JOHN J. HOFFMAN
ACTING ATTORNEY GENERAL OF NEW JERSEY
Division of Law
124 Halsey Street, Fifth Floor
Post Office Box 45029
Newark, New Jersey 07101
Attorney for the State Board of Nursing
FILED
OCT 2 8 2015
N.J. BOARD OF NURSING
STATE OF NEW JERSEY
DEPARTMENT
OF LAW & PUBLIC SAFETY
DIVISION
OF CONSUMER
AFFAIRS
BOARD OF NURSING
IN THE MATTER OF THE LICENSE OF
EUGENIA KHURGIN, R.N.
License #26NR13881700
TO PRACTICE NURSING IN THE
STATE OF NEW JERSEY
Administrative Action
FINAL ORDER
This matter was opened to the New Jersey State Board of
Nursing ("Board") upon receipt of information that respondent
does not possess the required education for licensure as a
registered professional nurse in the State of New Jersey, which
the Board has reviewed and upon which the following findings of
fact and conclusions of law are made:
FINDINGS
OF FACT
1. Respondent is a registered professional nurse in the
State of New Jersey who was initially granted a New Jersey
nursing license on August 29, 2008.
2. Respondent first arrived in the United States in 2005,
and has lived in New Jersey since she arrived in the country..
3. In 2007, respondent applied for licensure
as a nurse
in New Mexico and was granted a license by that state.
Respondent never worked as a nurse in New Mexico.
4. Respondent acknowledged that when she graduated from
school in Minsk, in Belarus, she had obtained a degree as a
physician. Respondent's diploma beats the date of June 27,
1998.
5. The Board obtained records of respondent's educational
history from her licensing file at the New Mexico Board of
Nursing on or about September 17, 2014, and forwarded those
documents for evaluation to CGFNS International (also known as
the Commission on Graduates of Foreign Nursing Schools) in order
to obtain an evaluation of her nursing educational
credentials.
6. The resulting evaluation indicated
that respondent's
studies and the diploma were equivalent to a diploma as a
physician.
7. The records themselves demonstrate that respondent
only had four weeks of education in nursing practice.
8. Although when the Board granted respondent's
application for licensure in 2008, Respondent had truthfully
disclosed the names of the educational institutions she had
attended, the Board did not refer
respondent
'
s educational
credentials to CGFNS for evaluation. Respondent's application
2
for licensure was granted by endorsement, i.e. , base entirely on
the fact that respondent then held a current valid license in
New Mexico.
CONCLUSIONS OF LAW
1. Pursuant to N.J.S.A. 45:11-26(a), licensure
as a nurse
in the State of New Jersey requires completion of a course in
professional nursing study in an accredited school of
professional nursing.
2. Pursuant to N.J.S.A. 45:11-26(b), the Board may issue
a license to practice nursing without examination to an
applicant who has been duly licensed by examination under the
laws of another State if, in the opinion of the Board, the
applicant has the qualifications required by this Act for the
licensing of professional nurses or equivalent qualification.
3. Pursuant to N.J .A.C. 13:37-2.3, graduates of foreign
nursing programs require a transcript review performed by the
Commission on Graduates of Foreign Nursing Schools (CGFNS).
4. Pursuant to N.J .A.C. 13:37-4.1, a registered
professional nurse licensed in another state who wishes to be
licensed in New Jersey may be licensed by endorsement if he or
she meets the requirements set forth in N.J.S.A. 45:1-14 et
seq. , N.J.S.A. 45:11-26 and N.J.S.A. 45:11-27.
3
5. Pursuant to New Mexico's Nursing Practice Act, 561-
3.13, before being considered for licensure as a registered
nurse, an applicant must furnish evidence of having successfully
completed an approved program of nursing for licensure as a
registered nurse.
6. The evaluation by ICD, a division of CGFNS
International, indicates that respondent's course of study
outside of the United States was the equivalent of the
completion of a specialized Bachelor in Medicine degree.
7. Respondent's own admission, and the evaluation by ICD,
indicates that respondent did not graduate from a school of
professional nursing. Accordingly, respondent did not meet the
statutory requirements for licensure under both New Jersey and
New Mexico law, as respondent did not complete a course in
professional nursing study in an accredited school of nursing
(New Jersey), or an approved program of nursing for licensure as
a professional nurse (New Mexico), and the Board does not
consider obtaining a diploma as a physician to be the equivalent
of a course in professional nursing study in an accredited
school of nursing.
