Kansas and Missouri Professional Licensing Attorney Danielle Sanger Provides a List of Tips for Nurses Under Investigation

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Receiving a certified letter from your state licensing board indicating that they are opening an investigation into your performance as a nurse is a harrowing experience. Most nurses I know go through several stages of emotion—terror, embarrassment, anger, and fear are all common. I have helped hundreds of similarly situated nurses through this process and can assure you that many of those representations, while stressful, had positive outcomes. While I cannot provide specific legal advice for every possible situation in a blog-post, I thought it would be helpful to give an overview of general counsel that I regularly offer nurses who call me frantically upon opening a letter indicating that they are about to be investigated.  The list of general tips follows.

If you are a nurse in Kansas or Missouri facing an investigation, call attorney Sanger today at 785-979-4353 to schedule a free consultation. Do not agree to speak with an investigator without an experienced attorney by your side. Your career, reputation, and livelihood are at risk, and the challenge facing you is one you cannot navigate alone.

Advice for Nurses Receiving Notices of Investigation

  1. Hire an experienced licensing attorney immediately. The biggest mistake you can make now is trying to “go it alone” or to “work with” the investigators. Both of these are horrible strategies that routinely result in catastrophe.  Hire an expert to help you gather evidence, deal with investigators, and present the best picture of your actions.
  2. Focus on telling the truth and being transparent. Like most things in life, it is far more serious to be caught lying than caught making a mistake. Given the extensive record keeping in most medical facilities, it is extremely unlikely that you will get away with any lie you tell, and the ramifications of lying are usually significant.
  3. If you have one, contact your professional insurance carrier. If you do not have one, it is too late to attain insurance for whatever conduct is being investigated.
  4. Keep silent. As you have seen on television, “anything you say can and will be used against you.” This is a serious situation and is no time for posting about your problems on social media. All too often I see my clients’ unfortunate statements, written in a period of anger or frustration, come back to haunt them as admissions in administrative hearings. Do not speak about your case with coworkers or friends either; any of these people can be called as witnesses to testify about your statements.
  5. Do not copy patient records, even if you need them for your defense. A licensing attorney can attain the documents you need when the time comes to put on your defense. Making copies of or otherwise improperly accessing patient records is likely a HIPAA violation and will further harm your case.
  6. Do not speak to investigators, former patients, or family members of former patients. These folks are likely fishing for information from you; speaking with them hurts your case.
  7. If an investigator contacts you, refer the investigator to your attorney and do not make any statement.
  8. Remain professional. You are a member of a profession honored for its professionalism. While you may have every right to be frustrated or angry, now is not the time to give investigators the impression that you fail to meet the standards of your profession.

Contact an Experienced Kansas and Missouri Licensing Attorney Now

You have worked too hard to attain your nursing license.  An inquiry from a licensing board means that your livelihood is in jeopardy. Contacting an experienced licensing attorney to help you through this process and can mean the difference between getting back to helping your patients or clients and losing your career forever.

Kansas and Missouri professional licensing attorney Danielle Sanger is prepared to advocate for your best interests and defend you. Call Attorney Sanger at 785-979-4353 to schedule a free consultation with an attorney experienced dealing with licensing issues.

 

 

 

Kansas and Missouri Professional Licensing Attorney Danielle Sanger Explains: Most Common Reasons for Chiropractor Discipline

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Chiropractors are a vital part of the medical community. That said, like any other medical professional, they face scrutiny from licensing boards and have false allegations made against them from time to time. They are obviously human as well and are susceptible to mistakes in judgment. I have much enjoyed my representation of chiropractors, and am often asked by my chiropractor clients about what the most common reasons that their peers find themselves before the state licensing board. I have drafted this post to answer that question.

If you are a chiropractor in Kansas or Missouri facing an investigation that jeopardizes your professional license, call attorney Sanger today at 785-979-4353 to schedule a free consultation. Your career, reputation, and livelihood are at risk, and the challenge facing you is one you cannot work your way through this alone.

Most Common Reasons for Chiropractor Discipline

Insurance Fraud: Medicare fraud is the most common reason chiropractors lose their licenses. Insurance fraud can be committed by engaging in fictitious billing for services that were not rendered and prescribing unnecessary procedures.

Negligence/Malpractice: An allegation of negligence/malpractice arises when a patient alleges that a chiropractor failed to meet the standard of care for a procedure and the patient suffered an injury as a result.

