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Wednesday, November 30, 2022

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Background Checks Hold Long-Term Care Employees to Higher Standards

Background checks hold long-term care employees to higher standards

Proper and thorough employment screening is essential in any industry, and health care is no exception. Professionals who manage the health, wellness and long-term care of patients are tasked with particularly sensitive responsibilities, and the potential for abuse is enormous. In this light, background checks are a smart - and typically mandatory - move on the part of health care organizations that hope to maintain their reputations and protect the well-being of patients.

However, one area that has a pattern of poor accountability and low standards in terms of employee selection is long-term care. There has been a recent push from lawmakers and health care providers alike to reverse this trend.

The Affordable Care Act: Countering a Widespread Problem 
While the industry has made major strides to hold long-term care employees to higher standards, this has not always been the case. According to the Centers for Medicare & Medicaid Services (CMS), since the Omnibus Budget Reconciliation Act was passed in 1987, millions of U.S. citizens have been victims oflong-term care patient abuse, neglect and misappropriation of funds.

To address this issue, the Affordable Care Act of 2010 included legislation to establish a framework for a nationwide program to conduct background checks in each state on all prospective direct patient access employees of long-term care facilities and providers. These organizations could include nursing facilities, home health agencies, hospice and personal care providers, long-term care hospitals, residential care providers and intermediate care facilities for patients with intellectual disabilities. The framework is administered by the CMS with the assistance of the Department of Justice and Federal Bureau of Investigation.

In an effort to support the initiative and emphasize the importance of increased background checks for long-term care workers, the CMS has awarded more than $50 million to 26 states to design comprehensive national background check programs for direct patient access employees. For instance, Lexology reported long-term care facilities in Connecticut were required to register with a statewide background check portal beginning Feb. 8, 2016.

As a result of these actions, health care organizations have been better able to identify potentially abusive employees. In fact, OPEN MINDS reported between September 2010 and 2014, roughly 3% of prospectivelong-term care workers in six states were disqualified from employment due to information uncovered by mandatory criminal background checks.

The Burden of Responsibility Rests on Health Care Organizations 
While employees themselves are certainly held accountable for acts of fraud, Background checks hold long-term care employees to higher standardsneglect or other abuses that affect long-term care patients, health care organizations that make hiring decisions are ultimately responsible for vetting employees. In some cases, a prospective employee may already be banned or prohibited from practicing in any federally funded health care organization due to previous fraud or abuse.

In fact, both the U.S. Office of the Inspector General and General Services Administration have exclusion lists that health care providers are expected to access and analyze during the hiring process. As of May 2013, health care providers must screen their employees and contractors monthly to confirm they are not excluded based on past violations, as mandated by the OIG's Updated Special Advisory Bulletin on the Effect of Exclusion from Participation in Federal Health Care Programs.

Considering this level of responsibility, it makes sense that health care organizations would strive for conducting the most thorough, diligent background checks possible. While both the CMS and OIG provide portals and services for providers to conduct background investigation, this analysis is not always as accurate as some might hope. For example, an audit in 2011 revealed the OIG's List of Excluded Individuals/Entities was missing 61% of existing state exclusions.

Health care organizations that provide long-term care to patients can practice due diligence and invest more heavily in protecting themselves and their patients by partnering with a third-party employment screening vendor experienced in investigating health care workers. By doing so, providers can avoid the liability associated with long-term care patient abuse and garner deepened trust among patients.

Sign up today to receive your Free Demo of our GSA/OIG Service before it's too late.  In the message box, enter promo code: OPENhealth 

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