Missouri Board of Nursing Investigations: What Triggers Them?

/in /by

Understanding What Can Lead to a Formal Review of Your License

If you’re a nurse practicing in Missouri, few things are more unsettling than receiving notice that you’re under investigation by the Missouri State Board of Nursing. These investigations can have serious consequences for your license, your livelihood, and your professional reputation. But what exactly triggers a Board investigation?

In most cases, the process is set in motion by specific events that raise concerns about a nurse’s ability to provide safe and ethical care. Understanding the most common triggers can help you stay alert, avoid pitfalls, and take proactive steps if you’re ever notified of an investigation.

1. Employer Reports

One of the most common sources of nursing Board investigations is a report filed by your employer. Missouri law requires healthcare employers to report conduct that could jeopardize patient safety or violate nursing standards.

Employers may report:

  • Medication errors
  • Suspected impairment at work
  • Insubordination or policy violations
  • Negligence in patient care
  • Boundary violations with patients or staff

Under RSMo § 383.133, licensed healthcare facilities in Missouri are mandated reporters. That means they are legally obligated to report certain types of conduct to the Board—even if you resign or are terminated before the issue is resolved internally.

Unfortunately, even misunderstandings or politically motivated reports can lead to a formal investigation. Once the report is filed, the Board takes over and evaluates the matter based on state nursing laws and professional standards.

2. Patient or Family Complaints

Patients and their families have the right to file complaints directly with the Missouri State Board of Nursing. Even if the allegations are unfounded, the Board has an obligation to investigate any complaint that suggests a possible violation of the Missouri Nurse Practice Act.

Common patient-driven complaints include:

  • Rude or inappropriate communication
  • Neglect or poor bedside manner
  • Suspected medication mistakes
  • Privacy breaches or HIPAA violations
  • Injuries or adverse outcomes

While many of these may seem minor, they can quickly escalate into formal investigations—especially if there’s documentation, witness statements, or a history of previous complaints.

3. Criminal Arrests and Charges

Another major trigger for an investigation is a criminal arrest or conviction, particularly for offenses involving:

  • Controlled substances
  • Theft
  • Assault
  • Fraud
  • Driving under the influence (DUI)

Missouri law requires nurses to report certain criminal charges to the Board—especially those that involve moral turpitude or call your professional judgment into question.

Under RSMo § 335.066, the Board has the authority to take disciplinary action even for off-duty conduct if it reflects poorly on your ability to safely practice nursing. A single criminal charge—whether it results in conviction or not—can still lead to a review of your license.

4. Positive Drug Tests or Impairment Reports

If you fail a workplace drug test or are suspected of being impaired while on duty, your employer will likely report the incident to the Board. Even voluntary admissions of substance abuse—such as seeking treatment—can prompt an investigation into whether you are fit to practice.

The Board may:

  • Open a disciplinary case
  • Refer you to the Missouri Alternative Program for substance use recovery
  • Suspend or restrict your license pending evaluation

These investigations are particularly sensitive and may require drug testing, treatment verification, and ongoing monitoring—even before a formal hearing takes place.

5. Social Media Activity

Social media has become an increasing source of Board complaints and investigations. Nurses who share inappropriate photos, make off-color jokes, or even unintentionally reveal patient details online may face serious consequences.

You could be investigated for:

  • Posting patient-related content (even without names)
  • Making discriminatory or threatening comments
  • Sharing photos from the workplace in uniform
  • Participating in viral trends that cross ethical lines

Remember, the Board evaluates public conduct as well as clinical conduct. A post that seems harmless to you may be seen as unprofessional or unethical under state nursing standards.

6. Anonymous Tips and Peer Reports

Although less common, the Board also acts on anonymous tips or reports from co-workers. These tips are usually taken seriously if they involve safety concerns, illegal behavior, or patterns of questionable care.

Examples might include:

  • Improper charting or falsification of records
  • Taking shortcuts with medication administration
  • Conflicts with patients or staff
  • Concerns about emotional or mental instability

The Board is not required to disclose the source of the tip when beginning an investigation—meaning you may not even know who made the allegation.

What Happens Once an Investigation Begins?

Once the Board receives a complaint or report, they initiate a formal investigation that may include:

  • Reviewing medical records and documentation
  • Interviewing witnesses, employers, and patients
  • Requesting a written explanation from you
  • Offering a voluntary consent agreement or proceeding to a disciplinary hearing

The outcome can range from dismissal of the complaint to license suspension or revocation, depending on the evidence and whether you have competent legal representation.

Why Legal Representation Matters

Many nurses believe they can resolve an investigation by simply “telling their side of the story.” Unfortunately, well-intentioned explanations are often used against them.

A nursing license defense attorney can:

  • Help you respond to the Board’s inquiries
  • Protect your rights during interviews
  • Challenge flawed or incomplete evidence
  • Negotiate alternatives like voluntary monitoring or continuing education
  • Prepare for a formal hearing if needed

Without legal help, even minor mistakes or miscommunication can lead to life-altering discipline.

Contact Sanger Law Office, LLC for a Free Consultation

If you’ve been notified of an investigation by the Missouri State Board of Nursing, don’t wait. Your license and your career are too important to risk.

📞 Call (816) 520-8040 today for your free consultation with an experienced Missouri nursing license defense attorney. We’re here to help you defend your future.