State Licensing Investigations

Who can file a complaint with the Michigan Department of Licensing and Regulatory Affairs (LARA)?

In Michigan, anyone can file a complaint with LARA against a nurse, physician, psychologist, social worker, or other medical or mental healthcare providers.

How does LARA respond to a filed complaint?

LARA will usually assign an investigator to investigate the allegations documented in the complaint. Normally the investigator will obtain relevant documents and contact the professional who is the subject of the complaint for an interview. In some instances, the investigator will initiate the contact by telephone and might begin to ask questions during the initial conversation. If LARA determines based on the documentation and interviews that a violation has not occurred, then LARA will end the investigation and close the file.  If the file is closed, then the investigation (and the information and documents generated as a result) will remain confidential and not accessible to the general public.

By contrast, if LARA believes there might have been a violation of law or the standard of care, then LARA will often proceed to retain an expert witness to review the information and documents generated by the investigation. LARA may consider the expert’s opinion in deciding whether or not to proceed with an administrative complaint.  An administrative complaint is a formal complaint against a healthcare provider (or other licensed professional) that is filed by LARA as the Petitioner when LARA believes there has been a violation of law or the applicable standard of care.

Why should I retain an attorney to assist with a LARA licensing investigation?

If you are contacted by a LARA investigator about a complaint, then you should take that very seriously and consult with an attorney who has expertise in licensing cases before you talk with the investigator.  If a healthcare provider or other professional asks the LARA investigator for additional time to contact an attorney, then the LARA investigator will normally accommodate such a request.  Often healthcare providers will underestimate the level of risk associated with talking to the investigator without legal representation.  Sometimes, Healthcare providers will meet with the investigator without legal counsel, hoping that their cooperative efforts will save time or help remove suspicion.  However, what often happens is that healthcare providers volunteer information, some of which may be used against them later in a formal administrative complaint.

Retaining an experienced licensing defense attorney early (before talking with the investigator) helps healthcare providers obtain the best possible outcome.  When a written complaint is filed with LARA, the complainant’s identity is usually kept confidential and a copy is not provided to the healthcare provider being investigated. Often LARA investigators will share more details with legal counsel than they will with the individual being investigated regarding the content of the allegations.  It is usually in the healthcare provider’s best interest to obtain as much detail as possible regarding the content of the written complaint because such detail can often help the healthcare provider to develop a stronger defense strategy and plan.

LARA investigators will often provide experienced legal counsel with the option of responding to the investigator’s questions in writing, in place of having a formal meeting (or conference call); by contrast, LARA investigators usually will not offer such an option or opportunity to an individual without legal counsel.  Frequently it is a better option for the healthcare provider being investigated, to have their experienced legal counsel respond to the investigator’s questions in writing, versus having a formal meeting or conference call.

There are several reasons why a healthcare provider may (or may not) want to provide information in writing, and/or copies of relevant documentation, to the LARA investigator, and such reasons vary depending on the particular facts and circumstances of each case.  Experienced legal counsel can help to develop the healthcare provider’s best strategy and plan regarding whether information might be provided to the LARA investigator in written form, versus orally in a discussion or meeting with the investigator.

In addition, experienced legal counsel can help to act as a shield of protection from a LARA investigator who might wish to aggressively explore facts or issues that could lead to potential professional liability exposure.  There are various ways that such protection can be provided, depending on the facts and issues involved in a particular LARA investigation.

Further, having experienced legal counsel provides the healthcare provider with an advocate who can be on alert to identify and help protect against potentially dangerous situations that often arise in meetings and conferences with LARA investigators.  LARA investigators often do not have a medical background. The investigator may not understand the complexities of how the healthcare system is arranged or the way that healthcare is typically delivered in the particular setting in question.  Experienced licensing defense counsel will help to identify situations in which the investigator might not be correctly understanding the relevant facts or issues and will intervene to provide clarification and advocacy as necessary to defend the healthcare provider

Letters of support from colleagues and retained experts can be very helpful to the healthcare provider being investigated.  Experienced legal counsel can provide drafting assistance and valuable advice regarding what type of content would be best to include in letters of support and can also help to identify highly qualified experts.

If you are a healthcare provider who is contacted by a LARA investigator for an interview as a witness relating to a complaint filed against another professional, then you should proceed with caution.  LARA can expand the scope of its investigation to focus on healthcare providers beyond the individual against whom the initial complaint was filed.  For example, if the care that you provided was closely related to the care provided by the healthcare provider under investigation, then many of the issues of concern may also relate to you.  In this situation, you may be at risk of LARA filing an administrative complaint against you, instead of, or in addition to, the healthcare provider who initially was the focus of the LARA investigation.

Often there are professional sensitivities that exist between various healthcare providers, and those sensitivities often get lost or overlooked by a LARA investigator.  Having an attorney who is experienced with licensing cases can help to make sure that such sensitivities are properly recognized and observed in the investigation process.

If you have additional questions regarding LARA licensing investigations or are a healthcare provider recently contacted by a LARA investigator, please contact Douglas Vanden Berge at 616.233.5127 or dpvanden@rhoadesmckee.com.