FACIS® LVL III – Comprehensive Health Care Background Check Report

Date of Birth: 01/10/****

Sex: FEMALE

Race: WHITE

Record Source: PA ADMINISTRATIVE OFFICE OF COURTS

Record Jurisdiction: BERKS

Record State: PA

Case Number: CP-06-CR-00102158753-2019

Category: CRIMINAL/TRAFFIC

Publication Name:

Ohio Board of Nursing – Board Actions

Publication Date:

2011-03-01

Entry Date

2011-10-07

Action Summary

Automatic Suspension/Action Pending

Publication Name:

Ohio Board of Nursing – Board Actions

Publication Date:

2011-07-01

Entry Date

2011-12-10

Action Summary

Indefinite Suspension w/permanent practice restriction

Publication Name:

Ohio Board of Nursing – Board Actions

Publication Date:

2015-01-08

Entry Date

2015-02-03

Action Summary

Notice of Opportunity for Hearing/Action Pending

Code

160000000X

Provider Type

Nursing Service Providers

Publication Name:

Ohio Board of Nursing – Meeting Minutes

Publication Date:

2011-09-28

Case Number

CASE #11-0231578

Publication Date

2011-09-28

Acquisition Date

2015-02-23

Entry Date

2016-01-13

Action Summary
CONSENT AGREEMENTS On Friday July 29 2011, the Board considered the terms of the following proposed Consent Agreements that were reviewed by Board members. Action: It was moved by Michael Feinstein, seconded by Sandra Tullock, that the Board approve the Consent Agreements for violations of Chapter 4723. ORC entered into by and between the Board in the following case(s): Johnson, Mary L., R.N. 3A2589417 (CASE #11-0231578) Motion adopted by majority vote of the Board members. July 29, 2011y

Code

160000000X

Provider Type

Nursing Service Providers

Publication Name:

Ohio Board of Nursing – Board Actions

Publication Date:

2015-08-13

Entry Date

2015-08-20

Code

163W00000X

Provider Type

Nursing Service Providers

Publication Name:

Ohio Board of Nursing – Meeting Minutes

Publication Date:

2010-09-28

Case Number

CASE #12-885248912

Publication Date

2010-09-28

Acquisition Date

2015-02-23

Entry Date

2016-03-16

Action Summary
CONSENT AGREEMENTS On Friday, July 30, 2010, the Board considered the terms of the following proposed consent agreements that were reviewed by Board members: Action: It was moved by Michael Feinstein, seconded by Neil Armstrong, that the Board approve the consent agreements for violations of Chapter 4723. ORC entered into by and between the Board in the following case(s): Johnson, Mary, L. R.N. 3A2589417 (CASE #12-885248912) Motion adopted by majority vote of the Board members. JULY 30, 2010y

Code

160000000X

Provider Type

Nursing Service Providers

Publication Name:

Ohio Board of Nursing, Momentum Magazine – Newsletters

Publication Date:

2015-11-10

Entry Date

2015-12-15

Action Summary
The following includes lists of Board disciplinary actions taken at public meetings regarding licensed nurses or certificate holders. You can review the type of action taken by checking the individuals credential at the Ohio eLicense Center at: http://www.nursing.ohio.gov/ Verification.htm#VERInfo, or by clicking on License and Certificate Verification on the Board of Nursings website (www.nursing.ohio. gov). You may also request a copy of a public disciplinary record by completing the electronic form on the Boards website at: http:// www.nursing.ohio.gov/iw-DisciplineRecReq.htm or by clicking on Discipline Records Requests on the Boards website.y

Start Date

2015-07-01

Code

163W00000X

Provider Type

Nursing Service Providers

Publication Name:

Ohio Board of Nursing – Meeting Minutes

Publication Date:

2011-05-24

Case Number

CASE #11-0231578

Publication Date

2011-05-24

Acquisition Date

2015-02-23

Entry Date

2016-01-13

Action Summary
OHIO BOARD OF NURSING MINUTES OF MEETING AUTOMATIC SUSPENSIONS AND NOTICE FOR OPPORTUNITY Action: It was moved by William Chalks, seconded by Janet Arwood, that the Board issue a Notice of Automatic Suspension and Opportunity for Hearing for violations of Chapter 4723. ORC for the following case(s): Johnson, Mary L., R.N. 3A2589417 (CASE #11-0231578) Motion adopted by majority vote of the Board members with Jose Iglesias abstaining. Complete copies of the Automatic Suspensions and Notices of Opportunity for Hearing shall be maintained in the exhibit book for the March 2011 Board Meeting. March 18, 2011y

