By Zelda Meeker, Content Marketing Manager, Nurse.com
LinkedIn: Nurse.com
More than three years after Operation Nightingale exposed a widespread nursing diploma scheme, federal prosecutions and state licensing investigations continue to reveal the scope and consequences of the fraud.
One of the latest developments came in September 2026, when Carleen Noreus, a former South Florida nursing school operator, was sentenced to 87 months in federal prison, according to the Miami Herald. Noreus pleaded guilty in June to conspiracy to commit wire fraud and conspiracy to commit money laundering after a two-week federal trial.
Federal prosecutors alleged Noreus was responsible for 2,956 fraudulent nursing diplomas issued through two now-closed South Florida nursing schools. Out of those who received fraudulent diplomas through the schools, around 2,274 passed their examinations, allowing them to obtain licenses and work as nurses, according to the U.S. Department of Justice (DOJ).
Federal prosecutors also alleged that one nurse who obtained fraudulent credentials through Noreus’ schools later contributed to the death of a patient while working at a Saint Louis, Missouri, hospital in 2023. Prosecutors said the nurse failed to provide appropriate care to a patient and didn’t notify the attending physician or nurse in charge as required.
When Nurse.com covered the nursing diploma scandal that year, nurses expressed concerns about patient safety, trust in the profession, and how people who hadn’t completed required nursing education could potentially obtain licenses.
Three years later, Operation Nightingale has resulted in convictions, prison sentences, and additional federal charges.
What was Operation Nightingale?
Operation Nightingale became public in January 2023 when it was announced that charges were filed against more than two dozen people accused of participating in schemes involving fraudulent nursing diplomas and transcripts.
According to federal investigators, the documents falsely indicated that recipients had completed the required coursework and clinical education at Florida nursing schools.
The credentials allowed purchasers to meet educational eligibility requirements for the National Council Licensure Examination (NCLEX). Those who passed the NCLEX could then seek nursing licenses and employment as registered nurses (RNs) or licensed practical nurses/licensed vocational nurses (LPNs/LVNs).
It was later reported that more than 7,600 fraudulent diplomas were distributed through Palm Beach School of Nursing and Quisqueya School of Nursing LLC alone.
The schools involved had previously been authorized to issue nursing diplomas, making this situation more complicated than simply creating certificates from nonexistent institutions.
In fact, regulators have cautioned against assuming that every graduate from an implicated school obtained fraudulent credentials.
The California Board of Registered Nursing noted that the schools involved in Operation Nightingale also had legitimate graduates. Fraudulent transcripts and diplomas could resemble the documents issued to students who completed their education.
What happened after the nursing diploma scandal?
By April 2024, three defendants who were found guilty in a jury trial had been sentenced to federal prison, with terms ranging from 33 to 70 months.
In September 2025, federal authorities announced Phase II of Operation Nightingale, bringing fraud-related charges against 12 additional defendants accused of participating in schemes to sell fraudulent nursing diplomas and transcripts.
The first phase of the investigation resulted in 30 defendants being charged and ultimately convicted, either through guilty pleas or at trial. According to federal investigators, schemes uncovered during the second phase produced approximately 7,300 fraudulent diplomas.
The prosecutions continued into 2026. In April, another individual was sentenced to 21 months in federal prison after pleading guilty to wire fraud. According to the DOJ, he allegedly conspired with others to sell fraudulent nursing diplomas and educational transcripts and helped purchasers fraudulently obtain nursing licenses.
In June 2026, the DOJ announced that Noreus had pleaded guilty following two weeks of trial. State authorities had previously terminated both nursing schools connected with her case.
Three months later, in September 2026, Noreus was sentenced to seven years in federal prison.
How could a person with a fraudulent diploma pass the NCLEX?
One of the most confusing aspects of Operation Nightingale for nurses may be how someone who didn’t complete the required nursing education could still pass the NCLEX.
The answer involves understanding the different roles nursing education and the NCLEX play in licensure.