Criminal Convictions: A criminal conviction may result in a licensure action, but it often depends on the type and severity of the conviction. For example, a conviction for reckless driving is unlikely to have any effect on a chiropractor’s license, but a conviction for illegal drug distribution most likely will.  Similarly, any conviction that suggests that the chiropractor may not be safe with the public or the public’s money, such as convictions for sexual assault, domestic violence, or fraud, may trigger a suspension action.

Sexual misconduct: Chiropractors should not have a sexual relationship with a patient.  This is strictly enforced. What I commonly see is a consensual relationship that started gradually and in conjunction with treatment. When the relationship was going well, the chiropractor thought there was no harm in pursuing it; however, when the relationship was discovered or ended, a complaint arose.

Illegally Prescribing Medications: There is an opioid epidemic in the United States right now, and some of its cause is medical professionals who overprescribed addictive drugs or provided prescriptions to drug-seeking patients who were already addicted. Be scrupulous in your prescription practices to avoid allegations of misconduct.

How Can a Chiropractor Prevent License Suspension or Revocation?

While an allegation may have been made against you, that does not mean that you will be suspended. Before you can have any disciplinary action taken against you, you must receive “due process,” meaning that you must receive the specific allegations against you, the evidence supporting those allegations, and an opportunity to prevent your version of events and evidence at a hearing. With the help of an experienced licensing attorney, you can often have the allegations against you dismissed or reduced. Going through this process alone is foolhardy.

Contact an Experienced Kansas and Missouri Licensing Attorney Now

You have worked too hard to attain your chiropractic license.  An inquiry from your licensing board means that your livelihood is in jeopardy. Contacting an experienced licensing attorney to help you through this process and can mean the difference between getting back to helping your patients or clients and losing your career forever.

Kansas and Missouri professional licensing attorney Danielle Sanger is prepared to advocate for your best interests and defend you. Call Attorney Sanger at 785-979-4353 to schedule a free consultation with an attorney experienced dealing with licensing issues.

 

Kansas and Missouri Professional Licensing Attorney Danielle Sanger Explains Why Physicians Should Think Twice About “Voluntary Suspensions” of Medical Licenses

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I have seen physician’s lives and careers devastated because they agreed to a “voluntary suspension” of their medical license or a restriction on their license while the medical board investigates allegations of misconduct. While the physician under investigation believed that the voluntary suspension would be brief and that it would put them in a good light with investigators, both assumptions were incorrect. In fact, the suspension lasted far longer than initially hoped, and agreeing to the voluntary suspension ended up having a host of negative consequences.

If you are a physician in Kansas or Missouri facing an investigation that jeopardizes your professional license, call attorney Sanger today at 785-979-4353 to schedule a free consultation. Do not agree to any suspension of any kind or speak to an investigator without an attorney to defend you. Your career, reputation, and livelihood are at risk, and the challenge facing you is one you cannot navigate alone.

Expect Suspensions to Last Longer Than Promised

Physicians under investigation are sometimes asked to sign an Interim Stipulated Order (ISO) or Interim Consent Order (ICO) accepting a voluntary restriction on their license or, even worse, suspending their practice pending the outcome of the investigation. These requests are usually accompanied by a suggestion that the suspension will be brief. However, these investigations often take a year or longer, especially in the case of physicians. Additionally, there are other ramifications of a “temporary suspension,” such as:

Reports to the National Practitioner Data Bank (NPDB)

If you consent to an interim restriction on your license, that restriction will be reported to the National Practitioner Data Bank (NPDB). You will have to deal with any consequences of the report to the NPDB on your career, even though no allegation has been proven.

Withdrawal of Board Certification, Credentialing, and Employment

If your medical license is temporarily suspended, you should anticipate that your board certifications will also likely be withdrawn. The suspension of the license and withdrawal of board certification will frequently result in an employer terminating the employee as well. Accordingly, a voluntary suspension ends up being a death sentence for your career.

DEA Registrations

If you are a prescribing physician, you must also consider the serious impact of a restricted license on your DEA Registration. To hold a DEA Registration, the Drug Enforcement Administration (DEA) requires every DEA Registrant physician to possess a medical license granting state authority to prescribe controlled substances. So if you agree to a restriction on your prescribing privileges or consent to voluntarily withdraw from your medical practice while you await the outcome of an investigation, you should anticipate a request to surrender your DEA Registration. 

