Discipline and Complaints - How to Submit a Complaint
Questions & Answers to Properly Submit Complaints to the Arizona State Board of Nursing
1. Who can file a complaint?
Anyone can file a complaint, however, law mandates certain individuals and institutions. Pursuant to  32-1664 (B):
“A licensee, a certificate holder, and a health care institution as defined in §36-401 shall, and any other person may, report to the board any information the licensee, certificate holder, health care institution or individual may have that appears to show that a licensee or certificate holder is, was or may be a threat to the public health or safety.”
Sources of complaints related to licensees/certificate holders may include employers, coworkers or other healthcare professionals, patient or family members, law enforcement, self-reports, and/or other regulatory agencies.
Sources of complaints related to applicants for licensure/certification may include responses to questions asked on the application, information related to a current or prior investigation and discipline in another state, and/or information received as a result of a criminal background check.
2. What conduct should be reported?
Conduct that violates expected standards of care that may result in various degrees of harm. There is no list of what should be reported, as it is a matter of judgment for the person making the report based on all the relevant factors.
Examples of conduct that demonstrates poor judgment or skill resulting in violations of the Nurse Practice Act that are reportable to the board are: suspected drug diversion, failing to account for wastage of control drugs/falsification of documents, impairment, positive drug screen without a valid prescription, misappropriation/theft, exploitation of a vulnerable patient, physical/verbal abuse, patient neglect, sexual abuse/boundary violations, falsification of documents, single serious medication errors or repeated medication errors or charting errors, giving medications without an authorized order, criminal charges/convictions, failing to assess or intervene in behalf of a patient.
Please note, violations are NOT limited to direct patient care or incidents occurring while on duty as a nurse/CNA.
Effective September 18, 2003,and pursuant to HB 2361, license and certificate holders are required by law to report criminal charges that may affect patient safety to the board, in writing, within ten days from when the charge(s) are filed.
You are encouraged to become familiar with the laws and rules of the Board of Nursing. The “The Nurse Practice Act” is available (at no charge) on our website (Nurse Practice Act) or may be purchased by contacting the board by phone or in writing.
3. What conduct is not typically reportable to the Board?
Examples of low risk issues not involving patient care, professional judgment or wrongdoing that do not require reporting to the Arizona Board of Nursing are: rudeness to peers, co-worker disputes, personality conflicts, absenteeism, tardiness, labor-management disputes such as work schedules/wages/wrongful termination.
Facility specific operational issues that are under the jurisdiction of the Arizona Department of Health Services or other state agencies should not be reported to the Board of Nursing.
4. When should a report be made?
Emergent matters involving suspected drug diversion or chemical impairment may be reported immediately to the CANDO Nurse Consultant, Connie Linck, RN, MN, CNAA, BC by calling (602) 771-7864. The call should be followed with a written complaint stating the “who, what, where and when” of the events.
Written complaints should be reported as soon you have substantiated or otherwise have reasons to believe that a violation of the Nurse Practice Act has occurred and you have followed the policies within your facility regarding mandatory reporting. If the facility or agency’s administrators refuse or delay reporting, it is appropriate for a staff nurse or nurse manager to take responsibility for reporting to the Board.
5. Where should the complaint be sent?
Mail your complaint to:
Arizona State Board of Nursing
C/O Complaints/Investigations
4747 North 7th Street
Suite 200
Phoenix, AZ 85014-3655
OR fax your complaint to:
(602) 771-7888
6. How do I file a complaint?
Initial reports to the Board should be in writing except for emergent matters such as suspected drug diversion /impairment or sexual abuse complaints. Provide as much detail as possible regarding the “who, what, where, why and how”.
Identify the nurse or certified nursing assistant involved, including the correct spelling of the name, license or certificate number if known, social security number (if available) to assist in identifying the correct individual. If available, provide last known address and phone number of the individual.
Provide a detailed summary of each allegation of the Nurse Practice Act, including dates of each alleged incident and the medical record number or name of the patient involved. Supplying the medical record number or name of the patient is not a violation of confidentiality or HIPPA.
