Ala. Admin. Code r. 610-X-8-.03 - [Effective 9/14/2024] Grounds For Discipline Of, Denial Of Renewal Of, Or Denial Of Reinstatement Of A License, Permit, Certificate, Approval or Multistate Licensure Privilege
The Board may deny the renewal or reinstatement application of, reprimand, fine, place on probation with conditions for continued practice, suspend, require the evaluation of, impose continuing education requirements upon, revoke and/ or otherwise discipline the holder of any license, permit, approval, certificate, or multistate privilege to practice in Alabama, upon proof that the person:
1. Is guilty of
fraud or deceit in procuring or attempting to procure a license, multistate
licensure privilege, or certificate of qualification to engage in advanced
practice nursing by:
a. Filing false, forged
or altered documents or credentials, including required continuing education
documentation.
b. Misrepresenting
or falsifying facts in applying for initial, renewal, or reinstatement of a
license, permit, certificate, or approval.
c. Having another person appear for a
licensing, permitting, or certification examination.
2. Has been convicted of a felony.
3. Is guilty of a crime involving moral
turpitude or of gross immorality that would tend to bring reproach upon the
nursing profession.
a. For purposes of this
rule a person is guilty of a crime if the person:
1. Has been convicted of the crime.
2. Regardless of court disposition, has
entered a plea of guilty, no contest, nolo contendere, not guilty by reason of
insanity, or other similar plea, or has stipulated that a prima facie case
exists that would support conviction.
b. For purposes of this rule, a crime
involving moral turpitude or of gross immorality that would tend to bring
reproach upon the nursing profession is any crime, whether felony or
misdemeanor, that involves:
1.
Drugs.
2. Theft.
3. Lewdness or any sexual offense.
4. Abuse.
5. Violence.
6. Fraud.
7. Any other conduct detrimental to the
public's health, safety or welfare.
4. Is unfit or incompetent due to the use of
alcohol, or is addicted to the use of habit-forming drugs to an extent as to
render the individual unsafe or unreliable as demonstrated by one or more of
the following:
a. Testing positive for alcohol
and/or unauthorized moodaltering drugs.
b. Misappropriation or diversion of drugs
from the workplace for self-use.
c.
Obtaining or attempting to obtain an unauthorized prescription by fraudulent
means for self-use.
d. A pattern of
abuse or misuse of habit forming and/or mood-altering drugs or
alcohol.
e. Impairment while on
duty due to alcohol or the use of illegal, unauthorized, or duly authorized
mood-altering drugs.
f. Refusal to
submit to drug screen.
g.
Submission of or attempt to submit a diluted, adulterated, or substituted
specimen for drug testing.
h. The
use of alcohol or habit forming or mood-altering drugs to such an extent that
medical or psychiatric treatment, rehabilitation, or counseling is sought by
the licensed nurse or is recommended by a legally authorized
prescriber.
i. Admitting to a
substance use disorder.
5. Is unable to safely practice nursing with
reasonable skill and safety to patients by reason of illness, inebriation,
excessive use of drugs, narcotics, alcohol, chemicals, or any other substance,
or as a result of any mental or physical condition, as demonstrated by one or
more of the following:
a. Testing positive for
alcohol and/or unauthorized moodaltering drugs.
b. Misappropriation or diversion of drugs
from the workplace for self-use.
c.
Obtaining or attempting to obtain an unauthorized prescription by fraudulent
means for self-use.
d. A pattern of
abuse or misuse of habit forming and/or mood-altering drugs or
alcohol.
e. Impairment while on
duty due to alcohol or the use of illegal, unauthorized, or duly authorized
mood-altering drugs.
f. Refusal to
submit to drug screen.
g.
Submission of or attempt to submit a diluted, adulterated, or substituted
specimen for drug testing.
h. The
use of alcohol or habit forming or mood-altering drugs to such an extent that
medical or psychiatric treatment, rehabilitation, or counseling is sought by
the licensed nurse or is recommended by a legally authorized
prescriber.
i. Admitting to a
substance use disorder.
j. More
than one alcohol or drug-related arrest within a five-year period.
k. A mental or physical condition which
renders the individual unable to safely practice nursing with reasonable skill
and safety as demonstrated by one or more of the following:
1. Conduct that poses a serious risk of harm
to the individual or any other person.
2. Cognitive deficits that render the
individual unable to exercise appropriate nursing judgment.
