The Florida-educated nurse failed to recognize her patient was suffering from a rapid, abnormal heartbeat or to quickly call a doctor that June night in 2023.
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Colleagues rushed in after the patient’s alarm sounded and noticed the nurse had botched an IV placement and, later, that she was trying to feed the patient, who was also vomiting and struggling to breathe, Missouri’s nursing board said. The nurse then disappeared and failed to respond to repeated phone calls. Her patient died early the next morning at the St. Louis hospital.
After the death, Missouri issued a “cease and desist” order to the nurse, prohibiting her from working in that state. It determined she was never properly trained as a registered nurse, and that any credentials she possessed from her South Florida nursing school were “based on fraud.”
But Florida, which had issued Tahira Bastien the multi-state license allowing her to practice in Missouri five years ago, took no action against her, even though it clearly knew of the incident: A search of Bastien’s name in Florida’s healthcare licensing database leads to a document about Missouri’s order.
Nearly three years later, Bastien remains licensed to work in hospitals, nursing homes and other health-care facilities in the Sunshine State.
The travails of that 53-year-old nurse from Fort Lauderdale illustrate a little-known legacy of a scandal that has gripped U.S. nursing since emanating from Florida over the last decade. FBI investigators say more than 7,000 people paid for fake nursing diplomas from Florida-based schools. Some used their fraudulent transcripts to obtain nursing licenses allowing them to work in hospitals and clinics here and across the country.
As the Orlando Sentinel reported earlier this year, the rise of the private, for-profit schools at the center of the scandal followed the state’s 2009 decision to loosen regulations on its nursing education, making it easier to launch shoddy schools and harder to shut them down.
Now, the Sentinel has learned, Florida is taking an inconsistent approach to cleaning up its mess, yanking the licenses of 47 nurses who attended schools cited by the FBI but allowing others to keep working, even when it has been alerted to their shortcomings.
And the state has made no public accounting of what it is doing.
It’s an approach that frustrates regulators in other states grappling with the revelation that Florida-credentialed nurses in their own health care facilities may not be competent to provide care. Many are taking a more aggressive approach than Florida in identifying and banning suspect nurses, but the process can be difficult.
One nursing board member in Washington state said during a public meeting there that Florida should be prohibited from issuing nursing licenses valid in other states “until they straighten out their process.”
The Sentinel’s efforts to track Florida’s response to the fake-diploma scandal have been hampered by the repeated refusal of the state board of nursing to answer key questions about the matter, including how many nurses with phony degrees were, or still are, licensed to work here. Instead, the news organization has mined records on the agency’s website and in court files that suggest the number is likely in the hundreds.
Nursing board members and staff referred questions from the Sentinel to the Florida Department of Health. An unnamed agency spokesperson wrote in an emailed statement on April 22 that the nursing board makes licensure decisions “on a case-by-case basis.” The statement provided some statistics on the board’s decisions, but did not explain the board’s overall response to nurses caught up in the diploma mill scheme nor respond to questions about Bastien and other individual nurses.
Among the nurses the Sentinel highlighted in its inquiry to the state was Chipo Gavi, forbidden from working in Maryland with her Florida-issued, multi-state license in 2023 because the nursing board there deemed her “a danger to public health.” A complaint showed she didn’t “know how to care for patients,” and then the state discovered her diploma came from a disgraced Florida school, Carleen Health Institute, according to documents from Maryland’s nursing board.
Gavi, who had worked as a nurse supervisor for less than three months before the board received the complaint about her, told Maryland investigators she paid $16,000 and took some online classes but received no in-person training at that South Florida school. While prosecutors say some people exchanged money for credentials, others, like Gavi, claimed to have completed coursework, though they did not fulfill Florida’s requirements for a nursing degree.
Gavi continues to be eligible to work in Florida, though the state’s licensure database shows Maryland’s action.
In part because the state database does not specify whether or where nurses are working, the Sentinel was not able to confirm the current employment status of Gavi, Bastien or other nurses it investigated. Bastien and Gavi could not be reached for comment.
