Over the past few years, 27 states have participated in the National Background Check Program to develop screening programs for long-term-care facilities. The Office of Inspector General (OIG) recently completed its fifth in a series of six reports on the program. This report focused on Idaho and Mississippi, the two states continuing the program. Twenty-seven states have completed their participation in the program.

What is the National Background Check Program?

The National Background Check Program started in 2010 as a voluntary grant to help states develop federal and state background check programs for employees working with our most vulnerable populations in long-term-care facilities.

Benefits of participating in the program include:

• Up to $3 million in federal funding over three years (with the state required to match at $1 for every $3 of federal funding received). 
• States are allowed to request up to three additional 1-year extensions (with no additional federal funding). 
• The Centers for Medicare & Medicaid Services (CMS) provides technical assistance to participating states.
• Assessments of the states’ progress and recommendations for improvement. 

Participants have a set of 13 requirements to adhere to in the development of their background screening program, including:

• Identifying individuals who have direct access to patients;
• Requiring background checks for them;
• Identifying offenses that would disqualify these individuals from working with patients;
• Conducting criminal histories and state abuse/neglect checks;
• Reporting disqualifying offenses.

States are also required to report back to CMS quarterly with collected data, including types of background checks that were conducted and the outcomes of these checks.

What were the results of the Interim Assessment?

• Both Idaho and Mississippi faced challenges implementing requirements due to legislative barriers.

  • Idaho: Under current Idaho law, applicants to long-term-care facilities are not currently required to disclose previous residencies. Because of this, Idaho was unable to adhere to the program requirement to check state abuse/neglect registries. They are currently considering adding the needed legislation to meet this requirement. Idaho is also unable to conduct continuous monitoring until legislation is approved.

  • Mississippi: Due to lacking legislative authority, Mississippi is also unable to conduct continuous criminal monitoring.

• Mississippi has not adhered to the program’s data reporting requirements.

  • At the time the OIG report was published, CMS had not received any data regarding Mississippi’s participation in the program. There were delays due to the COVID-19 pandemic to get Mississippi’s reporting system up-to-date, and it is still in the process of being implemented.

• Both states had inconsistencies on their financial reports, making ongoing costs of the program difficult to determine. With more consistent reporting in the future, OIG would be able to determine long-term costs for these states and others.

OIG’s Conclusion

Like many of the other states that have participated in the program, there are difficulties in getting the legislative authority that would allow states to maintain the program’s requirements. There are also challenges with states’ inter-departmental coordination in order to get the legislative authority needed.

OIG also needs accurate financial reporting from participating states to determine long-term program costs, and required data reporting is necessary to determine the program’s effectiveness. CMS said that it will continue to work with participating states to ensure accurate reporting.

State background check programs help protect our most vulnerable populations who depend on long-term-care facilities. If states are able to effectively adhere to the program requirements, including implementing continuous criminal monitoring, there is an opportunity to reduce harm from neglect, abuse, and other disqualifying offenses.

How can PreCheck Help?

Contact us to learn how we can help your organization build a long-term-care provider screening program, including continuous criminal monitoring, to help keep our most vulnerable populations safe.