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National Background Check Program for Long-Term Care Providers: A Final Assessment

Issued on  | Posted on  | Report number: OEI-07-24-00100

Report Materials

Why OIG Did This Review

  • As many as 70 percent of seniors may need care in long-term care setting at some point in their lives. In 2023, nearly 16 percent of residents living in long-term care settings reported experiencing abuse.
  • In 2010, the Patient Protection and Affordable Care Act (the Act) established a National Background Check Program, which provided Federal financial assistance for States to develop or enhance systems for long-term care settings to conduct background checks on prospective employees.
  • Twenty-nine States participated in the program at various times from 2010 to 2024. The last two States ended participation on May 31, 2024.
  • The Act included a mandate for OIG to produce an evaluation of this program.

What OIG Found

The National Background Check Program successfully established a program to help States identify efficient, effective, and economical procedures for conducting background checks on prospective long-term care employees.

The National Background Check Program helped States successfully build systems to disqualify employees with concerning criminal convictions from working in long-term care settings.

States reported two procedures that were appropriate, efficient, and effective for conducting background checks: having an automated system for conducting background checks and having the ability to monitor status changes to a person’s background check after the initial background check has been completed.

States rarely reported that conducting background checks resulted in any unintended consequences, such as a reduction in workforce.

The most common challenges that States encountered while in the program were a lack of State legislative authority and difficulty coordinating between State-level departments.

States spent more than $100 million in combined Federal and State funds to develop or enhance systems to conduct background checks of potential employees of long-term care providers.

What OIG Recommends

OIG issued recommendations during the program that aided the outcomes in this final assessment. OIG does not have further recommendations for CMS.

Report Type
Evaluation
HHS Agencies
Centers for Medicare and Medicaid Services
Issue Areas
Contracts Financial Stewardship Nursing Homes, Nursing Facilities, and Assisted Living Facilities
Target Groups
Elderly
Financial Groups
Grants

Notice

This report may be subject to section 5274 of the National Defense Authorization Act Fiscal Year 2023, 117 Pub. L. 263.