Start Date

2015-07-01

Code

160000000X

Provider Type

Nursing Service Providers

Publication Name:

Ohio Board of Nursing, Momentum Magazine – Newsletters

Publication Date:

2011-07-01

Entry Date

2012-01-19

Action Summary

Indefinite Suspension w/permanent practice restrictions

Start Date

2015-07-01

Code

000V000025

Provider Type

Nursing Service Providers

Publication Name:

Ohio Board of Nursing, Momentum Magazine – Newsletters

Publication Date:

2015-02-10

Entry Date

2015-03-16

Action Summary

Notice of Opportunity for Hearing/Action Pending

Start Date

2014-09-01

Code

160000000X

Provider Type

Nursing Service Providers

Publication Name:

Ohio Board of Nursing – Meeting Minutes

Publication Date:

2014-11-24

Publication Date

2014-11-24

Acquisition Date

2015-01-26

Entry Date

2015-09-23

Action Summary
OHIO BOARD OF NURSING MINUTES OF MEETING Board Actions NOTICES OF OPPORTUNITY FOR HEARING Action: It was moved by James Sanders, seconded by Jonas Baker, that the Board issue a Notice of Opportunity for Hearing for violations of Chapter 4723., ORC for the following case(s): Johnson, Mary, R.N. 3A2589417 (CASE #14-520894); Motion adopted by majority vote of the Board members with Becky Brown abstaining. Complete copies of the Notices of Opportunity for Hearing shall be maintained in the exhibit book for the September 2014 Board Meeting. SEPTEMBER 19, 2014y

Start Date

2014-09-01

Code

160000000X

Provider Type

Nursing Service Providers

Publication Name:

Ohio Board of Nursing – Board Actions

Publication Date:

2010-11-24

Entry Date

2011-01-05

Action Summary

Stayed Suspension w/temporary practice restriction

Start Date

2014-09-01

Code

160000000X

Provider Type

Nursing Service Providers

Publication Name:

Ohio Board of Nursing, Momentum Magazine – Newsletters

Publication Date:

2011-06-01

Entry Date

2012-01-12

Action Summary

Automatic Suspension/Action Pending

Start Date

2014-09-01

Code

000V000025

Provider Type

Nursing Service Providers

Publication Name:

Ohio Board of Nursing – Meeting Minutes

Publication Date:

