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Federal Register / Vol. 86, No. 125 / Friday, July 2, 2021 / Notices
Registrations should not be revoked as that would be inconsistent with the public interest. The Respondent argued that he has accepted responsibility for his misconduct, and further that this type of conduct can no longer reoccur, as preventive safeguards are now in place.
Referring to the five operative factors under 823f, the Respondent noted that the Respondent has the backing and support of the state nursing boards. Id. at 14. He is knowledgeable and experienced with respect to controlled substances. He has never been accused of any violation, state or federal, of controlled substance statutes.
He has always complied with these statutes. Finally, there is no evidence that any of his other conduct could be a threat to the public safety. Thus, in balancing the five factors under 823f, the retention of his registrations would not be inconsistent with the public interest. Id. at 15.
Governments Case in Chief Before presenting witnesses, the Government offered the sworn and notarized COR history for the Respondent, which was admitted without objection. See GX 1. The Government otherwise presented its case in chief through the testimony of a single witness. The Government presented the testimony of a Diversion Investigator.

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Diversion Investigator DI
The DI has worked for the Drug Enforcement Administration for five and a half years and holds a Bachelors Degree in Accounting and a Masters Degree in Business Administration. Tr.
1617. She has graduated from the 12week Basic Diversion Investigator School. Id. at 17. She has also received advanced diversion investigator training, tactical diversion training, and asset forfeiture training. Id. at 18.
The instant investigation commenced when the DEA learned that the Respondents Tennessee Nursing license had been suspended by the Tennessee Board of Nursing. Id. The DI later learned that the Respondent had been excluded from Medicare, Medicaid and all other federal health care programs by HHS/OIG. The DI obtained a copy of the Respondents Alford plea of guilty to the Virginia felony offense of False Statement to Medicaid, a copy of the sentencing order and a copy of the Respondents exclusion letter by HHS/
OIG. Id. at 1922; GX 3, 4, 5. The DI
verified the Respondents exclusion by accessing the HHS website. Tr. 23; GX
6. The DI confirmed on the HHS website
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the exclusion remained active as of the day of the hearing. Tr. 24.
On cross-examination, the DI
conceded the instant case did not involve the diversion of controlled substance, nor was she aware of any such violations by the Respondent. Id.
at 2425.
Respondents Case in Chief Keith A. Jenkins, N.P.
The Respondent, Keith A. Jenkins, is a licensed Advanced Practice Registered Nurse in Tennessee and Ohio. Id. at 33;
RX 1, 7. He holds DEA registrations in Tennessee and Ohio. Tr. 33, 3940; RX
4. Other than this instant proceeding, the Respondent has never been disciplined or cautioned by the DEA. Tr.
39, 61. The Respondent has never been admonished, reprimanded or disciplined by any of the state nursing boards regarding his prescribing practices. Id. at 61. The Respondent has never been convicted of any offense involving controlled substances. Id.
His educational background includes an Associates Degree in Medical Laboratory Technology from Cumberland College in 1997, an Associates Degree in Nursing in 2002, a Masters Degree in Nursing and Adult Bariatric Nurse Practitioner in 2014, post-Masters Certificate for Family Nurse Practitioner in 2015, and postMasters Certificate for Psychiatric Nurse Practitioner in 2017. Id. at 28.
The Respondent is currently working on his Doctorate, which he expects to complete by January 2020.
The Respondent is an adjunct faculty member in a nurse practitioner program.
Id. at 2829; RX 1. He teaches various courses, including Pharmacology. Tr.
41. He works part-time at two clinics, a bariatric clinic, and a primary care psychiatric clinic. Id. at 29. The Respondent typically prescribed controlled substances, Phentermine and Qsymia. At the psychiatric clinic, controlled substances typically prescribed include benzodiazepines, such as Clonazepam. Other controlled substances prescribed there include Alprazolam, Ritalin, and Adderall. Id. at 30. The Respondent also volunteers at a free clinic and may prescribe, on average, one opioid per month. Id. at 31, 80.
The Respondent reported taking precautions in prescribing controlled substances, including checking the state database for patient drug use pattern or use history. Id. at 32. Additionally, he requires drug screens if warranted by the results of the database inquiry, as well as randomly. To remain current with obligations regarding prescribing
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controlled substances, the Respondent reported that he attends at least two medical conferences per year, a number of continuing education courses, and receives regulatory updates. Id. at 41, 44; RX 9, 10, 11. His adjunct faculty position also requires him to stay current with prescribing protocol.
The Respondents Ohio APRN
includes the authority to prescribe controlled substances. Tr. 34; RX 7. At the time of the hearing, the Respondents authority to prescribe in Ohio was unrestricted. However, the Respondents Tennessee license reflected the disciplinary action of probation, requiring some continuing education as a result of the Virginia state court conviction. Tr. 36; RX 8. The Respondent has completed the required continuing education. Tr. 4243; RX 9, 10, 11. His Tennessee prescribing authority remained unrestricted. Tr. 36, 60. In September 2019, despite disclosing the circumstances surrounding his Virginia conviction, the Respondent obtained South Carolina nursing licensure. Id. at 3738; RX 12.
He retains unrestricted prescribing authority in South Carolina. Tr. 38.
As relates to the Respondents underlying misconduct, the Respondent worked for Actera Home Health from 20082015, as Administrator. Id. at 45.
He did not generally provide any clinical support or prescribe medication. Id.
His employment there ended as a result of an audit by state authorities.
The mother of a child patient of the home health service was found to be abusing medication. Id. at 46. In response to actions by the service, the mother filed a complaint with state regulators against the home health service, resulting in an investigation and audit. Id. Although the investigation revealed no wrongdoing by the service, the audit disclosed a billing discrepancy. A different child patient was signed up for personal care services. Id. at 47, 71, 7374. The service used an Electronic Medical Record system EMR to maintain treatment records and to bill for services. The Respondent explained that the services EMR system could not directly bill Medicaid, so the service used a secondary billing system to bill Medicaid, which auto billed weekly. Id.
at 48, 70. The secondary billing system would automatically pull claims over to it from the EMR. Id. at 48, 7071.
Services for this child were initiated and reported in the EMR system, which automatically initiated the Medicaid billing through the secondary billing system. Id. at 48, 71, 78. The normal checks and balances within the home
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