DISCUSSION
In the opinion of the Board, while both physicians and
nurses have the ultimate goal of healing the sick, the
4
professional focus and education of a physician differs greatly
from the professional focus and education of a nurse, and the
formal education provided to physicians and nurses reflect those
differences; the credential of a physician cannot be substituted
for the credential of a nurse.
DISCUSSION ON FINALIZATION
Based on the foregoing findings and conclusions, a
Provisional. Order of Discipline ("POD"), preliminarily
concluding that the nursing license of respondent Eugenia
Khurgin had been wrongfully issued and that rescission was
required, was entered on June 19, 2015 an d a copy was served on
the respondent. The POD was subject to finalization by the
Board at 5:00 p.m. on the 30th business day following entry
unless respondent requested a modification or dismissal of the
stated Findings of Fact or Conclusions of Law by submitting a
written request for modification or dismissal setting forth in
writing any and all reasons why said findings and conclusions
should be modified or dismissed and submitting any and all
documents or other written evidence supporting respondent's
request for consideration and reasons therefor.
The Board, in the POD, preliminarily concluded
that Ms.
Khurgin had failed to complete a course of professional nursing
study in an accredited school of professional nursing, as
5
required by N.J.S.A . 45:11-26(a). This failure, the Board
determined, resulted in her failing to meet the statutory
requirements for licensure under applicable New Jersey law.
Additionally, the Board preliminarily found that respondent's
studies in Minsk, Belarus, were comparable to the completion of
a specialized Bachelor of Medicine program in the United States.
As such, the Board concluded that the respondent's diploma as a
physician was not equivalent to a course in professional nursing
study in an accredited school of nursing, as mandated by
N.J.S.A . 45:11-26(b) (2). The license to practice nursing in
this State, the Board concluded, was therefore issued in error
and must be rescinded.
In a written response to the POD, Alex Keoskey, Esquire,
counsel for the respondent, requested that the Board dismiss or
modify the findings of fact and conclusions of law detailed in
the POD because, he argued, the Board's conclusions were
incorrect. Specifically, while conceding that she did not
complete a course in professional nursing as required by New
Jersey law, Ms. Khurgin contended that she had demonstrated the
requisite skill, education and experience to be licensed as a
registered nurse in this State.
Following review of the submissions, the Board found that
further proceedings
were
necessary and determined to conduct a
6
hearing. On October 13, 2015, a quorum of the Board conducted
the hearing. The Attorney General, by David M. Puteska, Deputy
Attorney General ("DAG"), presented the State's case by
introducing the following joint exhibits that were admitted into
evidence without objection:
J-1 Provisional Order of Discipline filed June 19,
2015 and all attached exhibits;
J-2 Education, Licensure Credentials, Work History
and Performance Report prepared by Georgia Persky
Consulting, dated August 14, 2015 and all
attached exhibits;
J-3 Letter, dated August 17, 2015, from Catherine M.
Steinhauser, RN, BSN, to the Board of Nursing;
J-4 Application of Respondent Eugenia Khurgin to the
State of New Mexico for Licensure as a Registered
Nurse;
J-5 Board of Nursing, State of New Mexico, Default
Order in the Matter of Eugenia Khurgin; and
J-6 Certification
of Erica N. Fuller and attached
exhibits.
DAG Puteska argued that this was a simple matter of a
person who was issued a license for professional nursing when in
fact she does not possess the appropriate educational
requirements for licensure as a professional registered nurse in
New Jersey. He further contended that while she may have
practiced as a nurse for six (6) years, the uncontroverted
evidence proves that Ms. Khurgin attended medical school and was
7
awarded a degree in medicine, rather than completing a course in
professional nursing from an accredited school of professional
nursing, as required by N.J.S. A. 45;11-26(a). DAG Puteska
contended that the respondent's nursing license was wrongly
issued and therefore must be rescinded.
Following the presentation by DAG Puteska, Mr. Keoskey
initiated the respondent's case by offering the testimony of
Georgia Persky, RN, MBA, PhD. She provided testimony as to her
credentials and was, without objection, accepted as an expert in
the field of nursing. Ms. Persky testified that she was asked
to review the credentials and educational preparation of the
respondent in order to ascertain her qualifications to practice
as a registered nurse under applicable New Jersey laws and
regulations governing nursing. She also prepared a written
report detailing her findings which was introduced into evidence
as J-2.
In preparing her opinion regarding the respondent, Ms.
Persky testified that she, among other things, interviewed Ms.
Khurgin, reviewed the respondent's transcript and other
translated educational documents and had physically visited the
respondent's medical school in Minsk in previous years.
