Statutes, codes, and regulations
Alabama Administrative Code
Title 610 - ALABAMA BOARD OF NURSING
Chapter 610-X-8 - DISCIPLINARY ACTION
Section 610-X-8-.03 - Grounds For Discipline Of, Denial Of Renewal Of, Or Denial Of Reinstatement Of A License, Permit, Certificate, Approval or Multistate Licensure Privilege

Ala. Admin. Code r. 610-X-8-.03

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Current through Register Vol. 43, No. 1, October 31, 2024
Section 610-X-8-.03 - Grounds For Discipline Of, Denial Of Renewal Of, Or Denial Of Reinstatement Of A License, Permit, Certificate, Approval or Multistate Licensure Privilege

The Board may deny the renewal or reinstatement application of, reprimand, fine, place on probation with conditions for continued practice, suspend, require the evaluation of, impose continuing education requirements upon, revoke and/ or otherwise discipline the holder of any license, permit, approval, certificate, or multistate privilege to practice in Alabama, upon proof that the person:

1. Is guilty of fraud or deceit in procuring or attempting to procure a license, multistate licensure privilege, or certificate of qualification to engage in advanced practice nursing by:
a. Filing false, forged or altered documents or credentials, including required continuing education documentation.
b. Misrepresenting or falsifying facts in applying for initial, renewal, or reinstatement of a license, permit, certificate, or approval.
c. Having another person appear for a licensing, permitting, or certification examination.
2. Has been convicted of a felony.
3. Is guilty of a crime involving moral turpitude or of gross immorality that would tend to bring reproach upon the nursing profession.
a. For purposes of this rule a person is guilty of a crime if the person:
1. Has been convicted of the crime.
2. Regardless of court disposition, has entered a plea of guilty, no contest, nolo contendere, not guilty by reason of insanity, or other similar plea, or has stipulated that a prima facie case exists that would support conviction.
b. For purposes of this rule, a crime involving moral turpitude or of gross immorality that would tend to bring reproach upon the nursing profession is any crime, whether felony or misdemeanor, that involves:
1. Drugs.
2. Theft.
3. Lewdness or any sexual offense.
4. Abuse.
5. Violence.
6. Fraud.
7. Any other conduct detrimental to the public's health, safety or welfare.
4. Is unfit or incompetent due to the use of alcohol, or is addicted to the use of habit-forming drugs to an extent as to render the individual unsafe or unreliable as demonstrated by one or more of the following:
a. Testing positive for alcohol and/or unauthorized moodaltering drugs.
b. Misappropriation or diversion of drugs from the workplace for self-use.
c. Obtaining or attempting to obtain an unauthorized prescription by fraudulent means for self-use.
d. A pattern of abuse or misuse of habit forming and/or mood-altering drugs or alcohol.
e. Impairment while on duty due to alcohol or the use of illegal, unauthorized, or duly authorized mood-altering drugs.
f. Refusal to submit to drug screen.
g. Submission of or attempt to submit a diluted, adulterated, or substituted specimen for drug testing.
h. The use of alcohol or habit forming or mood-altering drugs to such an extent that medical or psychiatric treatment, rehabilitation, or counseling is sought by the licensed nurse or is recommended by a legally authorized prescriber.
i. Admitting to a substance use disorder.
5. Is unable to safely practice nursing with reasonable skill and safety to patients by reason of illness, inebriation, excessive use of drugs, narcotics, alcohol, chemicals, or any other substance, or as a result of any mental or physical condition, as demonstrated by one or more of the following:
a. Testing positive for alcohol and/or unauthorized moodaltering drugs.
b. Misappropriation or diversion of drugs from the workplace for self-use.
c. Obtaining or attempting to obtain an unauthorized prescription by fraudulent means for self-use.
d. A pattern of abuse or misuse of habit forming and/or mood-altering drugs or alcohol.
e. Impairment while on duty due to alcohol or the use of illegal, unauthorized, or duly authorized mood-altering drugs.
f. Refusal to submit to drug screen.
g. Submission of or attempt to submit a diluted, adulterated, or substituted specimen for drug testing.
h. The use of alcohol or habit forming or mood-altering drugs to such an extent that medical or psychiatric treatment, rehabilitation, or counseling is sought by the licensed nurse or is recommended by a legally authorized prescriber.
i. Admitting to a substance use disorder.
j. More than one alcohol or drug-related arrest within a five-year period.
k. A mental or physical condition which renders the individual unable to safely practice nursing with reasonable skill and safety as demonstrated by one or more of the following:
1. Conduct that poses a serious risk of harm to the individual or any other person.
2. Cognitive deficits that render the individual unable to exercise appropriate nursing judgment.
3. Impairment of functional capacity.
4. Inappropriate or disruptive behavior in the workplace.
