Criminal Convictions for Nurse Aides With Substantiated Findings of Abuse, Neglect, and Misappropriation

WHY WE DID THIS STUDY

The Patient Protection and Affordable Care Act mandates that OIG submit a report to Congress evaluating the Nationwide Program for National and State Background Checks on Direct Patient Access Employees of Long Term-Care Facilities and Providers not later than 180 days after the program's completion. This memorandum report provides baseline information for the mandated report on the extent to which nurse aides with substantiated findings of abuse, neglect, and/or misappropriation had previous criminal convictions that could have been detected through background checks and the nature of those convictions.

HOW WE DID THIS STUDY

In September 2011, we requested from each State's nurse aide registry a roster of all nurse aides who received a substantiated finding of abuse, neglect, and/or misappropriation of property during 2010. For each nurse aide on these rosters, we requested criminal history record information from the Federal Bureau of Investigation. We recorded convictions from each positively matched individual's criminal history.

WHAT WE FOUND

Nineteen percent of nurse aides with substantiated findings had at least one conviction in their criminal history records prior to their substantiated finding. Among these nurse aides, the most common conviction (53 percent) was for crimes against property (e.g., burglary, shoplifting, and writing bad checks). We also determined whether nurse aides with each type of substantiated finding were more likely to have certain types of convictions. We found that nurse aides with substantiated findings of either abuse or neglect were 3.2 times more likely to have a conviction of crime against persons than nurse aides with substantiated findings of misappropriation, and nurse aides with substantiated findings of misappropriation were 1.6 times more likely to have a conviction of crime against property than nurse aides with substantiated findings of abuse or neglect.

WHAT WE CONCLUDED

CMS may wish to provide the information in this memorandum report to States that participate in the background check program as well as to the Long Term Care Criminal Convictions Workgroup. We plan to use this baseline information in the mandated report to assess the extent to which the background check program may reduce the number of incidents of neglect, abuse, and misappropriation of resident property.