DHP COMPLAINTS AND INVESTIGATIONS

Christina Bargdill, RN, MHS

Regional Enforcement Manager

Virginia Department of Health Professions

OBJECTIVES

• PROVIDE AN OVERVIEW OF DHP

• DISCUSS HOW TO FILE A COMPLAINT

• DISCUSS THE INVESTIGATION PROCESS

• PROVIDE GENERAL INFORMATION REGARDING DISCIPLINE PROCESS

• HIGHLIGHT LAWS REGS AND RESOURCES

DHP MISSION

• To ensure safe and competent patient care by licensing health professionals, enforcing standards of practice, and providing information to health care practitioners and the public.

VIRGINIA HEALTH REGULATORY BOARDS

• Audiology & Speech and Language Pathology

• Counseling

• Dentistry

• Funeral Home Directors & Embalmers

• Long Term Care Administrators

• Medicine

• Nursing

• Optometry

• Pharmacy

• Physical Therapy

• Psychology

• Social Work

• Veterinary Medicine

STATISTICS: BIENNIAL REPORT 2014-2016

STATISTICS: BIENNIAL REPORT 2014-2016

BOARD TOTAL NUMBER OF LICENSEES COMPLAINTS INVESTIGATED COMPLAINTS/ 1000 LICENSEES

FY 2015 FY 2016 FY 2015 FY 2016 FY 2015 FY2016

NURSING 213,308 218,535 2,492 2,414 11.9124 12.3001

MEDICINE 61,687 67,447 1,655 1,654 23.2626 21.869

PHARMACY 34,879 35,972 261 249 16.4282 14.3723

DENTISTRY 13,161 14,184 664 541 39.3587 28.4123

COUNSELING 11,713 13,378 118 139 9.73278 9.4932

AGENCY TOTALS 372,934 393,764 5,831 5,678 15.544 14.763

*Data extracted from Biennial Report Virginia Department of Health Professions July 1, 2014 – June 30, 2016 http://www.dhp.virginia.gov/about/docs/DHPBiennialReport2014-2016.pdf

How to File A Complaint

HOW TO FILE A COMPLAINT

Online at: www.dhp.virginia.gov

Email complaint to: enfcomplaints@dhp.virginia.gov

Mail complaint to:

Virginia Department of Health Professions

9960 Mayland Drive, Suite 300

Henrico, VA 23233

Fax complaint to: (804) 527-4424

Telephone: 1-800-533-1560 or (804) 367-4691

Video Hyperlink

https://youtu.be/DtqA8QR_pxg

The Investigation Process

THE INVESTIGATION PROCESS • An investigation is opened when there is a possible

violation of law or regulation within DHP’s jurisdiction

• The investigation is assigned to an investigator

• The investigator is an impartial fact finder who investigates on behalf of the board, interviewing fact witnesses, obtaining relevant documents, and collecting evidence

• A comprehensive investigative report is submitted to the appropriate board for review and decision

• Investigative reports are confidential pursuant to §2.2-3704 and §54.1-2400.2

The Discipline Process

THE DISCIPLINE PROCESS

• Complaint/Report (non-public)

• Investigation (non-public)

• Staff and Board Review (non-public)

• Pre-hearing Consent Order (public once accepted)

• Confidential Consent Agreement (in lieu of disciplinary action-non public)

• Informal Conference (SCC or Agency Subordinate) (notice of IFC is public)

• Formal Hearing (notice of formal hearing is public)

• Board action/sanctions (orders are public)

• Advisory Letter (in lieu of disciplinary action is non public) www.dhp.virginia.gov

Chapter 1 Title 54.1

Code of Virginia

General Provisions

54.1-111

Unlawful acts; prosecution; proceedings in equity; civil penalty A. It shall be unlawful for any person, partnership, corporation or other entity to engage in any of the

following acts:

1. Practicing a profession or occupation without holding a valid license as required by statute or regulation.

2. Making use of any designation provided by statute or regulation to denote a standard of professional or occupational competence without being duly certified or licensed.