5. A judicial finding of incompetence.
6. Any other conduct in the workplace that suggests an inability to safely practice nursing with reasonable skill and safety to patients.
6. Has been convicted of any violation of a federal or state law relating to controlled substances, including misdemeanor and felony offenses.
7. Pertaining to an applicant for or holder of a license, certificate, or approval, to practice nursing or a multistate privilege to practice, is guilty of unprofessional conduct of a character likely to deceive, defraud, or injure the public in matters pertaining to health, as demonstrated by one of more of the following:
a. Failure to practice nursing in accordance with the standards adopted by the Board in Alabama Board of Nursing Administrative Code Chapters 610-X-5, 610-X-6, 610-X-7, or 610-X-9.
b. Practice beyond the scope of the individual licensed nurse's practice, as determined by, but not limited to:
1. Educational preparation.
2. License status.
3. Advanced practice approval.
4. Collaborative practice agreements.
5. State and federal statutes and regulations.
6. State and national standards appropriate to the type of practice.
7. Nursing experience.
8. Standardized procedures.
9. Knowledge, skills and ability to manage risks and potential complications.
10. Required instruction and supervision.
c. Failure to perform an assessment or evaluation of a patient's status.
d. Failure to implement the plan of care or institute interventions that might be required to stabilize a patient's condition or to prevent complications.
e. Failure to:
1. Use appropriate nursing judgment.
2. Administer medications and treatments in a responsible manner.
3. Demonstrate competence in administering or carrying out patient care.
4. Document nursing care.
5. Account for controlled substances.
f. Falsifying, altering, destroying, or attempting to destroy patient, employer or employee records.
g. Abandoning or neglecting patients.
h. Failure to respect or safeguard the patient's, or significant other's, dignity, right to privacy, safety, and confidential health information unless disclosure is required by law.
i. Failure to maintain professional boundaries.
j. Intentionally or negligently causing or permitting one or more of the following to a patient:
1. Physical abuse.
2. Sexual abuse.
3. Emotional abuse.
a. Verbal abuse.
2. Willful harassment or intimidation.
3. Financial exploitation.
k. Permitting a dual relationship with a patient to disrupt, delay, or inappropriately influence the nursing care provided to that patient or any other patient.
l. Exhibiting inappropriate unprofessional or disruptive conduct or behavior in the workplace.
m. Engaging in fraud, deceit, or misrepresentation in seeking employment, practicing, seeking to practice, or advertising by:
1. Falsification, alteration, or forgery of a temporary permit, identification card, license, advanced practice approval, or credentials.
2. Falsification or misrepresentation of credentials, licensure status, advanced practice approval, collaborative practice status, or educational background.
3. Forgery of educational documents.
4. Falsification, misrepresentation, or forgery of employment records.
5. Falsification or misrepresentation of any information on an application for employment.
n. Intentionally or negligently misrepresenting or falsifying facts in billing a patient or any public or private third-party payor.
o. Aiding, abetting, directing, or assisting an individual to violate or circumvent any law or rule intended to guide the conduct of a licensed nurse or any other licensed health care provider.
p. Failure to ensure verification of current Alabama temporary permit, licensure, and credentials of nursing personnel for whom the licensed nurse is administratively responsible.
q. Personal use of unauthorized or illegal drugs or substances, which includes taking medication prescribed for someone else.
r. Testing positive for unauthorized or illegal moodaltering drugs or substances or submitting or attempting to submit a diluted, adulterated, or substituted specimen for drug testing.
s. A pattern of abuse or misuse of habit forming and/or mood-altering drugs or substances or alcohol.
t. Practicing, attempting to practice, or continuing to practice when the licensed nurse is unable to perform with reasonable skill and safety due to the licensed nurse's mental or physical impairment resulting from:
1. Alcohol.
2. Unauthorized, duly authorized, or illegal drugs or substances.
u. Obtaining or attempting to obtain controlled drugs or substances without direction from a legally authorized prescriber or through fraudulent means.
v. Furnishing or administering drugs or controlled substances to any person, without direction from a legally authorized prescriber.
w. Misappropriation, diversion, or attempted misappropriation or diversion, of drugs or substances from the workplace.
x. Refusal to submit to drug screen.
y. Appropriating real or personal property of a patient, employer, or any other person or entity; or failing to take precautions to prevent misappropriation of real or personal property of a patient, employer, or any other person or entity.