The FBI and the U.S. Attorney’s Office in Miami announced the first phase of their “Operation Nightingale” investigation in early 2023. They eventually accused more than a dozen Florida nursing schools of selling thousands of fake diplomas.
All of the schools are now closed and criminal charges were filed against more than 40 school operators and associates, most of whom have since pleaded guilty. Some made a lot of money, including Stanton Witherspoon, who pleaded guilty in 2023 to helping sell transcripts from Siena College, a Broward County nursing school, to hundreds of students, raking in $3.5 million.
About 30% of the people who bought fake diplomas passed the national nursing exam, officials said, perhaps because they had some previous medical training.
Some ended up employed in well-known healthcare facilities, including Harbor UCLA Medical Center in Los Angeles, the University of Washington Medical Center in Seattle and the Veterans Health Administration, where at least 61 such nurses got jobs in facilities across the country, the Sentinel found. That left medical institutions and states confronting the question of what to do about them.
In public meetings since the scandal broke, Florida nursing board members and staff describe an approach to weeding out already-licensed nurses with fake degrees that appears neither uniform nor thorough.
“I don’t believe that the board is going through and looking up everybody’s education and opening cases on them, but as they become aware of them, then they do,” said Deborah Loucks, the board’s senior assistant attorney general during an April 2025 meeting.
Since Operation Nightingale was revealed, Florida’s nursing board has refused to grant new licenses to would-be nurses who received degrees from any of the discredited schools, with members saying they can’t allow people who didn’t receive the proper state-required training to see patients.
“We’re charged with the protection of the public,” then-board chair Deborah Becker told a roomful of applicants during a meeting last August.
That’s hard to square with the fate of nurses like Bastien, who remains licensed in Florida after Missouri said her mistakes led to the death of a patient at one of St. Louis’ largest hospitals. Bastien obtained a Florida registered nursing license in January 2021, shortly after getting a degree from Carleen, which was implicated in the Operation Nightingale scandal.
By the time Bastien started work at Mercy Hospital South in St. Louis about two years later, she had already been terminated from Banner–University Medical Center in Phoenix after that large teaching hospital affiliated with the University of Arizona accused her of making two medication errors, according to a letter from the executive director of Missouri’s nursing board.
Then, at Mercy, she abandoned a patient whose condition was rapidly deteriorating.
“No one could find you during this time, you were not answering your phone,” reads the cease-and-desist order from the Missouri State Board of Nursing barring her from working anywhere in the state. “Two other nurses stabilized the patient….Another rapid response was called on the patient and you still did not respond … The patient was pronounced dead at 0338.”
The Missouri nursing board accused Bastien of a host of violations including “incompetence and gross negligence,” “fraud” and “conduct that constitutes a serious danger to the health, safety or welfare of a patient or the public.”
How the process worked – until it didn’t
Becoming a registered nurse in the United States is a two-step process: Students must complete a nursing board-approved degree program and then obtain the board’s approval to take the national Nurse Council Licensure Exam, or NCLEX. It’s a multiple choice, pass-or-fail test that takes up to five hours to complete.
Educators from highly regarded nursing schools say passing NCLEX, typically on the first try, is a critical measure of a nurse’s knowledge base. But hands-on, clinical practice is a vital part of their programs because it allows nurses-in-training to practice skills like inserting IVs or catheters.
“I can read about it, but that doesn’t mean I’m capable of doing it,” said Charrita Ernewein, an assistant professor of nursing at the University of Tampa, a private, accredited school with a high-performing nursing program.
That university requires its students to complete at least 600 hours in hospitals or clinics before they graduate.
A graduate of one of the Operation Nightingale schools, on the other hand, told Maryland investigators — who revoked his license — that his clinical training in Florida “consisted of video simulations using inanimate mannequins, and I did not perform any patient care during my RN clinical training,” records show.
Florida requires nursing schools to provide such training and specifies that clinical work should make up a significant part of the curriculum, either 40% or 50%, depending on the type of degree.
