Kevin Neudecker
Kevin Neudecker

As the COVID-19 pandemic continues, long-term care facilities must keep the ill and elderly safe even as their resources are stretched and staff turnover increases.

With each new hire, there is a chance of bringing in a bad actor — one who might commit fraud, neglect patients, or overprescribe or abuse drugs in your nursing home. Thankfully, there are specific actions LTC managers can take to keep those individuals away from patients and out of your workplace.

Understand compliance requirements and risks

Several regulations protect long-term care organizations from making bad hires. Your organization must conduct thorough background checks and avoid hiring individuals who are barred from healthcare employment.

The following background screening requirements are applicable to long-term care employers:

  • The Centers for Medicare and Medicaid Services requires comprehensive background checks to prevent “long-term care patient abuse, neglect and misappropriation of funds.” 
  • The Department of Health and Human Services Office of the Inspector General recommends consistent monitoring for sanctioned and excluded individuals. 
  • The Joint Commission requires accredited organizations to keep background screening activities consistent with internal policy and state law.
  • Many states have specific requirements for background checks on LTC employees. 

Compliance with healthcare background screening regulations supports a healthy hiring process and keeps your organization in good standing with accreditation bodies. It can also help you avoid the penalties of non-compliance, because hiring an excluded individual can result in significant fines. The average OIG civil monetary penalty is $130,000. A Texas-based long-term care facility paid a $360,000 fine for employing excluded individuals and billing federal healthcare programs for services provided by those individuals. 

Conduct thorough background checks

An essential first step to protect your long-term care organization from bad actors is establishing a comprehensive background screening program. Key to your success will be working in partnership with a background check provider who understands the requirements and nuances of healthcare background screening. That provider can inform you of regulatory changes, trends and resources to help protect your organization from making risky hires. 

Background screening for LTC candidates requires a search for criminal activity, as well as industry-specific licenses and sanction histories. It is also important to review state requirements for LTC employees. To increase your ability to make well-informed hiring decisions, make sure background checks include the following components:

  • Criminal history: Conduct a thorough search of criminal history records.
  • Driving records: Search motor vehicle records for individuals in patient transport positions.
  • Social security number trace: Conduct a trace to confirm candidate identity.
  • Sanction checks: Search databases and lists containing the names of individuals prohibited from working in healthcare. States may impose specific lists that need to be checked and can vary by state.
  • Employment, license and education verifications: Verify candidate work experience, licenses and other credentials.

Continually check for sanctions and exclusions

Your pre-hire background check helps you avoid hiring bad actors, but once employees begin work, you need a mechanism to stay informed about actions impacting their employment. Specifically, LTC providers need to be aware of newly sanctioned or excluded individuals to stay in compliance and avoid costly fines. Sanction and exclusion lists are updated regularly, so even searching them on a quarterly or monthly basis can leave your long-term care facility open to risk.

Continuous monitoring provides up-to-the-minute updates, letting you know in real time when any employee receives disciplinary or administrative actions affecting their ongoing employment eligibility. Continuous monitoring of the OIG’s List of Excluded Individuals and Entities and the General Services Administration’s System for Award Management database helps keep you informed, so you can protect patients.

With the support of a continuous monitoring solution, such as CS SafeGuard, you’ll know about any new employee sanctions as they occur, rather than finding out after patients have been put in harm’s way. You can also take advantage of roster management tools to manage monitoring activities for groups of employees across multiple facilities and locations. As a critical component of your LTC background screening program, continuous monitoring supports better compliance, lower risk of fines and improved patient safety.

As a trusted long-term care facility, you already know the importance of doing all that is necessary to protect those in your care. Hiring skilled candidates who are free of healthcare sanctions and exclusions is critical to success. By implementing a thorough background screening program, and including continuous monitoring to stay on top of ongoing compliance obligations, providers can take the necessary measures to identify and avoid bad actors.

Kevin Neudecker is vice president of Quality and Compliance with Corporate Screening in Cleveland, Ohio. He is Fair Credit Reporting Act Advanced Certified by the Professional Background Screening Association.