A license from the Board of Registered Nursing (BRN) is required to practice nursing in California. Once you meet the board’s licensing criteria, the board will register you as a nurse and issue you an RN license. You can also apply for the Licensed Vocational Nurse (LVN) license. There are situations when your license could be at risk, mainly when the board acts on a complaint and investigates your wrongdoing. Surrendering could seem like the best option.

Giving up your California nursing license is a big decision with many ramifications. Although it could appear like a quick remedy for workplace challenges, you should weigh all the consequences before moving forward. This decision carries both immediate and long-term risks. As a registered nurse, you should know that losing your license is irreversible and will have long-term effects on your personal and professional life. Let us look at the implications in detail.

The Board of Registered Nursing Investigative Process

It is necessary to differentiate the various licenses for practicing nurses in the field. The licenses are issued based on the roles nurses play and the responsibilities each handles. Licensed Vocational Nurses (LVNs) provide primary patient care under the supervision of RNs or physicians.

As an LVN, you are tasked with monitoring the patient's vital signs, giving them their medication, and helping them with their everyday tasks. As an RN, your scope of practice is more expansive. Along with LVN duties, you also carry out extra duties like creating care plans, delivering complicated treatments, instructing patients, and managing the medical staff.

Certified Nurse Assistants (CNAs) play a different role. They carry out crucial patient care duties under the direction of RNs and LVNs. CNAs obtain licenses from the California Department of Public Health (CDPH).

The Board of Registered Nursing (BRN) performs an initial review after someone files a complaint about you. This process helps the board ascertain whether the matter is under its purview and whether potential Nursing Practice Act violations may have occurred. Should it be considered pertinent, the BRN will open an official investigation.

BRN investigators will interview you, the complainant, and any witnesses during the investigation. This guarantees a comprehensive analysis of the complaint. They also investigate relevant documents, like medical records.

Next, the BRN looks at the facts and determines if there is merit to the allegations and if your behavior violated any rules or code of ethics. This assessment ensures that accurate information is used to arrive at the conclusions of the investigation. According to the findings presented, the BRN will choose further actions. If they substantiate the complaint, possible outcomes include:

  • Issuing you a citation.
  • Imposing fines.
  • Requiring you to complete more years of schooling or attain extra certifications.
  • Suspending or revoking your nursing license or putting you on probation.

If your complaint cannot be proven, the board will close the matter without taking unfavorable action against you. In this process, you can defend yourself from the allegations made by your accuser or provide your version of the incident, warranting a fair hearing.

Surrendering your license to practice as a nurse may appear to be a better option if you face a complaint and/or investigation by the Board of Registered Nursing. It would be reasonable to assume that you would desire not to get entangled in more troubles and the possibilities of the investigation. However, giving up your license means giving up your career. It can also hurt your reputation in the field in the long run.

Consequences of Surrendering Your Registered Nursing License

If you surrender your RN license, you will automatically be listed on:

  • Specific List of the Excluded Individuals or Entities under the federal Health and Human Services (HHS) OIG and
  • The list of the California Medi-Cal Program’s Suspended and Ineligible Provider.

  1. List of Excluded Individuals or Entities under The federal Health and Human Services (HHS) Office of Inspector General (OIG)

If you are on the HHS OIG List, you are not eligible to use government healthcare programs like Medicare and Medicaid. This exclusion also reduces work options in facilities that rely on federal financing, prohibiting you from billing or receiving payments from these programs.

Placement on the List of Excluded Individuals/Entities by the Federal Office of Inspector General (OIG) of Health and Human Services (HHS) has consequences beyond your ineligibility for federal healthcare programs. Because of your OIG status, many businesses in the healthcare industry may be reluctant to hire you, particularly those that rely on government money. This lowers your chances of landing a job in the healthcare industry and restricts your employment options inside these companies.

It is also possible for your exclusion to impact your state certification and license. Depending on your OIG status, certain states, including California, could take action that could make it more difficult for you to maintain or get state-specific certificates or licenses.

It could also damage your reputation in the workplace. Your professional behavior could come under scrutiny from coworkers and future employers if you are on the OIG list. This could further restrict your career options and influence how others see your qualifications.

