More than 7,600 aspiring nurses cheated the health care system and obtained fraudulent nursing degrees from three South Florida nursing schools, according to federal authorities, in a scheme health care professionals say could undermine trust in the profession.
Some 2,600 of those individuals used fake diplomas to take the nursing board exam (NCLEX) and passed, giving them access to work in health care facilities across the country. The diplomas were issued by Siena College in Broward County, the Palm Beach School of Nursing in Palm Beach County and Sacred Heart International Institute in Broward County — all of which are now closed. Though the scheme involved Florida schools, it affected multiple states.
“I'm in South Florida. It's a hotbed of fraud, whether it's identity fraud, or PPP fraud, and health care fraud, but this is something that we have not seen before,” Fernando Porras, assistant special agent in charge, told Yahoo News. Porras is leading the oversight investigation for the U.S. Department of Health and Human Services.
The investigation, known as Operation Nightingale, found that the national scheme began in 2016 and ended in 2021, accumulating more than $100 million.
“We sent in — on several occasions — undercover agents to purchase these degrees as they were explained to us and they were able to purchase the degrees having no medical background or having taken any course —they just paid the amount [$17,000],” Porras explained.
On Jan. 25, the U.S. Attorney's Office of the Southern District of Florida indicted 25 individuals in Delaware, New York, New Jersey, Texas and Florida who were allegedly working as recruiters for the illegal licensing scheme.
“You don't just wake up one morning and find out that the Palm Beach School of Nursing [or Siena College and Sacred Heart International Institute] is issuing fake degrees. You don't see that publicized in an infomercial. You find out about it because you are told by a recruiter,” Porras said.
The 25 defendants are each facing up to 20 years in prison for allegedly participating in a wire fraud scene that created the shortcuts for thousands to receive bogus nursing diplomas.
According to Porras, the Florida schools that were issuing the fake diplomas were once “legitimate schools.”
“They were certified by the state of Florida to provide nursing degrees,” he said. “They got to a point that their passing rate was dismal. And so they were put on probation. And then shortly after, their certification was revoked. So once they were revoked, and they could no longer issue any diplomas, "they would back-date the attendance of these students. So, let's say they were revoked in 2019; then they would issue the certificate and the diploma as if the student had attended between 2016 and 2017."
Now, state licensing boards nationwide have annulled the licenses of dozens of nurses who were practicing with fake degrees.
In November, Delaware revoked 26 licenses of nurses tied to the scheme, but officials say there could still be more nurses who need to be let go.
“We have heard accounts of additional individuals that have been sent to the Board of Nursing for investigation regarding concern with attendance at those [three South Florida] schools,” Christopher Otto, executive director of the Delaware Nursing Association, told Yahoo News.
And some of the individuals who obtained illegal registered nursing (RN) degrees were already licensed practical nurses (LPNs).
“For those individuals, their RN or registered nurse license is the one that is annulled. But if they have met the licensing requirements to practice as an LPN, that LPN license is still, in most cases, active,” Otto said.
In Georgia, 22 working nurses obtained fake licenses and diplomas. According to local Atlanta TV station WSB-TV, the Georgia Board of Nursing sent letters to the nurses asking them to surrender their fraudulent nursing licenses on Jan 17, but they haven't yet. Yahoo News was not able to immediately reach the board for comment.
Brenda Hage, the director of nursing at Florida Gulf Coast University, which is about two hours away from the South Florida schools that were shut down, told Yahoo News that the scheme is offensive to real nurses.
“I think I feel more dismayed than surprised,” Hage said. “We work so hard as nurses to be credible and to be viewed as ethical by the patients that we care for, and then when somebody tries to game the system, or do something illegal like this, it really offends and concerns all nurses.”
But Hage said her biggest concern is the individuals who passed the national nursing board exam (NCLEX) without the proper education or training.
“This creates a false sense of information to the public, that somehow it's really easy to sit for the NCLEX exam to become a licensed registered nurse, and nothing can be further from the truth,” Hage said.
According to Hage, the NCLEX exam is rigorous and usually takes up to five hours to complete.
“This is not something that you can bypass,” Jennifer Kennedy, the president of the American Nurses Association, told Yahoo News.
But Kennedy says she is not surprised that a scandal like this occurred in the health care industry because some states have cut their regulatory requirements.
“So we're hoping through this scandal that we can leverage this and can restore some of the authority that legislatures have stripped from boards of nursing throughout this country,” Kennedy said.
A recent Gallup poll found that over 79% of U.S adults believe nurses have very high honesty and ethical standards compared with more than a dozen other professions. But now health care officials say the degree scandal will push them to win back Americans' trust.
“We have to reassure the public that this has been dealt with. We'll monitor for harm, and I can’t guarantee it, but we'll do everything possible to prevent it from happening again,” Otto said.
So far there have been no reports of patient harm from the nurses with fake degrees, and none of the fake nurses have been charged.
“Just because an error or an adverse outcome wasn't reported doesn't mean that there weren't any misses,” Hage said. “I think they should be charged. The fact that they knew that this was a fraudulent practice, and they engaged in fraud, makes them culpable.”
Health care officials say the years-long scheme is unprecedented and could have affected anyone who visits a health care facility.
“This case potentially could affect any one of us — we go to emergency rooms, we have loved ones in hospice, in skilled nursing facilities, that can potentially be receiving care from someone that is not properly trained,” Porras said.