Section Nur 402.04 - Disciplinary Sanctions(a) Other than immediate license suspensions authorized by RSA 541-A: 30, III, and RSA 326-B: 37, IV, the board shall impose disciplinary sanctions only: (1) After prior notice and an opportunity for a hearing; or(2) Pursuant to a mutually agreed upon settlement or consent decree.(b) In addition to the acts described in RSA 326-B: 37, II, the following shall also be considered acts of misconduct or dishonesty for any person licensed under RSA 326-B: (1) Accepting a nursing or nursing-related assignment when the licensee knows or has reason to know he or she is unqualified to perform the assignment;(2) Leaving an assignment from the acute care, long term care, home care or community setting, without notifying the appropriate authority, whereby such departure endangers the health, safety, and welfare of those individuals entrusted to the licensee's care;(3) Violating care recipients' rights, confidentiality, privacy, or records;(4) Practicing in a manner that discriminates on the basis of age, race, sex, handicap, national origin, sexual orientation, nature of illness or health status, physical or mental infirmity;(5) Misappropriating human or material resources;(6) Physical, mental and/or verbal abuse, battery, exploitation, harassment, or neglect of individuals;(7) Receiving, or agreeing to receive, fees or other considerations for influencing the care, activities or records of individuals;(8) Failure to maintain standards of practice or education pursuant to RSA 326-B: 2;(9) Claiming as their own another's license, or allowing others to use a license not their own;(10) Administering therapeutic agents, treatments, or activities, or recording of same, in an inaccurate or negligent manner;(11) Failure to record or report in an accurate manner without omission, falsification, or alteration any patient care data, or health care, employment or board records;(12) Failure to take appropriate action to safeguard individuals from incompetent health-care, nursing practices, nursing-providers, ancillary personnel or others involved with care-recipients;(13) Performing nursing activities or interventions, or providing nursing-related activities beyond the authorized scope of practice;(14) Practicing without a current license, or altering a license pocket-card by changing dates, numbers, or any information appearing on a license pocket-card;(15) Falsifying or not providing information requested by the board;(16) Being the subject of 3 different medical injury actions reported under RSA 326-B: 37; and(17) Any pattern of behavior consisting of more than one incident of professional misconduct that is incompatible with the standards of practice.(c) Acts of misconduct for APRNs, RNs and LPNs shall also include: (1) Delegating or directing activities or tasks to individuals when the licensee knows or has reason to know that the individual(s) is not qualified to perform the activity or task;(2) Failure of licensee to supervise individuals or groups required to practice nursing or provide nursing-related activities under supervision;(3) Requiring a licensee to perform specific nursing interventions or nursing related activities when the licensee clearly and cogently states their inability, either through lack of education, practice or knowledge and skills, to perform the delegated activity; and(4) Permitting the use or disclosure of program information under control of the APRN's by a person not authorized to receive it in violation of RSA 318 or administrative rules of the board of pharmacy.(d) When the board receives notice that a licensee has been disciplined for acts related to professional conduct by the licensing authority of another jurisdiction, the board shall issue an order providing the opportunity for a hearing and directing the licensee to demonstrate why reciprocal discipline should not be imposed in New Hampshire.(e) In a disciplinary proceeding brought on the basis of discipline imposed in another jurisdiction, a licensee shall not be subject to disciplinary sanctions which exceed those imposed by the other jurisdiction unless the board first provides specific notice of an intention to consider other sanctions. When such notice is provided, the licensee shall be subject to any disciplinary sanction authorized by RSA 326-B: 37, III.(f) Following opportunity for a hearing and after a finding that misconduct or dishonesty has occurred by a licensee, the board shall impose disciplinary sanctions, to the extent authorized by RSA 326-B: 37, III, and the Omnibus Budget Reconciliation Act (OBRA) of 1987; Section 1819 and 1919 of the Social Security Act ( 42 U.S.C. 1395 & 1396).(g) In imposing sanctions, the board shall apply the following factors in determining the level or kind of disciplinary sanction imposed: (1) The seriousness of the offense;(2) The licensee's prior disciplinary record;(3) The licensee's state of mind at the time of the offense;(4) The licensee's acknowledgment of his or her wrongdoing;(5) The licensee's willingness to cooperate with the board;(6) The purpose of the rule or statute violated;(7) The potential harm to public health and safety; and(8) The nature and extent of the enforcement activities required of the board as a result of the offense.(h) Discipline imposed upon a licensee under (b) above shall be intended to be the minimum sanction or sanctions, both in type and extent, that the board believes will, based upon the unique facts and circumstances of each act of misconduct: (1) Protect the public; and(2) Deter both the licensee charged and any other licensee from engaging in such misconduct in the future.(i) The type of disciplinary sanctions available to the board shall include the following, listed in ascending order of severity:(1) Issuance of a public reprimand pursuant to RSA 326-B: 37, III(a);(2) Imposing conditions on the licensee's scope of practice pursuant to RSA 326-B: 37, III(a);(3) Imposing one or more limitations on the licensee's scope of practice pursuant to RSA 326-B:37, III(a);(4) Placing the licensee on probation for a specific period of time pursuant to RSA 326-B: 37, III(a);(5) Requiring the licensee to practice under the direct supervision of an RN pursuant to RSA 326-B: 37, III(e);(6) Imposition of an administrative fine pursuant to RSA 326-B: 37, III(f);(7) Requiring the licensee to submit to the care, counseling, or treatment of a physician, counseling service, health care facility, professional assistance program, or any comparable person or facility pursuant to RSA 326-B:37, III(d);(8) Requiring continuing nursing education in the area or areas in which they have been found deficient or incompetent pursuant to RSA 326-B:37, III(c);(9) Requiring participation in a rehabilitative program in the area or areas in which they have been found deficient or incompetent pursuant to RSA 326-B: 37, III(c);(10) Imposition of a period of license suspension pursuant to RSA 326-B: 37, III(a);(11) Declining to renew or reinstate a license pursuant to RSA 326-B: 37, III; and(12) Revocation of a license pursuant to RSA 326-B: 37, III(b).(j) Copies of board orders imposing disciplinary sanctions and copies of all settlement agreements or consent decrees shall be sent to the licensing body of each state in which the licensee is licensed and to such other entities, organizations, associations, or boards as are required to be notified under applicable state or federal law.N.H. Code Admin. R. Nur 402.04
(See Revision Note at chapter heading for Nur 100) #5887, eff 8-26-94; ss by #6778, eff 6-26-98; ss by #7741, eff 8-13-02; ss by #8873, eff 4-24-07; ss by #10299, eff 3-22-13; ss by #10571, eff 4-17-14
Amended by Volume XXXV Number 45, Filed November 12, 2015, Proposed by #10953, Effective 10/22/2015, Expires 10/22/2025.Amended by Volume XXXVI Number 19, Filed May 12, 2016, Proposed by #11082, Effective 4/26/2016, Expires 4/26/2026.