3. Making use of any titles, words, letters or abbreviations which may reasonably be confused with a designation provided by statute or regulation to denote a standard of professional or occupational competence without being duly certified or licensed.

4. Performing any act or function which is restricted by statute or regulation to persons holding a professional or occupational license or certification, without being duly certified or licensed.

5. Failing to register as a practitioner of a profession or occupation as required by statute or regulation.

6. Materially misrepresenting facts in an application for licensure, certification or registration.

7. Willfully refusing to furnish a regulatory board information or records required or requested pursuant to statute or regulation.

8. Violating any statute or regulation governing the practice of any profession or occupation regulated pursuant to this title.

9. Refusing to process a request, tendered in accordance with the regulations of the relevant health regulatory board or applicable statutory law, for patient records or prescription dispensing records after the closing of a business or professional practice or the transfer of ownership of a business or professional practice.

54.1-111 A Unlawful acts; prosecution; proceedings in equity; civil penalty

• Any person who willfully engages in any unlawful act enumerated in this section shall be guilty of a Class 1 misdemeanor. The third or any subsequent conviction for violating this section during a 36-month period shall constitute a Class 6 felony.

54.1-111 B Unlawful acts; prosecution; proceedings in equity; civil penalty

B. In addition to the criminal penalties provided for in subsection A, the Department of Professional and Occupational Regulation or the Department of Health Professions, without compliance with the Administrative Process Act (§ 2.2-4000 et seq.), shall have the authority to enforce the provisions of subsection A and may institute proceedings in equity to enjoin any person, partnership, corporation or any other entity from engaging in any unlawful act enumerated in this section and to recover a civil penalty of at least $200 but not more than $5,000 per violation, with each unlawful act constituting a separate violation; but in no event shall the civil penalties against any one person, partnership, corporation or other entity exceed $25,000 per year. Such proceedings shall be brought in the name of the Commonwealth by the appropriate Department in the circuit court or general district court of the city or county in which the unlawful act occurred or in which the defendant resides.

Chapter 24 Title 54.1

Code of Virginia

54.1-2400 General Duties and Powers of Health Regulatory Boards

• (1) To establish the qualifications for registration, certification, licensure or the issuance of a multistate licensure privilege

• (2) To examine or cause to be examined applicants for certification or licensure

• (3) To register, certify, license or issue a multistate licensure privilege to qualified applicants as practitioners of the particular profession or professions regulated by such board

• (4) To establish schedules for renewals of registration, certification, licensure, and the issuance of a multistate licensure privilege

• (5) To levy and collect fees for application processing, examination, registration, certification or licensure or the issuance of a multistate licensure privilege and renewal that are sufficient to cover all expenses for the administration and operation of the Department of Health Professions, the Board of Health Professions and the health regulatory boards.

• (6)To promulgate regulations in accordance with the Administrative Process Act (§ 2.2-4000 et seq.)

54.1-2400 (7)

• To revoke, suspend, restrict, or refuse to issue or renew a registration, certificate, license or multistate licensure privilege which such board has authority to issue for causes enumerated in applicable law and regulations.

54.1-2400 (9)

• To take appropriate disciplinary action for violations of applicable law and regulations, and to accept, in their discretion, the surrender of a license, certificate, registration or multistate licensure privilege in lieu of disciplinary action.

54.1-2400.2

Confidentiality of Information Obtained During an Investigation or

Disciplinary Proceeding; Penalty

54.1-2400.2 A

• Any reports, information or records received and

maintained by the Department of Health Professions or any health regulatory board in connection with possible disciplinary proceedings, including any material received or developed by a board during an investigation or proceeding, shall be strictly confidential.

54.1-2400.2 B

• In no event shall confidential information received, maintained or developed by the Department of Health Professions or any board, or disclosed by the Department of Health Professions or a board to others, pursuant to this section, be available for discovery or court subpoena or introduced into evidence in any civil action. This section shall not, however, be construed to inhibit an investigation or prosecution under Article 1 (§ 18.2-247 et seq.) of Chapter 7 of Title 18.2.

