Operation Nightingale: the fake nursing diploma scheme, and what happened to the nurses who bought one

What was Operation Nightingale?

Operation Nightingale is the name the Justice Department, the FBI and the Office of Inspector General of the Department of Health and Human Services (HHS-OIG) gave to a coordinated case against nursing diploma fraud in South Florida. On 25 January 2023, the US Attorney for the Southern District of Florida, Markenzy Lapointe, announced charges against 25 people. The DOJ press release described "an illegal licensing and employment shortcut for aspiring nurses." HHS-OIG said search warrants were executed the same day in Delaware, New York, New Jersey, Texas and Florida.

The three schools at the centre of the first phase were Siena College in Broward County, Palm Beach School of Nursing in Palm Beach County, and Sacred Heart International Institute in Broward County. All three were licensed in Florida and authorised to issue nursing diplomas. All three are now closed. They are unrelated to Siena College in New York and to Sacred Heart University in Connecticut, a confusion the AP noted at the time.

The FBI's acting special agent in charge in Miami put the scale plainly: "over 7,600 people around the country with fraudulent nursing credentials who are potentially in critical health care roles treating patients."

How did the fake nursing diploma scheme work?

Every nursing licence in the United States rests on two things: graduating from a board-approved pre-licensure program, and passing the NCLEX. The scheme attacked the first one. According to the charging documents, recruiters found people who wanted to work as registered nurses (RNs) or licensed practical or vocational nurses (LPN/VNs). The recruiters arranged with school owners and staff to produce diplomas and transcripts showing courses and clinical hours that never happened.

The DOJ's 25 January 2023 release states it in one line, repeated for each school: "In fact, the aspiring nurses never completed the necessary courses and clinicals."

With a diploma and transcript in hand, a buyer could apply to a state board, sit the national exam and, after passing, get licensed and hired. The AP reported that many buyers took the NCLEX in New York, "where they can sit it multiple times." Under the Nurse Licensure Compact, which DOJ says 43 states have adopted, a multistate licence obtained this way let the holder work in other compact states without a new licence.

The exam itself was not the weak point. Buyers still had to pass the NCLEX. The AP noted that some buyers were experienced LPNs trying to become RNs, and some had been health care workers in other countries. That helps explain how about 2,400 of them passed a hard exam without the training on paper. It does not make the paper true.

This matters for anyone thinking about a shortcut today. A licence is a bundle of claims: that you trained in a real program, did the clinical hours and passed the exam. Faking one link breaks the whole bundle, even if you passed the exam honestly.

The money machine: who paid what

Prosecutors said buyers paid an average of $15,000 each for a diploma and transcript, according to the AP's report of 1 March 2023. Multiply that by 7,600 and you are past $100 million in Phase I alone.

The money was split between the recruiters, who found buyers, and the schools, which issued the documents. The court record shows what some of it came to. In its September 2023 release, DOJ said the manager of Siena College, Eunide Sanon, pleaded guilty to conspiracy to commit wire fraud and was sentenced on 23 May 2023 to 27 months in prison and ordered to forfeit $1,287,633. The owner of Palm Beach School of Nursing, Johanah Napoleon, pleaded guilty to wire fraud and conspiracy to commit wire fraud and was sentenced on 18 July 2023 to 21 months and ordered to forfeit $3.2 million. Two people tied to a related operation, PowerfulU Healthcare Services, were each sentenced in August 2022 to 27 months and ordered to forfeit $3,309,000.

The buyer got none of that back. Forfeiture goes to the government. A person whose licence is revoked has paid $15,000, spent months on applications and exam fees, and is left with a document a federal court has called fraudulent.

Who was behind it, according to the court record

The public record names the school owners, managers and recruiters who were charged. It does not name buyers, and neither do we.

• Siena College. Its manager, Eunide Sanon, was charged by information and pleaded guilty on 14 March 2023. Three recruiters from New Jersey and New York pleaded guilty in August 2023.
• Palm Beach School of Nursing. Owner Johanah Napoleon pleaded guilty on 21 November 2022, before the operation was announced. Five more defendants tied to the school pleaded guilty on 10 May 2023.
• Sacred Heart International Institute. Owner Charles Etienne pleaded guilty on 11 April 2023 to conspiracy to commit wire fraud. A recruiter was found guilty by a jury on 28 September 2023, and five more pleaded guilty that September.

By September 2023, DOJ reported 20 guilty pleas or convictions. Its later releases put Phase I at 30 defendants "charged and convicted by plea or at trial in 2023."

The second phase widened the net. On 15 September 2025, DOJ announced charges against 12 more defendants, including owners and staff of schools such as Techni-Pro Institute, Sigma Institute of Health Careers, Med-Life Institute, Azure College and Carleen Home Health School. DOJ said these schemes "generated approximately 7,300 fake diplomas." Several of those defendants are only charged, and DOJ's own release reminds readers that "an indictment is merely an accusation."

The largest Phase II case so far ended on 18 June 2026. DOJ reported that Carleen Noreus, owner of the two Carleen Home Health School campuses, pleaded guilty to conspiracy to commit wire fraud and conspiracy to commit money laundering after a two-week trial. Evidence at trial showed she was responsible for 2,956 fraudulent diplomas between April 2018 and October 2025, and that about 2,274 of the people who got them passed their board exams. The US Attorney said: "Nursing licenses must be earned through education, training, and demonstrated competence, not purchased through fraud."

What happened to the nurses who bought a diploma?

The criminal cases targeted the sellers. The licences belonged to the buyers, and state boards came for those.

The National Council of State Boards of Nursing (NCSBN), which owns the NCLEX, said in its statement of 26 January 2023 that boards in affected states were "taking appropriate action, in accordance with their state laws and due process, that includes loss of license."

