You Just Received a Notice of Agency Action Letter from the Maryland Board of Nursing. What Now?

May 3, 2018
The Law Firm of J.W. Stafford

Dim hospital room

Nurses have an extraordinarily difficult job. From providing patient care to dealing with doctors and the healthcare bureaucracy, it is easy for even the most experienced nurse to be overwhelmed and, on occasion, make a mistake. Unfortunately, sometimes these mistakes prompt a formal letter from the Maryland Board of Nursing with the title, “Notice of Agency Action.” When that happens, the important thing is to remain calm and contact a qualified Maryland professional licensing attorney who can advise you on the appropriate steps to take next.

Asking for an Evidentiary Hearing

A Notice of Agency Action is a document charging a licensee under the jurisdiction of the Maryland Board of Nursing–e.g., a registered nurse, licensed practical nurse, certified nursing assistant, a medication technician, electrologist or a medicine aide–with a violation of the Nurse Practices Act. A violation does not necessarily mean a criminal act. More often than not, it may be an act of professional negligence, such as conducting a medical procedure outside the scope of the nurse’s license or failing to file the right paperwork.

The Maryland Board of Nursing may issue a Notice of Agency Action after receiving a complaint against the nurse from anyone. It may be a doctor, a co-worker, or simply a patient who was unhappy with the care he or she received. Certain law enforcement actions, such as a drunk driving arrest, may also trigger a Notice of Agency Action once the Board is informed.

The Notice of Agency Action itself is not a final decision suspending or revoking the nurse’s license. Rather, it is a statement of allegations, similar to a civil complaint. Once you receive a Notice of Agency Action, you have 30 days (from the date of the letter) to write the Board and request a hearing on the charges presented. This request must be mailed or faxed to the Board’s Director of Discipline and Compliance in Baltimore within the 30-day period.

Make Sure the Board of Nursing Knows How to Contact You

One critical thing you need to do at this stage is make sure the Maryland Board of Nursing has accurate and up-to-date contact information for you. The last thing you want is for the Board to make a summary decision against you without a chance for you to be heard because you did not receive critical correspondence about your case. This is not simply a hypothetical situation: It was the subject of a 2015 decision by the Maryland Court of Special Appeals.

The nurse in that case worked for a home health care agency. The mother of one of the nurse’s patients filed a complaint with the Board, basically alleging that she was sleeping during her shift. The Board conducted its own investigation and, after determining the charges had merit, sent a Notice of Agency Action to the nurse. The nurse responded within the 30-day period, requesting an evidentiary hearing and providing a then-current address.

However, while her case was pending, the nurse moved and neglected to inform the Board of her new address. She subsequently did not receive the notice of her hearing date, which was mailed to the old address. The Board proceeded to conduct a hearing without the nurse present. It probably comes as no surprise that the Board ruled against her, holding that there was sufficient evidence to sustain the complaint against her.

Once the nurse learned of the Board’s decision, she asked for reconsideration and a new hearing. The Board denied her request. The nurse then appealed to the Maryland courts, but a circuit court judge agreed that the Board should have made more of an effort to locate and notify her about the hearing date. The Court of Special Appeals reversed, holding that the Board had provided the nurse with “legally sufficient notice,” and that the burden was on her to provide up-to-date contact information. In light of the court’s decision, you need to be absolutely certain that your correct contact information is always on file with the Maryland Board of Nursing.  

Negotiating a Settlement or Fighting the Charges in Court

Assuming you ask for a hearing and give the Board your correct address, the next step will be to attend a settlement conference. This is an informal fact-finding meeting with the Board. The goal is to reach a negotiated settlement without the need for a formal evidentiary hearing. You are entitled to the assistance of counsel at a settlement conference, and, of course, you are free to reject any proposed resolution and demand an evidentiary hearing instead.

The evidentiary hearing itself is similar to a civil trial. A prosecutor appointed by the Board will present evidence supporting the complaint. You and your attorney may then cross-examine the prosecution’s witnesses and present your own rebuttal evidence. Note that unlike a criminal trial, you do not have any right against self-incrimination. If you refuse to testify or obstruct the Board’s investigation, that can be held against you. Remember, the Board’s primary goal is the protection of public health, not your due process rights.

If the Board ultimately issues an order suspending your license or placing you on probation, you do have the right to appeal, as the case discussed above illustrates.

What if I Have a Substance Abuse or Mental Health Disorder?

If the Maryland Board of Nursing issues a complaint against you related to your personal substance abuse (or a similar mental health issue), you may be eligible to participate in a Rehabilitation Program. If accepted, you would enter into a legal contract known as a “consent agreement” with the Board. The consent agreement requires you to undergo certain professional counseling and treatment for a period of time. You may also be placed under certain practice and employment restrictions, as the Board determines appropriate. As long as you comply with the terms of your consent agreement, which typically last up to five years, you will not be subject to any formal disciplinary actions.

Get Advice in Dealing With the Maryland Board of Nursing

Once again, the best piece of advice on how to deal with a Notice of Agency Action is to contact a Maryland nursing license attorney who understands how the administrative hearing process works. Contact the Law Firm of J.W. Stafford, L.L.C., at 410-514-6099 if you have received a letter from the Maryland Board of Nursing and need assistance today.

(image courtesy of Daan Stevens)