Surrendering a single state license- ramifications to keeping other licenses?

[PDRN]

I am in my state’s assistance program for mental health issues that culminated in diversion, and am listed on the National Practitioners Database, I hold MN and CA licenses, too, but plan on surrendering CA. Since one desperate act has unlocked so many levels of hell as far as consenquences, I’m going to guess that doing so will affect keeping my compact and MN licenses? Like I’ll have to fly to the moon and obtain the virgin blood of the 5th grey stone every time I renew? Or they won’t allow me to renew? 
Anyone ever surrendered one license but tried to keep others?

stellar career up to the point of insanity, for what it’s worth.

[Rose_Queen, BSN, MSN, RN]

Considering that disciplinary action in one state is required to be reported in other states and can/will lead to disciplinary action on each license, I can’t imagine a state where surrendering another license won’t have impact. Have you consulted with an attorney familiar with nursing licensure? I would do that before voluntarily surrendering a license. TAANA.org can help you find such a lawyer. 

[Kmrn65, RN]

I don't know about Michigan, I am I. NC but I am sorry that you are experiencing this.

In NC the board stipulates that you can't work more than one job at a time, or any OT, etc. For the first year in the program nor as a traveler.

I would assume that you should self report to all states you want to keep licenses in, but honestly if it were me I would choose one state to maintain licensure in.

[solarex]

For all nurses and advanced practice nurses reading this......NEVER EVER surrender your license.  I know, if you are licensed in multiple states, it can be tricky because multiple states may want you to do their monitoring programs even though they aren't your home state for compact purposes.  Here is how you get around this and why you NEVER surrender a license. EVER.  Once you enter a monitoring program for your home state, that home state's monitoring program will send your progress reports to the other states you are licensed in.  Also, if you are in trouble, this may sound crazy, but you actually want your non-home states to SUSPEND your license.  You don't want it revoked of course, but you also don't want it on Probation.  If your non home states put you on probation, you are under consent order for these states, which means your home state monitoring program case manager will have to send them monthly or quarterly reports from your home monitoring states.  It's a hassel and annoying, but can be done.

Now, here is why you never surrender.  Lets say your home state is Virginia, and you are license in TX, CA, and Kansas, and you know you will never practice in TX, CA, and Kansas again and you just want the investigations over and done and for it all to be over with these 3 states, and your focus is Virginia.  So, you surrender your license or licenses in TX, CA, Kansas, but in Virginia where you live, all is well and you are in your monitoring program in VA, you are back to work, doing your random testing and meetings, and progressing and rebuilding.  Here is what happens.  Because you surrendered your license in another state, you AUTOMATICALLY go into the National Practitioner Data Bank which can limit your future employment options (by a little, not a lot, but it can limit you some) and your malpractice insurance will be higher.  OK, not a gigantic deal, but here is the real problem.  When you go into the NPDB for Surrending a License, there is about a 75% chance or more that you then automatically are entered into the state where you surrendered your license Medicaid/Medicare Debarrment List.  This is a list that says you can't work for any healthcare facility in the state where you surrendered your license that has Medicaid or Medicare.  Folks, that means ANYwhere in nursing.  VA, Prison, Hospital, Dialysis, School, ANYWHERE  Here's what happens next, if you are on ANY states Medicare/Medicaid Exclusion List (which is likely to happen if you Surrender a License) then you automatically will go on the FEDERAL Office of Inspector General Exclusions List.  What does that mean?  That means you now can not work at ANY facility in the USA that has anything to do with Medicaid or Medicare.  So, your choise to surrender in California, or Kansas now effects your home state and you can no longer work in it.  Even though your in monitoring and your Board in Virginia says you can work, the Federal Government says you can't work in any Medicare/Medicaid facility which is virtually ALL areas of nursing.  Oh yea, a facility that hires you with you on list can suffer 50,000 dollars fines and ALL facilites scrub and check these lists monthly.  You are not working when on this list.  When you surrender a license, how long will you be on it?  A minimum of 3 years and a max of 5 years.

So, NEVER surrender a license.  EVER.  

[hppygr8ful, ASN, RN, EMT-I]

Most employers don't just run you through the state BON in question. Wherever you apply you will be checked through NURSYS and the Office if the Inspector  General (OIG).  When your name is put into Nursys all licenses you hold along with their status will be listed so there's no avoiding one state not knowing what your status is. If your "Insanity" involved criminal charges such as crimes of moral turpitude you may be on the OIG list whcig will prevent you from being employed by any organization that is reimbursed Medicare/Medsicaid. As you work your way through the alternative to discipline program youy will be able to apply to be removed from the OIG.  MOst states will suspend your liscense until your probation is done. 

