A pilot program involving the screening of potential employees at long-term-care facilities could further exacerbate staffing shortages within the industry if more widely adopted.
The three-year project, which began Oct. 1 and is scheduled to end Oct. 1, 2007, is aimed at curtailing physical abuse and mistreatment of patients and improving quality of care. The CMS last week awarded $2.3 million to CNA Corp., a not-for-profit public interest research group, to provide assistance to the facilities from up to 10 states that will be selected for the program.
The pilot program was established by the Medicare Modernization Act and was a reason the American Health Care Association, a long-term-care advocacy group, supported the Medicare reform law, said Jeff Smokler, a spokesman for the association.
The project will be conducted at various long-term-care facilities such as home-health agencies, long-term-care hospitals, nursing homes and hospice centers. The deadline for states to apply to the program was Oct. 18 and the project should be fully under way by early 2005, said Laurie May, director of CNA's Health Care Operations and Research Policy Center.
The General Accounting Office found in a July 2003 study that the number of nursing homes that reported incidents of workers inflicting harm on residents declined by about one-third from 2000 to 2002, but that 20% of nursing homes still had been cited for such acts. In many cases of reported abuse, the staff members who were involved had criminal records, said Janet Wells, director of public policy for the National Citizens' Coalition for Nursing Home Reform.
Wells' group supports the pilot but would have preferred that the screening be made mandatory in all states. Originally, screening of long-term-care workers in all states was part of a bill that Sen. Herb Kohl (D-Wis.) introduced in 1997, but it was scaled back, largely because of cost, Wells said.
The process of screening employees "may introduce some labor problems," May said. "This is already a labor market that's pretty tight."
The screening of employees could slow down the hiring process by days, further delaying the filling of an open position. The program will examine what type of work potential employees can do while they are awaiting background check clearance, May said.
Recent federal grants have tried to ease the strain of a shortage of employees at long-term-care facilities.
For example, the CMS earlier this month awarded a $246,829 grant to James S. Taylor Memorial Home, Louisville, Ky., to hire an outside company to help the nursing home increase employee retention rates. Also, the U.S. Department of Labor's High Growth Job Training Initiative has provided grants to long-term-care facilities and others to help with workforce problems, Smokler said.
He added there is a shortage of at least 100,000 nurses and nurses' aides at nursing homes around the country. Despite that, the association was fully behind the pilot because its aim is to improve quality of care.
Smokler said the association has advocated for background checks for potential employees at long-term-care facilities for about a decade and has recognized a need for a federal law mandating screening of all healthcare workers. Many states do require background checks, but the activities that are red-flagged-type of crimes; whether federal or local records were examined-vary from state to state.