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Criminal Checks Have Slight Effect on Ability to Fill LTC Jobs

February 3, 2012:

Trudy Whitehead, Clinical/Technical Editor

Criminal background checks do not significantly reduce the number of applicants for jobs involving direct access to long-term care (LTC) patients, a study by the Office of Inspector General reveals.

The study, the results of which were released January 19, 2012, focuses on a program that began as a pilot and then was continued under the Patient Protection and Affordable Care Act of 2010. The “Nationwide Program for National and State Background Checks for Direct Patient Access Employees of Long Term Care Facilities and Providers” seeks to establish a framework for a national program that eventually will check the backgrounds of all prospective employees with direct access to patients of LTC facilities and providers.

So far, 10 states have received matching federal funding under the program to institute national criminal background checks on applicants for direct patient access jobs in long-term care facilities and with home care agencies that receive funding from Medicare or Medicaid. The checks, which include fingerprints, aim to make it much more difficult for those with criminal histories to move from state to state to take advantage of vulnerable patient populations.

Of the two hundred administrators of long-term care providers that replied to the OIG survey, all but 6 percent have conducted background checks on job applicants. Of those, 4 percent had encountered applicants who refused to undergo the checks. Close to a quarter of the administrators believe that the criminal checks reduce the pool of applicants, who perhaps do not apply because they have a criminal history. However, more than three-quarters report that there are still adequate numbers of applicants for each job vacancy. Nonetheless, 9 percent of the administrators said that some posted jobs did not receive any applications from qualified prospective employees.

The pilot program began because of perceived abuse and neglect of long-term care patients, as well as misappropriation of funds. These abuses were recognized as a widespread problem for millions of long-term care patients and their families. Long-term care facilities include skilled nursing and nursing facilities, home health agencies, hospice and personal care providers, LTC hospitals, residential care providers arranging for or providing LTC services, and intermediate care facilities for the intellectually disabled.

The ACA requires the OIG to report on the efficiency and financial viability of conducting background checks, as well as how effective such checks are at barring those with criminal histories from accessing the vulnerable LTC population. When the current state programs are complete or nearly complete, the OIG will conduct another survey to gauge whether changes in the procedures to investigate criminal backgrounds have decreased the pool of applicants.


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