Contact an Experienced Kansas and Missouri Licensing Attorney Now

You have worked too hard to attain your professional license.  If you are a physician under investigation and your licensing Board requests that you consent to restrictions on your medical license, you need to know that the restriction will probably last more than a few months and there are numerous other consequences to consider depending upon your type of practice and level of licensure.

An inquiry from a licensing board means that your livelihood is in jeopardy. Contacting an experienced licensing attorney to help you through this process and can mean the difference between getting back to helping your patients or clients and losing your career forever.

Kansas and Missouri professional licensing attorney Danielle Sanger is prepared to advocate for your best interests and defend you. Call Attorney Sanger at 785-979-4353 to schedule a free consultation with an attorney experienced dealing with licensing issues.

 

 

Kansas and Missouri Professional Licensing Attorney Danielle Sanger Explains the Effects of a DUI or DWI on Your Career as Medical Professional

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In Kansas, it’s called a DUI. In Missouri, it’s called a DWI. Either way, it can spell big problems for your career as a medical professional. I have helped many medical professionals through the licensure and employment issues associated with an arrest for driving while impaired and can help you as well. But too many professionals fail to attain the help of an experienced licensing attorney when they receive a notice of investigation or violation.  This failure ends up making the state’s job far too easy. Because I get so many calls asking about the career effects of a DUI/DWI conviction, I wrote the following blog post to explain the many ramifications.

If you are a professional in Kansas or Missouri facing an investigation that jeopardizes your professional license, call attorney Sanger today at 785-979-4353 to schedule a free consultation. Your career, reputation, and livelihood are at risk, and the challenge facing you is one you cannot work your way through this alone.

The Effects of a DUI/DWI

There is no question that a DUI/DWI conviction can have a significant impact on your life. While for some people it is a sign that they have a drinking problem, for others, it signifies a one-time mistake in judgment. Regardless, it has a greater impact on those in the medical field than those in other professions, as medical professionals have a heightened responsibility to appear free from intoxicating substances and often have state licensing boards that look unkindly on any criminal conviction.  Having advised countless medical professionals regarding their recent arrest for DUI/DWI, here are the most common effects:

Professional Licensure Loss, Suspension, or Discipline– A medical professional often has to report an arrest and usually must report a conviction to his or her licensing body. You will want to consult with an experienced licensing attorney before making the report. You want to avoid doing more damage than you have to in making this report, and an experienced attorney that has a relationship with the board can help you frame the issue in a light most favorable to the license holder.

Contractual Requirements—Many medical employers see a DUI/DWI arrest or conviction as a signal of an employee with a substance abuse problem. Many hospitals and clinics require employees to disclose any arrest within a certain amount of time. Again, this is the sort of disclosure you want to make with the help of an experienced licensing attorney. Having worked with many medical professionals on similar issues, a skilled attorney likely knows how to disclose in a way least harmful to your career.  That said, some employers make criminal charges a ground for suspension or even termination, so you will want to review your employee handbook with your attorney as well.

Lack of transportation—While your DUI/DWI is pending, you will likely be prevented from driving for a period, often months. This is an inconvenience and makes getting to and from work difficult. It can also be independent grounds for termination if your position requires a valid driver’s license.

Leave Issues—An arrest for DUI/DWI will likely require your presence at least one or two hearings. If you go to trial to contest your case, you will likely spend another few days in court. If you are convicted, you may have to serve days or weeks in jail depending on the severity of your case. Even if you accept a plea agreement, that too will require a hearing. In the end, you may have to miss several days of work, which your employer may not look upon warmly.

Contact an Experienced Kansas and Missouri Licensing Attorney Now

You have worked too hard to attain your professional license.  Whether it is a medical, counseling, nursing, accounting, veterinary or any other type of license, a DUI/DWI can mean that your livelihood is in jeopardy. Contacting an experienced licensing attorney to help you through this process and can mean the difference between getting back to helping your patients or clients and losing your career forever.

Kansas and Missouri professional licensing attorney Danielle Sanger is prepared to advocate for your best interests and defend you. Call Attorney Sanger at 785-979-4353 to schedule a free consultation with an attorney experienced dealing with licensing issues.

Kansas and Missouri Professional Licensing Attorney Danielle Sanger Explains: Is My Licensure Case Criminal or Civil?

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Medical professionals often come to my office for a consultation and one of the first questions they ask is “is this a criminal or civil?” I don’t blame them for being confused, as depending on the conduct in question, it could end up being civil, criminal, or both. Because I so often get questions about the intricacies of these matters, I have written the following blog post to explain the difference between civil and criminal matters and the legal implications of your disciplinary board matter.