Respondent's expert asserted that educational, and
professional practices of physicians and registered nurses have
8
a different focus. Ms. Persky opined that a Physician's Model
focuses on disease processes and resolution of those processes
while the Nursing Model focuses on a more holistic, integrative,
outcomes-based approach to the patient care process. [See J-2,
page 41. She indicated that her review revealed that Ms.
Khurgin, in her studies at the Belarus Medical School from 1992-
1998, attended post-secondary medical school for six (6) years
and took courses relating to every physical
system. Respondent
also undertook, Ms. Persky noted, a four (4) week summer program
within the six years that concentrated on nursing practice.
[See J-2, page 41,
Finally, Ms. Persky opined that, despite the fact that the
respondent did not complete a "course of professional nursing
study in an accredited school of professional nursing . . . ",
as required by N.J.S.A. 45:11-26(a), the respondent's program in
medicine and four (4) week summer program in nursing was
"equivalent" to nurse training in the
United States. [J-2, page
103 . She further testified that she believed Ms. Khurgin could
continue to competently and safely practice nursing in New
Jersey. In reaching this conclusion, Ms. Persky relied on the
facts that: 1) the respondent had practiced as a nurse for
approximately six (6) years without any complaints relative to
her quality of care or practice; 2) her performance
evaluations
9
at Jersey Shore University Medical Center ("Jersey Shore") were
stellar; and 3) no misconduct has ever been alleged and that all
of the credentials submitted to New Jersey and New Mexico were
genuine. Hence, Ms. Persky testified that in her opinion the
Board should continue to license the respondent and allow her to
practice as a nurse.
On cross examination, Ms. Persky conceded that respondent
attended medical school and not nursing school. Additionally,
she testified that in her forty-five (45) years of nursing
management, she is unaware of any licensed nurse who she
supervised who did not possess a nursing degree. Finally, she
testified that she had reviewed joint exhibit J-5 which
indicated that, as of August 27, 2015, respondent's license to
practice nursing in New Mexico had been revoked by default.
Respondent also presented the testimonies of Lucricia
Schwartz and Kathleen Sullivan, respondent's Nurse Manager and
nurse educator, respectively, at Jersey Shore. These witnesses
testified, among other things, that Ms. Khurgin is an excellent
nurse with superior skills.
Following its consideration of the entire record, the Board
determined that its prior Provisional order should become final
with no modifications. The Board carefully evaluated
respondent's arguments, submitted documentation and testimonies.
10
There is no question that this matter presents difficult issues
for the Board. However, the Board found that, as set forth
below, the facts and law as written compel a conclusion that Ms.
Khurgin's license must be rescinded as it was wrongfully issued.
Courts have concluded that licenses issued in error,
particularly those issued when the applicant did not actually
meet the educational requirements, can be rescinded, canceled,
or otherwise voided. See Packer v. Board of Behavioral Science
Examiners , 125 Cal. Rptr. 96 (Ct. App. 1975) (license to practice
as a marriage, family and child counselor revoked based on
graduation from an accredited school); Gersch v. Illinois
De partment of Professional Regulation , 720 N.E.2d. 672 (Ill.
App. Ct. 1999) (registration as a licensed clinical social worker
canceled based on lack of advanced educational degree). These
cases indicate that respondents should not be permitted to
benefit from Board errors. The respondent here has already
benefitted by practicing nursing for approximately six (6) years
while not qualified to do so.
The evidence produced in the hearing indicates that the
respondent first arrived in the United States and specifically
New Jersey in 2005. She graduated from medical school in 1998
and obtained a degree as a physician. In 2007, she applied for,
and was granted, licensure as a nurse in New Mexico. New
11
Mexico's applicable statutes require, among other factors, that
an applicant provide evidence of having successfully completed
an approved program of nursing for licensure as a registered
nurse. [New Mexico Nurse Practice Act, X61-3.13(A)].
Ms. Khurgin subsequently applied for, and was granted,
licensure as a professional registered nurse in New Jersey in or
about 2008. Her application for licensure was granted by
endorsement; N.J.S.A. 45:11-26(b); based on the fact that she
held a current and valid license in New Mexico.' Now, however,
with the issuance of the New Mexico Default Order, there is no
basis for the granting of a license to the respondent by
endorsement.
Case law indicates that an administrative agency has the
inherent power to reconsider a previous decision. See Mastro v.
Board of Trustees, Public Employees' Retirement System, 266 N.J.
Su
p
er. 445 (1993); In re Parole Application of Trantino , 89 N.J.
The Board notes that in a Default Order, effective August
27, 2015, the New Mexico Board of Nursing revoked respondent's
license to practice nursing following its issuance of a Notice
of Contemplated Action ("NCA") against the respondent. This
document contends that the Board had sufficient evidence to
suspend, revoke or impose other action against her license based
on violation of the New Mexico Nursing Practice Act. Ms.