The 2009 Florida law that aimed to boost the number of nurses in the state limited the nursing board’s oversight, opening the door for potential fraud, some Florida nursing board members have said in public meetings.
The law eased regulations on nursing schools and made it easier for new ones to open. Within five years, the number of Florida nursing programs more than doubled. But many of the roughly 250 newcomers were for-profit institutions that churned out students whose pricey degrees left them ill-prepared to enter the field.
Most of the approximately two dozen schools accused of selling fake diplomas obtained permission to open shortly after the law passed. They appear to have operated legitimately for several years, though their graduates often struggled to pass the national nursing exam. They later turned to fraud, prosecutors said, selling diplomas to students who did not complete state-required nursing education programs.
“If we could have been checking on these schools, I feel like we could have prevented some of this, possibly,” said Becker, then the board’s chair, during a 2024 meeting.
Some schools apparently sold diplomas for years before the allegations became public. A 2019 tip to the FBI’s Baltimore office about someone selling nursing diplomas started the investigation into one of the largest schools involved in the scheme, Palm Beach School of Nursing, special agent Tom Clark testified during the 2023 trial of three people accused of recruiting students, fabricating grades and printing fake transcripts for the school.
In early 2021, as part of that investigation, an undercover agent using the alias “Adeyemi Afolabi” walked into a storefront office in Fort Lauderdale for a business run by a friend of Palm Beach School of Nursing’s registrar. There, he told an employee he wanted to purchase a nursing degree. In less than two weeks, the agent was able to obtain a diploma and transcripts that stated he went to school for two years and graduated with an associate’s degree in 2018. He paid $16,000 for the credentials.
The agent, who was born in Miami but has Nigerian ancestry, said he used a Nigerian name for the assignment and confirmed in court he was chosen for the role because he fit “the profile” of people purchasing fake nursing degrees. Many of the people who obtained degrees from Operation Nightingale schools are immigrants who were nurses or had other health care experience in their home countries.
The FBI reviewed the files of roughly 4,500 students who supposedly attended the Palm Beach school and three other schools implicated in the scheme, Clark said, and determined only about 60 were legitimate students.
The FBI has called those who bought diplomas “co-conspirators,” though some students have insisted they took some real classes, often online, and did not know their Florida nursing schools did not meet state standards.
Florida’s inconsistent approach
Florida’s nursing board, though it did not respond to questions about how many workers with phony diplomas are licensed here, should know which of its nurses may not have legitimate credentials.
The Interstate Commission of Nurse Licensure Compact, a group of states which share some licensing authority and to which Florida belongs, has flagged people whose names the FBI has identified as part of Operation Nightingale. A Florida nursing board staff member also testified in federal court in Fort Lauderdale that the board had a list of hundreds of licensed nurses with degrees from the targeted schools.
And typically when other states take action against nurses who also hold Florida licenses, records of those decisions are reported to a national database and then show up in Florida’s public licensing database run by the Florida Department of Health.
But Florida hasn’t always acted on that information.
The state’s board has revoked the licenses of at least 47 registered nurses with fake credentials, often after learning that another state took action, according to state health department records. More than 75 other nurses with Operation Nightingale school diplomas relinquished their Florida credentials, the health department said in its April 22 email in response to the Sentinel’s questions. In many of those cases, Florida threatened revocation after it was told those nurses had been forbidden from working in other states, records show.
But the board has allowed dozens of others accused of buying phony diplomas and banned from working in other states to keep their Florida licenses, the records show.
The state has also prevented some Florida nurses with degrees from those schools from getting advanced credentials or a higher-level license that allows them to work in other states — but cleared them to keep working as regular RNs here.
In its unsigned statement, the health department offered a brief explanation of how nurses with diplomas from the Operation Nightingale schools might still be working. “Individuals may be permitted to obtain or retain licensure only if they demonstrate completion of additional Board-approved nursing education,” it read.
But the Sentinel’s review of more than a dozen nursing board meetings where license issues were considered, as well as other records, found nearly three dozen still-licensed Florida nurses with Operation Nightingale school diplomas and no clear evidence they redid their education elsewhere.