Hppy

[solarex]

Very true and great point.  A suspended license will get you in the national databank, but overwhelmingly NOT likely to get you into the State Medicaid/Medicare Exclusion Database or the Federal Office of Inspector General Exclusion Database.  If you were entered into a State Exclusion Database or the Federal Database for a suspended license, this is generally removable immediately when your licensed is reinstated and you are put back on probation by the nurse board, BUT..........Here is the danger....When you have a revoked nursing license or when you Surrender your nursing license, it's nearly automatic.  The odds of going into a State Database with a surrendered nursing license is about 75%, and here is the problem.  The Nurse Board recommends to the State Medicaid/Department of Health how long you should be excluded for, and this exclusion is generally no less than 3 years, and usually with a surrendered license, 5 years.  Once that recommendation is received and you are entered into that State's Exclusion Database, that State automatically (by law) has to report you to the OIG (Federal Database) and the Federal OIG exclusion database takes the recommendations from the state on the length of exclusion of which you will have a 5 year exclusion and getting off it it is incredibly difficult before that 5 year mark.  This is why you never surrender you license.  Surrendering a license is basically like having a Revoked license in the eyes of Medicaid/Medicare State and OIG Exclusion Federal Database.

Even if your license is intact in your home state and you are working well through recovery, the state that you surrendered your license to across the country will likely catch up to you and once you are in the OIG Database, you aren't working anywhere in the medical field, period.  Check this out, with the Nursy's system when you apply to work somewhere, the employer also check's each state's Medicaid Exclusion Database to ensure you are not on it, because sometimes a nurse can be on a State Exclusion Database, but not on the Federal OIG Database, but employers will quickly terminate you because they expect that state to report it to the Feds, and they anticipate that it will be a matter of time before you are on the OIG Federal Database.

Never surrender your license, ever!  For criminal CONVICTIONS where you plead guilty for a felony, it's an automatic 5 year exclusion minimum and often 10 years.  What I am getting at is this.... there are many nurses who do well in recover and they recover and are able to practice and go back into nursing, but the decision to surrender their license in another state basically ends their career.  In order to overcome it, forget about 5 year monitoring program, think in terms of like 7.5 years.  2.5 to 3 years before you can work again and the time to get off the exclusion list, then the Nurse Board starts your 5 year clock for monitoring, and during those first 2.5 or 3 years, you aren't working in nursing, so right off the bat a financial issue is there.  Most nurses will not wait it out 7.5 years.  Again, NEVER surrender your license.

[hppygr8ful, ASN, RN, EMT-I]

A surrendered license will not get you listed in the OIG database. As I stated what gets you in the database is being accused and found or pleaded guilty of are crimes of moral turpitude. The list of such crimes is lengthy and varies by state but can include murder, manslaughter, theft and fraud.

[solarex]

On 8/3/2022 at 2:45 PM, hppygr8ful said:

A surrendered license will not get you listed in the OIG database. As I stated what gets you in the database is being accused and found or pleaded guilty of are crimes of moral turpitude. The list of such crimes is lengthy and varies by state but can include murder, manslaughter, theft and fraud.

LOL, with all due respect, you don't know what you are talking about.  I have 3 friends in recovery of which 2 were RN's and 1 an advanced practice nurse.  They ALL went into the OIG database.  All 3 of them.  If you go to any respectful nursing recovery rehab program (There are those out there in the US and there is such as thing as recovery that primarily focuses on nurses and doctors), and they all will tell you to never surrender a license for this reason.  There are hundreds of nurses and thousands over the years who end up on the OIG database for surrendered licenses.  Noticed I wrote the word surrendered.  Big Difference in Suspended (will not get you on the database) and surrendered.  My wife is an attorney that specializes in healthcare issues.  You would not believe the calls she gets weekly from nurses who are trying to get off the database because they surrendered their licenses.  

[hppygr8ful, ASN, RN, EMT-I]

11 minutes ago, solarex said:

LOL, with all due respect, you don't know what you are talking about.  I have 3 friends in recovery of which 2 were RN's and 1 an advanced practice nurse.  They ALL went into the OIG database.  All 3 of them.  If you go to any respectful nursing recovery rehab program (There are those out there in the US and there is such as thing as recovery that primarily focuses on nurses and doctors), and they all will tell you to never surrender a license for this reason.  There are hundreds of nurses and thousands over the years who end up on the OIG database for surrendered licenses.  Noticed I wrote the word surrendered.  Big Difference in Suspended (will not get you on the database) and surrendered.  My wife is an attorney that specializes in healthcare issues.  You would not believe the calls she gets weekly from nurses who are trying to get off the database because they surrendered their licenses.  

With all due respect you are misinterpreting what I said. I have been in recovery for closes to 20 years after a 30 year love affair with alcohol. I did hit rock bottom while working but I never drank on the job and I never diverted any medication. What did happen was in the hopelessness that became my life I attempted a thankfully unsuccessful effort at suicide.  I listened to some bad advice and instead of invoking HIPAA and seeking treatment on my own. I ended up in a 5 year one size fits all BON sponsored program that ended up costing me $45,000.00 and that was back in 2002-2006. I can only imagine what it must cost today. 

