Texas Board of Nursing Complaint Process 

The Complaint

The Texas Board of Nursing provides “due process” to the nurse or medical staff by notifying him or her of the investigation and the allegations, unless doing so could possibly jeopardize the board’s investigation. The medical provider is given the opportunity to respond to the allegations made against him or her and show that they are in complaince with the Texas Nursing Practice Act.

It is critical to respond to a BON complaint in a timely manner.  Consulting an experienced Texas nurse attorney can prove to be an important step to a successful case outcome.  The matter should be taken seriously and the nurse should respond rapidly.

You may choose to respond to a complaint or a notice of investigation without legal counsel, however, without expert legal guidance your well intention to respond can lead to additional allegations against you. Often times this happens because nurses accidentally bring light to other possible nursing violation issues without intending to do so.

Nursing Board Investigation Evidence

The nursing board investigator’s job is to obtain all necessary evidence and witness interviews to substantiate the allegation against the nurse. Most of the investigation process is handled through the mail, email and via phone. Occasionally, the nursing board investigator may make on in person visits. When all relevant evidence has been obtained, the board investigation team reviews the evidence with intent to determine if there is probable cause to believe that a nurse was in violation of the nursing practices.

If a case is substantiated, an agreed order will be sent to the medical provider. If the case is not resolved by an agreed order it then will further go to either an informal settlement conference or a SOAH trial/hearing (State Office of Administrative Hearings).

If a case is closed by the nursing board, the complaint and all evidence will be expunged from the nurse’s file, however, if the case is closed “without prejudice” it is allowable to bring new disciplinary action on the same case if sufficient evidence is available.

Informal Settlement Conference

This step involves the nurse and his or her attorney attending an informal settlement conference at the Texas Board of Nursing office in Austin. The hearing is normally scheduled several months in advance. Parties in attendance of the conference may include the Executive Director, or her designee, Director of Investigations, legal counsel for the Board, the assigned investigator and the nurse and their attorney.

During the informal settlement conference case details and evidence is explored by the Texas BON and the nurse is questioned regarding the situation at hand. The nurse’s attorney and the nurse are given the opportunity to respond and the attorney is permitted to provide any additional evidence that is relevant to the case as hand.

It is advisable to consult an experienced Texas nurse attorney who can anticipate what type of questions will be asked and best help you prepare for your case.

If it is determined that the nurse or medical provider should be disciplined, the board will prepare a proposed agreed order and send it to the nurse and their attorney. The agreed order will contain proposed findings of fact, conclusions of law and agreed sanctions. Some common nursing board sanctions and penalties include a warning, reprimand, imposition of fines, the completion of remedial education, supervision and/or restrictions on the nurse’s license for defined periods of time. The Texas BON may also revoke or suspend the nurse’s license.

If the nurse is in agreement with the findings of the proposed agreed order, the nurse and their attorney signs the order before a notary and returns it to the nursing board. The proposed agreed order is then scheduled for review by the entire nursing board. The Board may choose to ratify the agreed order as is, suggest modifications, or reject it.

A copy of the final agreed order is mailed to the nurse and their attorney. The disciplinary action is then posted in the next Texas BON quarterly newsletter and is entered into the National Council of State Boards of Nursing Disciplinary Data Bank. All nursing board disciplinary actions are public information and become a permanent part of the nurse’s professional record.

Formal Conference

If the nurse opposes the proposed agreed order, or if the nursing board is unable to reach the nurse during the investigation, the board will file formal charges based on the allegations. A public disciplinary hearing before an administrative law judge (SOAH hearing- State Office of Administrative Hearings) is scheduled many months in advance.

Based on the facts, conclusions of law and the Proposal for Decision, the nursing board may find that a violation of the Texas Nursing Practice Act has occurred and impose a penalty, or may find that there was no violation and further close the case without taking further action.