Since the diploma mill allegations became public in January 2023, other states have scrambled to ensure people who bought nursing school diplomas, and therefore lacked proper training, weren’t working in their health care facilities.
Delaware, for instance, revoked the licenses of more than 75 nurses whose diplomas came from the “Operation Nightingale” schools — and posted a link to a document listing their names on its nursing board’s home page.
By March 2023, New Jersey announced it had found 46 nurses with fake credentials and was working with other agencies to “detect, investigate, and resolve these allegations of diploma and credential fraud.”
Texas put the same message on its nursing board website and also urged the public to lodge complaints against nurses who may have purchased their credentials.
Washington state officials said they have rescinded the licenses or denied applications from more than 80 nurses who attended “suspect Florida-based schools.”
“It’s incumbent on everybody in all these different areas of nurse licensure to remain vigilant,” said Catherine Woodward, Washington Board of Nursing’s director of discipline, at a September meeting.
Florida learned the FBI was investigating several schools within its jurisdiction in August 2022, according to the statement from the health department. However, the Sentinel found that the nursing board issued licenses months later to nurses who apparently obtained fraudulent degrees.
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Washington and some other states, however, started rejecting licensure applicants or revoking nurses with diplomas from those schools even before the investigation was made public.
Washington, in fact, warned would-be nurses in January 2022 — a year before officials announced Operation Nightingale at a Miami press conference — that graduates of certain “Florida nursing programs” did not have the nursing education Washington required and that its board would not grant them licenses.
Dawn Morrell, a Washington nursing board member, said during a public meeting last year that Florida should not be able to issue the higher-level multi-state nursing licenses that allow people to work in other states in the national compact “until they straighten out their process.” Nurses who have obtained such licenses, which many Operation Nightingale graduates did in Florida before the scandal broke, are far more difficult for other states to police. Morrell noted that Florida was responsible for the lion’s share of people with fraudulent degrees who went on to obtain nursing licenses.
In addition to revoking licenses from already-working nurses, the Florida board can stop recent graduates from taking the NCLEX, if members decide their school has failed to meet the state’s nursing education requirements. Most nursing school graduates are routinely approved, but over the past three years, the board has stopped hundreds of people with diplomas from Operation Nightingale schools from sitting for the exam.
One nurse, who was living in the Washington, D.C. area while attending classes online at one of the Florida schools, told investigators she was advised to apply for a multi-state credential in Florida. She told the Maryland board of nursing she used a relative’s former Miami address on her application.
It’s not clear why that Florida license was recommended, but that credential allowed her to work in Maryland as a home health nurse — until that state learned of her credentials and forbade her from practicing there in 2024. She’s still licensed to work in Florida.
Florida is one of more than 40 states in the national nursing compact.
“I personally have been disappointed that the Interstate Commission of Nurse Licensure Compact has not taken action against Florida,” Morrell wrote in the email to the Sentinel.
The compact could take action but is not considering such a move against Florida right now, said the group’s chair, Sherry Richardson, in an emailed statement.
“The Florida Board of Nursing is currently working on cases involving potential license revocation or other actions on an individual’s license using the state’s required processes, including appropriate due process steps,” Richardson wrote.
Just a handful of states are not part of the compact and Operation Nightingale may serve as some vindication for the holdouts. The Alaska Nurses Association, for instance, published a statement urging its state not to join.
If it joined the compact, Alaska and its nursing board “would have no way of knowing if any fake nurses were working in their state,” it said. “Alaska has high standards and local enforcement for a reason: to protect the health and safety of Alaskan patients.”
The problems with Carleen
Florida-based Carleen Health Institute, which issued Bastien, the disgraced Missouri nurse, her diploma, was a key player in Operation Nightingale, prosecutors say. The school is a case study for how the state’s decisions permitted such institutions to open and expand and, even after federal investigators swooped in, allowed “graduates” with their credentials to become and in some cases remain nurses.