2015-09-17

Case Number

Case: 14-520894

Publication Date

2015-09-17

Acquisition Date

2015-10-09

Entry Date

2015-10-26

Action Summary
ADMINISTRATIVE MATTERS Board Meeting Overview On Thursday, the Executive Session was held at 10:00 a.m. and the public rules hearing was at 1:00 p.m. Beginning at 1:25 p.m. the following addressed the Board: Attorney Lisa Acosta, Mary Johnson, RN, and AAG Ted Fleming July 30, 2015 ADJUDICATION AND COMPLIANCE On Friday, July 31, 2015, William Chalks requested that each voting Board member verify that they reviewed in depth all materials pertaining to these matters by saying “yes” or “no” and that any Board member who did not review the materials abstain from voting on the matters. Board Actions HEARING EXAMINERS REPORT AND RECOMMENDATION Johnson, Mary, R.N. 3A2589417 (CASE #14-520894) Action: It was moved by James Sanders, seconded by Jose Iglesias, that the Board accept all of the Hearing Examiners Findings of Fact and Conclusions of Law, and the Recommendation in the Hearing Examiners Report and Recommendation, and that Ms. Johnsons application for reinstatement of her license to practice nursing as a registered nurse in the State of Ohio be granted subject to a stayed revocation and the probationary terms and restrictions set forth below for a minimum period of five (5) years, including the Permanent Practice Restrictions set forth below. Ms. Johnsons license to practice nursing as a registered nurse shall be subject to the following probationary terms and restrictions: 1. Ms. Johnson shall obey all federal, state, and local laws, and all laws and rules governing the practice of nursing in Ohio. 2. Ms. Johnson shall appear in person for interviews before the full Board or its designated representative as requested by the Board. 3. Ms. Johnson shall submit a request to the Bureau of Criminal Identification and Investigation (BCII) to conduct a criminal records check of Ms. Johnson, including a check of Federal Bureau of Investigation (FBI) records, and shall cause BCII to submit Ms. Johnsons criminal records check reports to the Board. Ms. Johnsons completed criminal records check, including the FBI check, must be received by the Board within six (6) months of effective date of this Order. Monitoring 4. Upon the request of the Board or its designee, Ms. Johnson shall, at her expense, obtain a chemical dependency evaluation by a Board approved chemical dependency professional and shall provide the Board with complete documentation of this evaluation. Prior to the evaluation, Ms. Johnson shall provide the chemical dependency professional with a copy of this Order and the Notice of Opportunity for Hearing. Further, Ms. Johnson shall execute releases to permit the chemical dependency professional to obtain any information deemed appropriate and necessary for the evaluation. The chemical dependency professional shall submit a written opinion to the Board that includes diagnoses, recommendations for treatment and monitoring, any additional restrictions that should be placed on Ms. Johnson’s license, and a statement as to whether Ms. Johnson is capable of practicing nursing according to acceptable and prevailing standards of safe nursing care. 5. Ms. Johnson shall provide the Board with satisfactory documentation of compliance with all aspects of the treatment plan developed by the chemical dependency professional described above until released. Further, the Board may utilize the professional’s recommendations and conclusions from the evaluation as a basis for additional terms and restrictions on Ms. Johnsons license. 6. Ms. Johnson shall abstain completely from the use of alcohol or any products containing alcohol. 7. Within forty-five (45) days of the effective date of this Order, and continuing throughout the probationary period, Ms. Johnson shall submit, at her expense and on the day selected, blood, breath, hair or urine specimens for drug and/or alcohol analysis at a collection site specified by the Board at such times as the Board may request. Refusal to submit such specimen, or failure to submit such specimen on the day she is selected, or in such a manner as the Board may request, shall constitute a violation of a restriction placed on a license for purposes of Section 4723.28(B), ORC. This screening shall require a daily call-in process. The specimens submitted by Ms. Johnson shall be negative, except for substances prescribed, administered, or dispensed to her by another so authorized by law who has full knowledge of Ms. Johnsons history. 8. Ms. Johnson shall attend a minimum of two (2) meetings per week of a support or peer group meeting approved in advance by the Board, or a Twelve Step program, and Ms. Johnson shall provide satisfactory documentation of such attendance to the Board every six (6) months, beginning forty-five (45) days after the effective date of this Order. Treating Practitioners and Reporting 9. Prior to initiating screens, Ms. Johnson shall provide a copy of this Order to all treating practitioners and shall provide to the Board a list of all treating practitioners, including addresses and telephone numbers. Further, Ms. Johnson shall be under a continuing duty to provide a copy of this Order, prior to initiating treatment, to additional treating practitioners, and to update the list of treating practitioners with the Board within forty-eight (48) hours of being treated by another practitioner. 10. Ms. Johnson shall cause all treating practitioners to complete a medication prescription report that is to be mailed by the practitioner directly to the Board. The medication report is to be completed for any and all substances prescribed, administered, or dispensed to Ms. Johnson throughout the duration of this Order. 