3. Impairment of functional
capacity.
4. Inappropriate or
disruptive behavior in the workplace.
5. A judicial finding of
incompetence.
6. Any other conduct
in the workplace that suggests an inability to safely practice nursing with
reasonable skill and safety to patients.
6. Has been convicted of any violation of a
federal or state law relating to controlled substances, including misdemeanor
and felony offenses.
7. Pertaining
to an applicant for or holder of a license, certificate, or approval, to
practice nursing or a multistate privilege to practice, is guilty of
unprofessional conduct of a character likely to deceive, defraud, or injure the
public in matters pertaining to health, as demonstrated by one of more of the
following:
a. Failure to practice nursing in
accordance with the standards adopted by the Board in Alabama Board of Nursing
Administrative Code Chapters 610-X-5, 610-X-6, 610-X-7, or 610-X-9.
b. Practice beyond the scope of the
individual licensed nurse's practice, as determined by, but not limited to:
1. Educational preparation.
2. License status.
3. Advanced practice approval.
4. Collaborative practice
agreements.
5. State and federal
statutes and regulations.
6. State
and national standards appropriate to the type of practice.
7. Nursing experience.
8. Standardized procedures.
9. Knowledge, skills and ability to manage
risks and potential complications.
10. Required instruction and supervision.
c. Failure to perform an
assessment or evaluation of a patient's status.
d. Failure to implement the plan of care or
institute interventions that might be required to stabilize a patient's
condition or to prevent complications.
e. Failure to:
1. Use appropriate nursing
judgment.
2. Administer medications
and treatments in a responsible manner.
3. Demonstrate competence in administering or
carrying out patient care.
4.
Document nursing care.
5. Account
for controlled substances.
f. Falsifying, altering, destroying, or
attempting to destroy patient, employer or employee records.
g. Abandoning or neglecting
patients.
h. Failure to respect or
safeguard the patient's, or significant other's, dignity, right to privacy,
safety, and confidential health information unless disclosure is required by
law.
i. Failure to maintain
professional boundaries.
j.
Intentionally or negligently causing or permitting one or more of the following
to a patient:
1. Physical abuse.
2. Sexual abuse.
3. Emotional abuse.
a. Verbal abuse.
2. Willful harassment or
intimidation.
3. Financial
exploitation.
k.
Permitting a dual relationship with a patient to disrupt, delay, or
inappropriately influence the nursing care provided to that patient or any
other patient.
l. Exhibiting
inappropriate unprofessional or disruptive conduct or behavior in the
workplace.
m. Engaging in fraud,
deceit, or misrepresentation in seeking employment, practicing, seeking to
practice, or advertising by:
1. Falsification,
alteration, or forgery of a temporary permit, identification card, license,
advanced practice approval, or credentials.
2. Falsification or misrepresentation of
credentials, licensure status, advanced practice approval, collaborative
practice status, or educational background.
3. Forgery of educational
documents.
4. Falsification,
misrepresentation, or forgery of employment records.
5. Falsification or misrepresentation of any
information on an application for employment.
n. Intentionally or negligently
misrepresenting or falsifying facts in billing a patient or any public or
private third-party payor.
o.
Aiding, abetting, directing, or assisting an individual to violate or
circumvent any law or rule intended to guide the conduct of a licensed nurse or
any other licensed health care provider.
p. Failure to ensure verification of current
Alabama temporary permit, licensure, and credentials of nursing personnel for
whom the licensed nurse is administratively responsible.
q. Personal use of unauthorized or illegal
drugs or substances, which includes taking medication prescribed for someone
else.
r. Testing positive for
unauthorized or illegal moodaltering drugs or substances or submitting or
attempting to submit a diluted, adulterated, or substituted specimen for drug
testing.
s. A pattern of abuse or
misuse of habit forming and/or mood-altering drugs or substances or
alcohol.
t. Practicing, attempting
to practice, or continuing to practice when the licensed nurse is unable to
perform with reasonable skill and safety due to the licensed nurse's mental or
physical impairment resulting from:
1.
Alcohol.
2. Unauthorized, duly
authorized, or illegal drugs or substances.
u. Obtaining or attempting to obtain
controlled drugs or substances without direction from a legally authorized
prescriber or through fraudulent means.
v. Furnishing or administering drugs or
controlled substances to any person, without direction from a legally
authorized prescriber.
w.