If you are a professional in Kansas or Missouri facing an allegation of misconduct or an investigation, call attorney Sanger today at 785-979-4353 to schedule a free consultation. Your career, reputation, and livelihood are at risk, and the challenge facing you is one you cannot work your way through alone.

The Difference Between Civil and Criminal Matters

To start the basics, a civil matter is one where the state seeks to take some “property” from you.  Now, you may think of property like physical property such as a car or land, but you also have a property interest in your license as a medical professional. You also have a property interest in your good name and reputation. You’ll remember from the U.S. Constitution’s 5th Amendment that the federal government cannot take your life, liberty, or property without due process of law.  The same holds true for state governments.  As a result, the state cannot take your professional license or your interest in your reputation without “due process.” Due process means an opportunity to know what the accusations are against you, an opportunity to review the evidence against you, and a hearing where you and your attorney can confront or attack those accusations and evidence with your own evidence. A civil matter may result in having some property—like your license—taken or suspended or having a fine imposed.

Criminal matters involve having your liberty taken by the state—they result in the accused going to jail if he or she is convicted.  A district attorney files a criminal matter in court, and you would usually learn of the charges by being served by a police officer or by being arrested. Because a loss of liberty, incarceration, is viewed as a more severe deprivation, more due process is required.  The standard of proof—beyond a reasonable doubt—is higher in a criminal case, a jury usually judges guilt or innocence, and the hearing or trial is much more formal.

If you receive a letter in the mail from a state administrative agency indicating that a licensure action or investigation has initiated against you, that administrative matter is civil in nature and not criminal. The letter signals that the state is starting your due process rights and alerting you to your opportunity to engage in that due process.

When Criminal and Civil Matters Overlap

If you have watched any amount of television, you have probably seen a crime drama where the criminal being arrested is given his Miranda warning of, “you have the right to remain silent, everything you say can and will be used against you in a court of law.”  While the crime drama may be just television, those rights are real.  That warning is relevant to you as well.

Take as an example, a pharmacist who is giving his relatives opioids for their pain without a prescription. If the state pharmacy board is alerted to this practice, the pharmacist will likely receive a notice of accusations in the mail, initiating his due process rights. That letter is a civil matter. If he is found to have violated the pharmacy regulations by a preponderance of the evidence—by a likelihood of at least 51%—he will have a civil penalty such as a fine, suspension, or license revocation. However, distributing opioids without a prescription is also a crime.

If the pharmacist in the above example admits in his civil hearing before the pharmacy board that he has been distributing opioids, that information can be used against him criminally. A statement made in a civil hearing, like any statement, can be used against you. The Assistant Attorney General who prosecuted the pharmacist’s licensing issue can simply hand the transcript of his admission to an Assistant District Attorney who can then charge the pharmacist with drug distribution.

As I stated above, the burden of proof in a criminal case is “beyond a reasonable doubt,” which is much higher than the civil hearing’s “preponderance of the evidence” standard. But if the pharmacist has admitted to distributing the opioids, that unequivocal admission will likely meet either standard.

As a result, a civil matter can easily turn into a criminal one if the conduct alleged violates both the state regulations that govern your medical field as well as the criminal statutes. While the example above dealt with opioid distribution, I have also seen civil cases transform into criminal ones in cases alleging sex with a patient, boundary violations, and financial transgressions.  Accordingly, it is a massive mistake to think you can handle your civil hearing alone or that you can play along with the investigation to make things go away. You are just digging yourself into a deeper hole and playing into the state’s hands when you attempt that sort of foolish strategy.

Contact an Experienced Kansas and Missouri Licensing Attorney Now

You have worked too hard to attain your professional license.  Contacting an experienced licensing attorney to help you through the misconduct hearing process, explain the criminal implications of any allegations against you, and can mean the difference between getting back to helping your patients and losing your career forever.

Kansas and Missouri professional licensing attorney Danielle Sanger is prepared to advocate for your best interests and defend you. Call Attorney Sanger at 785-979-4353 to schedule a free consultation with an attorney experienced dealing with nursing licensing issues.

