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Greater need for background
checks
Janine Fiesta. Nursing Management. Chicago: Nov 1999. Vol. 30, Iss. 11; pg. 26,
1 pgs
Copyright Springhouse Corporation Nov 1999
The push is on for a more uniform system of background checks for health care
employees. Studies and crimes against patients have prompted regulation ty the
Health Care Financing Administration (HCFA), state governments, hospitals, and
Congress. [Nurs Manage 1999:30(11):261
Federal regulations require that hospital hiring administrators request
information from the National Practitioner Data Bank concerning any physician,
dentist, or other health care practitioner who applies for a position or for
clinical privileges.' They also must check the data bank, which contains adverse
information about practitioners, every 2 years after the practitioner receives
the position or privileges.
For other health care employees, however, background check standards aren't as
clear-cut. Legislation continues to develop regarding background checks for
long-term and home-care staff, and acute care regulators are following suit.
The long-term model
A 1998 audit of eight Maryland nursing homes by the Department of Health and
Human Services, Office of Inspector General, found that according to FBI
records, 51 employees had been convicted for crimes. 2 The employees included
certified nurses aides, as well as staff holding jobs not subject to background
checks. An audit of Illinois nursing homes demonstrated similar results.3
Studies like these, as well as cases of patient abuse and neglect, have led to
increased criminal background checks on long-term-care employees. Many states
have passed laws requiring these investigations.
In 1997, background checks on 378 Florida nursing home employees showed that one
in five had arrests or convictions.4 Today, Florida law requires criminal
background checks for nursing home employees by the Florida Health Care
Association.5 In addition, HCFA requires Medicareparticipating home-care
organizations to run criminal background checks on prospective employees.
Acute care catch-up
In 1995, when a health care employee in Atlanta raped a paralyzed patient, acute
care facilities usually didn't conduct criminal background checks on new
employees.6 The hospital found out after the rape that the employee had three
felony convictions for robbery and forgery and had lied on his job application.
The hospital reacted by enacting a policy that requires criminal background
checks for all employees with access to vulnerable patients.
In other areas, state laws are addressing background checks in acute care.
Wisconsin, for example, passed a law last year that requires criminal background
checks on virtually every prospective and current employee at hospitals, nursing
homes, and home health agencies.7 The law's coverage extends to independent
contractors with access to patient and auxiliary employees such as maintenance
and housekeeping staff.
The Wisconsin law lists crimes that permanently bar health care employment.
Additionally, it lists crimes that don't block employment, including some crimes
deemed acceptable if the employee has demonstrated rehabilitation. The
organization may determine whether the conviction substantially relates to the
job duties or may put vulnerable patients at risk. In the absence of a
conviction, the organizations may decide if the behavior precludes hiring.8
Congress is considering several bills, including the Elderly and Disabled
Protection Act of 1999 and the Patient Abuse Prevention Act (proposed amendment
to the Social Security Act), that propose health care employee background
checks.9 The bills focus on nursing facilities, skilled nursing facilities, home
health agencies, and hospice programs. Although no federal laws currently
mandate background checks for health care employees in acute care, many
institutions choose to perform the checks to protect patients and staff and
reduce their legal liability.
REFERENCES
[Referance]
1. Department of Health and Human Services. Available World Wide Web:
http://hippo. findlaw.com/hippocon.html.
2. Department of Health and Human Services, Office of the Inspector General:
"Safeguarding Long Term Care Residents," September 14, 1998. Available World
Wide Web: http:// waisgate.hhs. gov/cgi-bin/waisgate? WAISdoclD=3106385
1,2+6+0+0&WAISaction= retrieve.
[Referance]
3. Ibid.
4. Merchants Association of Florida. Available World Wide Web: http://www.merchantsfla-com/mse-new/fa1197/criminal.html.
5. The News Chief. Available World Wide Web: http://www.newschief.com/stories/
120498/sta-nursing.shtml.
6. "Hospital rape leads to staff background checks," Healthcare Risk Management.
20(5):55-57, May 1998.
[Referance]
7. Bellandi, D.: "Paying for the Crime," Modern Healthcare. 28(48):54, 1998.
8. Wisconsin Department of Health and Family Services. Available World Wide Web:
http://wy,rw.dhfs.state.wi.us/caregiver/faq/.
9. HR1984, HR2627, and S1445. Available World Wide Web: http://www.congress.
org/legis.html.