Existing Provision Proposed provision Rationale

Article X Article X Article X

Prohibited Acts and Penal Prohibited Acts and Penal Prohibited Acts and Penal
Sec 59. Prohibited Acts.
Any of the following shall
constitute unlawful and illegal
acts.
a) Any person who is
practicing the nursing
profession in the Philippines:
1. Without a certificate of Addendum: Imposters may cause potential
registration, professional Who intentionally takes the harm to the patient. Board of
license, professional professional examination on Nursing regulates the nursing
identification card, special behalf on another profession by granting
permit or temporary permit or certificate of registration to
without having been declared qualified individuals by
exempt from examination in protecting the patient from
accordance with the provision unsafe and incompetent
of this Act; employees.
2. Who uses a certificate
of registration, professional
license, professional
identification, special permit or
temporary permit of another;
3. Who uses an invalid
certificate of registration,
professional license, a
suspended or revoked license of
registration, professional
license, or an expired or
cancelled special or temporary
permits;
4. Who, by any means of
misrepresentation, false
evidence, or concealment,
obtained a certificate of
registration, professional
license, professional
identification card, special
permit or temporary permit;
5. Who falsely poses or
advertises as a registered or
licensed nurse or uses any other
means that tend to convey the
impression that he/she is a
registered and licensed nurse;
6. Who appends “Nurse”,
“Nars”, or “Nrs.” Before his or
her name or
B.S.N/R.N/(Bachelor of Science
in Nursing/Registered Nurse)
after his or her name without
having been conferred said
degree or registration; or
7. Who, as a registered
and licensed nurse, abet or Any natural or judicial person,
assists to the illegal; practice of educational institutions offering Validation of the said trainings
a person who is not lawfully BSN without full compliance from professional nurses can
qualified to practice nursing; with the requirements considerably improve the
prescribed by law conducts success rate in the performance
b) Any natural or judicial Continuing Professional of cardio pulmonary
person, educational institutions Development for nurses resuscitation. It has been
offering BSN without full without accreditation from the reported that survival outcomes
compliance with the Board; or any natural or judicial of cardiac arrest remains low.
requirements prescribed by law person or health facility who One of the contributing factor is
conducts Continuing undertakes or offers in-service the lack of resuscitation skills
Professional Development for training program, for a fee or in from practicing professionals
nurses without accreditation kind, to obtain certificate in especially the nurses and
from the Board; or any natural certain Nursing Skills that doctors. This will hinder the
or judicial person or health enforces quality standard of willingness of the professional
facility who undertakes or offers nursing practice (ex.Basic Life to get proper trainings and be
in-service training program, for Support, Advance Cardiac Life more accurate in saving lives by
a fee and without Support and Intravenous performing CPR
permit/clearance from the Therapy)
Board and the Commission;
c) Any natural or judicial
person, or health facility who
subscribed to sub-standard
quality of nursing care and/or
nursing practice, such as non
compliance with the nurse-to-
patient ratio;
d) Any natural or judicial
person or health facility who
exercises and promotes
precarious working conditions
to nurse, such as, but not
limited to, the following:
1. Contracting or availing
of the services of a nurse either
without salary for allowance, for
salary below the applicable
wage prescribed under this Act,
whether or not under the
pretext of a training,
development program
certification or course and/or
seminar;
2. Depriving or denying a
nurse of the incentives and
benefits ad provided for the
existing laws;
3. Collecting any fees from
a nurse of from any person or
agent in his or her behalf in
exchange for a nurse’s voluntary
services in a health facility;
4. Requiring or obliging a
volunteer nurse to perform the
regular work functions and/or
regular staff nurse employed by
the health facility without
proper compensation, to render
full time service as a condition
for the continued availment of
her volunteer services, and/or
to be the sole nurse on duty,
except during disasters,
calamities, public emergencies
and war;
5. Contracting or availing
of the services of a volunteer
nurse, under the pretext of On-
The Job Training (OJT), contract
of service, and/or job orders, in
order to fill up the vacant
position that requires the hiring
of a full time regular employed
nurse, or for free in exchange
for any type of certification to
be issued by the health facility
for purposes of the nurse’s
employment application; or
6. Contracting or availing
of the services of a nurse, under
the pretext of training or
certification course, but
requiring the nurse to render
the tasks and responsibilities
expected of a regular staff or
public health nurse, in violation
of Section 48 hereof;
e.) Any violation of the
provisons of this Act.
Sec 60. Sanctions. – A fine of
not less than one hundred
thousand pesos (100,000.00)
nor more than three hundred
thousand pesos (300,000.00) or
imprisonment of not less than
one (1) year nr more than six (6
years) or, both, upon the
discretion of the court, shall be
imposed upon violation of any
prohibited acts enumerated in
section 59(a) hereof.
A fine of not
less than three hundred
thousand pesos nor more than
five hundred thousand pesos
and/or imprisonment of not less
than one year more than six
years shall be imposed upon
violation of any prohibited acts
enumerated in section 59b,c,e
hereof. In addition, suspension
or revocation of license to
operate the health facility may
may be issued upon the
discretion of the court. In cases
the violation is committed by a
partnership, corporation,
association, or any other
juridical person, the managing
parner, president, director/s or
manager who has committed or
consented such violation shall
be held directly liable and
responsible for the acts, as
principal or as co-principal’s
with the other participants, if
any.

