The U.S. Department of Health and Human Services Office of Inspector General (OIG) recently partnered with various law enforcement agencies in a multi-state enforcement action aimed at uncovering a nursing degree fraud scheme: Operation Nightingale. The Operation Nightingale Enforcement Action seeks to identify individuals involved in the sale of fake and fraudulent nursing degree documents, including diplomas and transcripts, to aspiring nurse candidates.

As of January 25, 2023, the U.S. Department of Justice (DOJ) charged twenty-five defendants with wire fraud and conspiracy to commit wire fraud in connection with the defendants’ alleged participation in creating a fraudulent and illegal shortcut for individuals to obtain licenses as registered nurses, licensed practical nurses, or vocational nurses. The defendants’ alleged sale of fake diplomas and transcripts enabled the aspiring nurse candidates to qualify for the national nursing board exam and, ultimately, upon passing the exam, to become employed and practice nursing in the health care field without completing the proper education and clinical training.

As part of the scheme, over 7,600 fake nursing degrees were issued to individuals from three Florida-based nursing schools: Siena College, Palm Beach School of Nursing, and Sacred Heart International Institute. While these schools are now closed, the OIG and its partner law enforcement agencies are working on identifying the individuals who purchased the fake documents and are working in health care settings as nurses. The ongoing investigation revealed that health care facilities in Texas, Maryland, New York, New Jersey, Florida, Georgia, Delaware, Ohio, and Massachusetts employed such individuals. State boards of nursing have begun investigating and annulling nursing licenses obtained as part of the fraudulent scheme.

Broader Implications on Health Care

Nurses are often responsible for providing critical care to patients, amplifying the need for practicing nurses to meet the minimum qualifications and competencies. As outlined in the charging documents released by the DOJ, the requirements to become a registered nurse or a licensed practical nurse are stringent to ensure public safety and prevent harm caused by inadequately educated or trained health care professionals. Circumventing the system and obtaining fake nursing diplomas without going through the rigorous curriculum and demanding clinical practice of a nursing school program potentially jeopardizes patient health and safety. The OIG and its various law enforcement partners will continue to identify individuals involved in the nursing diploma scheme to prevent such individuals from obtaining employment as nurses.

This nursing school fraud scheme also comes at a time when health care staffing shortages are at an all-time high. The American Health Association estimated that about 500,000 nurses would leave the workforce by the end of 2022. While staffing health care practices with licensed nurses remains challenging, we urge health care providers to confirm that their hiring process includes proper credentialing steps.