Board of Registered Nursing Audit Report Released to the Public


By Kendra J. Muller

On June 30, 2020, California State Auditor, Elaine M. Howle, released an investigative audit report finding that the Board of Registered Nursing (BRN) delivered a falsified report in response to a 2016 audit concerning the number of investigations assigned to BRN investigators. In 2016, the State Auditor found that BRN had not adequately or timely resolved complaints regarding nurses and recommended that BRN establish a plan to eliminate any backlog of complaints that had become substantial.

According to the 2020 State Auditor report, when BRN shifted individual investigator caseloads to 25 complaints in an effort to eliminate the complaint backlog, the Auditor noted that investigators could only take 20 complaints at a time in accordance with statements made by BRN’s chief of investigations during the 2016 audit. So instead, BRN needed to focus on processing complaints in a timelier manner to comply with the audit recommendations. Consequently, several BRN executives altered the investigative records by assigning the backlog of cases to employees who were not considered investigators, so the actual caseload showed 20 or fewer investigations per BRN investigator. This falsification resulted in BRN showing that it had resolved its backlog of cases, when in fact it had not. On November 28, 2018, the State Auditor accepted the reported data and concluded BRN had fully implemented the recommendation. Immediately after receiving this information, BRN executives reverted the caseload back to its higher volume by reassigning cases to investigators.

After a whistleblower informed the State Auditor of the allegedly falsified data, the State Auditor, in its 2020 audit, concluded that three executives were involved in the manipulation of the data and imposed a $5,000 fine to each. Two of the executives were interviewed and admitted wrongdoing. The third BRN executive no longer works for BRN and was not interviewed.

According to state law, BRN protects the public by prosecuting nurses guilty of violating provisions of the Nursing Practice Act, see Business and Professions Code section 2700 et seq. The complaint process starts when a patient or other individual submits an online complaint through the BreEZe system to BRN regarding a licensee of the Board. Allegations can include issues involving gross negligence, unprofessional conduct, and substance abuse. BRN must reply within 10 days to notify the complainant that they have received the complaint. BRN then has a formal analyst determine next steps and the need to launch a formal investigation. BRN must also notify complainants of the final action taken on the complaint. A backlog of cases can be harmful to the public, as nurses who have not been investigated, or took years to investigate, could be a risk to patients.

The June 30, 2020 audit recommends that within 30 days BRN reassess its current caseloads, and within 90 days fully implement the recommendations set forth in the 2016 audit. BRN responded that it will commit to all of the State Auditor’s recommendations and launched its own investigation into the matter.


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