SEC 61 Refund and

Compensation. – any nurse
found to have been a victim of
Section 59(d) hereof shall be
entitled to a full refund of all
fees illegally collected fees and
changes and the payment of
unpaid salary, if any which
should not be less than the
applicable wage for services
rendered.

Article XI
Miscellaneous
Sec 62 Implementing Agencies
– The Department of Health
(DOH) is hereby designated as
the agency tasked with
monitoring the compliance with
and implementation of the
provisions of this Act by public
health facilities. The
Department of Labor and
Employment is designated as
the agency tasked with
monitoring the compliance with
implementations of the
provisions of this Act by private
health facilities. The
Commission and the Board are
designated as the agencies
tasked with monitoring the
compliance with and
implementations of the
provision of this Act by
educational institutions, CPS
providers and health facilities.
The CHED is similarly designated
as the agency tasked with
monitoring the compliance with
and implementations of the
provisions of this Act by
educational institutions with
regard to nursing education
programs and curriculum

SEC 63 Appropriations – The

amount necessary to carry out
the provisions of this Act shall
be changed to savings of the
concerned agencies
immediately upon effectivity
hereof. Every year thereafter,
the amounts necessary to
effectively implement the
provisions of this Act shall be
included in the annual budget of
the concerned agencies to be
incorporated in the General
Appropriations Act (GAA)

In order to effectively carry out

the advance practice of the
nursing program, the annual
financial requirement needed to
train at least ten percent (10%)
of the nursing staff of the
participating government
hospitals and institutions shall
be chargeable against the
income of the Philippine Charity
Sweepstakes Office (PCSO) and
the Philippine Amusement and
Gaming Corporation (PAGCOR),
which shall equally share in the
costs; the same shall be
released to the Department of
Health subject to the usual
accounting and auditing
procedures: Provided, that the
Department of Health shall set
the budget for, as well as the
criteria for the availment of this
program

SEC 64. Implementing Rules

and Regulations. – Within
ninety days (90) after the
effectivity of this Act, the
Commission, the Board, the APO
for registered nurses, the Civil
Service Commission, the
Department of Health and other
concerned nursing organizations
and government agencies, shall
formulate the implementing
rules and regulations necessary
to carry out the provisions of
this Act. The implementing rules
and regulations shall be
published in the Official Gazette
of in in at least two (2)
newspapers of general
circulation
 Sec 65. Separability Clause. -
Should any provision of this Act
be declared unconstitutional,
the remaining parts not affected
thereby shall remain valid and
operational

SEC 66 Repealing Clause. –

Republic Act No. 9173, other
wise known as the Philippine
Nursing Act of 2002 is hereby
repealed. All other laws,
decrees, orders, circulars,
issuances, rules and regulations
and parts thereof which are
inconsistent with this Act are
hereby repealed, amended or
modified accordingly.

Sec 67. Effectivity.- This Act

shall take effect fifteen (15)
days after its publication in the
Official Gazette or in any two
(2) newspapers of general
circulation in the Philippines.

Approved.

ear after year, nursing consistently tops national polls of the most widely respected and trusted professions. The results of these polls reflect the special
relationship and bond between nurses and those under their care. In almost all cases, this trust and respect is well founded, but in a growing number of
documented cases the trusted nurse is actually an imposter.