54.1-2400.2 C

• Any claim of a physician-patient or practitioner-patient privilege shall not prevail in any investigation or proceeding by any health regulatory board acting within the scope of its authority. The disclosure, however, of any information pursuant to this provision shall not be deemed a waiver of such privilege in any other proceeding.

54.1-2400.2 D

• This section shall not prohibit the Director of the Department of Health Professions, after consultation with the relevant health regulatory board president or his designee, from disclosing to the Attorney General, or the appropriate attorney for the Commonwealth, investigatory information which indicates a possible violation of any provision of criminal law, including the laws relating to the manufacture, distribution, dispensing, prescribing or administration of drugs, other than drugs classified as Schedule VI drugs and devices, by any individual regulated by any health regulatory board.

54.1-2400.2 F

• This section shall not prohibit the Director of the Department of Health Professions, following consultation with the relevant health regulatory board president or his designee, from disclosing information about a suspected violation of state or federal law or regulation to other agencies within the Health and Human Resources Secretariat or to federal law-enforcement agencies having jurisdiction over the suspected violation or requesting an inspection or investigation of a licensee by such state or federal agency when the Director has reason to believe that a possible violation of federal or state law has occurred. Such disclosure shall not exceed the minimum information necessary to permit the state or federal agency having jurisdiction over the suspected violation of state or federal law to conduct an inspection or investigation. Disclosures by the Director pursuant to this subsection shall not be limited to requests for inspections or investigations of licensees. Nothing in this subsection shall require the Director to make any disclosure. Nothing in this section shall permit any agency to which the Director makes a disclosure pursuant to this section to re-disclose any information, reports, records, or materials received from the Department.

54.1-2400.2 G

• Whenever a complaint or report has been filed about a person licensed, certified, or registered by a health regulatory board, the source and the subject of a complaint or report shall be provided information about the investigative and disciplinary procedures at the Department of Health Professions. Prior to interviewing a licensee who is the subject of a complaint or report, or at the time that the licensee is first notified in writing of the complaint or report, whichever shall occur first, the licensee shall be provided with a copy of the complaint or report and any records or supporting documentation, unless such provision would materially obstruct a criminal or regulatory investigation. If the relevant board concludes that a disciplinary proceeding will not be instituted, the board may send an advisory letter to the person who was the subject of the complaint or report. The relevant board may also inform the source of the complaint or report (i) that an investigation has been conducted, (ii) that the matter was concluded without a disciplinary proceeding, (iii) of the process the board followed in making its determination, and (iv), if appropriate, that an advisory letter from the board has been communicated to the person who was the subject of the complaint or report. In providing such information, the board shall inform the source of the complaint or report that he is subject to the requirements of this section relating to confidentiality and discovery.

54.1-2400.2 G

• Any person found guilty of the unlawful disclosure of confidential information possessed by a health regulatory board shall be guilty of a Class 1 misdemeanor.

54.1-2400.2 I

• This section shall not prohibit investigative staff authorized under § 54.1-2506 from interviewing fact witnesses, disclosing to fact witnesses the identity of the subject of the complaint or report, or reviewing with fact witnesses any portion of records or other supporting documentation necessary to refresh the fact witnesses' recollection.

54.1 2400.6 Mandatory Reporting

54.1-2400.6 A (1) • The chief executive officer (“CEO”) and/or the chief of staff (“COS”) of every

hospital and other health care institution and the administrator of every assisted living facility in the Commonwealth each has a duty, unless prohibited by federal law, to report to the Department of Health Professions the following information regarding any person subject to regulation by a health regulatory board:

a. Any information of which the officer becomes aware in an official capacity, indicating that any person subject to regulation by a health regulatory board is in need of or has been admitted as a patient for treatment of substance abuse or a psychiatric illness that may render the health professional a danger to himself, the public or his patients;

b. Any information of which the official becomes similarly aware, indicating that any person licensed by a health regulatory board may have engaged in “unethical, fraudulent or unprofessional conduct;”

c. Any disciplinary action initiated or taken by the institution as a result of intentional or negligent conduct that causes or is likely to cause injury to a patient; a breach of professional ethics; professional incompetence; moral turpitude; or substance abuse; and

d. Any voluntary resignation from staff of a health professional while such professional is under investigation or the subject of disciplinary proceedings.

