FINACT18A-1308120-NUR.pdf

18A-1308120-NUR · State Board of Nursing · 2018-05-22

Doug Ducey Joey Ridenour Governor Executive Director

Arizona State Board of Nursing 1740 West Adams Street, Suite 2000 Phoenix. AZ 85007 Phone (602) 771-7800 Fax (602) 771-7888 E-Mail: [email redacted] Home Page: http://www.azbn.gov

TO: Case Management Office of Administrative Hearings

FROM: Trina Smith Legal Assistant Hearing Department

DATE: May 21, 2018

RE: Cindy Louise Tregay Docket No. 17A-1308120-NUR ______________________________________________________________________________

On May 18, 2018, the Board considered the Administrative Law Judge Decision (“ALJ Decision”), which recommended that the Board revoke Cindy Louise Tregay’s privilege to practice nursing in Arizona under the Nurse Licensure Compact.

The Board adopted the Findings of Fact, Conclusions of Law and Recommended Order in its entirety. ARIZONA STATE BOARD OF NURSING 1740 West Adams Street, Suite 2000 Phoenix AZ 85007 602-771-7800

IN THE MATTER OF THE PRIVILEGE TO PRACTICE NURSING UNDER THE NURSE FINDINGS OF FACT, LICENSURE COMPACT IN THE STATE OF CONCLUSIONS OF LAW ARIZONA ISSUED TO: AND ORDER NO. 17A-1308120-NUR CINDY LOUISE TREGAY, AKA CINDY LOUIS PURCELL RESPONDENT

A hearing was held before Velva Moses-Thompson, Administrative Law Judge (“ALJ”), at 1740 West Adams Street, Lower Level, Phoenix Arizona, on March 7, 2018. Elizabeth Campbell, Assistant Attorney General, appeared on behalf of the State. Cindy Louise Tregay (“Respondent”) was

not present and was not represented by counsel.

On April 12, 2018, the ALJ issued Findings of Fact, Conclusions of Law and Recommendations. On May 18, 2018, the Arizona State Board of Nursing met to consider the ALJ’s recommendations. Based upon the ALJ’s recommendations and the administrative record in this

matter, the Board makes the following Findings of Fact and Conclusions of Law.

FINDINGS OF FACT 1. The Arizona State Board of Nursing (“Board”) has the authority to regulate and control the practice of nursing in the State of Arizona pursuant to ARIZ. REV. STAT. sections 32-1606, 32- 1663, and 32-1664. The Board also has the authority to impose disciplinary sanctions against the

holders of nursing licenses for violations of the Nurse Practice Act, ARIZ. REV. STAT. sections 32-

1601 through 32-1669. In addition, the Board has the authority to impose disciplinary sanctions against holders of the privilege to practice nursing in the State of Arizona pursuant to the Nurse Licensure Compact, ARIZ. REV. STAT. sections 32-1668 and 32-1669.

2. Respondent Cindy Louise Tregay holds Colorado compact registered nurse licensure and the privilege to practice nursing in the State of Arizona under the multistate Compact. 3. From about July 18, 2013 to August 5, 2013, Ms. Tregay worked as a licensed practical

nurse at MGA Home Healthcare, LLC (“MGA”). See Exhibit 2.

4. From about July 18, 2013 to August 5, 2013, Ms. Tregay was assigned to Patient A. See id. 5. From about July 18, 2013 to August 5, 2013, Ms. Tregay lived with Patient A and her

family. 1

6. In June of 2013, Ms. Tregay was hospitalized after attempting to commit suicide by ingesting a variety of medication. 7. On or about August 22, 2013, the Board received a complaint from MGA that Ms. Tregay had a physical altercation with Patient A’s grandmother.

8. On July 20, 2017, the Board issued an Interim Order (“Order”) requiring that Ms. Tregay

submit to a psychological evaluation within forty-five days of Service of the Order. See Exhibit 3. 9. On or about August 10, 2017, a copy of the Order was sent to Ms. Tregay by certified mail. See id.

10. Ms. Tregay did not submit to a psychological evaluation.

11. On or about January 29, 2018, the Board issued a Complaint and Notice of Hearing setting the above-captioned matter for hearing at 1:00 p.m. on March 7, 2018 at the Office of Administrative Hearings in Phoenix, Arizona.

12. On or about February 20, 2018, Ms. Tregay filed a response to the Complaint and Notice

of Hearing.

See Exhibit 2.

13. Ms. Tregay did not request to appear telephonically at the duly noticed hearing. Although the start of the hearing was delayed until 9:37 a.m., Ms. Tregay did not appear, personally or through an attorney. Consequently, Ms. Tregay did not present any evidence to defend her license.

CONCLUSIONS OF LAW

1. The Complaint and Notice of Hearing that the Board mailed to Respondent at her address of record was reasonable, and Respondent is deemed to have received notice of the hearing. ARIZ. REV. STAT. § 41-1092.04; ARIZ. REV. STAT. § 41-1061(A).

2. The Board has jurisdiction to take action against Respondent’s privilege to practice

nursing in Arizona pursuant to the Nurse Licensure Compact, ARIZ. REV. STAT. section 32-1668 2 Nurse Licensure Compact at Ariz. Rev. Stat. section 32-1668 also includes the following relevant provisions: .... Article I Findings and Declaration of Purpose

B. The general purposes of this compact are to: .... 5. Invest all party states with the authority to hold a nurse accountable for meeting all state practice laws in the state in which the patient is located at the time care is rendered through the mutual recognition of party state licenses. ....