Be very specific in describing the event including the date and location of incident.
Provide a list of any witnesses. The Board is interested in first hand observations based on personal knowledge and not on hearsay from others.
Provide legible copies of relevant records/information.
Be sure to include your contact information.
Reporting forms are not required, but are available on our website ( RN/LPN/CNA Complaint Form) or can be sent to you via fax or mail by calling (602) 771-7800 or by email complaints@azbn.gov.
7. Is a failure to report those who may be a risk to the public a violation of the Nurse Practice Act?
In addition to the mandatory reporting law, 32-1664(B), failure to report is a violation of the nurse practice act, A.R.S. §32-1601 (16) (k) and A.A.C. R4-19-403 (7,8):
§32-1601Unprofessional conduct includes the following whether occurring in this state or elsewhere:
(16) (k) Failing to report to the board any evidence that a professional or practical nurse or nursing assistant is or may be:
- Incompetent to practice
- Guilty of unprofessional conduct
- Mentally or physically unable to safely practice nursing or to perform nursing related duties. A nurse who is providing therapeutic counseling for a nurse who is in a drug rehabilitation program is required to report that nurse only if the nurse providing therapeutic counseling has knowledge that patient safety is being jeopardized.
A.A.C. R4-19-403 For the purposes of A.R.S. §32-1601, a practice that is or might be harmful of dangerous to the health of a patient or the public includes the following:
7) Failing to report to the Board a licensed nurse whose work history includes conduct, or pattern of conduct, which leads to actual or potential adverse patient consequences threatening public health and safety;
8) Failing to take action in a health care setting to protect a patient whose safety or welfare is at risk from incompetent health care practice, or to report such practice to employment or licensing authorities; are violations of the Nurse Practice Act.
8. Will the person know who filed a complaint?
The applicant/licensee/certificate holder may be furnished with a copy of the complaint upon request. However, if disclosure of the name will pose a risk to the person making the complaint, a copy of the complaint with redacted ID information may be provided. If in the Board’s discretion, there is a risk of identification, the Board reserves the right to refuse furnishing a copy of the complaint.
9. Will the public be aware a complaint or self-report has been received?
Once a complaint is received, the license/certificate or application will be identified, as “complaint/self report received” should anyone should contact the Board via the online verification or by phone to check the status.
Specific information regarding the allegation is not provided to the public. As required by ARS §32-1664(L) ‘information received and records kept by the Board as a result of an investigation are not available to the public.”
10. What happens with the complaint?
When a complaint or self-report is received by the Board, it is first reviewed to determine jurisdiction. If the Board has jurisdiction, the license/certificate or application is flagged with a status of “Complaint/Self Report”, an investigator and a case number are assigned. Notification letters are sent and an investigation begins. The respondent is made aware of the allegations and is given an opportunity to respond with information regarding the event. The investigator collects objective information from a number of sources, interviews the subject of the complaint (“the respondent” or the “applicant”) and other witnesses, and then compiles the findings into an investigative report to present at a board meeting for review and action.
11. How long does the investigative process take?
This process takes an average of six to nine months to complete, depending on the complexity and seriousness of the alleged conduct. Some high risk/ high harm investigative cases have been completed in 1 month.
12. Can the license/certificate holder or applicant work while they are under investigation?
The ability to work as a nurse or CNA is unrestricted during the investigation, as long as the license or certificate remains active. However, Applicants are not issued a license/certificate until the conclusion of the investigation.
13. What can the subject of the complaint or people making the complaint do to assist in the investigative process?
If you are the subject of the complaint: keep the board apprised of any changes in your address and phone number, and respond promptly to any requests for information or documents.
If you have filed a complaint : submit all written documentation regarding your concerns and record any observations and impressions concerning the incident.
14. What happens when the case is presented to the Board Members?
The Board meeting is an open public meeting where investigative reports related to complaints that have been received and investigated by staff are reviewed to determine, based upon evidence in a case, whether there has been a violation of the Nurse Practice Act.
Board members will deliberate and make a motion, stating what action should occur.
