According to a recent report by the U.S. Department of Health and Human Services Office of the Inspector General (OIG), more than 90 percent of long-term care organizations employ individuals with previous criminal convictions.
Employing someone with certain types of criminal convictions can jeopardize a long-term care facility’s ability to process Medicare or Medicaid claims. Having an employee with a conviction history or history of abuse also puts the organization’s staff, patients, brand reputation and legal standing at risk.
To help elder care organizations mitigate the risks of hiring people with disqualifying criminal records and histories of abuse, we’ll identify the reasons long-term care organizations may be falling short in their background screening processes.
Then we’ll provide some recommendations for organizations to improve their background screening programs to better protect against hiring workers with disqualifying criminal convictions and abuse offenses.
The current gaps in long-term care background screening programs
There are a few major factors that contribute to nursing homes falling short in their background screening processes. The primary reason that 90 percent of long-term care organizations hire individuals with criminal convictions is the lack of federal requirements around worker screening for senior care organizations. Often, the background checking requirements are shifted to states, and the state requirements for long-term care organizations often vary.
Some states have no requirements for background checking workers in the elder care industry, while others have minimal requirements for background screening. Yet these minimal requirements are not stringent enough to catch all offenses.
When there is a state minimum requirement, it usually involves the following components: a statewide criminal background check wherever the worker lives and works, a check on the person’s licenses and certification to work, and in-state sex offender and abuse registry checks.
These minimum state requirements are not entirely effective because they are only searching in one or two states where the individual currently lives and works and usually search between five and seven years. This leaves a large gap where employers may miss prior criminal convictions occurring in other states or deeper in the past.
On top of all of these other gaps and oversights, many organizations fail to recheck workers throughout their careers. If someone commits a crime after getting hired, it could go unnoticed by the long-term care employer and put that organization out of compliance.
4 Recommendations for More Thorough Background Screening
To avoid the risks of hiring individuals with disqualifying convictions or histories of abuse, organizations should consider layering thorough background screening processes on top of their current programs. Even if your state does not require you to take added screening measures, going beyond the state’s minimum requirements can help to better protect your organization.
Consider these four recommendations below to help mitigate the risk of hiring workers with disqualifying criminal or abuse offenses.
1. Search misdemeanor and felony records
Use a background checking solution that searches criminal records in any location where the individual has lived as far back in time as each state allows. This type of background check will use address information from credit bureaus to search criminal records at the state and county level where the individual has lived. This will help cover gaps in a worker’s out-of-state history.
2. Conduct a national criminal search
Layer a national criminal database search on top of state and county level searches where individuals have lived. This is an efficient way to cast an even wider net and help cover any remaining gaps in the person’s history. A national search may turn up crimes committed in states or counties where the person did not have an address.
3. Verify Social Security number
If a person has a condemning history of abuse or criminal activity, that individual may go to great lengths to hide this information from employers. It is therefore recommended to validate a worker’s Social Security number to make sure it is issued by the Social Security Administration for that individual. This helps prevent a worker from using falsified documents or a separate identity to hide a nefarious history.
4. Check national registries and sanction lists
In addition to criminal background checks, it is also recommended that organizations check national sex offender, abuse and elder abuse registries. Also it’s important to check sanction and exclusion lists nationwide to see if a person has ever before been sanctioned and prevented from working in the health care industry. While abuse or sanctions offenses may not always result in criminal charges, hiring a worker with a history of abuse or sanctions poses risks to your organization’s legal standing, brand reputation, and employee and patient safety.
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The HireRight Blog is provided for informational purposes only. It is not intended to be comprehensive, and is not a substitute for and should not be construed as legal advice. HireRight does not warrant any statements in the HireRight Blog. Any statutes or laws cited herein should be read in their entirety. You should direct to your own experienced legal counsel questions involving your organization's compliance with or interpretation or application of laws or regulations and any additional legal requirements that may apply.
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