facts case summary of the following I. Factual and Procedural Background At the time when disciplinary action was taken against Appellant by the Appellee West Virginia Board of Examiners for Registered Professional Nurses (the "Board"), Ms. Williams was employed by Panhandle Support Services (the "Agency") in Parkersburg, West Virginia. She was a Nurse Manager responsible for the supervision of the homemaker-health workers that the Agency provided on an in-home basis to elderly individuals. In addition to her supervisory responsibilities, Appellant was charged with documenting the services that the Agency provided to its clients. The State of West Virginia contracted with the Agency to provide these in-home services pursuant to funding specifications based on the federal government's Medicaid Waiver Program. The Department of Health and Human Resources ("DHHR"), the state agency in charge of administering the program at this time,1 conducted periodic reviews of the in-home service providers to assure compliance with both state and federal regulations. During one of these reviews in February 1997, DHHR employee Samuel Estel 2 randomly selected five of the Agency's clients to review. In his examination of five client files,3 Mr. Estel learned that Ms. Williams had not conducted, as required, monthly reviews of client records. Upon additional inspection of the Agency's personnel files, he determined that two of the homemakers employed by the Agency did not have ade