| (a) The Board and the State Office of Administrative
Hearings (SOAH) shall utilize the Disciplinary Matrix set forth in
subsection (b) of this section in all disciplinary and eligibility
matters.
(b) The Disciplinary Matrix is as follows:
Attached Graphic
(c) The Board and SOAH shall consider the following
factors in conjunction with the Disciplinary Matrix when determining
the appropriate penalty/sanction in disciplinary and eligibility matters.
The mitigating and aggravating factors specified in the Matrix are
in addition to the factors listed in this subsection. Further, the
presence of mitigating factors in a particular case does not constitute
a requirement of dismissal of a violation of the Nursing Practice
Act (NPA) and/or Board rules. If multiple violations of the NPA and/or
Board rules are present in a single case, the most severe sanction
recommended by the Matrix for any one of the individual offenses should
be considered by the Board and SOAH pursuant to Tex. Occ. Code §301.4531.
The following factors shall be analyzed in determining the tier and
sanction level of the Disciplinary Matrix for a particular violation
or multiple violations of the NPA and Board rules:
(1) evidence of actual or potential harm to patients,
clients, or the public;
(2) evidence of a lack of truthfulness or trustworthiness;
(3) evidence of misrepresentation(s) of knowledge,
education, experience, credentials, or skills which would lead a member
of the public, an employer, a member of the health-care team, or a
patient to rely on the fact(s) misrepresented where such reliance
could be unsafe;
(4) evidence of practice history;
(5) evidence of present fitness to practice;
(6) whether the person has been subject to previous
disciplinary action by the Board or any other health care licensing
agency in Texas or another jurisdiction and, if so, the history of
compliance with those actions;
(7) the length of time the person has practiced;
(8) the actual damages, physical, economic, or otherwise,
resulting from the violation;
(9) the deterrent effect of the penalty imposed;
(10) attempts by the person to correct or stop the
violation;
(11) any mitigating or aggravating circumstances, including
those specified in the Disciplinary Matrix;
(12) the extent to which system dynamics in the practice
setting contributed to the problem;
(13) whether the person is being disciplined for multiple
violations of the NPA or its derivative rules and orders;
(14) the seriousness of the violation;
(15) the threat to public safety;
(16) evidence of good professional character as set
forth and required by §213.27 of this chapter (relating to Good
Professional Character);
(17) participation in a continuing education course
described in §216.3(f) of this title (relating to Requirements)
completed not more than two years before the start of the Board's
investigation, if the nurse is being investigated by the Board regarding
the nurse's selection of clinical care for the treatment of tick-borne
diseases; and
(18) any other matter that justice may require.
(d) Each specific act or instance of conduct may be
treated as a separate violation.
(e) The Board may, upon the finding of a violation,
enter an order imposing one or more of the following disciplinary
actions, with or without probationary stipulations:
(1) Denial of temporary permit or licensure (including
renewal, reinstatement/reactivation, or the return to direct patient
care from a limited license);
(2) Approval of temporary permit or licensure (including
renewal, reinstatement/reactivation, or the return to direct patient
care from a limited license), with one or more reasonable probationary
stipulations as a condition of issuance, renewal, or reinstatement/reactivation.
Additionally, the Board may determine, in accordance with §301.468
of the NPA, that an order denying a license application/petition,
license renewal, license reinstatement/reactivation, or temporary
permit be probated. Reasonable probationary stipulations may include,
but are not limited to:
(A) submit to care, supervision, counseling, or treatment
by a health provider designated by the Board as a condition for the
issuance, renewal, or reinstatement/reactivation of the license or
temporary permit or the return to direct patient care from a limited
license;
(B) submit to an evaluation as outlined in subsections
(k) and (l) of this section and/or pursuant to the Occupations Code §301.4521;
(C) participate in a program of education or counseling
prescribed by the Board;
(D) limit specific nursing activities and/or practice
settings and/or require periodic Board review;
(E) practice for a specified period under the direction
of a registered nurse or vocational nurse designated by the Board;
(F) abstain from unauthorized use of drugs and alcohol
to be verified by random drug testing conducted through urinalysis;
or
(G) perform public service which the Board considers
appropriate;
(3) Issuance of a Warning. The issuance of a Warning
shall include reasonable probationary stipulations which may include,
but are not limited to, one or more of the following:
(A) submit to care, supervision, counseling, or treatment
by a health provider designated by the Board;
(B) submit to an evaluation as outlined in subsections
(k) and (l) of this section and/or pursuant to the Occupations Code §301.4521;
(C) participate in a program of education or counseling
prescribed by the Board;
(D) limit specific nursing activities and/or practice
settings and/or require periodic Board review;
(E) practice for a specified period of at least one
year under the direction of a registered nurse or vocational nurse
designated by the Board;
(F) abstain from unauthorized use of drugs and alcohol
to be verified by random drug testing conducted through urinalysis;
or
(G) perform public service which the Board considers
appropriate;
(4) Issuance of a Reprimand. The issuance of a Reprimand
shall include reasonable probationary stipulations which may include,
but are not limited to, one or more of the following:
(A) submit to care, supervision, counseling, or treatment
by a health provider designated by the Board;
(B) submit to an evaluation as outlined in subsections
(k) and (l) of this section and/or pursuant to the Occupations Code §301.4521;
(C) participate in a program of education or counseling
prescribed by the Board;
(D) limit specific nursing activities and/or practice
settings and/or require periodic Board review;
(E) practice for a specified period of at least two
years under the direction of a registered nurse or vocational nurse
designated by the Board;
(F) abstain from unauthorized use of drugs and alcohol
to be verified by random drug testing conducted through urinalysis;
or
(G) perform public service which the Board considers
appropriate;
(5) Limitation or restriction of the person's license
or permit, including limits on specific nursing activities and/or
practice settings and/or periodic Board review;
(6) Suspension of the person's license or permit. The
Board may determine that the order of suspension be enforced and active
for a specific period and/or probated with reasonable probationary
stipulations as a condition for lifting or staying the order of suspension.
Reasonable probationary stipulations may include, but are not limited
to, one or more of the following:
(A) submit to care, supervision, counseling, or treatment
by a health provider designated by the Board;
(B) submit to an evaluation as outlined in subsections
(k) and (l) of this section and/or pursuant to the Occupations Code §301.4521;
(C) participate in a program of education or counseling
prescribed by the Board;
(D) limit specific nursing activities and/or practice
settings and/or require periodic Board review;
(E) practice for a specified period of not less than
two years under the direction of a registered nurse or vocational
nurse designated by the Board;
(F) abstain from unauthorized use of drugs and alcohol
to be verified by random drug testing conducted through urinalysis;
or
Cont'd... |
