Jeannine LeCompte, Compliance Research Specialist
Skilled Nursing Facilities (SNFs) are under a legal obligation to ensure that all employees are fully compliant with the regulations contained in the Office of Inspector General’s (OIG) compliance program guidelines. The third element of the OIG’s “seven elements of an effective compliance program” is the screening and evaluation of employees, physicians, vendors, and other agents.
SNFs must ensure that all employees are fully screened before being employed—and that this screening is kept up-to-date.
The OIG maintains a list of excluded individuals which can be accessed online at https://exclusions.oig.hhs.gov. Excluded individuals include those convicted of Medicare- or Medicaid-related crimes, those convicted of patient abuse or neglect, or those having a felony conviction relating to a controlled substance. Medicare- or Medicaid-related crimes include any offense involving healthcare fraud, obstruction of an investigation or audit, license revocation, and the making of false statements or misrepresentations of material fact.
SNFs should make sure no employee, prospective or current, is on the exclusion list. This screening process should include any other name or alias used by a prospective employee. All employees should be screened on a monthly basis, as the exclusion list is continually being updated, and employees could have committed an act that placed them on the exclusion list after being hired. Employing an excluded person will result in sanctions against the facility and take-back of funds paid from a government program for any work performed by that excluded person.
SNFs must make sure that the Human Resources personnel files contain confirmation that newly hired employees were screened prior to their first day of employment. In addition, SNFs should have policies in place which define which employees must undergo further criminal, financial, and/or other background checks prior to hire. There should be an audit process in place to ensure that these checks are done and recorded in personnel files.
As part of the employment process, potential employees should be made aware of this screening process, and written confirmation of this awareness and understanding of its implications should also be held on file. This is to ensure that the screening program is consistent with all laws and regulations.
Confirmation that employees are aware of the regulations and the organization’s compliance program should also be included in the personnel files. This can be done through questionnaires which test for employee awareness. Such records can be of immense help in determining liability if a problem arises.
SNFs should also have a process in place to ensure that individuals are appropriately licensed and credentialed for the job they will be performing. Once again, evidence of this check must be kept in the personnel files.
