OIG Report Highlights Need for Employee Background Checks in Home Health

Posted by Michael Jenkins on Wednesday, June 3, 2015

A recently released OIG report uncovered that roughly 4% of home health employees have at least one criminal conviction. As the report indicates, there are currently no Federal laws or regulations that require home health agencies to conduct a background check of potential or current employees. State laws vary regarding whether background checks must be performed and if background checks are required, state laws vary regarding what information must be checked; what job positions require a background check; and what types of convictions disqualify an individual from employment. Of the 99 home health agencies sampled 83% reported that they performed some sort of background check on all prospective employees. The remaining 17% only conducted background checks on certain employees.

The goal of the study conducted by the OIG was to determine whether following state law requirements would lead to the disqualification of individuals with past criminal convictions from employment at a home health agency (HHA). Six employees from the sample of 99 home health agencies selected had prior criminal convictions relating to crimes against persons in the last five years and/or were registered sex offenders. Of these six employees, the OIG found that three should have been disqualified from employment pursuant to state law. The OIG was unable to definitively say whether the remaining three employees would have been disqualified under their respective state regulations due to a lack of information contained in the FBI criminal history records about the conviction.

At the conclusion of the report the OIG recommended that the Center for Medicare and Medicaid Services (CMS) promote minimum standards in background check procedures. Specifically, the OIG would like more states to participate in the National Background Check Program. You may access the full report by clicking on the following link: OIG Report.

Should CMS choose to implement the OIG’s recommendations all HHAs would be required to participate in the National Background Check Program, which means that the agencies would be required to subject each HHA employee to three types of background checks. These background checks include: a background check of the State database, which only includes information regarding prior convictions committed within that state; a background check of statewide criminal history records; and a background check of FBI criminal history records, which includes all criminal convictions on both the federal and state level. Additionally, all HHAs would be required to follow any minimum standards for background check procedures that the CMS implements.

In Iowa, all health care facilities including HHAs are required to obtain both criminal and child and dependent adult abuse background checks for prospective employees prior to employment. See IA Code § 135C.33. Health care providers including HHAs may obtain the required background checks either my using the Single Contact Repository, a state created application that allows registered users to obtain all background checks required from one screen, or they may obtain a criminal history report from the Division of Criminal Investigation and a child and dependent abuse check from the Iowa Department of Human Services (DHS). If either background check comes back with a possible prior conviction this does not automatically disqualify an individual from employment. If the health care facility or HHA still wishes to employ said individual they must request a Record Check Evaluation by the DHS within 30 days. DHS will then determine whether the individual is employable or not. Health care providers including HHAs in Iowa do not have an obligation to continuously perform background checks on their current employees. However, if they are made aware of a possible conviction of a current employee the health care provider or HHA then has a duty to investigate. For more information on the Iowa requirements click the following link here