 

Missouri Professional Licensing Attorney Danielle Sanger Explains Issues Surrounding Fifth Amendment Self Incrimination

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Professionals sometimes come to me with questions about “pleading the Fifth” in their hearings before licensing boards in Missouri. This concept comes into play when testifying truthfully might subject the testifier to criminal charges. While the U.S. Constitution guarantees all citizens the right to protect themselves from self-incrimination, Fifth Amendment protections are not a panacea. Deciding whether or not to testify is a complex decision and should not be made lightly. If you are even thinking about exerting your Fifth Amendment rights, you must seek expert legal help immediately.

If you are a professional in Missouri facing an investigation, call attorney Sanger immediately at 785-979-4353 to schedule a free consultation. Your career, reputation, and livelihood are at risk, and the challenge facing you is one you cannot work your way through this alone.

The Fifth Amendment

The Fifth Amendment of the United States Constitution guarantees that a person cannot be forced to testify against themselves in a criminal matter. Basically, a prosecutor cannot call a defendant to the witness stand and ask him or her whether they committed a crime. Importantly, a jury or court cannot hold that decision to remain silent against a defendant.

A hearing before a licensing board is not a criminal trial, however. While not a criminal prosecution, the United States Supreme Court held in Lefkowitz v. Turley, 414 US 70 (1973), that a person cannot be forced to testify in a civil matter such as a licensing hearing when the testimony could later incriminate them criminally:

A witness’ privilege against self-incrimination `not only protects the individual against being involuntarily called as a witness against himself in a criminal prosecution but also privileges him not to answer official questions put to him in any other proceeding, civil or criminal, formal or informal, where the answers might incriminate him in future criminal proceedings.’

 

Accordingly, you can “plead the Fifth” in a Missouri licensing hearing, meaning that you can refuse to testify. But is that a good idea?

Implications of Pleading the Fifth in Missouri

Remember, when you plead the Fifth, you are saying that your testimony may implicate you in a crime. While that tactic may be a wise one to avoid criminal prosecution, it is likely to be held against you in a licensing case.  That is a significant difference between a criminal and civil proceeding; your silence cannot be held against you in a criminal proceeding, but a civil proceeding such as a licensing board hearing can draw a negative inference from your refusal to testify.

Imagine you are a nurse and are alleged to have distributed opioids to family members illegally. In your licensing hearing, it would be wise to plead the Fifth Amendment to avoid serious criminal charges related to drug distribution. That said, in a civil matter, your decision to plead the Fifth may be used against you and will likely be taken as an admission by the licensing board. This adverse inference by the licensing board will likely cost you your license. Accordingly, taking the Fifth is a good way to avoid criminal prosecution, but is a strategy that will likely lead to negative consequences in the licensing context. It is never a decision to make lightly or without the help of experienced licensing counsel.

Contact an Experienced Kansas and Missouri Licensing Attorney Now

If you are a professional facing criminal prosecution, you are likely also in jeopardy of losing your professional license.  Whether it is a medical, counseling, nursing, accounting, veterinary or any other type of license, an inquiry from a licensing board means that your livelihood is in jeopardy. Contacting an experienced licensing attorney to help you through this process and can mean the difference between getting back to helping your patients or clients and losing your career forever.

Kansas and Missouri professional licensing attorney Danielle Sanger is prepared to advocate for your best interests and defend you. Call Attorney Sanger at 785-979-4353 to schedule a free consultation with an attorney experienced dealing with licensing issues.

 

 

Kansas and Missouri Professional Licensing Attorney Danielle Sanger Explains Why You Need an Attorney at Your Licensing Board Hearing

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The United States Constitution prohibits the state from taking your property without “due process,” which means that the state has to legally prove its case after giving you a chance to review the evidence against you and defend yourself.  This due process requirement is not only in place when the state wants to take physical property like land; it also applies to other possessions such as your professional license.

The state should have to struggle to take something as valuable as your license, but too many professionals fail to attain the help of an experienced licensing attorney when they receive a notice of investigation or violation.  This failure ends up making the state’s job far too easy. Because I get so many calls asking me whether it is “worth it” to hire an attorney, I wrote the following blog post to explain the value of having experienced counsel by your side.

If you are a professional in Kansas or Missouri facing an investigation that jeopardizes your professional license, call attorney Sanger today at 785-979-4353 to schedule a free consultation. Your career, reputation, and livelihood are at risk, and the challenge facing you is one you cannot work your way through this alone.

