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Texas Board of Nursing Complaint Process

April 18, 2019

Every year, the Texas Board of Nursing (BON) receives over 16,000 complaints, though not all cases are determined to be violations of the Nursing Practice Act (NPA). In fact, many complaints received involve insufficient information about the nurse’s identity, are not within the jurisdiction of the BON, or are simply considered “minor incidents.” Therefore, not all complaints move forward into the investigation process or result in a disciplinary action. It should be noted that the complainant’s identity in all matters remains strictly confidential.

So, what happens when a complaint is made about a nurse in Texas to the BON and it moves forward? Let’s take a close look at the process:

The Investigation Process

When an allegation is made, the BON first informs the nurse about the allegations and the investigation taking place. This step allows the nurse to respond to the allegation and potentially demonstrate compliance with the NPA. While some investigations are conducted on-site, the majority are conducted through mail or over the phone.

Finding of no violation

After an investigation has been initiated, evidence is collected and reviewed to determine if the nurse in question violated the NPA. If it is determined that no violation took place, the case will be closed. In certain cases, the complaint and investigation are expunged right away or eventually expunged after a certain amount of time. If a closed case has been retained rather than expunged, it may also be reopened should additional information be received during the time of retention.

Finding of a violation

On the other hand, evidence in some cases determines that an NPA violation has occurred. These determinations prompt certain sanctions to be placed on the nurse by the BON, as a means of protecting the public. Sanctions often include fines, warning, reprimand, remedial education, suspension, probation, and even license revocation.

Investigation timeline

The average length of an investigation is between five and twelve months. Each case is unique and, therefore, results in a different complaint resolution timeline, but throughout the investigation, processes are assessed and reviewed consistently to guarantee a timely resolution. As the investigation progresses, the nurse and the complainant are both routinely informed of investigation updates and, eventually, the results of the investigation.

Informal Settlement

Once an investigation is concluded and a determination of a violation has been made, an informal settlement of the matter is common. An informal settlement generally occurs when the nurse is offered proposed orders, sanctions, or requirements, based on the investigative findings, which must be followed so the nurse may continue his/her practice safely.

When the nurse agrees

If the nurse agrees to the proposed order, it must be signed before a notary and returned to the BON, which then reviews and ratifies the order. Most agreed orders are ratified by the BON, but sometimes the BON will choose to reject the order should there be a disagreement.

When the nurse does not agree

If the nurse does not agree to the proposed order, s/he can make revisions to the orders for the BON to consider, and these proposed revisions may be ultimately accepted.

Informal settlement conferences

In certain circumstances, informal settlement conferences are called by the BON, and the nurse in question may be invited to participate. Other attendees may include the Executive Director, Director of Enforcement, a BON attorney, the investigator, and additional BON staff. The purpose of the informal settlement conference is for both the nurse and the BON to review the evidence and potential violations and reach a settlement of the matter. The BON panel will meet to determine and propose a newly agreed-upon order, which may then be signed by the nurse in the presence of a notary and submitted to the BON.

Ratified orders

Ratified orders become final and are sent to the nurse, the nurse’s most recent employer, and the complainants are also informed. The majority of nurse disciplinary actions are available to the public and are provided to the National Council of State Boards of Nurse, Inc., and the National Practitioner Data Bank. These disciplinary actions also remain within the nurse’s licensure record.

Formal Settlement

Certain NPA violation complaints result in a formal settlement process. Formal settlements occur when an agreement cannot be reached in an informal settlement or if the BON cannot make contact with the nurse throughout an investigation. When either of these situations arise, the BON will file formal charges and the nurse most respond in writing to these charges. If the nurse fails to provide required answers to the charges, license revocation procedures may be initiated.

However, if answers to the charges are filed, the case will proceed to public disciplinary hearings with an Administrative Law Judge. Following the hearings, the judge will propose his/her findings to the BON, which will review the proposal and proceed accordingly.

Defending your license

Throughout the BON complaint process, the nurse may defend his/her license. In order to defend your professional reputation, your career, and your license, working alongside an experienced and knowledgeable attorney will have a significant impact on the outcome of your case.

With professional experience as a nurse and administrator for more than a decade, our lead attorney brings unique and specific knowledge of the BNO complaint process and how to best serve your interests as you face the complaint against you. Contact us today for a complimentary consultation.