Nine out of 10 nursing homes in America have at least one convicted criminal on staff, according to a new report from the Department of Health and Human Services Office of Inspector General. The OIG recommends developing procedures to help implement a nationwide criminal background check program.

The OIG, which released its report Wednesday, checked the names of roughly 35,000 nursing home employees at 260 nursing facilities against criminal records kept by the Federal Bureau of Investigation. The agency discovered that 92% of the nursing homes sampled had hired at least one convicted criminal, and that overall, roughly 5% of all nursing home employees have at least one conviction.

The most common offense (44%) was a crime against property, such as burglary, shoplifting or writing bad checks, according to the report. Of those with criminal convictions, approximately one in eight had been convicted of a crime against person, such as assault. Roughly 16% had been convicted of a crime while employed at a nursing facility. Nearly 85% of those sampled were women, and almost 70% were considered direct-care employees.

The Patient Protection and Affordable Care Act requires the establishment of a nationwide criminal background check for all prospective nursing home employees who will have “direct patient access,” according to the OIG report. The agency recommends that the Centers for Medicare & Medicaid Services clearly define the employee classifications that are direct patient access employees, and work with States to develop a list of convictions that would disqualify a person from employment in a nursing facility. The new healthcare law offers states $160 million to improve criminal background checks on prospective employees of long-term care providers.

To view the report, visit the OIG website.