Misperceptions About Hiring an Attorney

Some people have the misperception that hiring an attorney will somehow make them look guilty. This could not be further from the truth. In fact, state licensing boards know that a skilled licensing attorney can actually help streamline the case, expose flaws in the state’s case, and resolve the case more efficiently. A licensing attorney often presents an alternative set of facts that demonstrate that the state’s version of events may be inaccurate.

When a person is unrepresented, the state board often assumes that he or she must not have a defense. This leads to the very conclusion that the person wanted to avoid, that they are guilty. When a person is not represented by counsel, the licensing board views the case as “shooting fish in a barrel.” Do not end up like a dead fish!

Attaining and Protecting Information

An experienced licensing attorney knows what evidence to present, what to withhold, and what to seek from the licensing board. That knowledge stems from having numerous cases before the board seeking to discipline the client. You are already at a disadvantage if you lack that sort of experience. You are also at a disadvantage if you do not know how much information to divulge. Professionals under investigation often think they will gain favor with the licensing board by providing them all of the information they are seeking, even damaging information. That strategy is never successful, as a layperson will often end up making the state board’s case for them by providing incriminating information in an effort to be “helpful.”

A skilled licensing defense attorney can advise you regarding which information to share and which information you may legally withhold. Differentiating between the information to share and to withhold may mean the difference between keeping and losing your license, and only an attorney with experience before your Missouri or Kansas licensing board can provide you with that sort of guidance.

Negotiating a Positive Outcome

Attorneys are trained negotiators. Sometimes a “good” outcome is a suspension instead of a license revocation, while other times, a complete dismissal of the allegations is the required. Either way, only a licensing attorney that has represented multiple clients before your licensing board can adequately advise you regarding what is a fair outcome in your case. Trying to negotiate on your own behalf is a sure way to get a poor result.

Contact an Experienced Kansas and Missouri Licensing Attorney Now

You have worked too hard to attain your professional license.  Whether it is a medical, counseling, nursing, accounting, veterinary or any other type of license, an inquiry from a licensing board means that your livelihood is in jeopardy. Contacting an experienced licensing attorney to help you through this process and can mean the difference between getting back to helping your patients or clients and losing your career forever.

Kansas and Missouri professional licensing attorney Danielle Sanger is prepared to advocate for your best interests and defend you. Call Attorney Sanger at 785-979-4353 to schedule a free consultation with an attorney experienced dealing with licensing issues.

 

 

Missouri Professional Licensing Attorney Danielle Sanger Describes the Most Common Kansas Child Care Provider Licensing Issues

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Clients frequently come to me with issues regarding their child care licensing issues. Whether it is because they accidentally hired an employee with a criminal past, they are alleged to have endangered a child, or their facility is understaffed, any one of these allegations can end your career as a childcare provider.

If you are a professional in Missouri facing an investigation, call attorney Sanger immediately at 785-979-4353 to schedule a free consultation. Your career, reputation, and livelihood are at risk, and the challenge facing you is one you cannot work your way through this alone.

Child Care Providers in Kansas: The Law

I attached a link to the Kansas statutes and regulations that dictate how child care licensing works in Kansas. For the purposes of this post, however, here are are all of the reasons that a person or business’s childcare license could be revoked:

K.S.A. 65-523. Grounds for limitation, modification or suspension of license or temporary permit.

The secretary may limit, modify or suspend any license or temporary permit issued under the provisions of K.S.A. 65-501 through 65-516, and amendments thereto, upon any of the following grounds and in the manner provided in this act:

  • Violation by the licensee or holder of a temporary permit of any provision of this act or of the rules and regulations promulgated under this act;
  • aiding, abetting or permitting the violating of any provision of this act or of the rules and regulations promulgated under this act;
  • conduct in the operation or maintenance, or both the operation and maintenance, of a maternity center or child care facility which is inimical to the health, safety or welfare of any woman or child receiving services from such maternity center or child care facility, or the public;
  • the conviction of a licensee or holder of a temporary permit, at any time during licensure or during the time the temporary permit is in effect, of crimes as defined in K.S.A. 65- 516, and amendments thereto; and
  • a third or subsequent violation by the licensee or holder of a temporary permit of subsection (b) of K.S.A. 65-530, and amendments thereto.

Below I will go through the most common types of allegations that I see.

“Conduct Inimical”

To be “inimical” means to be the enemy of something. As used above, it means that it is alleged that a daycare provider is acting in a way that is the enemy of the children’s health, safety, or welfare. This is a broad, subjective category, but I most commonly see allegations involving hitting children, unsanitary or unsafe facilities, or allowing staff to behave inappropriately in front of children in their care. Sadly, given our nation’s opioid epidemic, I frequently see cases where it is alleged that childcare providers are under the influence of opioids while caring for children.

