Massachusetts regulators began looking into the fraud issue a few months ago when a pair of nurses applying for licenses in Oregon attempted to claim reciprocity based on licenses they already held in Massachusetts. Both women did have licenses in Massachusetts but hadn't passed nursing examinations there, either. Instead, they'd used the reciprocity system to get Massachusetts licenses, both claiming that they already held licenses in Alabama. Oregon investigators dug into the women's stories and determined that neither one of them had held Alabama licenses or ever actually passed a national nursing licensure exam.
After being informed of the Oregon cases, Massachusetts officials suspended the licenses of those two nurses and dug into their system to look for similar cases. They found 11 similar instances from the past year alone, all involving individuals who had secured nursing licenses in Massachusetts by claiming previous licenses in other states. Regulators are in the process of going back over reciprocity records from previous years, to find out if the problem extends even further into the past.
So what went wrong? Did the Massachusetts nursing board just take people at their word and believe anyone who said they were licensed in another state? Not exactly. The state hires a background check firm to screen nursing applicants, and the background check company uses what is called the Nursys online database to verify previous licenses. The problem is, eight states don't "fully participate" in the Nursys database.
The background check firm still could have verified licenses in those states by calling their respective nursing boards and asking for paper records. However, the company didn't take that extra step. As a result, individuals were able to take advantage of the vulnerable system in order to con their way into nursing licenses in Massachusetts.
So far, officials have stated that no "quality of care" issues have arisen in connection with the nurses who were fraudulently practicing in Massachusetts. However, state regulators may have only just begun unearthing the problem. Not only could the issue with nursing background checks go back further than a year, but the state also uses similar background check methods to vet licenses from applicants in other healthcare fields as well. Some are questioning whether the state's healthcare background check standards might be compromised from top to bottom.
For now, the state is still employing the same background check firm but has asked that the company "tighten" their background check methods. That will mean more checking of paper records for the company, which will hopefully help to close loopholes with the reciprocity system. One of the big questions, though, is whether or not reciprocity is even a system that states can adequately control. Is it safe to give nurses a free pass in a new state if they claim to have been licensed elsewhere, especially if there isn't a comprehensive database of licenses for all 50 states? Or would Massachusetts and other states, as well, be smarter to do away with reciprocity altogether?
About Michael Klazema The author
Michael Klazema is Chief Marketing Technologist at EY-VODW.com and has over two decades of experience in digital consulting, online product management, and technology innovation. He is the lead author and editor for Dallas-based backgroundchecks.com with a focus on human resource and employment screening developments.