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OIG: CMS & States Must Work Together on Background Checks for Long-Term Care Employees

Posted on Friday, May 3, 2019 8:14 PM

According to a new reported released by the Office of Inspector General (OIG) and the Department of Health and Human Services (HHS), CMS must help the states implement background checks on long-term caregivers. 

Enacted by legislation in 2010, the National Background Check Program provides grants to states to develop systems to conduct background checks of state and federal criminal history records for prospective long-term-care employees for nine types of long-term-care facilities or providers:

  • providers of personal care services
  • residential care providers that arrange for long-term-care services or provide long-term-care services
  • skilled nursing facilities
  • nursing facilities
  • providers of adult day care
  • home health agencies
  • providers of hospice care
  • long-term-care hospitals
  • intermediate-care facilities for individuals with intellectual disabilities

The new report found that:

  • Alaska, Washington, D.C., Florida, New Mexico and Rhode Island implemented all program requirements and, in fact, conducted background checks for more than the required nine types of facilities and providers.
  • Delaware and Connecticut implemented most of the selected program requirements.
  • Illinois, Maryland and Missouri did not have legislative authority to meet program requirements.
  • Alaska had the highest rate of determinations of ineligibility, at 8%.
  • Florida, Illinois, Alaska and New Mexico had the greatest percentages of determinations of ineligibility.
  • Florida conducted the greatest number of background checks, resulting in the greatest number of determinations of ineligibility, 64,374.
  • The background check programs in Washington, D.C., Connecticut, Rhode Island and Delaware resulted in the lowest rates of determinations of ineligibility of prospective employees.


Based on the report’s findings, the OIG suggests that CMS take appropriate action to get the States to comply.  CMS agreed with their findings.

Source: NAHC Report

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