Criminal and Other Conduct

Being convicted of a crime may not mean the loss of your childcare license, but either having a felony conviction or employing someone who does is a common reason for revocation. Any sort of felony sex offense, drug offense, or assault, particularly domestic violence, is a bar to employment at a child care facility, even if it was committed as a child. Employing felons may also trigger a loss of license, so I always advise thorough background checks before any hire. Additionally, Kansas does not allow some people who require a conservator or cannot be legally responsible for themselves, such as people with significant mental disabilities, from working at a child care center. Kansas also people who have had their children taken from them due to abuse or neglect to work at child care centers.

Staffing Ratios and Capacity

As a childcare facility, you should know the required ratios of staff to children. Unfortunately, these license revocation issues often arise after an accident, when the State of Kansas revokes a license because there was, allegedly, inadequate staffing to prevent the accident. Staffing ratios depend on the age and number of children in your facility, know them.

If you are a childcare provider facing license revocation, your livelihood is in jeopardy. Contacting an experienced licensing attorney to help you through this process and can mean the difference between getting back to working with children and losing your career forever.

Kansas and Missouri professional licensing attorney Danielle Sanger is prepared to advocate for your best interests and defend you. Call Attorney Sanger at 785-979-4353 to schedule a free consultation with an attorney experienced dealing with licensing issues.

 

Kansas and Missouri Professional Licensing Attorney Danielle Sanger Provides an Overview of Physician License Claims

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Physician clients from both Kansas and Missouri often ask me why their licenses are so frequently targeted for discipline. My answer varies depending on the case, but always includes the factors: we live in an extremely litigious nation, physicians are perceived as “deep pockets” eager to pay out settlements, and medicine is a highly regulated field with a multitude of ways to break the rules daily. Taking those factors together, it is not hard to see why licensure claims are fast to rise, hard to defend, and require expert counsel.

The first sign that you are being investigated for a licensing issue is a request from the state for records or an interview.  It may be an innocuous request based on a report that will be easily explained, or it may be an aggressive action to take your license that will require an aggressive response. Either way, aggressive, experienced licensing counsel is critical to defending your license and livelihood from a suspension or revocation. I wrote the following post to outline why discipline could occur and what you should do if an allegation arises. If you are licensed medical professional in Kansas or Missouri facing an investigation, call attorney Sanger today at 785-979-4353 to schedule a free consultation. Your career is at risk, and you cannot work your way through this alone.

Types of License-Threatening Complaints Physicians Often See

There are several different types of licensing complaints that my physician clients see. Some are driven by the physician’s behavior, such as arrests for DUI or drug use.  Others stem from the allegations of misconduct related to medical clinic management, such as fraud, sexual misconduct towards patients, and faulty recordkeeping.  Regardless of the type of allegation, they are all extremely serious, as if they go unaddressed, they can result in your livelihood being taken from you. Having experienced counsel by your side is vital; even if the case against you is strong, the penalties may be mitigated by my knowledge of the medical boards in both Missouri and Kansas. So while you may still receive a reprimand for an error in judgment, that is usually considered a success when a revocation was at stake.

I am often asked about the most common types of misconduct allegations that I see. I have written the following list, which I have listed in order of most to least common:

Substance Abuse/DUI—these allegations often involve physicians also being charged criminally. As one might imagine, an arrest for DUI often rises from a physician’s arrest. Substance abuse allegations, however, often arise from third party claims.  This can be an ex-spouse or spurned medical partner. Increasingly, I see claims made by drug-seeking patients who were rightfully denied prescription medications filing these complaints in revenge.

Medication Violations—given the opioid epidemic, there is increasing drug-seeking behavior by patients. Allegations commonly arise when medications are provided improperly or over-prescribed. Commonly, patients also make revenge complaints when physicians refuse to prescribe more pills.

Fraud—these complaints often arise around behaviors suggesting that either unnecessary procedures are being performed or that patients are being overbilled for procedures. These complaints often arise amidst Medicare or Medicaid audits. Another form of fraud can occur as a result of sloppy or otherwise poor record keeping.

Sexual Misconduct Allegations—allegations of improper sexual contact with a client are, unfortunately, common. These allegations often arise in the context of consensual relationships that end badly as well as non-consensual assault allegations.