z. Failure to report illegal, substandard, unethical, unsafe or incompetent nursing practice or disciplinary action in any state, territory, country, or other jurisdiction.
(aa) Having a license, permit, registration, privilege to practice, approval or certification denied, conditionally issued, fined, reprimanded, censured, restricted, limited, placed on probation, suspended, revoked, voluntarily surrendered, or otherwise encumbered in any state, territory, country, or other jurisdiction, or having been court-martialed or administratively discharged by a branch of the United States Armed Forces, for any act or conduct which would constitute grounds for disciplinary action in Alabama.
(bb) Any act or omission which would constitute grounds for denial or termination of qualification to engage in advanced practice nursing.
(cc) Violation of any provision of the Alabama Nurse Practice Act, the Alabama Board of Nursing Administrative Code, or any state or federal law pertaining to matters of health which is likely to deceive, defraud, or injure the public.
(dd) Non-compliance with a monitoring agreement or contract with an alternative to discipline program or order issued in another jurisdiction pertaining to any license, certification, or registration for a health- related profession.
8. Has willfully or repeatedly violated any of the provisions of Article 2 of the Alabama Nurse Practice Act, by:
a. Failing to respond to official Board correspondence, including but not limited to:
1. Requests for information.
2. Subpoenas.
3. Notices.
4. Annual Reports for nursing education, standardized procedures, and report of employing agencies.
b. Practicing, seeking to practice, or attempting to practice professional nursing, practical nursing, advanced practice nursing, medication assistant certified practice, or nursing support technician certified practice without an active license, permit, certificate, temporary permit, or approval.
c. Impersonating an applicant for or holder of a license, permit, certificate, approval or multistate licensure privilege or permitting or allowing another person to use the individual's license, permit, certificate, approval or multistate licensure privilege.
d. Continued violation of any statute or rule after notice by the Board.
e. Failure to comply with any stipulated terms and conditions of any Board order, agreement, or contract.
9. Having been sentenced to a period of continuous incarceration serving a penal sentence for the commission of a misdemeanor or felony. The disciplinary action shall remain in effect until the board acts upon the application of the licensee for reinstatement of the license.
10. Failure of an individual who possesses a license, permit, approval, certificate, or multistate licensure privilege to practice in Alabama and who provides continuing education to comply with continuing education rules.
11. Failure to repay scholarship funds awarded by the Board for graduate study.
12. Payment of any fees or fines to the Board with a worthless check, invalid credit card, or by any other method that is not honored by the financial institution.
13. Violation of Code of Ala. 1975, § 34-21-86, which addresses prescribing practices for certified registered nurse practitioners or certified nurse midwives or any adverse action against a Drug Enforcement Administration certificate or certificate of qualification issued pursuant to Article 11 of the Alabama Uniform Controlled Substances Act.
14. Pertaining to an applicant for or holder of a Medication Assistant, Certified permit or a Nursing Support Technician, Certified permit, is guilty of unprofessional conduct of a character likely to deceive, defraud, or injure the public in matters pertaining to health, as demonstrated by one of more of the following:
a. Failure to practice in accordance with the standards adopted by the Board in Alabama Board of Nursing Administrative Code Chapters 610-X-14 for Medication Assistant, Certified, or Alabama Board of Nursing Administrative Code Chapter 610-X-17 for Nursing Support Technician, Certified.
b. Practice beyond the scope of the Medication Assistant, Certified's or Nursing Support Technician, Certified's practice, as determined by, but not limited to:
1. Educational preparation.
2. Permit status.
3. State and federal statutes and regulations, including, but not limited to, Chapter 610-X-14 of the Alabama Board of Nursing Administrative Code.
4. State and national standards appropriate to the type of practice.
5. Facility policy.
6. Knowledge, skills and ability to manage risks and potential complications.
7. Required instruction and supervision.
c. Failure to perform an evaluation of a patient's status.
d. Failure to implement the plan of care or institute interventions that might be required to stabilize a patient's condition or to prevent complications.
e. Failure to:
1. Use appropriate judgment.
2. Administer medications and treatments in a responsible manner, if administering medications and treatments is within the scope of practice of the permit.
3. Demonstrate competence in administering or carrying out patient care.
4. Document patient care.
5. Account for controlled substances.
