Series: Background Checks for Nursing Home Employees

New Jersey did not ensure that 11 of the 12 selected nursing homes complied with Federal requirements that prohibit the employment of individuals with disqualifying backgrounds during our audit period. In total, these 11 nursing homes did not comply (deficiency) or did not document compliance (potential deficiency) with background check requirements for 33 of the 120 employees reviewed. Specifically:

• Nine nursing homes allowed a total of 17 staff members to provide care before completing a background check.
• Four nursing homes employed a total of six staff members without performing background checks.
• One nursing home did not provide documentation that it had performed background checks for the 10 selected staff members.

These deficiencies and potential deficiencies occurred because New Jersey’s sampling of employees during its nursing home recertification surveys did not provide adequate coverage. Also, nursing homes did not have sufficient procedures to ensure that background checks were properly conducted for all staff members. This put residents at risk of abuse, neglect, exploitation, or mistreatment.

Alabama did not ensure, for the audit period of January 1, 2022, to April 8, 2024, that some of the nursing homes reviewed in our sample complied with Federal and State requirements that prohibit the employment of individuals with disqualifying background checks.

• Specifically, for the 439 nursing home employees we sampled, we found that for 139, the nursing homes either did not meet Federal requirements by having a background check completed before beginning work, did not meet State requirements by querying the Alabama Elderly and Adult in Need of Protective Services Abuse Registry (the Registry) before the employee began work, or a combination of both.

The State agencies did not ensure that selected nursing facilities in Hawaii complied with Federal requirements that prohibit employment of individuals with disqualifying backgrounds and State requirements for conducting employee background checks. Specifically, for the 10 selected nursing facilities, we found the following:

• Seven selected nursing facilities did not conduct background checks to ensure that employees were free from disqualifying backgrounds based on Federal regulations.
• All 10 selected nursing facilities did not conduct 1 or more State-required background checks of their employees.