Many states do not require criminal background checks on nursing home staff who manage residents' trust funds, and few demand audits of those accounts – a regulatory gap that contributes to scores of cases in which the money is stolen or mismanaged.
Nearly every state requires background checks for nursing home staff in caregiving roles, but 20 states don't apply that requirement to office workers who do not routinely have direct patient contact, a USA TODAY review of state laws finds. Those office employees typically manage the trust accounts that nursing homes must maintain for residents who request that the facility safeguard their money.
"Obviously, this is a problem that should be addressed, and obviously it's one that hasn't been addressed very well," says Janet Wells, former director of public policy for the National Consumer Voice for Quality Long-Term Care.
Federal law provides the regulatory framework for the nation's 16,000 nursing homes, which have to meet an array of standards to participate in Medicare and Medicaid. Federal rules do not require audits for resident trust fund accounts, and most states take the same approach.
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