The US Department of Health and Human Services (HHS) Office of Inspector General (OIG) posted a new report on March 19, 2026, finding that Indiana generally complied with federal requirements that prohibit the employment of individuals with disqualifying backgrounds. The audit assessed whether selected nursing homes in the state followed federal rules designed to prevent the hiring of individuals with disqualifying offenses.
OIG reviewed 825 employees across 8 nursing homes and found that all but 13 employees had completed background checks. Among those with completed checks, none had disqualifying offenses. In addition, employees in positions requiring professional licensure held current licenses at the time of employment and had no related disciplinary actions connected to disqualifying offenses.
OIG recommended that Indiana advise nursing homes to verify completion of employee background checks and maintain documentation of those checks. The state did not indicate whether it agreed or disagreed with the recommendation but stated that it would continue taking actions to address the issue.
The full report can be accessed here.
Compliance Perspective
Issue
Federal and state regulations prohibit long-term care facilities from employing individuals with disqualifying criminal or abuse-related histories. Background checks—including criminal history reviews and applicable abuse registry and exclusion list screenings—must be completed and documented before an employee begins work, with ongoing monitoring of databases such as the OIG’s List of Excluded Individuals and Entities (LEIE) to account for changes in eligibility after hire. Failure to complete and document these checks increases the risk of employing individuals who may pose a threat to resident safety and exposes facilities to regulatory enforcement, financial penalties, and reputational harm.
Discussion Points
- Review and, if necessary, revise background check policies and procedures to ensure alignment with current federal and state requirements. Policies should clearly require that all background checks, exclusion list screenings, and licensure verifications are completed and documented prior to the start of employment. Facilities may consider working with a consultant to evaluate hiring workflows, identify gaps, and implement best-practice procedures that support consistent compliance.
- Ensure that human resources staff and hiring managers receive regular education on background check requirements, exclusion list monitoring, and documentation expectations. Training should emphasize the importance of completing all required screenings before employment begins and maintaining accurate, audit-ready records. Med-Net Academy offers the course Staying on Top of Employee Checks, which reviews key topics such as the OIG Exclusion List, the List of Debarred Contractors, licensing and certification verification, and background screening procedures.
- Conduct routine audits to verify that required background checks, exclusion screenings, and licensure verifications are consistently completed and properly documented for all employees. Ongoing monitoring processes, including periodic LEIE checks, should also be validated. Facilities may benefit from engaging a third-party reviewer to perform mock audits or targeted reviews of hiring and onboarding records, helping to identify compliance gaps and strengthen survey readiness.
*This news alert has been prepared by Med-Net Concepts, Inc. for informational purposes only and is not intended to provide legal advice.*