It is difficult to determine whether the problem of imposter nurses is increasing or whether advanced verification technology and more rigorous employer
background checks and diligent reporting of imposters by state and territorial boards of nursing are contributing to catching these pretenders in the act. Although
the number of imposter nurses may be small, the potential for harm is quite high.

Boards of nursing regulate the nursing profession by granting licensure to qualified individuals and are charged with protecting the public from unsafe and
incompetent professionals. The National Council of State Boards of Nursing (NCSBN) is a not-for-profit organization whose membership comprises the boards of
nursing in the 50 states, the District of Columbia, and 5 United States territories-American Samoa, Guam, Northern Mariana Islands, Puerto Rico and the Virgin
Islands. Through the NCSBN, boards of nursing act and counsel together on matters of common interest and concern affecting the public health, safety, and
welfare, including the development of possible approaches for educating employers and the community about imposter nurses. They also develop potential
strategies for preventing these imposters from having access to patients such as the possible creation of a national database identifying all known imposter
nurses.

Imposter nurses pose a special problem to boards of nursing because if there is no nursing license, most boards have no jurisdiction and must refer the case to
the state's attorney general or district attorney for prose- cution. Many state boards do issue "cease and desist" letters. State boards of nursing and prosecuting
authorities often work closely to identity and remove imposter nurses from practice. There is, however, disparity from state to state in terms of how the imposter
nurse is charged. In some states, practicing nursing without a license is a gross misdemeanor and in other states it may be a felony. In Texas, first-time offenders
are charged with a misdemeanor. Anthony Diggs, MSCJ, director of enforcement at the Texas Board of Nurse Examiners, comments, "I would like to see all
imposter nurses charged with a felony on the first offense. That charge speaks to the serious nature of the crime and the potential for damage." Imposter nurses
are often easy to catch but hard to prosecute. Convictions are most often obtained when the imposter is employed by healthcare facilities that receive Medicare or
Medicaid funds and the imposter can be prosecuted for Medicare or Medicaid fraud.

What motivates individuals to misrepresent themselves as nurses when they lack the appropriate education, skills, and credentials is unknown, but the lure of
relatively high incomes and benefits; the prestige associated with the profession; easily obtained patient information and fellow healthcare facility employee
personnel records; and access to prescription drugs may play a role in spurring these deceptions. Likewise, the imposter's own conceit in assuming that their
knowledge is equal to legitimately licensed nurses may also be a contributing factor.
Imposters can be categorized in several ways:

One category of imposter includes those who practice as a nurse but are not legally authorized to be a nurse. Examples of this grouping include an unlicensed
person who poses as a nurse; a person who claims to be a nurse who has completed some, but not all, licensure requirements so is not eligible for nursing
licensure (eg, a person completes nursing education but has never passed the NCLEX(R)).

The second category includes those instances where the license is fraudulently obtained and a person gains licensure illegally based on false credentials.
Examples of this category can vary from a person who presents fraudulent credentials that are not identified as fraudulent and the person is ultimately licensed
illegally to a person who is licensed legally in one capacity but represents himself or herself as having a different license, such as a licensed practical nurse (LPN)
representing oneself as a registered nurse (RN) or an RN represents oneself as an advanced practiced registered nurse (APRN).

The third type of imposter involves identity theft, a person who is practicing or attempting to practice by assuming the identity of a properly licensed nurse. In this
situation, the imposter is both practicing without authority and presenting illegal credentials.

Imposters with no healthcare-related experience or training are extremely rare; however, some egregious examples exist. One such case involved a family who
posed as healthcare professionals across 6 states. Among their many crimes, the imposters stole the identities of nurses and targeted adult care homes and
dialysis centers. Nidia Jimenez, the nominal head of the family, was finally arrested in December 2004 in Arizona for embezzlement of funds from the dialysis
center where she was employed and for the attempt to obtain a credit card using the name and identification of another dialysis center employee. At the time of her
arrest, she was in possession of patient names, information, and other identification documents.

David Wayne Rhodes of Mesquite, Texas was recently convicted of 2 felonies and a misdemeanor for practicing nursing without a license and tampering with
government documents. Rhodes worked for more than 14 years as a nurse before being caught in December 2004. Ironically, before Rhodes was fired from his
position as a clinical services director at a nursing home for not having a nursing license, he was responsible for verifying licensure.

