It goes without saying that nursing licensure verification is a benefit to all stakeholders in our healthcare ecosystem. Our licensing system allows patients to be satisfied that nursing professionals have the skills and knowledge to provide care as determined by individual state boards of nursing and offers standards providers can rely on to fulfill their staffing needs.
Our licensing system requires nurses to be listed on a registered nurse registry and registration renewal requirements ensure nurses receive continuing education and as new information becomes available, allow all patients to enjoy the benefits of quality care best practices.
The Pitfalls of Nursing Licensure
If a nurse fails to renew their license, they are legally barred from providing care as a registered nurse. Failure to renew is just one scenario by which a nurse can lose their license.
Other scenarios include, but are not limited to:
> Exceeding the scope-of-care parameters
> Violating specific facility policies and procedures
> Medication errors
> Inaccurate charting
Providers may conclude that remaining compliant with the law in regards to their nursing staff’s licensure is a relatively simple task, one that requires no more than having an individual in personnel responsible for keeping track of the nurses’ licensure end date. That assumption is false.
Remaining compliant can be a particularly daunting task especially in practices with a large number of licensed staff members all who have different annual license expiration dates.
In some states such as, New Jersey, for example, providers and MCOs are responsible for verifying that current or prospective employees (regular or temporary), contractors or subcontractors are not excluded, unlicensed or uncertified by searching the several databases on a monthly basis.
NOT ALL LICENSES ARE CREATED EQUAL
Licensing requirements also vary depending on the type of nursing specialization. Certified registered nurse anesthetists (CRNAs), anesthesiologist assistants (AAs), nurse practitioners (NPs), certified nurse-midwives (CNMs), and clinical nurse specialists (CNSs), all have different qualification requirements required by the Department of Health and Human Services Centers for Medicare & Medicaid Services. Certified nursing assistants (CNAs) and licensed practical nurses (LPNs0 must also meet specific qualification requirements. Compliance with these requirements helps ensure a high quality of care while non-compliance can lead to serious consequences.
RECIPROCITY THROUGH THE NURSING LICENSURE COMPACT
Until quite recently, if a nurse wanted to work in a new state or jurisdiction, he or she was required to obtain licensure from that state. This outmoded and inflexible arrangement did not support the increasing need for nurses across the country. The solution was the Nursing Licensure Compact (NLC), formed in 2000, which increases access to care while maintaining public protection at the state level. Under the NLC, nurses are able to work in LNC participating states and jurisdictions without having to obtain additional licenses. In 2018, an enhanced version of the LNC (known as the eLNC) was adopted which now includes specific licensing standards which the original compact did not include such as fingerprint based criminal background checks. For nurses licensed in an eLNC jurisdiction, residency in the eLNC state is required to be issued a compact license. As a non-resident of an eLNC participating state, nurses can apply for licensure by endorsement for that state, but will only be issued a single-state license – not a compact license. Nurses can of course apply for multiple state licenses if they apply for each through states’ nursing boards.
Effective March 2021, 34 states and jurisdictions participate in this arrangement and another thirteen currently have pending legislation to join as shown below:
Image via NCBSN
The remaining nine states and jurisdictions which do not participate are:
- American Samoa
- District of Columbia
- Mariana Islands
- New York
- US Virgin Islands
The nursing boards in these states have resisted supporting legislation to join the eLNC for a number of reasons, including the potential for significant lost licensure revenue for the state board of nursing, uncertainty over licensure requirements, and public safety concerns. In some states, such as Pennsylvania, legislation to join the LNC has been proposed repeatedly. California and Washington are states that have quite recently, for the first time endorsed participating in the compact.
For RN licensure verification, the National Council of State Boards of Nursing (NCSBN) offers Nursys which is the only national database for verification of nurse licensure, discipline and practice privileges for RNs, LPN/VNs and APRNs licensed in participating jurisdictions, including all states in the Nurse Licensure Compact (NLC).
For certified nursing assistant (or nursing aide) licensure verification, many states provide nursing license number lookup web tools as summarized here. Licensing requirements differ from state to state. To facilitate the verification of the license status of practitioners, many States provide nursing aide license lookup tools as detailed on the industry website. For nursing aides interested in confirming their licensure, a quick internet search of “check my CNA license status” with your state of residence should pull up the resources needed, such as the certified nursing assistant licensure site.
IMPACT OF THE COVID-19 PANDEMIC ON NURSING LICENSURE & PRACTICE
During the COVID-19 pandemic, many states including those not participating in the eLNC) took emergency actions to increase the availability of nursing staff nationwide to address the many staff shortages that developed in areas where the infection rates and hospitalizations surged. For example, in New York which has been a stalwart hold-out to participation in the compact, the governor issued several executive orders which temporarily suspended or modified state laws related to nursing licensure requirements of the state. Also, some states have issued waivers and exceptions for nurses with inactive licenses, including retired nurses, to temporarily enter the workforce without meeting state requirements if they have licenses in good standing.
And while states seek to increase the pool of health care workers available to them, jurisdictions remain mindful of public safety. For example, Montana issued a temporary waiver to certified nurse aide training requirements during the pandemic, stating that facilities are still required to ensure that staff are trained and competent at performing assigned tasks and are not considered certified nurse aides until they pass testing after the pandemic is over. The CNA.mt. gov license lookup functionality offers easy access to the state’s nursing aide registry.
The consequences for failing to verify a nursing license can be devastating for providers. New Jersey law states, “Knowingly and willfully makes or causes to be made any false statement or representation of a material fact in any cost study, claim form, or any document necessary to apply for or receive any benefit or payment under this act P.L.1968, c. 41”. In this law, the terms knowingly and willfully can be interpreted as failing to put systems in place to ensure compliance with the law. Ignorantia juris non excusat or ignorantia legis neminem excusat (Latin for “ignorance of the law excuses not” and “ignorance of law excuses no one”, respectively) is a legal principle holding that a person who is unaware of a law may not escape liability for violating that law merely because one was unaware of its content. Following this same principle, being unaware that a caregiver does not meet licensure requirements and receiving compensation for care provided by the unlicensed caregiver would be punishable because providers are required to be aware of nurses’ licensure status at all times.
OIG MAKING IT A PRIORITY
Finally, the OIG has made fostering economic payment policies a priority by reducing improper payments with future planning efforts to include, “oversight of certification surveys and hospice-worker licensure requirements.” This priority includes prosecution for services provided by unlicensed and unqualified individuals. Recently, Dr. Labib Riachi, a New Jersey OB/GYN, was excluded from participating in Federal healthcare programs for several violations including operating with an unlicensed practitioner. While the OIG plan specifies hospice-work licensure only, it is clear that license verification in general is becoming more of a priority.
To help providers remain compliant and ensure their nursing license lookup system goes beyond a registered nurse registry, Streamline Verify now offers license verification. Our application serves as your primary source of verification, checking licenses monthly and storing a digital version of the licensing agency page for your records. You will receive monthly license verification audits with the status of each licensed provider on your staff and have the ability to generate up-to-date reports on demand. You will also receive semi-monthly reports for licenses due to expire within 30 days, and our system checks those licenses daily, so you know when a license has been updated as renewed within 24 hours. All of these searches are saved and serve as evidence of compliance should your company have to defend itself against unlicensed provider allegations. Contact us today to find out how we can set up your nursing licensure verification and give you the peace of mind of knowing you are 100% compliant with licensure requirements.