Article III General Provisions and Jurisdiction B. Party states may, in accordance with state due process laws, limit or revoke the multistate licensure privilege of any nurse to practice in their state and may take any other actions under their applicable state laws necessary to protect the health and safety of their citizens. . . . C. Every nurse practicing in a party state must comply with the state practice laws of the state in which the patient is located at the time care is rendered. . . . The practice of nursing will subject a nurse to the jurisdiction of the nurse licensing board and the courts, as well as the laws, in that party state. ....

Article V Adverse Actions In addition to the general provisions described in article III, the following provisions apply:

and ARIZ. REV. STAT. section 32-1669. 3 However, only the Colorado Board may discipline Respondent’s nursing license. 4 3. The Board bears the burden of proof and must establish cause to penalize Respondent’s

privilege to practice nursing in Arizona by a preponderance of the evidence. See ARIZ. REV. STAT.

section 41-1092.07(G)(2); A.A.C. R2-19-119(A) and (B)(1); see also Vazanno v. Superior Court, 74 ARIZ. 369, 372, 249 P.2d 837 (1952). 4. A preponderance of the evidence is:

The greater weight of the evidence, not necessarily established by

the greater number of witnesses testifying to a fact but by evidence that has the most convincing force; superior evidentiary weight that, though not sufficient to free the mind wholly from all reasonable doubt, is still sufficient to incline a fair and impartial mind to one side

of the issue rather than the other.

BLACK’S LAW DICTIONARY 1373 (10th ed. 2014).

.... B. The licensing board of a party state shall have the authority to complete any pending investigations for a nurse who changes primary state of residence during the course of such investigations. . . . The Nurse Licensure Compact at ARIZ. REV. STAT. section 32-1669(A) provides that “[a] person who is extended the privilege to practice in this state pursuant to the compact adopted pursuant to section 32- 1668 is subject to the same disciplinary requirements prescribed in this chapter, and the board's investigative and disciplinary powers and procedures apply to a person who practices in this state pursuant to this compact.” 4 See ARIZ. REV. STAT. section 32-1668, Nurse Licensure Compact at Article V, Adverse Actions, which provides in relevant part as follows: C. A remote state may take adverse action affecting the multistate licensure privilege to practice within that party state. However, only the home state shall have the power to impose adverse action against the license issued by the home state. D. For purposes of imposing adverse action, the licensing board of the home state shall give the same priority and effect to reported conduct received from a remote state as it would if such conduct had occurred within the home state. In so doing, it shall apply its own state laws to determine appropriate action.

5. The facts, as set forth previously, establish that Respondent committed unprofessional conduct as defined by ARIZ. REV. STAT. section 32-1601(22)(d) 5, 24(i) 6, and 22(j) 7; and A.A.C. R4- 19-403(3) and (31).

6. Given Respondent’s egregious behavior, Respondent has demonstrated that she cannot

be regulated at this time. 7. Because Respondent has committed unprofessional conduct, the Board has authority to revoke her privilege to practice nursing in Arizona under the Nurse Licensure Compact. ARIZ. REV.

STAT. § 32-1663(A), (D); and § 32-1664(O).

8. Considering the facts and circumstances of this matter, it is recommended that Respondent’s privilege to practice nursing in Arizona be revoked.

ORDER In view of the Findings of Fact and Conclusions of Law, the Board issues the following Order: Pursuant to A.R.S. § 32-1664(N), the Board REVOKES Cindy Louise Tregay’s Privilege

to Practice Nursing in Arizona Under the Nurse Licensure Compact.

RIGHT TO PETITION FOR REHEARING OR REVIEW Pursuant to A.R.S. § 41-1092.09, Respondent may file, in writing, a motion for rehearing or review within 30 days after service of this decision with the Arizona State Board of Nursing. The motion for rehearing or review shall be made to the attention of Hearing Department,

Arizona State Board of Nursing, 1740 West Adams Street, Suite 2000, Phoenix AZ 85007, and

must set forth legally sufficient reasons for granting a rehearing. A.A.C. R4-19-608.

ARIZ. REV. STAT. section 32-1601(22)(d) was effective August 2, 2012. For conduct occurring after July 1, 2016, ARIZ. REV. STAT. section 32-1601(24)(d), which was effective July 1, 2016, applies. ARIZ. REV. STAT. section 32-1601(24)(i) was effective July 1, 2016. ARIZ. REV. STAT. section 32-1601(22)(j) was effective August 2, 2012.

For answers to questions regarding a rehearing, contact the Hearing Department at (602) 771-7844. Pursuant to A.R.S. § 41-1092.09(B), if Respondent fails to file a motion for rehearing or review within 30 days after service of this decision, Respondent shall be prohibited from

seeking judicial review of this decision.

This decision is effective upon expiration of the time for filing a request for rehearing or review, or upon denial of such request, whichever is later, as mandated in A.A.C. R4-19-609. Respondent may apply for reinstatement of the said license pursuant to A.A.C. R4-19-404

after a period of five years.

DATED this 18th day of May, 2018. ARIZONA STATE BOARD OF NURSING SEAL

Joey Ridenour, R.N., M.N., F.A.A.N Executive Director

COPIES mailed this 21st day of May, 2018, by First Class Mail and Certified Mail No. [account number redacted] 5685 to:

Cindy Louise Tregay 2973 Eastwood Place Grand Junction, CO 81504

COPIES of the foregoing mailed this 21st day of May, 2018 to: Case Management Office of Administrative Hearings 1740 West Adams Street, Lower Level Phoenix AZ 85007 Elizabeth Campbell Assistant Attorney General Arizona Attorney General’s Office 2005 North Central Avenue Phoenix, Arizona 85004

By: T. Smith