DEPARTMENT OF HEALTH AND HUMAN SERVICES 
OFFICE OF INSPECTOR GENERAL 
WASHINGTON, DC  20201 
OCT  -5  2012 
TO: 	 Marilyn Tavenner 
Acting Administrator 
Centers for Medicare & Medicaid Services 
FROM:  Stuart Wright 
Deputy Inspector General 
for Evaluation and Inspections 
SUBJECT: 	 Memorandum Report:  Criminal Convictions for Nurse Aides With 
Substantiated Findings ofAbuse, Neglect, and Misappropriation, 
0 EI-07-1 0-004 22 
The Patient Protection and Affordable Care Act (ACA) mandates that the Office of 
Inspector General (OIG) submit a report to Congress evaluating the Nationwide Program 
for National and State Background Checks on Direct Patient Access Employees of 
Long-Term-Care Facilities and Providers (background check program) not later than 
180 days after the program's completion.  One required element ofthe mandated 
evaluation is an assessment of the impact ofthe background check program on reducing 
the number of incidents of neglect, abuse, and misappropriation of resident property to 
the extent practicable.  The objective of this memorandum report is to provide baseline 
information for the mandated report on the extent to which nurse aides with substantiated 
findings of abuse, neglect, and/or misappropriation had previous criminal convictions that 
could have been detected through background checks and the nature of those convictions. 
Knowledge of this data will assist in assessing the extent to which the background check 
program may reduce the number of incidents of neglect, abuse, and misappropriation of 
resident property. 
SUMMARY 
Section 6201 of the ACA established the background check program. 1  This voluntary 
program provides grants to States, the District of Columbia, and U.S. territories (States) 
to implement programs to conduct background checks on prospective long-term-care 
employees. The ACA mandates an OIG evaluation ofthe State programs, including an 
assessment of the impact of the background check program on reducing the number of 
1 P.L. 111-148, enacted March 23,2010.  Page 2  Marilyn Tavenner 
 
incidents of abuse, neglect, and misappropriation of resident property to the extent 
practicable.2 
 
In September 2011, we requested from each States nurse aide registry a roster of all 
nurse aides who received a substantiated finding of abuse, neglect, and/or 
misappropriation of property during 2010.  For each nurse aide on these rosters, we 
requested criminal history record information from the Federal Bureau of Investigation 
(FBI).  Nineteen percent of nurse aides with substantiated findings had at least one 
conviction in their criminal history records prior to their substantiated finding.  Among 
these nurse aides, the most common conviction (53 percent) was for crimes against 
property (e.g., burglary, shoplifting, and writing bad checks).  We also determined 
whether nurse aides with each type of substantiated finding were more likely to have 
certain types of convictions.  We found that nurse aides with substantiated findings of 
either abuse or neglect were 3.2 times more likely to have a conviction of crime against 
persons than nurse aides with substantiated findings of misappropriation, and nurse aides 
with substantiated findings of misappropriation were 1.6 times more likely to have a 
conviction of crime against property than nurse aides with substantiated findings of abuse 
or neglect.  Finally, nurse aides with substantiated findings in 2010 had a higher rate of 
convictions than nurse aides employed in nursing facilities overall. 
 
BACKGROUND 
 
State Nurse Aide Registries 
The Omnibus Budget Reconciliation Act of 1987 added sections 1819 and 1919 of the 
Social Security Act (SSA) to ensure the delivery of quality care to Medicare and 
Medicaid long-term-care facility residents.  These provisions require each State to 
maintain a nurse aide registry of all individuals who are certified to work as nurse aides 
in that State, as well as all individuals who have substantiated findings of abuse or 
neglect of residents, or misappropriation of resident property.3  Federal regulations 
promulgated pursuant to these provisions prohibit long-term-care facilities from hiring 
nurse aides who have had a finding entered into the State nurse aide registry concerning 
abuse, neglect, mistreatment of residents or misappropriation of their property....4  
Long-term-care facilities must also report to the nurse aide registry any knowledge of 
actions by a court of law that would indicate unfitness to serve as a nurse aide.5   
 
When a long-term-care facility suspects that abuse, neglect, or misappropriation of 
resident property has occurred, the facility must investigate and report the results to the 
State survey and certification agency.6  If the State survey and certification agency finds 
that the allegation is substantiated, a finding is placed in the nurse aide registry for the 
                                                 