Misappropriation, diversion, or attempted misappropriation or diversion, of
drugs or substances from the workplace.
x. Refusal to submit to drug screen.
y. Appropriating real or personal
property of a patient, employer, or any other person or entity; or failing to
take precautions to prevent misappropriation of real or personal property of a
patient, employer, or any other person or entity.
z. Failure to report illegal, substandard,
unethical, unsafe or incompetent nursing practice or disciplinary action in any
state, territory, country, or other jurisdiction.
(aa) Having a license, permit, registration,
privilege to practice, approval or certification denied, conditionally issued,
fined, reprimanded, censured, restricted, limited, placed on probation,
suspended, revoked, voluntarily surrendered, or otherwise encumbered in any
state, territory, country, or other jurisdiction, or having been
court-martialed or administratively discharged by a branch of the United States
Armed Forces, for any act or conduct which would constitute grounds for
disciplinary action in Alabama.
(bb) Any act or omission which would
constitute grounds for denial or termination of qualification to engage in
advanced practice nursing.
(cc)
Violation of any provision of the Alabama Nurse Practice Act, the Alabama Board
of Nursing Administrative Code, or any state or federal law pertaining to
matters of health which is likely to deceive, defraud, or injure the
public.
(dd) Non-compliance with a
monitoring agreement or contract with an alternative to discipline program or
order issued in another jurisdiction pertaining to any license, certification,
or registration for a health- related profession.
8. Has willfully or
repeatedly violated any of the provisions of Article 2 of the Alabama Nurse
Practice Act, by:
a. Failing to respond to
official Board correspondence, including but not limited to:
1. Requests for information.
2. Subpoenas.
3. Notices.
4. Annual Reports for nursing education,
standardized procedures, and report of employing agencies.
b. Practicing, seeking to practice, or
attempting to practice professional nursing, practical nursing, advanced
practice nursing, medication assistant certified practice, or nursing support
technician certified practice without an active license, permit, certificate,
temporary permit, or approval.
c.
Impersonating an applicant for or holder of a license, permit, certificate,
approval or multistate licensure privilege or permitting or allowing another
person to use the individual's license, permit, certificate, approval or
multistate licensure privilege.
d.
Continued violation of any statute or rule after notice by the Board.
e. Failure to comply with any stipulated
terms and conditions of any Board order, agreement, or
contract.
9. Having been
sentenced to a period of continuous incarceration serving a penal sentence for
the commission of a misdemeanor or felony. The disciplinary action shall remain
in effect until the board acts upon the application of the licensee for
reinstatement of the license.
10.
Failure of an individual who possesses a license, permit, approval,
certificate, or multistate licensure privilege to practice in Alabama and who
provides continuing education to comply with continuing education
rules.
11. Failure to repay
scholarship funds awarded by the Board for graduate study.
12. Payment of any fees or fines to the Board
with a worthless check, invalid credit card, or by any other method that is not
honored by the financial institution.
13. Violation of Code of Ala.
1975, §
34-21-86, which addresses prescribing practices for
certified registered nurse practitioners or certified nurse midwives or any
adverse action against a Drug Enforcement Administration certificate or
certificate of qualification issued pursuant to Article 11 of the Alabama
Uniform Controlled Substances Act.
14. Pertaining to an applicant for or holder
of a Medication Assistant, Certified permit or a Nursing Support Technician,
Certified permit, is guilty of unprofessional conduct of a character likely to
deceive, defraud, or injure the public in matters pertaining to health, as
demonstrated by one of more of the following:
a. Failure to practice in accordance with the
standards adopted by the Board in Alabama Board of Nursing Administrative Code
Chapters 610-X-14 for Medication Assistant, Certified, or Alabama Board of
Nursing Administrative Code Chapter 610-X-17 for Nursing Support Technician,
Certified.
b. Practice beyond the
scope of the Medication Assistant, Certified's or Nursing Support Technician,
Certified's practice, as determined by, but not limited to:
1. Educational preparation.
2. Permit status.
3. State and federal statutes and
regulations, including, but not limited to, Chapter 610-X-14 of the Alabama
Board of Nursing Administrative Code.
4. State and national standards appropriate
to the type of practice.
5.
Facility policy.
6. Knowledge,
skills and ability to manage risks and potential complications.