The National Council of State Boards of Nursing (NCSBN) describes the U.S. nursing licensure model as a two-part system. A graduate must provide evidence of graduating from a nursing program approved by a nursing regulatory body to become eligible for the NCLEX. The candidate must then pass the licensing examination.
The fraudulent diplomas and transcripts allegedly made it appear that purchasers had completed the education necessary to become eligible for the NCLEX. Some purchasers then passed the examination.
But passing the NCLEX doesn’t establish that a candidate actually completed the coursework and supervised clinical education documented on a transcript.
In other words, an exam result and a nursing education record verify different parts of a candidate’s qualifications. That distinction helps explain why nursing regulators have continued investigating licenses even when an individual successfully passed the NCLEX.
What happened to licenses connected to Operation Nightingale?
Because nursing licenses are regulated by individual states and jurisdictions, there hasn’t been one nationwide outcome for every person whose credentials were associated with Operation Nightingale.
State boards of nursing have had to investigate applicants and licensees and determine what action is appropriate under their laws and regulations.
California, for example, has maintained an Operation Nightingale resource for applicants, licensees, and employers. The California Board of Registered Nursing stated that it continues to identify and investigate California applicants or licensees who attended nursing education programs connected with the investigation.
The Texas Board of Nursing also maintains a dedicated Operation Nightingale resource that includes information for employers as well as formal charges, disciplinary actions, and licensure denials.
When Phase II was announced, the North Carolina Board of Nursing said it was working with the Federal Bureau of Investigation, NCSBN, and other nursing regulatory bodies to identify applicants and licensees who may have received fraudulent diplomas or transcripts for licensure.
While many schools had legitimate graduates, individual cases require regulators to determine whether a person actually completed the required education.
Did Operation Nightingale change nursing credential verification?
The nursing diploma scandal put a spotlight on how nursing schools, employers, and regulators verify educational credentials.
In May 2024, the NCSBN released fraud detection guidance for nursing educators, employers, and others who evaluate applications, transcripts, and credentials for education, employment, certification, and related purposes.
The guidance recommends examining educational and employment documents for potential inconsistencies and verifying information rather than relying solely on documents submitted by an applicant.
The NCSBN also emphasizes the potential patient safety implications of credential fraud. Fraud involving nursing education isn’t simply an administrative or employment problem. Nursing programs include classroom education, laboratory learning, and clinical experiences intended to prepare students to provide safe care.
The consequences of bypassing that preparation are one reason nursing regulatory bodies approve education programs in the first place.
According to the NCSBN, nursing faculty verify through graduation that students have demonstrated clinical competence necessary for safe nursing practice, while regulatory bodies rely on program approval as part of determining NCLEX eligibility.
Lessons from Operation Nightingale
Operation Nightingale highlights the importance of verifying nursing programs, education, and professional credentials. Prospective students should confirm a program’s approval status and licensure requirements, while nurses and employers should regularly verify licenses and educational credentials.
The cases also reinforce that passing the NCLEX doesn’t replace nursing education and clinical training. Each step of the education and licensure process helps ensure nurses are properly prepared to provide safe, qualified patient care.
Frequently asked questions
What is Operation Nightingale?
Operation Nightingale is a federal investigation into schemes that sold fraudulent nursing diplomas and transcripts to people seeking eligibility for nursing licensure.
How did people with fraudulent nursing diplomas take the NCLEX?
The fraudulent records allegedly made purchasers appear to have completed the nursing education required for NCLEX eligibility.
Does passing the NCLEX prove someone completed nursing school?
No. The NCLEX assesses knowledge for entry-level nursing practice, while educational records document completion of required coursework and clinical training.
Is Operation Nightingale still ongoing?
Yes. As of September 2026, federal prosecutions and state-level investigations and licensing reviews connected to fraudulent nursing credentials were continuing.
This article was originally published on the Nurse.com blog and is republished here with permission.