2 ACA  6201(a)(7). 
3 SSA  1819(e)(2) and 1919(e)(2).   
4 42 CFR  483.13(c)(1)(ii). 
5 42 CFR  483.13(c)(1)(iii). 
6 42 CFR  483.13(c)(2) through 42 CFR  483.13(c)(4). 
Criminal Convictions for Nurse Aides With Substantiated Findings (OEI-07-10-00422)    Page 3  Marilyn Tavenner 
 
implicated nurse aide.7  Only the State survey and certification agency may place 
substantiated findings on the registry.8 
 
Nurse aide registries must include at a minimum:  (1) the full name of the individual, 
(2) identifying information, (3) the date the individual became eligible for placement in 
the registry, and (4) information regarding substantiated findings, as appropriate.9  
Federal regulations require States to remove registry records of individuals who have not 
performed nursing or nursing-related services for a period of 24 consecutive months, 
unless the individuals registry entry includes substantiated findings of abuse, neglect, or 
misappropriation of property.10   
 
Individuals with substantiated findings of abuse, neglect, or misappropriation of property 
must remain on the registry permanently, unless the findings were made in error, the 
individual was found not guilty in a court of law, or the State is notified of the 
individuals death.11  The Balanced Budget Act of 1997 established the only exception, 
which allows nurse aides with substantiated findings of neglect to petition the State to 
have their names removed from the registry.12  Such an individual must wait at least 
1 year from the date on which the substantiated finding was added to the registry, and the 
State must determine that the employment and personal history of the nurse aide did not 
reflect a pattern of abusive behavior or neglect, and that the neglect involved a singular 
occurrence.13 
 
Apart from the prohibition on employing as nurse aides individuals who have 
substantiated findings of abuse, neglect, or misappropriation, or who have been found 
guilty of abuse, neglect, or mistreatment of residents by a court of law, there is no Federal 
prohibition on employing individuals convicted of other types of crimes.14 
 
Background Check Program 
Section 6201 of the ACA requires the Secretary of Health and Human Services to 
establish a background check program in which States may voluntarily apply for grant 
funds to conduct national and State background checks of prospective direct patient 
access employees of nursing facilities and other long-term-care providers.  The program 
is administered by CMS in cooperation with FBI.  The ACA provides up to $160 million 
in Federal funds for the program. 
 
To implement the background check program, CMS began soliciting applications for 
grant awards in June 2010.  Program start dates for each participating State vary based on 
when the State received a grant award; however, the completion date of the program 
                                                 
7 Centers for Medicare & Medicaid Services (CMS), State Operations Manual, Pub. No. 100-07, ch. 5, 
 5310.3. 
8 42 CFR  483.156(b)(2). 
9 42 CFR  483.156(c)(1). 
10 42 CFR  483.156(c)(2). 
11 42 CFR  483.156(c)(1)(iv)(D). 
12 P.L. 105-33  4755, amending SSA  1819(g)(1) and 1919(g)(1). 
13 P.L. 105-33  4755, amending SSA  1819(g)(1) and 1919(g)(1). 
14 42 CFR  483.13(c)(1)(ii). 
Criminal Convictions for Nurse Aides With Substantiated Findings (OEI-07-10-00422)    Page 4  Marilyn Tavenner 
 
(i.e., the date that participating States will deplete their grant funds) is unknown at this 
time.  As of September 2012, 19 States had received grants. 
 
Section 6201 of the ACA establishes requirements for the background check programs 
that participating States must implement.  States are required to conduct three types of 
background checks:  (1) a search of any State-based abuse and neglect registries and 
databases, and the abuse and neglect registries of all known States in which the employee 
lived; (2) a check of State criminal history records; and (3) a fingerprint-based FBI 
criminal history records check.15  Participating States must also describe and test methods 
to reduce duplication of fingerprinting, including the development of rap back 
capabilities.16  Rap back is the term used to describe processes to ensure that State law 
enforcement departments inform the appropriate State agency of any criminal conviction 
by the employee that occurs at any time following the preemployment background check.  
The State agency in turn informs the employer of the conviction. 
 
Mandated OIG Evaluation 
The ACA requires OIG to submit a report to Congress evaluating the background check 
program not later than 180 days after its completion.  In July 2010, we began an 
evaluation entitled Nationwide Program for National and State Background Checks for 
Long-Term-Care Employees (OEI-07-10-00420).  In addition to the mandated report, 
which we will publish at the end of the background check program, we are producing 
interim reports as needed.  This memorandum is one such interim report.    
 