Khurgin failed to appear at the hearing and her license was then
revoked by default. [See J-5). As indicated above, as a result
of the revocation by default of respondent's New Mexico license,
there is no basis for the grant of New Jersey licensure via
endorsement. [See N.J.S.A . 45:11-26(b) (2)).
12
347 (1982) . The Board has reconsidered its decision to grant a
nursing license to Ms. Khurgin and concluded that the license
was issued in error. Respondent does not satisfy the
requirements for licensure in that she has not completed an
approved program of nursing for licensure as a professional
nurse. The Board's discovery of its mistaken belief that
respondent graduated from an approved nursing program
constitutes a
new development or new evidence relating to
established facts or a material misapprehension
concerning an essential matter which is critical
to an agency determination . . .
such as, in the Board's decision as to whether to grant a
license or not. [See Tran tino , supra , 89 N.J. at 365).
Therefore, the Board has a reasonable basis to reconsider its
decision to grant respondent a license.
In reconsidering its prior determination, the Board
reviewed its endorsement statute. N.J.S.A . 45:11-26(b)(2)
provides, in the pertinent portion, that the Board
may issue a
nursing license to an applicant
who has been duly licensed . . . by . . . the
laws of another State . . . or any foreign
country, if in the opinion of the board the
applicant has the qualifications required by
this act for the licensing of professional
nurses, or equivalent qualifications.
13
N.J.S.A. 45:11-26(b)(2). A state agency may not ignore the
plain language of a statute. Licensing requirements for
professional nurses in the State of New Jersey include
successful completion of a "course of professional nursing study
in an accredited school of professional nursing." N.J.S.A.
45:11-26(a). Applicants by endorsement are held to the same
requirement. [See N.J.S.A, 45:11-26(b) (2) and N.J.A.C. 13:37-
4.1). Quite simply, licensed professional nurses in the State
of New Jersey must have completed a course in professional
nursing study in an accredited nursing program. Respondent has
not.
4.
Further, the Board's review of an evaluation of
respondent's educational transcript indicated in 2014 that her
course of study outside of the United States was the equivalent
to the completion of a specialized Bachelor in Medicine degree
or, in other words, a diploma as a physician. (See J-6). The
Board concludes that the educational credentials and training as
a physician is not equivalent or comparable to the training and
education in professional nursing study in an accredited school
of nursing as required by New Jersey law.
Ms. Khurgin asserts that N.J.S.A. 45:11-26 requires
applicants to complete professional nursing courses to
demonstrate he or she possesses the requisite skill, education,
14
training and experience to practice as a nurse. Hence,
respondent argues that, despite not possessing the requisite
nursing education, the evidence demonstrates that she possesses
the necessary skill, training and experience to be licensed as a
registered nurse in this State. The Board however is unable to
find support for this proposition in the applicable laws. The
Board found that the respondent's license was issued erroneously
in that she does not meet the educational requirements and that
her educational credentials are not equivalent. Therefore, it
concluded her license must be rescinded.
Notwithstanding the Board's conclusion to rescind the
respondent's nursing license, the Board emphasizes that Ms.
Khurgin's,competence is not in question here. The Board has
determined to rescind, not revoke, the respondent's license as
Ms. Khurgin has done nothing to warrant any discipline. Rather,
the Legislature has spoken by detailing licensure requirements
for professional nurses and the respondent has simply not met
those requirements. New Jersey is a diverse State with
healthcare workers from many different countries with differing
educational credentials. While these workers may be highly
skilled abroad, often their credentials are not substantially
equivalent to New Jersey nursing practice and standards.
Although the Board's findings here result in prohibiting
15
respondent from practicing nursing in New Jersey at this time,
this does not have to be permanent. If Ms. Khurgin obtains the
necessary education - a course of professional nursing study
from an accredited nursing program -- the Board would welcome her
new application for a nursing license.
ACCORDINGLY
,
IT IS on this 28th day of OCTOBER 2015,
ORDERED that:
1. Respondent's New Jersey license is hereby rescinded,
as it was wrongfully issued by the Board. The rescission is
effective beginning October 28, 2015.
2. Respondent shall refrain from practicing
as a nurse
and shall not represent herself as a Registered Professional
Nurse until such time as she obtains the statutorily required
education, meets all other requirements, applies to the Board
and is granted licensure as a nurse in the State of New Jersey.
NEW JERSEY STATE BOARD OF NURSING
By:
PATRICIA
MURPHY, PhD, APN
Board President
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