Besides the social impact, your ability to derive income from your nursing skills will be hampered. Your ability to bill for services rendered under federal healthcare programs or participate in them will be hindered. This restriction makes it more difficult to perform job-related tasks, particularly those requiring billing or government insurance. This financial impact also extends further. Managing claims or resolving conflicts related to your prior employment can become increasingly difficult.

  1. The List of the California Medi-Cal Program’s Suspended and Ineligible Providers

Similarly, you cannot work with or bill Medi-Cal patients if your name appears on the California Medi-Cal Program's Suspended and Ineligible Provider List. This classification limits your ability to work within the Medi-Cal system, which serves low-income individuals and families in California.

Under Welfare and Institutions Code (WIC) 14043.6(a), if you surrender your license, certificate, or approval while a disciplinary hearing is pending or if it is revoked or suspended by any federal or other state authority, you will be automatically suspended from the Medi-Cal program. This suspension is effective as of the date when you lost, surrendered, or had your license, certificate, or approval revoked. If the revocation or suspension in another state is based only on behavior not considered unprofessional under California law, the department could decide not to suspend you. This exception is contingent upon receiving the required federal clearances and guaranteeing the continuation of federal funding for the Medi-Cal program.

The director could suspend you for noncompliance with Medi-Cal standards under WIC 14123 to safeguard program interests and recipients' health. This can be a stayed, conditional, or permanent suspension. Automatic suspension occurs if you are found guilty of any patient-related offense, fraud, or misuse of the Medi-Cal program. The director could decide to hold an informal hearing after a conviction. If an appeal overturns your sentence, you can petition for readmission to the Medi-Cal program without waiting the usual one year.

The director must notify the Administrative Director of the Division of Workers' Compensation and suspend you from Medi-Cal in addition to Medicare or Medicaid. If the suspension is for behavior that is not considered unprofessional under California law, the department could apply for a federal waiver, subject to federal approval and financial support.

If safeguarding the interests of the Medi-Cal program or the public welfare becomes essential, the director could temporarily suspend you before a hearing. This suspension would remain in place until the hearing is over and a decision is made.

You are not permitted to file claims for services provided while suspended, and businesses that hire you must also refrain from filing these kinds of claims. The administrator will communicate your suspension to the Division of Workers' Compensation Administrative Director and the state licensing body.

Situations Where Surrendering Your Nursing License is Inconsequential

If you commit certain significant violations of the California Nursing Practice Act, your license will automatically be suspended. This suspension takes effect immediately, and no administrative hearing is required. This prompt action is necessary to protect the public's safety and maintain the nursing profession's standards.

This suspension occurs automatically in response to several serious violations, namely:

  • Serious criminal convictions — Your license will be immediately suspended if you are found guilty of a felony or a crime involving moral turpitude. This covers crimes like drug trafficking or violent crimes that directly endanger the public.
  • Sexual misconduct — You will immediately have your license suspended if you are involved in any kind of sexual misconduct or abuse. The trust of patients and professional ethics are both seriously damaged by this violation.
  • Substance abuse — If you are found to be abusing controlled substances while carrying out your nursing duties, your license will be instantly suspended. The suspension for this violation protects the public.
  • Extremely unprofessional behavior — You should anticipate having your license automatically suspended if you engage in activities like falsifying medical records or committing large-scale fraud.

In these situations, the board skips the administrative hearing procedure and moves swiftly to safeguard patients and uphold high standards.

You might consider voluntarily surrendering your license if you face potential disciplinary action. However, surrendering your license does not remove the automatic suspension resulting from significant violations.

Appealing OIG and Medi-Cal Exclusion Lists and Reinstating Your RN License

To appeal your listing on both the OIG (Office of Inspector General) and Medi-Cal exclusion lists, you must first address the OIG exclusion. The OIG list is federal, and removal from it is necessary before you can resolve your Medi-Cal exclusion.

Removing your name from the OIG list is a complex and sometimes drawn-out process. It entails proving that you adhere to federal compliance guidelines and resolving the problems that caused your exclusion. Usually, this involves thorough paperwork and a well-thought-out strategy to determine the grounds for your exclusion.

You can apply to have your license reinstated even if you surrendered it. While appealing to have your name excluded from the list, you should also work on reinstating your Registered Nurse license with the California Board of Registered Nursing at the same time. The BRN will determine if you fulfill the prerequisites to resume your practice. Regaining your license can strengthen your argument for being taken off the Medi-Cal exclusion list.

