Enforcement FAQs

If the nursing care you, or someone you know was unacceptable you may report your concerns to the Board's Enforcement Unit.  If you have concerns about a nurse's practice or potential substance abuse you should report this.  Your complaint will be Investigated to determine if any of the laws that govern nursing have been violated.  Complaints typically come from employers, co-workers, patients, or family of patients.

We request that all complaints come in writing to:  Enforcement Unit, Iowa Board of Nursing, 400 SW 8th Street, Suite B, Des Moines, Iowa 50309-4865.  Fax 515.281.4825.  As an e-mail attachment to Enforce@iowa.gov.  There are complaint forms and instructions on this website.

A complaint is a detailed description of an alleged behavior by a nurse that may violate the Board rules. The complaint must be in writing and signed by the person filing the complaint.

Anyone who has information that a nurse may have violated the Board rules may file a complaint. This includes consumers, other regulatory agencies and other nurses or professionals. Iowa Code 272C.8 assures that anyone filing a complaint shall not be civilly liable unless the complaint is filed out of malice.

Iowa law and Board rules mandate that all licensed nurses are required to report suspected acts or omissions committed by another licensee of this board. Those who do not report violations are subject to discipline for failing to report.

Violations of the Iowa Code and/or Board rules may include:

• Abusive behavior: physical, verbal, sexual
• Boundary issues including exploitation or sexual misconduct
• Criminal convictions, both misdemeanor or felony
• Falsification of patient records, applications, or license renewal records
• Substance abuse
• Scope of practice issues
• Nurse License Compact violations
• Audit failures
• Practicing without an active license

The Chief Investigator assigns the case to one of eight investigators.  The investigator usually contacts the complainant when they are ready to begin working the case.  Investigators are assigned numerous cases to work at any given time.  The person filing the complaint will receive a letter informing them who the assigned investigator is for the case.  The complainant may contact the investigator at any time to provide additional information about the case. Complaints involving substance use disorders, mental health concerns, or physical disability may be referred to INAP ( Iowa Nurse Assistance Program ), a confidential, alternative to discipline program.  As a confidential program, INAP does not provide additional information to complainants.  

An investigation involves gathering and reviewing a variety of information and documents such as patient records, personnel records or court records. Some of these records may have to be subpoenaed or require a signed release of medical information from the involved patient. The investigator may interview pertinent witnesses as well as the nurse named in the complaint.

The fact that an investigation is taking place is not public information. Board staff cannot confirm or deny that any investigation is in process.

After all information is gathered, it is presented to the Board for their review.

1. Complaint is closed.
   After review of all investigative information, if the Board finds the evidence is not sufficient to support a probable cause finding, the case is closed. The Board may issue an Informal Letter of  Admonishment. There are no public records if the case is closed and/or an Informal Letter of Admonishment is issued. In most circumstances, both the complainant and the nurse will receive a letter advising them of the closure.
2. Licensee can enter into a settlement agreement.
   A settlement agreement may be offered during the investigation if the involved nurse acknowledges wrongdoing and/or wishes to expedite the process. In this situation the Board will review a Notice of Hearing, Statement of Charges, Settlement Agreement and Final Order (Combined) if signed by the licensee. If probable cause is determined, the Board will review the settlement offer. If the Board agrees to the settlement, the document will be signed by the chairperson. The order goes into effect when received by the nurse per certified mail.
3. Notice of Hearing and Statement of Charges.
   If the Board determines probable cause after review of all investigative information, a Notice of Hearing and Statement of Charges will be issued from the board office. This document will provide a date/time at the next scheduled board meeting for a formal hearing before the Board. The document is sent per restricted certified mail and MUST be signed for by the nurse.

A settlement agreement will be offered to the nurse. If the nurse accepts the offer, the nurse must sign the agreement and return it to the board office. It will be presented to the Board in lieu of the hearing. If the Board accepts the settlement agreement exactly as written, the document will be signed by the chairperson. The order goes into effect when received by the nurse per certified mail.

If the matter is not resolved through the settlement process or the nurse wishes a formal hearing, the case will be presented to the Board as scheduled. The State will be represented by an Assistant Attorney General. The proceeding is held before an Administrative Law Judge (ALJ) with the Board members hearing evidence. The nurse may appear personally or be represented by counsel at the expense of the licensee. After all evidence and testimony is presented, the Board will deliberate in a closed session. The ALJ will prepare the Board’s findings for their review. The Board will issue a Findings of Fact, Conclusions of Law, Decision and Order based on the information presented during the hearing. The Order will go into effect when received by the nurse per certified mail.

Sanctions the Board may impose include, but are not limited to:

• Citation and Warning
• Civil penalty/Fine
• Continuing Education
• Probation with conditions
• Suspension
• Revocation

The Board is required to send the Notice of Hearing and final orders to your address of record by restricted certified mail or personal service. By law, you are required to notify the Board in writing of any address changes. If service cannot be accomplished through those methods, notice can occur by publication in a newspaper of general circulation in the county of your last-known address.

Disciplinary actions are published in the Nursing Newsletter and on this under Enforcement. These actions are reported to National Council of State Boards of Nursing (NCSBN) and other relevant national databanks. NCSBN disseminates disciplinary information to all state boards of nursing. Action taken by the Board may affect your license to practice in other states.

If a complaint is filed while you are employed using your multistate license from another compact state, the Iowa Board of Nursing will investigate the allegation in regards to your Privilege to Practice in this state. Your home state will be notified and may sanction your license in that state.

If you are working in another compact state on your Iowa multistate license and a complaint is filed, the Iowa Board of Nursing may sanction your license. The state where the incident occurred may also sanction your Privilege to Practice in that state.

Access to the Code of Iowa pertaining to nursing and the Iowa Administrative Code/Board of Nursing Rules can be found on our Iowa Laws page.  Additional information may also be found on the website under ENFORCEMENT and PRACTICE. If you still have questions, please contact the enforcement unit at 515.281.6472 or Email.

The Department of Inspections and Appeals (DIA) regulates nursing homes and home health agencies. DIA surveyors respond to complaints about those facilities/agencies and take action based on state and federal regulations specific to those areas. The Iowa Board of Nursing has purview over licensed nurses only. An investigation by the IBON focuses on possible violations of laws and rules specific to nursing. If you have a complaint concerning a nursing home, please forward your complaint to DIA . Visit the DIA website to learn more.

To report a complaint about a certified nursing assistant (CNA) or a certified medication aide (CMA), call the Department of Inspections & Appeals at 515.725.5331. 

It is important that you report all of your criminal history upon request for licensure. Each history is reviewed on a case by case basis. The severity of the crime, amount of time elapsed since it occurred, and your life since then are all considerations. Board staff cannot offer any guaranteed approvals or denials. You may, however, petition a review of your convictions: Eligibility Petition Form & Instructions

You are required to report all criminal convictions within 30 days of final disposition. Final disposition may include a plea of guilty, jury ruling, deferred judgment or other type of conviction. Please send the information about your conviction to the Enforcement Unit. You do not need to report traffic charges, but be aware that Operating While Intoxicated is considered a criminal conviction.