15. Who can address the Board Members?
If you have submitted a complaint or you have had a complaint submitted against your application or your license/certificate, you are welcome to attend the Board meeting to hear the discussion and board decision. The Board Meeting is not a hearing but you may choose to give a verbal presentation (up to 5 minutes), providing information you feel is pertinent for the Board to consider. You may also choose to just be available to respond to their questions, or you may be present and not speak at all.
16. What are the possible Board Members decisions or actions?
Board actions are categorized as: Dismissal, Non-disciplinary Action, Disciplinary Action, and Administrative Violations. This information is available to the public. Once the case has gone to Board and action is taken, the complaint/self report status is closed and the licensee/certificate holder’s record updated to reflect the Board’s action or pending action.
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Dismissal
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Dismissal - Evidence does not support the case has merit or that there has been a violation of the Nurse Practice Act.
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Non-Disciplinary
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Letter of Concern A letter from the Board expressing concern that a licensee, certificate holder or applicant may have been engage in questionable conduct that is considered low risk or harm to the public. A letter of concern issued by the Board is not an appealable agency action.
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Disciplinary Actions
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Civil Penalty - A monetary fine issued by the Board, not to exceed $1,000, given singly or in combination with any disciplinary action for a violation of the Nurse Practice Act.
Decree of Censure - This is an official discipline by the Board that the nurse’s conduct violated the Nurse Practice Act but does not represent a continued risk to the patient/public.
Probation - This action allows the nurse to continue working during the period of probation subject to compliance with the terms and conditions. During the period of probation the nurse must be supervised in their practice and complete certain requirements which are aimed at rehabilitation or educating the nurse in his/her area(s) of practice. For example, a nurse with a substance abuse issue may be required to enter and complete treatment, attend A.A./N.A. meetings, abstain from alcohol and other drug use along with other requirements. A nurse who lacks sufficient knowledge of medications or safe administration may be required to take a pharmacology course, etc.
Suspension - A person who has been suspended may not practice during the period of suspension. A person who has been suspended has terms and conditions which must be fulfilled during the period of suspension, before being allowed to resume practice. Examples of terms and conditions may include completing a refresher course, psychological or substance abuse treatment in addition to other requirements. A licensee that has been suspended often has a period of probation following successful completion of the terms of suspension.
Revocation - This action prohibits the nurse/certificate holder from practicing for a minimum of five years, pursuant to A.A.C. R4-19-404. When a license/certificate has been revoked, the applicant for re-issuance must provide detailed information to the Board that the reason for revocation no longer exists and that the issuance of a license/certificate would no longer threaten the public health or safety. A.A.C. R4-19-404 or R4-19-815) The individual whose license/certificate has been revoked may not practice or otherwise indicate to the public that they hold a license/certificate.
Denial - A person (applicant) who has been denied a license/certificate may not practice and is not eligible to reapply to the Board for a period of five years.
Voluntary Surrender - A Consent Agreement has been signed in which an APRN, RN, LPN, CNA has voluntarily surrendered their license or certificate.
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Administrative Violations
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Administrative Penalty - A penalty/fine given to a licensee or certificate holder who has worked on an expired license/certificate, or failed to notify the Board of an address change within 30 days. It is not reportable to NCSBN or other national data centers.
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17. When is the Board decision final?
For discipline to be final and in effect, a person must either consent to the discipline as voted upon by the board by signing a “Consent Agreement” or if not signed, the person has had an opportunity for a hearing. Hearings are conducted at the Office of Administrative Hearings and the person conducting the Hearing is an Administrative Law Judge who is an attorney.
The Administrative Law Judge recommended “Findings of Fact, Conclusions of Law and Order” and transcripts of the Hearing are reviewed by the Board Members prior to voting on the appropriate disciplinary actions (if any) to be taken. If discipline is determined to appropriate by the majority of the Board Members, a “Board Order” is then the final decision.
The respondent or applicant may file a motion for rehearing or review of the decision if there has been one of the seven caused listed in the Rules that materially affected the individual rights.
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