According to a recent report by the Department of Health and Human Services’ (DHHS) Office of Inspector General (OIG), around 22% of Medicare beneficiaries admitted to nursing homes experienced preventable injuries. In fact, in the 2014 OIG Work Plan, the OIG declared it will place a key focus on the quality and care of nursing homes and how often beneficiaries are harmed during their stay. With the government keeping a closer eye on nursing homes, there is an opportunity to review your organization’s background screening initiatives, as they can impact patient safety and care.

The Patient Care and Safety Problem in Nursing Homes

The February 2014 OIG report, “Adverse Events in Skilled Nursing Facilities: National Incidence Among Medicare Beneficiaries”, found that nearly a quarter of Medicare patients at nursing homes suffered preventable injuries during the 2008-2012 period examined in the study. Unfortunately, this is just part of the larger number of adverse events that are preventable each year. A September 2013 study published in the Journal of Patient Safety, estimates that about 210,000 to 400,000 “premature deaths associated with preventable harm to patients” occur each year in the United States. While a comprehensive background screening and drug testing program was not part of the recommendations from the OIG’s report, they did recommend that nursing homes “seek to reduce harm to nursing home residents through methods used to promote hospital safety”. At PreCheck, we believe thorough background screening is an important component of establishing a patient safety culture.

The Value of Comprehensive Background Checks in Nursing Homes

According to CMS, skilled nursing and nursing facilities are considered long term care (LTC) facilities and providers. This is significant because Section 6201 of the Affordable Care Act of 2010 “established the framework for a nationwide program to conduct background checks on a statewide basis on all prospective direct patient access employees of LTC facilities and providers.” For nursing homes and skilled nursing facilities, performing comprehensive backgrounds is part of complying with the law. But not just any type of background check will do. Make sure that you are performing the right type of background checks, as not all background checks or background check companies are equal.

While it might be tempting to go with the attractive $9.95 instant background checks available in the market, it’s definitely not a great idea when the government is focusing on patient safety, particularly in nursing homes. Take the time to research your background check vendor to ensure that they have the knowledge and expertise in healthcare. Do they check all of the available exclusion lists such as the OIG LEIE, for example? While the FBI national background check can be a component of your screening process, it is highly recommended that you conduct county-level and state-level criminal record searches as they contain the most up-to-date information. Be wary of national database criminal searches, as the information they contain may be months or years out of date.

A comprehensive and effective background screening program will protect your nursing facility and its patients from harm and keep excluded individuals off your payroll. Not only is it important to ensure that you are performing the right types of background checks and components such as exclusion checks and healthcare professional license verifications, for example, but it’s also important to ensure that you keep ongoing monitoring in place. A background check represents a moment in time, which doesn’t guarantee that someone with a “clear” background check today will have no records a year or two from today. The OIG recommends that you perform exclusion screening on a monthly basis; but it’s also a recommended practice to conduct ongoing background checks on current staff, such as annually, to safeguard your patients and staff.

The OIG Recommends Random Drug Testing for all Healthcare Workers

In a March 2014 OpEd Column published in the New York Times, the OIG stated they “believe hospitals should be required to perform random drug tests on all healthcare workers with access to drugs.” While nursing homes are not hospitals, the number of preventable patient adverse events in nursing facilities has become a concern in recent years. In April 2014, USA Today reported, “more than 100,000 doctors, nurses, medical technicians and healthcare aides are abusing or dependent on prescription drugs in a given year, putting patients at risk.” Prescription drug abuse is, unfortunately, prevalent in the healthcare industry because of ease of access to these drugs. Random drug testing, therefore, is an emerging best practice in healthcare and nursing homes could benefit from implementing this type of program. Not only does a random drug testing program help identify staff members that are impaired or have addiction problems that need to be addressed, but it also defers drug use by some drug users. Random drug testing, therefore, can be an important component of your employee screening initiatives and can help protect your patients from harm.

Are you evaluating background screening and drug testing vendors? Contact us today to learn how PreCheck’s healthcare-focused screening services can help you protect your patients and staff.