Criminal Conviction—domestic violence, assault, and other criminal charges almost always result in a concurrent review of a physician’s license.

Medical Negligence—when serious malpractice claims arise, there is often a concurrent license action against the physician.

Unlicensed Practice of Medicine—physicians that practice outside the bounds of their licensure run the risk of a claim of unlicensed practice of medicine. They have a medical license but may not have the licensure required for the specialty they are dabbling in.

Contact an Experienced Kansas and Missouri Licensing Attorney Now

Any physician in Kansas or Missouri contacted by a state investigator or licensing board should contact experienced counsel immediately. Your license to practice is in jeopardy, and these initial moments are crucial. You have no obligation to speak to anyone without counsel present and talking to an investigator without counsel may be a fatal error. Contacting an experienced licensing attorney to help you through this process and can mean the difference between getting back to helping your patients and a license suspension or revocation.

Kansas and Missouri professional licensing attorney Danielle Sanger is prepared to advocate for your best interests and defend you. Call Attorney Sanger at 785-979-4353 to schedule a free consultation with an attorney experienced dealing with licensing issues.

 

Kansas and Missouri Professional Licensing Attorney Danielle Sanger Explains—HIPAA Violations and Your Medical License

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Everyone working in the medical field is aware of “HIPAA.” Congress created the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to protect patients’ privacy and to make sure that patients’ records were held securely. Serious penalties may result from doctors, nurses, hospitals, or other medical providers violating HIPAA, ranging from minor fines of $100 for an inadvertent, de minimus violation to $1.5 million for a pattern of willful acts. In serious cases, HIPAA violations could also result in criminal prosecution. In addition to these civil and criminal penalties, physicians in Kansas or Missouri accused of a HIPAA violation may face the loss of their medical license.  To avoid these severe consequences, it is important to understand the potential ways a violation can occur, to take steps to prevent violations, and to understand what your rights are once violations are noticed.

Whether HIPPA violation allegations against you are minor or extreme, aggressive, experienced licensing counsel is critical to defending your license and livelihood from a suspension or revocation. I wrote the following post to outline HIPAA situations that frequently result in discipline and what you should do if an allegation arises.  If you are licensed medical professional in Kansas or Missouri facing an allegation of a HIPAA violation, call attorney Sanger today at 785-979-4353 to schedule a free consultation. Your career is at risk, and you cannot work your way through this alone.

Frequently Occurring HIPAA Violations

Rules governing HIPAA compliance are byzantine and change frequently. As a rule of thumb, do not disclose or allow disclosure or release of patients’ medical information. The following is an overview of common types of HIPAA violations:

Unauthorized information disclosure – It may be too simplistic just to say “do not release patients’ medical records.” Most trained medical staff are not going to release medical information to total strangers. However, violations frequently occur in the “grey areas” such as releasing personally identifiable medical information to the patient’s family, insurance company, or other medical providers.

Unsecured records – Patients expect that their records are secure and not accessible by third parties. HIPAA requires that that sort of protection be in place.  Digital records should also be stored in a way that prohibits access by using encrypting software and password protection.  Patients’ paper records should be kept under lock and key, with limited personnel having access to them.

Data breaches – Hacking and viruses can result in HIPAA violations related to illegal access to patient records. Your medical office should have antivirus software to prevent data corruption and firewalls to prevent hacking. Strong passwords must be required of those who need to access patient records to prevent both improper internal access as well as hacking.

Lost or stolen electronic devices – Private health information can easily be disclosed when an employee or physician removes files on a portable device and then loses the device. Removal of patient files in this manner should be limited, and protections should be in place to make devices trackable if they are lost.

Improper record disposal – Even if you dispose of patient records, the disposal must be HIPAA compliant. It does not matter if a record is taken from your briefcase, your computer, or a dumpster.  Contract with a licensed disposal firm for records destruction and document complete destruction.

Contact an Experienced Kansas and Missouri Licensing Attorney Now

Any medical provider or clinic in Kansas or Missouri contacted by a state investigator or licensing board should contact experienced counsel immediately. Your business and license to practice are in jeopardy, and these initial moments are crucial.

Kansas and Missouri professional licensing attorney Danielle Sanger is prepared to advocate for your best interests and defend you if you are accused of a HIPAA violation. Call Attorney Sanger at 785-979-4353 to schedule a free consultation with an attorney experienced dealing with licensing issues.