54.1-2400.6 A

• The required report shall: • Be made in writing to the Director of DHP to the Director of

the Department of Health Professions, or in the case of a director of a home health or hospice organization, to the Office of Licensure and Certification at the Department of Health (the Office)

• Be made within a specified *30-day period

• Describe fully the circumstances giving rise to the report

• Identify persons with knowledge of relevant facts

• Include relevant medical records

54.1-2400.6 A

• Institutions are not required to submit proceedings, minutes, records or reports that pertain to peer review proceedings that are privileged under § 8.01-581.17, except that the provisions of § 8.01-581.17 shall not bar (i) any report required by this section or (ii) any requested medical records that are necessary to investigate unprofessional conduct reported pursuant to this subtitle or unprofessional conduct that should have been reported pursuant to this subtitle. Under no circumstances shall compliance with this section be construed to waive or limit the privilege provided in § 8.01-581.17. No person or entity shall be obligated to report any matter to the Department or the Office if the person or entity has actual notice that the same matter has already been reported to the Department or the Office.

PENALTIES FOR FAILURE TO REPORT

• Any person who fails to make a report as required is subject to a civil penalty of up to $25,000.

• Any person who fails to make a report to the Board of Medicine as required may be subject to a civil penalty of up to $5,000.

54.1-2506 Delegation of Authority

54.1-2506 A

• The Director and investigative personnel appointed by him shall be sworn to enforce the statutes and regulations pertaining to the Department, the Board, and the health regulatory boards and shall have the authority to investigate any violations of those statutes and regulations and to the extent otherwise authorized by law inspect any office or facility operated, owned or employing individuals regulated by any health regulatory board. The Director or his designee shall have the power to subpoena witnesses and to request and obtain patient records, business records, papers, and physical or other evidence in the course of any investigation or to issue subpoenas requiring the production of such evidence.

54.1-2506 B

• All investigative personnel shall be vested with the authority to • Administer oaths or affirmations for the purpose of receiving

complaints of violations of this subtitle • Serve and execute any warrant, paper or process issued by

any court or magistrate, the Board, the Director or in his absence a designated subordinate, or by any regulatory board under the authority of the Director

• Request and receive criminal history information under the provisions of § 19.2-389

• Request and receive social security numbers from practitioners or federal employee identification numbers from facilities

54.1-2506 C

• The Director shall have the authority to issue summonses for violations of statutes and regulations governing the unlicensed practice of professions regulated by the Department. The Director may delegate such authority to investigators appointed by him. In the event a person issued such a summons fails or refuses to discontinue the unlawful acts or refuses to give a written promise to appear at the time and place specified in the summons, the investigator may appear before a magistrate or other issuing authority having jurisdiction to obtain a criminal warrant pursuant to § 19.2-72.

42 CFR 164.512 (d) HIPPA Uses and Disclosures for

Health Oversight Activities

42 CFR 164.512 (d)

(1) Permitted disclosures. A covered entity may disclose protected health information to a health oversight agency for oversight activities authorized by law, including audits; civil, administrative, or criminal investigations; inspections; licensure or disciplinary actions; civil, administrative, or criminal proceedings or actions; or other activities necessary for appropriate oversight of:

(i) The health care system;

(ii) Government benefit programs for which health information is relevant to beneficiary eligibility;

(iii) Entities subject to government regulatory programs for which health information is necessary for determining compliance with program standards; or

(iv) Entities subject to civil rights laws for which health information is necessary for determining compliance.

