HARRIS COUNTY, Texas (KTRK) -- A warning to hospitals and healthcare facilities across the country: more than two dozen people across five states face federal charges for allegedly selling fake nursing diplomas to thousands of people.
Four defendants : Simon Itaman, Anna Itaman, Ludnie Jean, and Serge Jean are from Harris County, and investigators believe there could be more people working illegally as nurses.
On Wednesday, in a press conference, the US Department of Justice said Operation Nightingale found that the scheme peddled more than $100 million over several years. The operation was named after Florence Nightingale, the founder of modern nursing.
RELATED: Feds announce massive takedown of fraudulent nursing diploma scheme
This is highly concerning to federal investigators, who say someone who is not properly trained and certified can pose a risk to their patients. They believe they know who those responsible are and are working to track them down.
"When we talk about a nurse's education and credentials, 'shortcut' is not a word we want to use," Markenzy Lapointe, U.S. Attorney for the Southern District of Florida, said.
Federal investigators said one of the ways they were tipped off about the fraudulent plot was when the Florida state auditing process discovered poor passing rates at three nursing schools. They allege the executives at these schools sold at least 7,600 fake diplomas at about $15,000 each.
These fake degrees allow aspiring nurses to skip hours of clinical training, qualifying them to sit for the national nursing board exam with the potential of putting patients' health and safety at risk.
The Justice Department said these students never completed the necessary courses and clinicals.
"When we take an injured son or daughter to a hospital emergency room, we don't expect, really cannot imagine, that the licensed practical nurse or registered nurse treating our child took a shortcut around educational and licensing requirements," Lapointe remarked.
RELATED: Feds announce massive takedown of fraudulent nursing diploma scheme
The sweeping enforcement action spanned five states: Texas, Florida, New York, New Jersey, and Delaware.
Two of the related entities listed in the case are in northwest Houston. One is Nursing Bridges Institute, owned by the Itamans. The other is Jean's NCLEX Review LLC, owned by the Jeans. Court documents state the Jeans worked for the Itamans before opening up their own business.
Attempts for comment from these defendants, who face up to 20 years in prison, have been unsuccessful. Federal investigators said they are now working with licensing boards in each state to make sure anyone who got a fraudulent diploma can no longer provide care.
"To date, we have not learned of nor uncovered any evidence of patient harm stemming from these individuals potentially providing services to patients," Special Agent Omar Perez Aybar with US Department of Health & Human Services said.
To read more about this case, read the full release on the US Department of Justice's website.
For more on this story, follow Rosie Nguyen on Facebook, Twitter and Instagram.