In January 2023, federal authorities announced the results of a sweeping investigation known as Operation Nightingale. More than 7,600 fraudulent nursing diplomas and transcripts had been sold by accredited but corrupt Florida nursing schools.
Individuals used these documents to sit for national nursing board exams, obtain licensure in multiple states, and secure employment as registered nurses and licensed practical or vocational nurses.
Healthcare employers faced an immediate operational and compliance problem with consequences that extended well beyond the initial headlines.
What Happened in Operation Nightingale
Between approximately 2016 and 2021, operators at several Florida-based nursing schools sold fake diplomas and transcripts for about $15,000 each. These documents falsely indicated completion of required coursework and clinical hours.
Key schools involved included Siena College in Broward County, Palm Beach School of Nursing, Sacred Heart International Institute, Carleen Health Institute, and Med-Life Institute. The scheme generated more than $100 million.
As of late 2025, more than 30 individuals have been charged and convicted in federal court for their roles in the operation.
The schools were accredited at the time they were selling fraudulent credentials. Many employers assume accreditation equals legitimacy, but Operation Nightingale proved otherwise.
The Licensing Fallout Across the Country
The impact extended far beyond Florida. Fraudulent degrees were used to obtain nursing licenses in multiple states, including Connecticut, Delaware, New York, New Jersey, Texas, and Maryland.
In Connecticut alone, at least 58 licenses had been revoked or surrendered as of June 2025. Across the country, thousands of credentials have been reviewed, with hundreds of licenses revoked, suspended, or voluntarily surrendered.
The FBI notified state nursing boards nationwide to investigate individuals linked to these institutions. Healthcare employers were left asking difficult questions:
- Do we employ anyone connected to these schools?
- Were our verification processes sufficient?
- How do we protect patients and our organization moving forward?
Why This Illuminates the Importance of Primary Source Verification
Documentation alone doesn’t count as verification. That’s one of the most important lessons from Operation Nightingale.
Fraudulent transcripts can look legitimate. Diplomas can carry official seals. Licenses can be issued if the underlying documentation isn’t fully vetted.
Primary source verification and ongoing license monitoring need to be core components of your compliance program. A robust screening process should include direct verification of education from the issuing institution, verification of clinical training completion where required, primary source license verification with the appropriate state board, ongoing license monitoring to detect status changes, and identification of high-risk or known problematic institutions.
When employers rely solely on copies of documents provided by candidates, they assume risk that may not become visible until a federal investigation or state board audit forces a review.
The Hidden Value of a Proactive CRA
A Consumer Reporting Agency does more than process background checks.
Reputable CRAs maintain internal intelligence on known diploma mills, unaccredited institutions, and schools under investigation. When an order includes a degree from a flagged institution, experienced compliance teams can identify that risk and alert the client before a hiring decision is finalized.
During Operation Nightingale, proactive screening partners did not wait for clients to call. UBS contacted our healthcare clients directly when the scandal broke. We ran reports to identify whether candidates or employees had credentials from the listed institutions. We helped clients review prior screenings and understand their potential exposure.
A good screening partner brings dedicated account management, institutional knowledge of industry risks, the ability to audit and run retrospective reporting, and a compliance-focused approach. Many organizations underestimate how much institutional memory and investigative awareness matters when choosing a CRA.
Red Flags Employers May Miss
Healthcare HR teams manage high volumes of applicants. It’s not realistic to expect internal teams to maintain a constantly updated database of questionable institutions nationwide.
Some red flags that experienced screening professionals watch for include recently closed schools with high graduate volume, institutions that changed names multiple times, programs with unusually short completion timelines, gaps between graduation and licensure attempts, and geographic inconsistencies between education and testing.
CRAs that specialize in healthcare screening are trained to identify patterns that may not be obvious at first glance.
Compliance Is Not Static
Operation Nightingale isn’t an isolated incident. Regulatory enforcement is increasing. State boards are working more closely with federal investigators. Multi-state licensure makes it easier for credential fraud to spread across state lines.
Healthcare employers need to move beyond the minimum hiring checklist. You need thorough education and license verification, ongoing monitoring of active licenses, documented adverse action processes when issues arise, clear audit trails, and a screening partner that keeps you informed about emerging risks.
Failing to verify credentials properly has consequences beyond regulatory fines. Patient harm, reputational damage, and liability exposure are all on the table.
Moving Forward: A Compliance-First Hiring Strategy
Operation Nightingale proved what many compliance teams already suspected: you have to verify everything.
A diploma that looks official might not be valid. A license might have been issued based on fraudulent documentation. A credential that was clean last year might not be clean today.
Verification services, license monitoring, and experienced account management aren’t administrative luxuries. They’re how you mitigate risk.
Healthcare organizations that invest in thorough, proactive screening are better positioned to protect patients, maintain regulatory compliance, and respond quickly when industry-wide issues surface.
About Universal Background Screening
Universal Background Screening partners with healthcare organizations nationwide to deliver compliant, primary source education verification, professional license verification, ongoing monitoring, and comprehensive background screening solutions.
Our healthcare clients rely on dedicated account managers, proactive compliance communication, and rigorous verification processes designed to protect patients and reduce organizational risk.
To learn more about how UBS supports healthcare compliance and credential integrity, contact our team directly.