7. Required instruction and
supervision.
c. Failure
to perform an evaluation of a patient's status.
d. Failure to implement the plan of care or
institute interventions that might be required to stabilize a patient's
condition or to prevent complications.
e. Failure to:
1. Use appropriate judgment.
2. Administer medications and treatments in a
responsible manner, if administering medications and treatments is within the
scope of practice of the permit.
3.
Demonstrate competence in administering or carrying out patient care.
4. Document patient care.
5. Account for controlled
substances.
f.
Falsifying, altering, destroying, or attempting to destroy patient, employer or
employee records.
g. Abandoning or
neglecting patients.
h. Failure to
respect or safeguard the patient's, or significant other's, dignity, right to
privacy, safety, and confidential health information unless disclosure is
required by law.
i. Failure to
maintain professional boundaries.
j. Intentionally or negligently causing or
permitting one or more of the following to a patient:
1. Physical abuse.
2. Sexual abuse.
3. Emotional abuse.
4. Verbal abuse.
5. Willful harassment or
intimidation.
1. Financial
exploitation.
k.
Permitting a dual relationship with a patient to disrupt, delay, or
inappropriately influence the care provided to that patient or any other
patient.
l. Exhibiting
inappropriate unprofessional or disruptive conduct or behavior in the
workplace.
m. Engaging in fraud,
deceit, or misrepresentation in seeking employment, practicing, seeking to
practice, or advertising by:
1. Falsification,
alteration, or forgery of a permit, identification card, license, or
credentials.
2. Falsification or
misrepresentation of credentials, permit status, or educational
background.
3. Forgery of
educational documents.
4.
Falsification, misrepresentation, or forgery of employment records.
5. Falsification or misrepresentation of any
information on an application for employment.
n. Intentionally or negligently is
representing or falsifying facts in billing a patient or any public or private
third-party payor.
o. Aiding,
abetting, directing, or assisting an individual to violate or circumvent any
law or rule intended to guide the conduct of a licensed nurse, Medication
Assistant, Certified, or any other licensed health care provider.
p. Personal use of unauthorized or illegal
drugs or substances, which includes taking medication prescribed for someone
else.
q. Testing positive for
unauthorized or illegal moodaltering drugs or substances or submitting or
attempting to submit a diluted, adulterated, or substituted specimen for drug
testing.
r. A pattern of abuse or
misuse of habit forming and/or mood- altering drugs or substances or
alcohol.
s. Practicing, attempting
to practice, or continuing to practice when the Medication Assistant, Certified
is unable to perform with reasonable skill and safety due to the licensed
nurse's mental or physical impairment resulting from:
1. Alcohol.
2. Unauthorized, duly authorized, or illegal
drugs or substances.
t.
Obtaining or attempting to obtain controlled drugs or substances without
direction from a legally authorized prescriber or through fraudulent
means.
u. Furnishing or
administering drugs or controlled substances to any person.
v. Misappropriation, diversion, or attempted
misappropriation or diversion, of drugs or substances from the
workplace.
w. Refusal to submit to
drug screen.
x. Appropriating real
or personal property of a patient, employer, or any other person or entity; or
failing to take precautions to prevent misappropriation of real or personal
property of a patient, employer, or any other person or entity.
y. Failure to report illegal, substandard,
unethical, unsafe or incompetent practice or disciplinary action in any state,
territory, country, or other jurisdiction.
z. Having a license, registration, privilege
to practice, permit or certification denied, conditionally issued, fined,
reprimanded, censured, restricted, limited, placed on probation, suspended,
revoked, voluntarily surrendered, or otherwise encumbered in any state,
territory, country, or other jurisdiction, or having been court- martialed or
administratively discharged by a branch of the United States Armed Forces, for
any act or conduct which would constitute grounds for disciplinary action in
Alabama.
(aa) Violation of any provision of
the Alabama Nurse Practice Act, the Alabama Board of Nursing Administrative
Code, or any state or federal law pertaining to matters of health which is
likely to deceive, defraud, or injure the public.
(bb) Non-compliance with a monitoring
agreement or contract with an alternative to discipline program or order issued
in another jurisdiction pertaining to any license, certification, permit or
registration for a health-related profession or occupation.
15. Any other reasons
authorized by law.
Notes
Author: Alabama Board of Nursing
Statutory Authority: Code of Ala. 1975, §§ 34-21-2(j)(1), 34-21-25, 34-21-86.
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