11. Within twenty-four (24) hours of release from hospitalization or medical treatment, Ms. Johnson shall notify the Board of any and all medication(s) or prescription(s) received. Employment Conditions 12. Ms. Johnson shall notify the Board, in writing, of the name and address of any current employer within thirty (30) days following the employment as a nurse. 13. Ms. Johnson, within fifteen (15) days of the effective date of this Order, if working in a position in which a license to practice nursing is required, shall provide her employer(s) with a copy of this Order and the Notice of Opportunity for Hearing. Further, Ms. Johnson is under a continuing duty to provide a copy of this Order and the Notice of Opportunity for Hearing to any new employer prior to accepting employment as a nurse. Ms. Johnson shall have her employer(s), if working in a position where a nursing license is required, submit written reports regarding job performance on a quarterly basis beginning within thirty (30) days of the effective date of this Order or beginning within thirty (30) days of working in a position as a nurse. Ms. Johnson shall have her employer(s) send documentation to the Board, along with the first employer report, of receipt of a copy of this Order and the Notice of Opportunity for Hearing, including the date they were received. 14. Ms. Johnson shall, prior to working in a position where a license to practice nursing is required, complete and submit satisfactory documentation of completion of a nurse refresher course or an extensive orientation approved in advance by the Board or its designee. Reporting Requirements of Ms. Johnson 15. Ms. Johnson shall sign release of information forms allowing health professionals and other organizations to submit the requested documentation directly to the Board. 16. Ms. Johnson shall submit any and all information that the Board may request regarding her ability to practice nursing according to acceptable and prevailing standards of safe nursing practice. 17. Ms. Johnson shall not submit or cause to be submitted any false, misleading, or deceptive statements, information, or documentation to the Board or to employers or potential employers. 18. Ms. Johnson shall submit the reports and documentation required by this Order on forms specified by the Board. All reporting and communications required by this Order shall be made to the Compliance Unit of the Board. 19. Ms. Johnson shall submit the reports and documentation required by this Order or any other documents required by the Board to the attention of the Compliance Unit, Ohio Board of Nursing, 17 South High Street, Suite 400, Columbus, OH 43215-7410. 20. Ms. Johnson shall verify that the reports and documentation required by this Order are received in the Board office. 21. Ms. Johnson shall inform the Board within five (5) business days, in writing, of any change in employment status or of any change in residential or home address or telephone number. Permanent Practice Restrictions Ms. Johnson shall not practice nursing as a registered nurse (1) for agencies providing home care in the patients residence; (2) for hospice care programs providing hospice care in the patients residence; (3) for staffing agencies or pools; (4) as an independent provider where the nurse provides nursing care and is reimbursed for services by the State of Ohio through State agencies or agents of the State; or (5) for an individual or group of individuals who directly engage Ms. Johnson to provide nursing services for fees, compensation, or other consideration or as a volunteer. Ms. Johnson shall not function in a position or employment where the job duties or requirements involve management of nursing and nursing responsibilities, or supervising and evaluating nursing practice. Such positions include but are not limited to the following: Director of Nursing, Assistant Director of Nursing, Nurse Manager, Vice President of Nursing. FAILURE TO COMPLY The stay of Ms. Johnsons revocation shall be lifted and Ms. Johnsons license to practice nursing as a registered nurse will be automatically suspended if it appears to the Board that Ms. Johnson has violated or breached any terms or conditions of this Order. Following the automatic suspension, the Board shall notify Ms. Johnson via certified mail of the specific nature of the charges and automatic suspension of her license. Upon receipt of this notice, Ms. Johnson may request a hearing regarding the charges. DURATION The Board may only alter the probationary period imposed by this Order if: (1) the Board determines that Ms. Johnson has complied with all aspects of this Order; and (2) the Board determines that Ms. Johnson is able to practice nursing according to acceptable and prevailing standards of safe nursing care without Board monitoring, based upon an interview with Ms. Johnson and review of the reports as required herein. Any period during which Ms. Johnson does not work in a position for which a license to practice nursing is required shall not count toward fulfilling the probationary period imposed by this Order. Motion adopted by a majority vote of the Board members with Jonas Baker abstaining. This ORDER shall become effective immediately and is hereby entered upon the Journal of the Board for the 31st day of July, 2015. July 31, 2015y

Start Date

2014-09-01

Code

160000000X

Provider Type

Nursing Service Providers

Publication Name:

Florida Board of Nursing – Meeting Minutes

Publication Date:

2018-12-14

Publication Date

2018-12-14

Acquisition Date

2019-01-02

Entry Date

2019-01-10

Action Summary
December Draft Minutes Credentials A Committee C. Applicants for Licensure LPN, RN, and APRN Prior Discipline Endorsement 11. Johnson, Mary L; 1701/636674- Present with attorney Paul Levine. A motion was made by Konover to approve for a Single State License with a V6B. Motion passed unanimously. December 6, 2018y

Start Date

2014-09-01

Description

https://floridasnursing.gov/meeting-information/past-meetings/

Code

160000000X

Provider Type

Nursing Service Providers