The most common imposter is an individual who does have some training, education, or experience in healthcare but represents himself or herself as having
credentials they lack. Little training, coupled with arrogance, allows the imposter's belief that he/she has greater knowledge and ability than the imposter actually
has. This can pose a serious threat to patient welfare.

Drawn directly from the Arizona Board of Nursing's newsletter is the case of Melissa Addison. Addison was employed at least 3 months as an LPN after claiming
to have graduated from an LPN program and producing a photocopy of an LPN license that had been altered with her name. Following repeated requests for
Addison to show her employer her original license, the employer performed an online verification identifying that Addison had an expired CNA certificate and not
an LPN license. Addison reportedly gained access to the LPN license through a personal relationship with the actual nurse. In addition to presenting fraudulent
credentials, Addison's inability to perform at a level consistent with acceptable LPN practice raised suspicion at her place of employment.

A more benign case, in the sense that the imposter never gained access to patients, occurred at University Medical Center in Tucson, Arizona. Richard Puczko, a
respiratory therapy student, was hired as an RN. Fortunately, his deception was discovered during the 2-day orientation period. Although not charged, Puczko will
remain on the Arizona Board of Nursing's "Imposter Nurse" list indefinitely.

Some healthcare facilities, pressured by the demands of a nursing shortage, are not as diligent in their verification process as they need to be to ensure that only
licensed nurses are permitted to work. In the past, applications for nursing positions were carefully examined by nurse managers; today, that task often falls to
human resources personnel who may be less familiar with what inconsistencies to look for in resumes and applications.

Meticulous examination of the resume and job application is vital to make sure that the dates, positions, salaries, and experience are consistent within the
accepted parameters of the nursing profession and do not reflect wide variation from acknowledged norms for the duties and responsibilities of each position.
Simply ensuring that the names on various documents provided for verification match will help prevent imposters from being hired.

Boards of nursing have several recommendations designed to detect nurse imposters before they have opportunity to harm patients:

Employers must insist on viewing the original source document of nursing license and refuse to accept photocopies as verification.

"Because photocopies can be so easily altered, it is imperative that employers require that the original license be presented at the time of application," comments
Valerie Smith, MS, RN, associate director, Arizona State Board of Nursing, she continues, "The best analogy I can provide is if someone is stopped by a police
officer for a traffic violation, the presentation of a copy of a drivers license is not going to be acceptable; likewise a copy of a nursing license is unacceptable
because of the high potential for fraud."

When nurses are working under a privilege to practice granted through a state's participation in the Nurse Licensure Compact (NLC), employers should verify the
nursing license and/or privilege via NCSBN's Nursys(R) online database (where licenses issued by any of the states in the interstate Nurse Licensure Compact
may be verified1) or through the individual state board of nursing verification process.

Employers should also periodically check their state board of nursing's Web site and read the newsletter that many state boards of nursing produce that list
imposter nurses. "Periodically, I receive phone calls from healthcare facilities telling me that they found 1 of their employees on our list," remarks Smith, "We know
that the list is an invaluable community service."

The fact that the number of imposter nurses appears to be increasing may be a sign that employers, despite the pressures inflicted by the nursing shortage, are
availing themselves of the resources provided by the boards of nursing in their respective states. NCSBN and its member boards recognize the need to inform the
general public about services that the public may use to verify that the nurses who care for their loved ones are appropriately licensed and in good standing with
the state board of nursing. The aging population in the United States and the large number of chronically ill patients that require private long-term homecare
increase the number of people needing access to nursing services. Spouses, adult children, and guardians of patients need to be made aware of the dangers of
hiring imposter nurses, especially when they do not use the services of home health agencies, but rather seek out individual arrangements with nurses to care for
their loved ones. Family caretakers need to be as proactive in employing nurses, as they are when they hire babysitters for their children and contractors for their
home.

Protection of the public remains the principal charge of boards of nursing. Boards continually strive to shield the public from imposter nurses through the various
mechanisms for verification. Other systems are currently under development that are designed to support boards in their vigilance to detect any persons who seek
to violate the trust between patients and nurses.
The mutual recognition model of nurse licensure allows a nurse to have 1 license (in his or her state of residency) and to practice in other states (both physical
1

and electronic), subject to each state's practice law and regulation. Under mutual