42 CFR Part 2 Confidentiality of Alcohol and Drug Abuse Patient Records

§2.1(a) Disclosure Authorization

• Records of the identity, diagnosis, prognosis, or treatment of any patient which are maintained in connection with the performance of any drug abuse prevention function conducted, regulated, or directly or indirectly assisted by any department or agency of the United States shall, except as provided in subsection (e) of this section, be confidential and be disclosed only for the purposes and under the circumstances expressly authorized under subsection (b) of this section.

PROFESSIONS REGULATED BY BOARD OF NURSING

• Advanced Certified Nurse Aide • Authorization to Prescribe • Certified Nurse Aide • Certified Massage Therapist • Clinical Nurse Specialist • Licensed Nurse Practitioner • Licensed Practical Nurse • Medication Aide • Registered Nurse

54.1-3007 1. Fraud or deceit in procuring or attempting to procure a license,

certificate, or registration;

2. Unprofessional conduct;

3. Willful or repeated violation of any of the provisions of this chapter;

4. Conviction of any felony or any misdemeanor involving moral turpitude;

5. Practicing in a manner contrary to the standards of ethics or in such a manner as to make his practice a danger to the health and welfare of patients or to the public;

6. Use of alcohol or drugs to the extent that such use renders him unsafe to practice, or any mental or physical illness rendering him unsafe to practice;

7. The denial, revocation, suspension or restriction of a license, certificate, registration, or multistate licensure privilege to practice in another state, the District of Columbia or a United States possession or territory; or

8. Abuse, negligent practice, or misappropriation of a patient's or resident's property.

18VAC90-20-300 2

Unprofessional conduct means, but shall not be limited to: a. Performing acts beyond the limits of the practice of professional or practical

nursing as defined in Chapter 30 (§54.1-3000 et seq.) of Title 54.1 of the Code of Virginia, or as provided by §§54.1-2901 and 54.1-2957 of the Code of Virginia;

b. Assuming duties and responsibilities within the practice of nursing without adequate training or when competency has not been maintained;

c. Obtaining supplies, equipment or drugs for personal or other unauthorized use;

d. Employing or assigning unqualified persons to perform functions that require a licensed practitioner of nursing;

e. Falsifying or otherwise altering patient, employer, student, or educational program records, including falsely representing facts on a job application or other employment-related documents;

f. Abusing, neglecting or abandoning patients or clients;

g. Practice of a clinical nurse specialist beyond that defined in 18VAC90-20-290;

h. Representing oneself as or performing acts constituting the practice of a clinical nurse specialist unless so registered by the board;

i. Delegating nursing tasks to an unlicensed person in violation of the provisions of Part VIII (18VAC90-20-420 et seq.) of this chapter;

continued

j. Giving to or accepting from a patient or client property or money for any reason other than fee for service or a nominal token of appreciation;

k. Obtaining money or property of a patient or client by fraud, misrepresentation or duress;

l. Entering into a relationship with a patient or client that constitutes a professional boundary violation in which the nurse uses his professional position to take advantage of the vulnerability of a patient, a client or his family, to include but not limited to actions that result in personal gain at the expense of the patient or client, a nontherapeutic personal involvement or sexual conduct with a patient or client;

m. Violating state laws relating to the privacy of patient information, including but not limited to §32.1-127.1:03 of the Code of Virginia;

n. Providing false information to staff or board members in the course of an investigation or proceeding;

o. Failing to report evidence of child abuse or neglect as required in § 63.2-1509 of the Code of Virginia or elder abuse or neglect as required in § 63.2-1606 of the Code of Virginia; or

p. Violating any provision of this chapter.