f. Falsifying, altering, destroying, or attempting to destroy patient, employer or employee records.
g. Abandoning or neglecting patients.
h. Failure to respect or safeguard the patient's, or significant other's, dignity, right to privacy, safety, and confidential health information unless disclosure is required by law.
i. Failure to maintain professional boundaries.
j. Intentionally or negligently causing or permitting one or more of the following to a patient:
1. Physical abuse.
2. Sexual abuse.
3. Emotional abuse.
4. Verbal abuse.
5. Willful harassment or intimidation.
1. Financial exploitation.
k. Permitting a dual relationship with a patient to disrupt, delay, or inappropriately influence the care provided to that patient or any other patient.
l. Exhibiting inappropriate unprofessional or disruptive conduct or behavior in the workplace.
m. Engaging in fraud, deceit, or misrepresentation in seeking employment, practicing, seeking to practice, or advertising by:
1. Falsification, alteration, or forgery of a permit, identification card, license, or credentials.
2. Falsification or misrepresentation of credentials, permit status, or educational background.
3. Forgery of educational documents.
4. Falsification, misrepresentation, or forgery of employment records.
5. Falsification or misrepresentation of any information on an application for employment.
n. Intentionally or negligently is representing or falsifying facts in billing a patient or any public or private third-party payor.
o. Aiding, abetting, directing, or assisting an individual to violate or circumvent any law or rule intended to guide the conduct of a licensed nurse, Medication Assistant, Certified, or any other licensed health care provider.
p. Personal use of unauthorized or illegal drugs or substances, which includes taking medication prescribed for someone else.
q. Testing positive for unauthorized or illegal moodaltering drugs or substances or submitting or attempting to submit a diluted, adulterated, or substituted specimen for drug testing.
r. A pattern of abuse or misuse of habit forming and/or mood- altering drugs or substances or alcohol.
s. Practicing, attempting to practice, or continuing to practice when the Medication Assistant, Certified is unable to perform with reasonable skill and safety due to the licensed nurse's mental or physical impairment resulting from:
1. Alcohol.
2. Unauthorized, duly authorized, or illegal drugs or substances.
t. Obtaining or attempting to obtain controlled drugs or substances without direction from a legally authorized prescriber or through fraudulent means.
u. Furnishing or administering drugs or controlled substances to any person.
v. Misappropriation, diversion, or attempted misappropriation or diversion, of drugs or substances from the workplace.
w. Refusal to submit to drug screen.
x. Appropriating real or personal property of a patient, employer, or any other person or entity; or failing to take precautions to prevent misappropriation of real or personal property of a patient, employer, or any other person or entity.
y. Failure to report illegal, substandard, unethical, unsafe or incompetent practice or disciplinary action in any state, territory, country, or other jurisdiction.
z. Having a license, registration, privilege to practice, permit or certification denied, conditionally issued, fined, reprimanded, censured, restricted, limited, placed on probation, suspended, revoked, voluntarily surrendered, or otherwise encumbered in any state, territory, country, or other jurisdiction, or having been court- martialed or administratively discharged by a branch of the United States Armed Forces, for any act or conduct which would constitute grounds for disciplinary action in Alabama.
(aa) Violation of any provision of the Alabama Nurse Practice Act, the Alabama Board of Nursing Administrative Code, or any state or federal law pertaining to matters of health which is likely to deceive, defraud, or injure the public.
(bb) Non-compliance with a monitoring agreement or contract with an alternative to discipline program or order issued in another jurisdiction pertaining to any license, certification, permit or registration for a health-related profession or occupation.
15. Any other reasons authorized by law.

Ala. Admin. Code r. 610-X-8-.03

Filed September 29, 1982. Amended: Filed February 17, 1984; effective March 24, 1985. Amended: Filed September 29, 1989; effective November 4, 1989. Amended: Filed February 15, 1991; effective March 22, 1991. Amended: Filed February 5, 1998; effective March 12, 1998. Repealed and New Rule: Filed January 29, 2002; effective March 5, 2002. Amended: Filed July 22, 2005; effective August 26, 2005. Repealed and New Rule: Filed May 21, 2010; effective June 25, 2010.
Amended by Alabama Administrative Monthly Volume XXXII, Issue No. 09, June 30, 2014, eff. 7/29/2014.
Amended by Alabama Administrative Monthly Volume XXXVII, Issue No. 11, August 30, 2019, eff. 9/9/2019; operative 1/1/2020.
Amended by Alabama Administrative Monthly Volume XLII, Issue No. 10, July 31, 2024, eff. 9/14/2024.

Author: Alabama Board of Nursing

Statutory Authority:Code of Ala. 1975, §§ 34-21-2(j)(1), 34-21-25, 34-21-86.