Common Reasons Licensing Boards Open Investigations

Licensing boards exist to protect the public, and they open investigations when they receive information suggesting that a licensed professional may have violated the standards of their profession. Understanding the most common triggers for investigations can help you both prevent problems and respond effectively if you face one.

Key Takeaways

• Investigations are most commonly triggered by complaints from patients, clients, employers, or colleagues
• Self-reporting requirements (criminal arrests, malpractice settlements) also trigger investigations
• Documentation deficiencies are among the most common findings
• Many investigations arise from misunderstandings or communication failures
• Understanding common triggers helps you maintain best practices

The Most Common Triggers

1. Patient or Client Complaints

The most frequent source of licensing board investigations. Common complaint themes include:

• Perceived negligence or substandard care
• Communication failures or rudeness
• Billing disputes
• Dissatisfaction with outcomes
• Boundary concerns
• Perceived discrimination

2. Employer Reports

Many employers are required or choose to report concerns to licensing boards:

• Termination for cause
• Positive drug tests
• Incident reports involving patient safety
• Policy violations
• Performance concerns

3. Self-Reporting Requirements

Most licensing boards require professionals to self-report certain events:

• Criminal arrests or convictions (including DUI)
• Malpractice settlements or judgments
• Discipline by other licensing boards
• Substance use disorders
• Certain health conditions affecting ability to practice

Failure to self-report can itself become a violation.

4. Colleague or Peer Reports

Other professionals may report concerns about a colleague:

• Observed impairment
• Unsafe practices
• Ethical violations
• In healthcare, many states require mandatory reporting of suspected incompetence or impairment

5. Criminal Charges or Convictions

Criminal activity, even outside of professional practice, can trigger an investigation:

• DUI or DWI
• Drug charges
• Fraud
• Assault
• Sexual offenses
• Theft

6. Insurance or Third-Party Reports

Information from insurance companies, pharmacies, or other entities:

• Unusual prescribing patterns (for healthcare providers)
• Insurance fraud allegations
• Prescription monitoring program alerts
• Malpractice claims

7. Documentation and Recordkeeping Issues

Poor documentation is one of the most common findings in investigations:

• Incomplete records
• Late or missing documentation
• Failure to maintain required records
• Inadequate informed consent documentation

8. Scope of Practice Violations

Practicing outside the boundaries of your license:

• Performing procedures not authorized by your license
• Practicing without required supervision
• Exceeding the scope of your training

9. Continuing Education Non-Compliance

Failing to complete required continuing education:

• Falsifying CE records
• Failing to complete required hours
• Not meeting specialty-specific requirements

10. Social Media and Online Conduct

An increasingly common trigger:

• Posting patient or client information (even without names, if identifiable)
• Unprofessional online behavior
• Promoting unproven treatments or services
• Violating privacy standards

Prevention Best Practices

• Maintain meticulous documentation: Your records are your first line of defense
• Communicate clearly: Many complaints arise from communication failures
• Know your self-reporting obligations: Understand what your board requires you to report
• Stay within your scope of practice: Know and respect the boundaries of your license
• Complete continuing education on time: Do not let CE requirements lapse
• Be thoughtful on social media: Treat online platforms as professional spaces
• Seek help for personal issues: Monitoring programs for substance use or mental health are designed to be supportive

Frequently Asked Questions

Can a patient or client file a complaint for any reason? Yes. Anyone can file a complaint. The board determines whether the complaint warrants investigation.

Am I required to self-report a DUI? In most states, yes. Check your state's specific requirements.

Can an employer file a complaint anonymously? Policies vary, but many boards accept anonymous complaints.

What percentage of complaints result in discipline? This varies widely by state and profession, but a significant percentage of complaints are dismissed without formal discipline.

Can I be investigated without being notified? In some states, initial review may occur before you are notified. However, if a formal investigation is opened, you will typically be notified and given an opportunity to respond.

How BoardWise Can Help

BoardWise helps professionals respond effectively when facing a licensing board investigation. Our platform guides you through organizing your documentation and preparing a thorough response.

*BoardWise provides educational information and drafting assistance for license defense. We are not a law firm and do not provide legal advice.*