PROFESSIONS REGULATED BY BOARD OF MEDICINE

• Doctor of Medicine and Surgery

• Doctor of Osteopathic Medicine

• Doctor of Podiatry • Doctor of Chiropractic • Interns and Residents • University Limited License • Physician Assistant • Respiratory Therapist • Occupational Therapist • Occupational Therapy

Assistant

• Radiological Technologist • Radiological Technologist

Limited • Radiologist Assistants • Licensed Acupuncturists • Licensed Athletic Trainers • Licensed Midwife • Behavior Analysts • Assistant Behavior Analysts • Polysomnographic

Technologists • Surgical Assistants • Surgical Technologists

54.1-2915 1.False statements or representations or fraud or deceit in obtaining

admission to the practice, or fraud or deceit in the practice of any branch of the healing arts;

2.Substance abuse rendering him unfit for the performance of his professional obligations and duties;

3.Intentional or negligent conduct in the practice of any branch of the healing arts that causes or is likely to cause injury to a patient or patients;

4.Mental or physical incapacity or incompetence to practice his profession with safety to his patients and the public;

5.Restriction of a license to practice a branch of the healing arts in another state, the District of Columbia, a United States possession or territory, or a foreign jurisdiction, or for an entity of the federal government;

6.Undertaking in any manner or by any means whatsoever to procure or perform or aid or abet in procuring or performing a criminal abortion;

7.Engaging in the practice of any of the healing arts under a false or assumed name, or impersonating another practitioner of a like, similar, or different name; continued

8. Prescribing or dispensing any controlled substance with intent or knowledge that it will be used otherwise than medicinally, or for accepted therapeutic purposes, or with intent to evade any law with respect to the sale, use, or disposition of such drug;

9. Violating provisions of this chapter on division of fees or practicing any branch of the healing arts in violation of the provisions of this chapter;

10. Knowingly and willfully committing an act that is a felony under the laws of the Commonwealth or the United States, or any act that is a misdemeanor under such laws and involves moral turpitude;

11. Aiding or abetting, having professional connection with, or lending his name to any person known to him to be practicing illegally any of the healing arts;

12. Conducting his practice in a manner contrary to the standards of ethics of his branch of the healing arts;

13. Conducting his practice in such a manner as to be a danger to the health and welfare of his patients or to the public;

14. Inability to practice with reasonable skill or safety because of illness or substance abuse;

15. Publishing in any manner an advertisement relating to his professional practice that contains a claim of superiority or violates Board regulations governing advertising;

16. Performing any act likely to deceive, defraud, or harm the public;

17. Violating any provision of statute or regulation, state or federal, relating to the manufacture, distribution, dispensing, or administration of drugs;

18. Violating or cooperating with others in violating any of the provisions of Chapters 1 (§ 54.1-100 et seq.), 24 (§ 54.1-2400 et seq.) and this chapter or regulations of the Board;

19. Engaging in sexual contact with a patient concurrent with and by virtue of the practitioner and patient relationship or otherwise engaging at any time during the course of the practitioner and patient relationship in conduct of a sexual nature that a reasonable patient would consider lewd and offensive;

20. Conviction in any state, territory, or country of any felony or of any crime involving moral turpitude; or

21. Adjudication of legal incompetence or incapacity in any state if such adjudication is in effect and the person has not been declared restored to competence or capacity.

18VAC85-20-105.

• A practitioner shall not willfully refuse to provide information or records as requested or required by the board or its representative pursuant to an investigation or to the enforcement of a statute or regulation.

PROFESSIONS REGULATED BY BOARD OF PHARMACY

• Business CSR • Humane Society • Limited Use Pharmacy

Technician • Medical Equipment

Supplier • Non-resident Pharmacy • Non-resident Wholesale

Distributor • Non-restricted

Manufacturer • Nurse Practitioner CSR

• Optometrist CSR • Permitted Physician • Pharmacist • Pharmacy • Pharmacy Intern • Pharmacy Technician • Physician Selling Controlled

Substances • Restricted Manufacturer • Warehouser • Wholesale Distributor

54.1-3316 1. Has been negligent in the practice of pharmacy or in any activity requiring a license, permit,

certificate, or registration from the Board;

2. Has engaged in unprofessional conduct specified in regulations promulgated by the Board;

3. Has become incompetent to practice pharmacy or to engage in any activity requiring a license, permit, certificate, or registration from the Board because of a mental or physical condition;

