In a March 7 S&C letter, “Public Comments on the Report of the National Background Check Program (NBCP) Long-Term Care Criminal Convictions (LTCCC) Work Group,” CMS provided a listing of the public comments made for the ACA’s mandatory background check program. The OIG had released an interim report in March 2011 that reviewed nursing home’s background checks on employees, which brought to light several issues CMS needed to address in this program.
The report, “Nursing Facilities’ Employment of Individuals with Criminal Convictions” (OEI-07-09-00110), found that 92% of the nursing facilities in its sample had employed at least one person with at least one criminal conviction. It further found that there is great discrepancy in the requirements for background checks amongst the states. As a result, the OIG recommended that CMS create a clear way to define employee classifications for direct access employees and to work with states to develop a list of convictions (state and local) that would disqualify the person from working in a nursing facility permanently as well as periods of time when that person would be barred. The OIG report used FBI criminal history records and the agency did not have a way of providing information to see if the offenses took place within nursing facilities or if they involved nursing facility residents.
The workgroup that CMS formed to respond to the OIG’s recommendation created the standards and definitions that were requested and provided a public comment period. The S&C letter referenced above provides a recap of the comments made by the public on this information, including:
- Definition of Direct Access Employee
- Disqualifying Convictions
- Disqualifying Time Periods
- Variance Process
- Rehabilitation Factors
