Disciplinary records on Iowa nurses now harder to access

By: - May 20, 2022 4:27 pm

Disciplinary charges are no longer published by the Iowa Board of Nursing when they're filed. (Photo courtesy of the Iowa Board of Nursing)

Last October, the Iowa Board of Nursing approved set of disciplinary charges against an Iowa-licensed nurse, Allison Krawza.

But today, seven months after the board approved those charges, four months after a hearing on the matter, and three months after a final order was signed in the case, the board has yet to publish even its written statement of charges against Krawza.

A check of her name in the board’s online disciplinary database yields the response, “No records we found” [sic], indicating she has no history of discipline.

In fact, the board’s online list of disciplinary actions doesn’t list a case against Krawza. And because that list was last updated in December 2021, any board orders pertaining to any Iowa-licensed nurse since that time are not on the list.

Krawza’s case is not unusual. Disciplinary records that by law are considered public documents are no longer being published by the Board of Nursing; the board’s website is falsely indicating no case exists for certain nurses who have been charged or sanctioned; and incorrect information is being given to the public as to how they can access disciplinary records.

Nursing board director cites staff shortage

The board’s executive director, Kathleen Weinberg, says there are several factors at play.

Weinberg says the online list of disciplinary actions hasn’t been updated since last year because of staffing issues. “Unfortunately, we are currently three staff members short, including the staff member who updates this list,” she said. “We hope to have the position filled soon.”

She says the list, which is the only document displayed on the board’s webpage for disciplinary actions, is only a “courtesy document” and that anyone looking for “specific case information” should instead look to the board’s meeting minutes.

But a review of those minutes indicates the only piece of information typically provided on a case is the licensee’s name, along with an internal case number used by the board for tracking purposes. There is no information as to what the licensees are charged with, what led to the charges, when the hearings on each matter will be held, or what penalties, if any, are being imposed.

While it can be frustrating that the final public document is not available sooner, licensing boards must take care to ensure that the licensee’s due process rights are respected at every step of the disciplinary process.

– Kathleen Weinberg, Iowa Board of Nursing

In addition, some of the information in the minutes isn’t accurate. For example, the minutes indicate the board filed charges against a nurse named Angela Smith and that the matter proceeded to a hearing at which point the board voted to dismiss the case.

Weinberg says “Smith’s case should not have been publicized in any manner. This case was a dispute regarding providing information during an investigation, and not disciplinary charges, though it appears it was improperly placed on the agenda and publicized as discipline.”

She says “all case information on Ms. Smith is investigative in nature and must be kept confidential” under Iowa law.

Charges remain unpublished in wake of court ruling 

Another factor in the disclosure delays is a 2021 Iowa Supreme Court decision that resulted in all of the state’s licensing board’s being forced to keep confidential, at least until a case is resolved, all the facts and circumstances that led to a charges being filed.

For most licensing boards, the court’s ruling has resulted in the continued publication of written charges that specify the regulations that were violated, while the actions that resulted in the violations are redacted from public view until a final order is issued in the case.

The Board of Nursing has taken a different approach. The board now waits until there is final resolution in a case – a process that sometimes takes a year or more — before publishing the initial statement of charges against a licensee. If someone wants to see those charges before the case is resolved, Weinberg said, a redacted version of the document will be provided in response to an Open Records Law request.

But that process of looking to the board minutes and then filing formal requests for documents isn’t spelled out anywhere on the board’s website. In fact, the site specifically instructs members of the public to rely on its database to access disciplinary records, and it includes illustrated, step-by-step instructions on how to search the database.

No mention is made of cases that don’t appear in the database and are referenced only in board minutes, and no mention is made of case documents that can be accessed only through Open Records Law requests.

And while the issuance of a final order in a case will eventually result in an unredacted statement of charges being published by the board, the process of issuing final orders is also subject to months of delays. Weinberg says those delays are “entirely dependent on the turnaround time of administrative law judges” who draft the final orders.

That turnaround time, she says, varies greatly depending on the complexity of the case and the judge’s workload. “We have no control over how long these decisions take to draft,” she said. “Drafts are sometimes done in a few weeks; other drafts have taken months.”

After a judge finishes drafting a decision, it is placed on the board’s next meeting agenda so the board can review it and approve it. Then the order must be served on the licensee, Weinberg said, to ensure due process. Frequently, she said, serving the licensee entails calls to a county sheriff or publishing a public notice in the newspaper for three consecutive weeks.

Only after all those steps are taken, she says, will the final decision by the board – and the initial set of charges – be published.

“While it can be frustrating that the final public document is not available sooner, licensing boards must take care to ensure that the licensee’s due process rights are respected at every step of the disciplinary process,” Weinberg said.

Other state licensing boards have taken a different approach to disclosure. In addition to publishing redacted statements of charges as the cases are initiated, they are keeping their published lists of disciplinary actions updated, and their online databases correctly display all sanctioned licensees.

The Iowa Board of Medicine, for example, often publishes a statement of charges against a physician, along with a press release on the matter, within 10 days of the board taking action.

In the Allison Krawza case, the Board of Nursing this week provided the Iowa Capital Dispatch with a copy of the unpublished statement of charges and final order in the case.

The documents show Krawza was disciplined by seven other states after she agreed last year to surrender her license to practice in Minnesota. In February, the Iowa board suspended her license indefinitely for a minimum of 12 months.

Still, a check of Krawza’s name in the Iowa board’s disciplinary database continues to display the message, “No records we found.”

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Clark Kauffman
Clark Kauffman

Deputy Editor Clark Kauffman has worked during the past 30 years as both an investigative reporter and editorial writer at two of Iowa’s largest newspapers, the Des Moines Register and the Quad-City Times. He has won numerous state and national awards for reporting and editorial writing. His 2004 series on prosecutorial misconduct in Iowa was named a finalist for the Pulitzer Prize for Investigative Reporting. From October 2018 through November 2019, Kauffman was an assistant ombudsman for the Iowa Office of Ombudsman, an agency that investigates citizens’ complaints of wrongdoing within state and local government agencies.