MIAMI (NewsNation) — Federal agents launched a multi-state operation Wednesday that focused on busting a massive fraudulent nursing diploma scheme, according to the U.S. Department of Health and Human Services Office of Inspector General.

The HHS-OIG partnered with law enforcement agencies to carry out the “Operation Nightingale” investigation — the operation’s name honoring the founder of modern nursing, Florence Nightingale.

The execution of search warrants in Delaware, New York, New Jersey, Texas and Florida resulted in 25 individuals being charged with involvement in the scheme. According to the Department of Justice, each defendant faces up to 20 years in prison.

These individuals were accused of selling false and fraudulent nursing degree diplomas and transcripts to fake nurses for $15,000 each, raising serious questions about patient safety in America.

Omar Perez Aybar, the special agent in charge of the U.S. Department of Health and Human Services, told NewsNation that an individual provided information to the FBI in Baltimore that there was a school in South Florida that was selling nursing certificates and transcripts to individuals who weren’t attending schools.

“The individuals who acquired the bogus nursing credentials used them to qualify to sit for the national nursing board exam,” the HHS-OIG explained. Each individual who tested needed to pass the test in order to become a licensed nurse and work in the field.

The DOJ wrote in a press release that more than 7,600 fake nursing diplomas were issued and distributed by three South Florida-based nursing schools. The schools, which have since closed, included Siena College in Broward County, Fla., Palm Beach School of Nursing in Palm Beach County, Fla. and Sacred Heart International Institute in Broward County.

However, Aybar said there were multiple other schools involved in this scheme in addition to the three schools previously listed.

“Not only is this a public safety concern, it also tarnishes the reputation of nurses who actually complete the demanding clinical and course work required to obtain their professional licenses and employment,” said U.S. Attorney for the Southern District of Florida Markenzy Lapointe, adding that “a fraud scheme like this erodes public trust in our health care system.” 

But who is a real nurse and who is a fake? And how will they find them?

In these filings, investigators laid out the type of facility and in what state these nurses worked. Two nursing care facilities in Texas, a VA medical center in Maryland and a skilled nursing facility in Ohio were all listed in the legal documents revealed.

No names of employees or facilities were made public at this time.

“There is a likelihood that individuals are working. What I want your viewers to know is that at no point in time have we learned of or uncovered any patient harm stemming from these individuals practicing in a health care space,” Aybar said.

Aybar explained that, “A good number of them had a level of medical training and perhaps that’s what they were able to rely on to sit in front of the board to take the test.”

He said that only 30% of these people passed the test and he believes that is indicative of how stringent the test really is.

“The fact that they didn’t get in, doesn’t excuse their behavior,” Aybar said and reassured that all parties involved will be held accountable for their part in the scheme.

This nursing scheme bust did happen at a time when there has been a national nursing shortage and when hospitals have been desperate to hire and keep nurses.

Aybar said that he doesn’t want the action of the people involved in the scheme to cast a shadow on real nurses who continue to work hard every day to serve the American people.

Sarah Warren, a registered nurse, said she can’t wrap her head around it. She joked that it is definitely a “creative way to tackle the nursing shortage,” but then reassured it was not the way to go. 

“I’m just curious about the details,” she said. “And it’s really sad that people decided to take this path to get into the nursing field. I’m wondering how they were made to believe that this would be a safe way to get through nursing school. It’s just it’s sad.”

Warren wondered whether students were fed marketed messages by fake recruiters saying that it would be an accelerated program and an easy way to get their nursing degree.

“But sadly, it was clearly a fraudulent scam. And people were taken advantage of, and patients were placed at risk in the process. It is a really concerning thing,” Warren said. 

Warren explained that there can be a lot of gatekeeping in nursing, meaning that there are many barriers to entry and a lack of access to nursing programs. Because of this, she also said it’s possible that people were frustrated with trying to get into the system the right way and were easily influenced by a shortcut.

“The sad reality is there aren’t enough nursing programs to get the number of students that we need to address the nursing shortage,” she said.

Investigators are now working to find out who these fake “working” nurses are in order to take the next steps legally.