Review of Allegations Related to Nurse Practitioner Supervision and Controlled Substance Prescribing in Pain Management at the VA Central Texas Healthcare System in Temple

The VA Office of Inspector General (OIG) initiated a healthcare inspection at the VA Central Texas Healthcare System (system) in Temple to assess allegations that two pain management advanced practice registered nurses (pain management APRNs) were not appropriately supervised and were unqualified to prescribe controlled substances. The complainant also reported concerns regarding the potential for patient harm; however, the complainant was not aware of any patient safety events. The OIG did not substantiate the allegations and made no recommendations.

The OIG reviewed the pain management APRNs’ proficiency reports and practice evaluations from October 2022 through March 2025, did not identify any competency concerns, and found the supervisor completed the reports properly. The OIG also reviewed reports entered into the Veterans Health Administration’s (VHA’s) patient safety event reporting system during the same time frame and did not find any patient safety events related to the pain management APRNs.

The OIG reviewed the pain management APRNs’ credentialing and privileging documentation and found the APRNs had active Texas-issued registered nurse licenses and nurse practitioner certifications, Drug Enforcement Administration registrations, and system-approved clinical privileges with authorization to prescribe controlled substances. Further, the OIG did not identify any reported patient complaints or patient safety events. 

The OIG concluded that the pain management APRNs’ service chief provided supervision as required by VHA and the APRNs were authorized and qualified to prescribe controlled substances.