involved, and the investigation is ongoing.
After obtaining the fraudulent diplomas and transcripts, the candidates allegedly then used the fake credentials to sit for the national nursing board exam and subsequently obtain licensure (and presumably healthcare jobs) in at least five states identified so far: Delaware, New York, New Jersey, Texas, and Florida. In collaboration with law enforcement, it is reported that states as far as Washington are beginning to identify nursing applicants who used credentials from the federally investigated Florida-based schools.
To date, 25 individuals have been charged for their alleged participation in the scheme. No patient harm resulting from the care provided by any of the individuals with fraudulent credentials has been reported yet.
It is yet to be determined what coordinated action licensing boards in affected states will take. As of this writing, Delaware has annulled 26 Delaware nurse licenses as a result of information from the Operation Nightingale investigation.
In the meantime, healthcare providers should prepare to guard against the potential patient safety and billing implications to the extent they are employing or contracting with any RNs or LPN/VNs with credentials from the schools associated with this scheme.
We are monitoring this evolving situation. Please contact us if you would like to assess the proactive steps your healthcare organization can take to mitigate risk associated with nurses hired who may have degrees from the schools and organizations implicated by this enforcement sweep.
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