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Board hears overview of complaint and enforcement process; staff report 15,293 complaints in FY2025
Summary
At a board-development session, Assistant Director of Enforcement Danielle Green outlined how complaints get screened and investigated under the Nurse Practice Act, described staffing and monitoring processes, and reported that the agency received 15,293 complaints during the fiscal year and sanctioned 1,496 licenses.
Assistant Director of Enforcement Danielle Green gave a board-development briefing July 18 that walked board members through the Texas Board of Nursing's complaint-driven investigative process under the Nurse Practice Act (Occupations Code, Chapter 301).
Green said complaints come from multiple sources (required reporters, patients and family members, employers, self-reports and news reports), and that staff first determine whether a written complaint contains sufficient information to allege a violation of the Nurse Practice Act. If so, the agency initiates an investigation, sends a notice letter to the licensee (unless notice would jeopardize the investigation), issues subpoenas for records, gathers witness statements, and may seek expert reviews or evaluations, such as a chemical-dependency evaluation, depending on the conduct.
Green and other enforcement staff described steps that follow a finding of a violation: a proposed agreed order may be offered (and executed by the licensee), or if the parties cannot agree, formal charges are filed and the matter is referred to the State Office of Administrative Hearings. Green used a "pill mill" example to explain situations in which staff would not notify a respondent because notice could jeopardize evidence collection. She emphasized that investigations are evidence-driven and that the existence of a complaint alone does not determine outcome.
Green cited three key statistics for FY2025: 15,293 complaints received across the agency's jurisdictions, more than 570,000 licensees in the agency's rolls, and 1,496 licenses sanctioned in the last fiscal year. She also described enforcement staffing levels (five teams, roughly 30 investigators plus supervisors and eligibility staff) and noted the board authorized seven additional FTEs to expand investigative capacity.
Board members asked follow-up questions about handling complaints that lack full detail, how the agency expands investigations to involve additional licensees when needed, and whether false complaints can expose the complainant to liability; staff responded that the agency may ask complainants for more information, will open additional investigations if evidence arises, and that retaliatory or false complaints are addressed under agency rules and could carry legal consequences though staff said such prosecutions are rare. The presentation concluded with appreciation from the board for staff work on enforcement and monitoring.