4. Uses drugs or alcohol to the extent that he is rendered unsafe to practice pharmacy or to engage in any activity requiring a license, permit, certificate, or registration from the Board;

5. Has engaged in or attempted any fraud or deceit in connection with the practice of pharmacy or any activity requiring a license, permit, certificate, or registration from the Board, including any application to the Board for such license, permit, certificate, or registration;

6. Has engaged in activities beyond the scope of a license, permit, certificate, or registration or has assisted or allowed unlicensed persons to engage in the practice of pharmacy or perform duties related to the practice of pharmacy for which a license or registration is required;

7. Has violated or cooperated with others in violating any provisions of law or regulation relating to practice of pharmacy or any activity requiring a license, permit, certificate, or registration from the Board;

8. Has had revoked or suspended any registration issued by the United States Drug Enforcement Administration or other federal agency that is necessary to conduct an activity also requiring a license, permit, certificate, or registration from the Board;

9. Has engaged in the theft or diversion of controlled substances or has violated any federal drug law or any drug law of Virginia or of another state;

10. Has had denied, suspended, or revoked in any other state a license to practice pharmacy or any license, permit, certificate, or registration necessary to conduct an activity requiring a license, permit, certificate, or registration from the Board, or has surrendered in another state such license, permit, certificate, or registration;

11. Has been convicted of any felony or of any misdemeanor involving moral turpitude;

12. Has issued or published statements intended to deceive or defraud about his professional service or an activity requiring a license, permit, certificate, or registration from the Board;

13. Has conducted his practice, or activity requiring a license, permit, certificate, or registration from the Board in such a manner as to be a danger to the health and welfare of the public; or

14. Has failed to comply with requirements of this chapter or any regulation of the Board relating to continuing education.

18VAC110-20-25. 1. Failing to comply with provisions of § 32.1-127.1:03 of the

Code of Virginia related to the confidentiality and disclosure of patient records or related to provision of patient records to another practitioner or to the patient or his personal representative;

2. Willfully or negligently breaching the confidentiality of a patient unless otherwise required or permitted by applicable law;

3. Failing to maintain confidentiality of information received from the Prescription Monitoring Program, obtaining such information for reasons other than to assist in determining the validity of a prescription to be filled, or misusing information received from the program;

4. Engaging in disruptive or abusive behavior in a pharmacy or other health care setting that interferes with patient care or could reasonably be expected to adversely impact the quality of care rendered to a patient;

continued

5. Engaging or attempting to engage in a relationship with a patient that constitutes a professional boundary violation in which the practitioner uses his professional position to take advantage of the vulnerability of a patient or his family, including but not limited to sexual misconduct with a patient or a member of his family or other conduct that results or could result in personal gain at the expense of the patient;

6. Failing to maintain adequate safeguards against diversion of controlled substances;

7. Failing to appropriately respond to a known dispensing error in a manner that protects the health and safety of the patient;

8. Delegating a task within the practice of pharmacy to a person who is not adequately trained to perform such a task;

9. Failing by the PIC to ensure that pharmacy interns and pharmacy technicians working in the pharmacy are registered and that such registration is current; or

10. Failing to exercise professional judgment in determining whether a prescription meets requirements of law before dispensing.

ONLINE RESOURCES

• Access DHP Website: www.dhp.virginia.gov

• Email complaints to: enfcomplaints@dhp.virginia.gov

• DHP Guidance Documents: http://www.dhp.virginia.gov/dhp_guidelines/default.htm

• Reporting by Hospitals and Health Care Institutions: http://www.dhp.virginia.gov/dhp_guidelines/76-34.doc

• DHP Brochure: http://www.dhp.virginia.gov/about/docs/2011DHPAgencyBrochure.pdf

• DHP Enforcement Brochure: http://www.dhp.virginia.gov/Enforcement/forms/EnforcementBrochure.pdf