Within five weeks, the AP counted these actions:

• New York told 903 nurses to surrender their licences or prove they were properly educated.
• Delaware annulled 26 licences. Its board director said, "These people who went to these Florida schools did not complete the curriculum."
• Washington's nursing commission rescinded 17 RN licences and denied four applications.
• Texas filed administrative charges against 23 nurses.
• Georgia asked 22 nurses to voluntarily surrender their licences.
• The Department of Veterans Affairs removed 89 nurses from patient care. It said it had found no instance of patient harm.

More boards followed. The Texas Board of Nursing says it is "seeking revocation of any licensure obtained through fraudulent means." The North Carolina Board of Nursing published a list of 24 Florida programs named in the investigation and warned that submitting false information to get a licence breaks the state's Nursing Practice Act. Maryland's board posts every order on a public page: summary suspensions, permanent voluntary surrenders, permanent revocations and denials of new applications.

The damage does not stay in one state. The National Practitioner Data Bank told boards in its Operation Nightingale guidance that revocations, suspensions and even voluntary surrenders made under investigation must be reported to the federal databank. It asked boards to use the code for "Fraud, Deceit or Material Omission in Obtaining License or Credentials" and to write "Operation Nightingale" in the report. Hospitals and other employers query that databank when they hire.

So the full bill for a bought diploma looks like this: the $15,000, the lost job, a federal databank entry that names the fraud, and years before any board will consider an application again.

The nurses who say they did the work

Not everyone with a diploma from these schools bought one. Some students attended, did their clinical hours and graduated from schools that were licensed at the time. They have argued, fairly, that they are being punished for their school's crimes.

New York's Office of the Professions said when it wrote to the 903 nurses that it expected some "did, in fact, attend required hours and clinicals and are properly licensed", and asked them to have a qualified nursing program verify their training. An Atlanta lawyer for several nurses told the AP: "There are obviously people who bought transcripts who are fraudulent and should not be practicing nursing under any circumstances. But there are also people who went to those schools legitimately and did nothing wrong."

In February 2024, NY1 reported that a group of nurses had sued New York State to get their licences back, saying they were denied due process. Their lawyer said he had filed class logs, travel expenses and clinical hour records, and that "You can't surrender a license in New York by simply putting it in the mail." The state education department declined to comment on the pending case.

The due process question is real, and it cuts both ways. A nurse with records can usually prove attendance. A nurse without them is in a hard spot even if they did attend, because the school that should vouch for them is closed and its owner has admitted fraud. If you ever pick a nursing program, the lesson is to keep your own records of every class and clinical shift.

Can a nurse come back after Operation Nightingale?

Sometimes, the long way. In December 2025, Iowa Capital Dispatch reported on an LPN who had been licensed in Iowa in 2020 on credentials the board later found fraudulent, including from a school investigated in Operation Nightingale. She surrendered her licence in July 2023. She then enrolled in a legitimate program, earned a verified degree from Mercy College of Health Sciences, and applied again in May 2025.

The Iowa Board of Nursing awarded her an RN licence with two years of probation and monitoring. It applauded her "for returning to school and obtaining a legitimate degree." It also said she "was not forthcoming about her previous education and failed to answer basic questions about the two schools."

That is the only road back that the record shows: do the real program, pass the exam again, disclose everything, and accept probation. It took her more than two years after the surrender, on top of the time already lost. The honest route at the start would have been shorter.

Red flags: how to tell a nursing program is real

The schools in this case were licensed. A licence alone did not protect anyone. These checks would have exposed the scheme to any buyer who looked:

1. No clinical rotations. Florida requires practical nursing, associate degree and diploma nursing programs to devote at least 50 percent of the curriculum to hands-on clinical training, DOJ noted in September 2025. A program that skips clinicals, or lets you buy them, is selling paper.
2. A recruiter, not an admissions office. Every Phase I scheme ran through recruiters paid to find buyers. Real programs have admissions staff and published entry requirements.
3. Speed that cannot be true. An RN diploma in weeks, from a school in another state, while you keep a full-time job, describes a document. It does not describe an education.
4. Cash for a transcript. If the payment buys the diploma and transcript rather than tuition for classes you attend, you are the buyer in a fraud case.
5. The school is on a board's list. The North Carolina Board of Nursing publishes the Florida programs named by the FBI. Check any school you are offered against it and against your own state board.
6. You keep no records. Keep your attendance logs, clinical sign-offs and receipts. They are what saved some nurses in New York.

If a recruiter offers you any of this, the FBI asked people with information about falsified medical degrees to call its hotline on (410) 277-6999, listed in DOJ's September 2025 release.

The honest route to the NCLEX

The buyers in this case spent $15,000 and passed the NCLEX anyway, which tells you something: the exam was passable for them. What they skipped was the training. You cannot skip it either, but you can make the exam part efficient.

The NCLEX tests whether you can make safe judgements across the whole of nursing care. It rewards steady, timed practice on that format more than cramming. Read the NCLEX-RN guide for the format and how the exam is scored, and the NCLEX-PN guide if you are on the practical nursing track. Then put your exam date into the free study plan tool on this page. It works back from that date to the hours a week you have and tells you whether you will be ready.

If English is your second language or you trained abroad, our piece on why internationally educated nurses fail the NCLEX more often covers the specific gaps. If you are an LPN looking for the legitimate bridge to RN, the CNA to LPN to RN ladder lays out each rung. And once you pass, passed the NCLEX, now what? covers the licence lookup, multistate eligibility and the first job.

If you want structure on top of the free guides, ExamTips Pro for the NCLEX-RN adds a week by week plan, the topic areas that carry the most marks and practice questions. That helps with the exam. Nothing helps a licence built on a program you did not attend.