The now-closed school was founded by Carleen Noreus, who is charged with conspiracy to commit wire fraud, conspiracy to commit money laundering, wire fraud and money laundering. She is one of the few operators charged in the scheme to plead not guilty and is scheduled to go to trial in federal court in June. Her lawyer did not respond to requests for comment about the case.
Bastien is listed in court records as a potential witness against her.
The school once had campuses in Plantation and West Palm Beach, with the South Florida institution operating with a stamp of approval by Florida’s nursing board. Carleen had agreements with two hospitals and a rehabilitation center in The Bahamas where students could do clinical training, according to documents it submitted to the nursing board in 2013.
Carleen graduates, however, struggled on the NCLEX, and the state nursing board voted in February 2020 to close its registered nursing programs because of those low scores.
But Carleen continued to issue diplomas to potential nurses for some time afterward, with more than 200 people whose transcripts said they graduated in 2021 and 2022 taking and passing the NCLEX, according to data posted to the nursing board’s website.
Amanuel Tecleab, who obtained a Carleen diploma in March 2020, was licensed in Florida, though he never worked nor lived here.
Tecleab told Florida board members during a meeting in June 2025 he was living in Seattle the entire time he attended Carleen, though he flew in for classes a few days each month at the school’s West Palm Beach campus. When the pandemic hit, the school canceled his clinicals, he said, and he never tended to patients before graduating.
Yet Tecleab worked as an RN at the University of Washington’s medical center for two years, until just after Operation Nightingale was made public. Around that same time, Washington’s nursing board rescinded his license.
He remained eligible to work in Florida for more than two years, however, until the nursing board here took away his license from this state, with board members saying their action was prompted by Washington’s revocation.
Reached by phone, Tecleab said he worked as a practical nurse for about a decade before enrolling at Carleen and still wants to work as an RN. He is attending classes at a Seattle-area school with the hope of earning a nursing degree there.
Some of Tecleab’s former Carleen classmates are still working as registered nurses, and he thinks he should be, too, because he believed he fulfilled Florida’s requirements.
“We are the victims,” Tecleab said. “It was not fair what they did.”
McIntosh Bazile, who has a Carleen diploma, did not take any classes and received “no actual instruction or clinical training,” according to documents from New Hampshire’s nursing board.
After obtaining his Carleen diploma, Bazile had to take the NCLEX, which 86% of people pass on the first try, five times before finally passing.
The grades on his Carleen transcript were “made up by employees” at the school, according to a 2025 letter he signed relinquishing his license in that northeastern state.
But Florida has taken no action against Bazile, who is still licensed here. He provided New Hampshire no evidence he’d taken classes at a legitimate school and his signed letter to that state’s nursing board said, “I do not meet the minimum requirements for RN licensure.”
Florida nursing board members also gave Yaily Steele, a South Florida-based registered nurse, the green light to continue practicing in 2024, when she sought a multi-state “upgrade” to her credential that would allow her to work in other states. The board denied the request because her diploma was issued by Carleen, but Loucks assured Steele she could keep working here as an RN.
Until last summer, Steele was working at HSA Palmetto General Hospital, a 368-bed acute care facility in Miami-Dade County, where her duties included “providing direct patient care and administering prescribed medications,” according to a lawsuit about medical leave she filed against her former employer. The state’s licensure database does not indicate if she is currently working.
Two years after Steele’s first request for a multi-state upgrade was denied, she pursued the enhanced credential again, after completing a legitimate nursing degree program. Board members approved her application in April.
Minutes after board members in that 2024 meeting told Steele that she couldn’t practice outside Florida, they told another nurse with a Carleen diploma he could keep his multi-state license — the exact same credential that Steele sought.
Adrian Gutierrez Llanes has a Carleen diploma and later earned a master’s degree from another school. He wanted to become a nurse practitioner, but board members told him they would not give him that advanced credential unless he redid his basic nursing education at a legitimate school.
Still, he was allowed to continue working as an RN here and elsewhere.
Reached by a Sentinel reporter, Bazile, Steele and Gutierrez Llanes declined to comment.
