Performance Improvement 2007. How Can the United States Make Sure That It Has a Qualified Workforce to Provide Services to Those Needing Long-Term Care?



This study assessed the contributions and effectiveness of existing federal mandates and state and provider based strategies for preventing or reducing the abuse of vulnerable adults. The study pursued this objective in three ways. It examined the usefulness of nurse aide registries and criminal background checks as ways to reduce abuse of nursing facility residents. The study also determined the relationship between past criminal background (or previous incidences of abuse) and the proclivity toward subsequent abuse, neglect or exploitation. Finally, the study identified how states and nursing facilities could improve screening and monitoring processes to ensure a qualified workforce.

The study found that federal and state governments, education and training centers, and employers have created a variety of formal ways to prevent abuse, neglect and exploitation in patients in nursing homes and other long-term care settings. These diverse mechanisms include: certification and licensure of paraprofessional long-term care workers, pre-employment screening (e.g., nurse aide registries, criminal background checks and drug tests) systems, and on-the-job training and personnel monitoring. Using data from two states, a correlation was found between criminal history and incidence of abuse. The study determined that while criminal background checks are only one component of preventing abuse, such checks are valuable during the hiring process. Use of background checks did not appear to limit the pool of potential job applicants. Finally, the study found that there are few federal, state or employer policies in place that support or reinforce post-hiring strategies to ensure a qualified workforce.

Report Title: Ensuring a Qualified Long-Term Care Workforce: From Pre-Employment Screens to On-the-Job Monitoring
Agency Sponsor: ASPE, Office of the Assistant Secretary for Planning and Evaluation
Federal Contact: Rosenoff, Emily, 202-690-6443
Performer: The Lewin Group; Falls Church, VA
PIC ID: 8330

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"PerformanceImprovement2007.pdf" (pdf, 717.63Kb)

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