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 OIG Background Check Report Bolsters Provider Push for Access to Data

A report by the Department of Health and Human Services Office of Inspector General (OIG) assessing states’ background check programs to prevent bad actors from getting jobs in the long term care profession reinforces the need for providers to have access to the National Practitioner Data Bank, a top official with the American Health Care Association (AHCA) tells Provider.

In “National Background Check Program for Long-Term Care Providers: Assessment of State Programs Concluded in 2017 and 2018 – OEI-07-18-00290,” OIG reviewed the background check programs in 11 states that concluded their participation in the National Background Check Program (NBCP) in 2017 and 2018. In doing so, OIG said it found “varied success” with state efforts, with most of the states hampered by a lack of legislative authority to get checks fully in place.

OIG reviewed background check programs for 11 of the 12 states that concluded program participation between 2017 and 2018. The states are California, Georgia, Kentucky, Maine, Michigan, Minnesota, Nevada, North Carolina, Oklahoma, Utah, and West Virginia.

Of the number, only Minnesota and West Virginia put in place all 13 selected NBCP requirements. “Two states implemented all selected program requirements. Nine states did not implement all the selected program requirements, primarily because of a lack of legislative authority for certain program requirements,” OIG said.

It is this lack of full implementation in the states that makes it imperative that long term and post-acute care providers have direct access on their own to data to help in the hiring process and identify problem individuals who may move from state to state and avoid detection, says David Gifford, MD, senior vice president of quality and regulatory affairs at AHCA.

“This report reinforces the need for long term care providers to have access to the National Practitioner Data Bank so that providers can have an immediate method to better vet individuals before hiring them,” he says.

While the state and federal background check programs are well-intentioned, there are numerous hurdles to full implementation in individual states, Gifford says.

“The long term care profession has asked repeatedly for facilities to have access to the Data Bank, which would allow providers to immediately begin conducting more thorough checks on health care workers while states work through the legislative and administrative details of implementing the background check program,” he says.  

Just last month, Mark Parkinson, AHCA president and chief executive officer, told a Senate hearing on skilled nursing safety that AHCA supports efforts to make it easier for providers to avoid hiring potential bad actors.

“We have asked repeatedly for facilities to have access to the National Practitioner Data Bank so that we can better vet individuals before hiring them. No one—not you, not I, not anyone—wants sexual predators or those with tendencies to injure the frail to be employed by any nursing facility,” Parkinson said at the time.

OIG said of the background checks that states conducted, more than 25,000 resulted in determinations of ineligibility for prospective employees. “The number of determinations of ineligibility varied among the states, as did the rates of determinations of ineligibility (from 0 percent to 3 percent),” the report said.

None of the states provided evidence of unintended consequences associated with conducting background checks, such as a reduction in the available workforce for long term care facilities or providers, OIG added.

The watchdog agency did not offer any new recommendations for CMS to take, but simply reiterated previous calls for CMS to take appropriate action to encourage participating states to obtain necessary authorities to fully implement NBCP requirements.

“The findings of this report are consistent with our previous assessments of the program and provide further support for one open OIG recommendation. We strongly encourage CMS to implement this open recommendation: Take appropriate actions to encourage states to obtain the necessary legislative authority to fully implement program requirements,” OIG said.

Read the report at

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