I never once suggested that a nurse should ever surrender their license and unless they never intend to work as a nurse or other professional health care role again they should fight doggedly for the right to keep their license. Even going through recovery through a BON program I was never placed on the OIG list and my license is clear and unencumbered. If someone is on the OIG list they have committed a crime of moral turpitude this might include diverting narcotics (most common), Working under the influence of intoxicants, DUI, Fraud such as falsifying or stealing prescriptions, or using deceit to illegally influence members of vulnerable populations. There is also the crime of physical/mental abuse of those populations. If caught they might surrender their license to avoid the financial and legal ramifications related to any of the above crimes.

My comments to the original poster were made to indicate that surrendering a license could have serious effects on licenses held in other states.   I feel and I know I am solely responsible for my feeling but the comments that I don't know what I am talking about to be unwarranted and insulting. 

I will now step out of this discussion to avoid further misinterpretations and insults. 

Hppy 

 

[solarex]

??? You literally just suggested in a previous post that Surrendering your license will NOT get you in the OIG Database. You literally just wrote that 2 posts ago and it is dangerously False. You more than likely WILL end up in the OIG Database if you surrender your license.  This was the purpose of my post. I don't care if a nurse surrenders or not. To each is their own, but I just want people to understand the consequences of what ramifications surrendering a license will likely have. I would be willing to bet most nurses (not all) but most have Never heard of a states Medicaid exclusion database or the Federal OIG exclusion database, and hundreds of nurses over the years across the US have surrendered licenses without fully understanding the consequences, only to find themselves in these Databases and their careers end.

Please, do Not put out information that is simply not true because you have a general "hunch or opinion" without fully knowing the truth. To put out info that nurses who surrender a state license will not cause them to end up on a state or federal exclusion list is not just False, but it can literally destroy someone's life or career as they surrender a license believing this will not put them on the OIG list, when in fact, it likely will, and if it does, it can literally end a career for many.

 

[Tampa Two]

     I can testify to surrending a license and ending a career.  I'm now a Physican's Assistant and I also teach at a Community College in Virginia in an ADN program for anatomy and physiology.  In 2008, I was licensed in Virginia, Wyoming, and Texas.  Virginia my home state and I was an ICU nurse.  I devloped substance abuse and diverted from my work in Virginia and got caught.  My license suspended for 1 year in Virginia with 5 year monitoring program/agreement, and suspended in Wyoming a year, and in Texas, they offered me a consent order which was 5 years of monitoring and requirements with their own program in order to keep my license even when I lived in Virginia.  I would have had to check in 2 times daily and take drugs tests not just for VA, but in a separate system for Texas and do weekly meetings for Texas in addition to my home state of VA.  I surrended my RN license to TX.  Didn't want the hassle.

In a year, I return to work in Virginia in the ICU as my same hospital who gave me a chance.  I was in Virginia's monitoring program and doing well in recovery.  3 months into my job, my manager and human resources call me in and tell me I am on Office of Inspector General's Exclusion List.  They put me on leave without pay and gave me 90 days to get off of the list to keep my job.  I made calls to Texas and the Federal Medicare Offices and got an attorney.  The exclusion was a 5 year mandatory for surrending my licence in Texas.  Even though my Virginia license was now intact, I could not get off the list until 5 years were up (and I had a lawyer in this area well skilled).  My career in nursing ended that day.  Virginia said I could remain in their monitoring program for the remaning 3 years and 9 months, but when/if I went back to work as a nurse in 3 years and 9 months (when I came off the exclusion list) that I would have to have an additional 2 years of monitoring as a nurse, because to pass the 5 year monitoring program, I had to be monitored while working as a nurse for at least 3 of those 5 years.  Also, I would have to have retraining when I came back to work in 3 years and 9 months because I would have been out of nursing so long.  My career in nursing ended that day.  There was nowhere to work.  Nowhere to practice.  Basically all healthcare jobs in nursing are tied to Medicaid or Medicare and the only place I could have worked would have been a testosterone clinic which were not around at that time, and the jobs are scarce, and they wouldn't hire a nurse in recovery anyway.

I applied for PA school and started a year later.  I graduated PA school with 4 months left until my Federal Office of Inspector General Exclusion was removed.  I went to work 10 days after the exclusion was lifted, but had to wait 4 months after graduating PA school just to work as a PA.  The OIG Exclusion list is a very scary and very real thing, and I was put on it and my career in nursing over because I surrendered a license in a state in which I never lived or never practiced and was half way across the country from Virginia.  Interestingly, I never was placed on the Virginia Medicaid or Wyoming Medicaid Exclusion lists for what I had done, even though my licenses were suspended in both states and I was publically reprimanded, but Texas put me on their State Medicaid Exclusion List for 5 years, and it took about 10 months later for me to reach the Federal Office of Inspector General Exclusion Database (which came from Texas) and that exclusion was 5 years with no way to get off it, even with an intact license in Virginia and showing progress in recovery and doing well and even back to work!

I agree with the one poster on the dangers of surrending a license.  You may get away with it, but I can attest to the fact that you are playing with fire.

[Quickstepper, MSN, RN]

Do not surrender your CA license!