Though board members allowed those three to keep their licenses, they told Funmi Obadun, a registered nurse with a transcript from Med-Life Institute, another Florida school implicated in the scheme, she could no longer work here.
“You now possess a license that was earned with fake transcripts,” board member Christine Mueller told her during a meeting in August 2023.
Obadun, who failed out of nursing school in New York before enrolling at Med-Life Institute, needed to take the NCLEX four times before finally passing it. She told board members that was a testament to her skills.
“Anybody out there cannot just go and pass and make that exam,” Obadun said. “You have to really know what you are doing.”
But others say cases like hers show why just passing the exam is not sufficient — and why nursing boards look at high NCLEX passage rates for first-time test takers as a sign of a nursing school’s quality.
“People who take the exam multiple times, might figure out how to answer the questions but they might not have knowledge,” said Ernewein, the University of Tampa faculty member.
The Florida board seemed to agree, voting to revoke Obadun’ s license.
“The fact that you haven’t had any errors or mistakes practicing as a nurse,” Loucks said, “is just good fortune for all of your patients.”
Obadun couldn’t be reached for comment.
Fixing the scandal?
Allowing people who haven’t been properly trained to work as nurses creates a potential threat to public safety, and that’s the worst fallout from the Operation Nightingale scandal, some in the industry say.
Others are just frustrated that the board’s response to nurses with questionable degrees seems contradictory, making it hard for them to understand its decisions.
Last year, for example, a woman with credentials from an Operation Nightingale school who was losing her license in Texas asked if she could be a licensed practical nurse in Florida.
When the board said no, she noted that classmates from the same Broward County school were licensed to work here.
Loucks, the attorney, seemed to admit there was not a consistent standard.
“So if someone went to the same school that you did, at the same time that you did, supposedly did the same thing that you did and they are working with a license, God bless them,” she said.
Maitland-based attorney Nicole Mayer said thinks the board doesn’t have a consistent standard because it doesn’t have staff to investigate all the potential cases.
Taking away the licenses of hundreds of nurses would be a huge undertaking for the board, which must prove the licensees did something wrong, said Mayer, who frequently represents nurses facing possible action against their licenses for other reasons.
“I think their position is they would want to revoke everybody, but they know it’s not feasible,” Mayer said.
But even if the nursing board could revoke the license of every nurse who obtained a fraudulent degree, Mayer said she doesn’t necessarily think it should.
“I understand the protection of the public is important, but at the same time, these are the fundamental rights of people, their careers on the lines,” said Mayer, who has not represented any clients with diplomas from Operation Nightingale schools.
Mayer said she thinks some of the Operation Nightingale students probably knew they were purchasing their diplomas, but others likely didn’t realize they weren’t fulfilling the state’s requirements because they completed some coursework.
The former school owners who entered guilty pleas and signed affidavits listing the names of people who had received phony diplomas had an incentive to cough up names, she said, because they were required to help prosecutors as a condition of their plea agreements.
But an executive for a national at-home nursing service that hired nine people with degrees from those schools said his company would not have employed them if it had known they may have purchased their diplomas. His company serves medically complex children and adults, he testified in a federal case against one of the Operation Nightingale school administrators.
“We need to ensure that that patient is being seen by a qualified nurse,” said Shannon Drake, then the chief legal officer for Aveanna Healthcare, according to a transcript of the trial. “So if their credentials are not real, it could create a potential safety issue for the patient.”
Nancy Gasper, the dean of Seminole State College’s nursing program, agreed.
Seminole State has among the best nursing exam passage rates in the state and requires its students to complete more than 500 clinical hours before they graduate.
The Operation Nightingale scheme created a “public safety issue,” Gasper said, and a scandal she hopes won’t permanently mar one of society’s most trusted professions.
“The public places a great deal of trust in their nurses and this puts a tarnish on their trust,” Gasper said. “This is a scary thing to have happened. It dampens the public’s sense of safety and it punishes programs like ours by painting ours with the same light.”
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