  1. Appealing an OIG and Medi-Cal Exclusion

When you apply for the exclusion, the OIG starts by issuing you a Notice of Intent (NOI) for many permissive and mandatory exclusions that last longer than the required five years. This document explains the rationale for the suggested exclusion and how it can affect your practice. You have 30 days to reply with any pertinent supporting documentation or arguments.

After examining your response, the OIG will issue a Notice of Exclusion if they choose to proceed. This notice becomes effective 20 days after it is mailed. At this point, you can appeal the decision to an Administrative Law Judge (ALJ). If the ALJ's ruling is unfavorable, you can file additional appeals with the Departmental Appeals Board (DAB) and, if necessary, the courts.

In addition to providing written evidence, you can make oral arguments for permissive exclusions. The appeals procedure for these exclusions is the same as the required exclusion procedure. Permissive exclusions can immediately go into force for specific exclusions but take effect after 20 days for others.

Within 60 days of receiving the notice, you can request a hearing if you would like to oppose the exclusion. If an ALJ rules that a hearing is not required and the exclusion is not considered necessary for urgent action, the exclusion will only go into force after that decision. You can seek judicial review and appeal any unfavorable decision to the DAB if needed.

Bear in mind that an exclusion does not affect your eligibility for benefits under federal health programs. Rather, it primarily affects your ability to collect payments from these programs.

  1. Reinstating a Surrendered or Revoked RN License

Reinstating your registered nurse license after surrendering it involves filing an application for reinstatement with the Board of Registered Nursing. This application entails filling out the necessary paperwork and providing documentation of your rehabilitation. This documentation demonstrates to the board that you have made significant efforts to address the problems that resulted in the complaint that compelled you to surrender your license. This proof is essential to showing that you can practice safely and successfully. You can include paperwork from:

  • Any rehabilitation or recovery programs.
  • Recent performance evaluations, and
  • Statements from current or past employers regarding your work performance.

Include documentation of your volunteer or community service hours and nursing course completion certificates.

If you reside in California, you must enclose a second copy of your live scan form, which shows that your fingerprints have been scanned. If you are not a resident of California, send fingerprint cards and the relevant payment.

Once the board receives your completed petition and any necessary supporting documentation, it will schedule a hearing. You should appear in person for the hearing before the board or an Administrative Law Judge (ALJ). At this hearing, you make your case, demonstrate your efforts at rehabilitation, and demonstrate your capacity to practice safely. The facts and testimony submitted will be the basis for the Board's or ALJ's evaluation of your case.

You can expect to receive the board’s decision within about eight to ten weeks. Depending on how long your license remained inactive, if your petition is approved, it could be reinstated with restrictions, including a probationary period or the need to repeat the National Council Licensure Examination (NCLEX) exam.

If your petition is denied, you can file another petition two years after the denial.

The burden of proof rests with you, the petitioner. You must provide substantial and persuasive evidence to demonstrate that restoring your license is justified. Therefore, you must present sufficient documentation and testimony showing that you are rehabilitated and competent to practice nursing safely. It starts with hiring an experienced professional license defense attorney.

Find a Reputable Registered Nursing License Defense Attorney Near Me

Surrendering a California nursing license is a weighty decision with serious implications. While resolving a board complaint could seem like an easy step, giving up your license can have serious, long-lasting consequences. This action often signals an admission of the complaints against you, which can tarnish your professional reputation and limit future job prospects. It also creates a permanent record of disciplinary action, complicating efforts to regain licensure or secure employment in the future.

You should weigh your options before making this big move. Examine possible substitutes for surrendering your license, like settling through negotiation for a less harsh penalty or finding another way to resolve the issue. Surrendering your license should be a last-resort option.

Speak with a license defense lawyer at The Legal Guardian to help you through this difficult choice. Our knowledgeable Long Beach attorneys will provide insightful advice, outline all possible outcomes, and suggest different approaches to protect your career. We will represent you in talks with the board, assisting you in making a wise choice. Hiring us guarantees you know all of your alternatives and have the best chance at safeguarding your career. Call us today at 866-448-6811.