OIG Issues Interim Report on National Background Check Program for Long-Term Care Employees.

Date posted: February 1, 2016

The Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently issued a report evaluating the National Background Check Program.  The program requires employees working in nursing facilities, home health agencies, and hospices to undergo screening to ensure the safety of beneficiaries in long-term care settings.  The Affordable Care Act (ACA) established the program, which provides several states with grant awards to implement background checks for prospective long-term care employees.  The ACA further requires the OIG to evaluate the program upon its completion.  The OIG’s interim report describes program implementation and offers guidance to assist the Centers for Medicare & Medicaid Services (CMS) in administering the program.

The OIG reported the following findings:

  • States receiving grants achieved varying degrees of program implementation due to unique factors affecting each state, such as the date a state received its grant;
  • Thirteen states had not yet obtained legislative authority to fully implement the program’s requirements while 12 states had already obtained such authority;
  • Ten states had not yet developed a mechanism to collect fingerprints as part of the background check;
  • Fifteen states lacked the ability to monitor criminal history subsequent to initial background checks;
  • The six states with available data to calculate disqualification rates barred approximately 3 percent of prospective employees based on screening results; and
  • Most states receiving grants were either not reporting data or reported data unusable for calculating disqualification rates.

The OIG recommended that CMS:

  1. Work with participating states to fully implement their background check programs; and
  2. Help participating states improve required reporting to ensure that CMS can effectively oversee the program.

CMS concurred with both recommendations.

The OIG report is available at:


Department of Health and Human Services Office of Inspector General.  “National Background Check Program for Long-Term-Care Employees: Interim Report.”  OEI-07-10-00420.  20 Jan. 2016.

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