According to the ACA, OIG must include the following in its evaluation: 
 
1.  A review of the various procedures implemented by participating States for 
long-term-care facilities or providers, including staffing agencies, to conduct 
background checks of prospective direct patient access employees under the 
background check program and identification of the most appropriate, efficient, and 
effective procedures for conducting such background checks; 
 
2.  An assessment of the costs of conducting such background checks (including startup 
and administrative costs); 
 
3.  A determination of the extent to which conducting such background checks leads to 
any unintended consequences, including a reduction in the available workforce for 
long-term-care facilities or providers;  
 
4.  An assessment of the impact of the background check program on reducing the 
number of incidents of neglect, abuse, and misappropriation of resident property to 
the extent practicable; and 
 
                                                 
15 P.L. 111-148  6201(a)(3)(A). 
16 P.L. 111-148  6201(a)(4)(B)(viii). 
Criminal Convictions for Nurse Aides With Substantiated Findings (OEI-07-10-00422)    Page 5  Marilyn Tavenner 
 
5.  An evaluation of other aspects of the background check program, as determined 
appropriate by the Secretary.17 
 
This memorandum report provides baseline information on issue 4 above.  The full 
mandated report will cover all of the issues listed above. 
 
Related Report 
A 2011 OIG evaluation determined the extent to which nursing facilities employed 
individuals with criminal convictions.  In that evaluation, we found that 92 percent of 
nursing facilities employed at least one individual with at least one criminal conviction.18  
Overall, 5 percent of all nursing facility employees had at least one criminal conviction.  
OIG recommended that CMS work with States participating in the background check 
program to develop a list of State and local convictions that disqualify an individual from 
nursing facility employment under the Federal regulation and periods for which each 
conviction bars the individual from employment.  In response, CMS formed a workgroup 
of States to provide recommendations on establishing (1) a list of specific conviction 
types that disqualify individuals from employment, (2) a list of conviction types that can 
be considered for rehabilitation, and (3) periods for disqualification.19 
 
METHODOLOGY 
 
Data Collection 
Nurse Aide Data.  From each State nurse aide registry, we obtained a roster of all nurse 
aides who received a substantiated finding of abuse, neglect, or misappropriation of 
property in 2010.  For each nurse aide with a substantiated finding, we requested the 
following data elements:  (1) full name, (2) date of birth, (3) Social Security number 
(SSN), (4) race, (5) sex, (6) date of initial registration, (7) effective date of the 
substantiated finding, and (8) whether the substantiated finding was for abuse, neglect, or 
misappropriation of property.  We received data on a total of 1,611 nurse aides with 
substantiated findings in 2010.  Table 1 shows the number of nurse aides with each 
finding type. 
                                                 
17 P.L. 111-148  6201(a)(7)(A)(ii). 
18 OIG, Nursing Facilities Employment of Individuals With Criminal Convictions, OEI-07-09-00110, 
March 2011. 
19 The Long-Term-Care Criminal Convictions Workgroup is made up of 11 States and CMS central and 
regional office staff. 
Criminal Convictions for Nurse Aides With Substantiated Findings (OEI-07-10-00422)    Page 6  Marilyn Tavenner 
 
Table 1:  Number of Nurse Aides With Substantiated 
Findings in 2010 by Type 
Number of 
Finding Type 
Nurse Aides 
Abuse  563 
Neglect  511 
Misappropriation  466 
Abuse and Neglect  64 
Abuse and Misappropriation  4 
Neglect and Misappropriation  2 
Abuse, Neglect, and Misappropriation  1 
   Total  1,611 
Source:  OIG analysis of nurse aide registry data, 2012. 
 
Criminal History Records.  For each nurse aide with a substantiated finding, we 
requested criminal history record information from FBI.20  We provided the nurse aide 
data obtained from State nurse aide registries to FBI.  FBI performed a name-based 
match with the Interstate Identification Index, which is an electronic repository of 
criminal history record information.  For the 1,611 names we provided, we received 
criminal history information for 852 individuals with names that closely matched.21  
Using the SSN, date of birth, race, and gender identifiers, we further examined the 
matches FBI provided to identify nurse aides with criminal convictions.  We identified 
341 nurse aides with substantiated findings who also had criminal convictions.22   
 
Using six broad categories of offenses, we recorded convictions from each positively 
matched individuals criminal history.23  Following are the six broad categories of 
offenses and examples of specific offenses included in each category.  (These lists do not 
include every specific offense we found in each of the six categories.)  
  crimes against persons:  assault, battery, rape; 
  crimes against property:  burglary, larceny, possession of stolen property, 
shoplifting, theft, counterfeiting, writing bad checks; 
  driving under the influence of drugs or alcohol (DUI):  driving under the 
influence, driving while intoxicated; 
  driving-related crimes (other than DUI):  leaving the scene of an accident, driving 
with a suspended license; 
  drug-related crimes:  possession of drugs or paraphernalia, sale of controlled 
substances; and 
  other:  disorderly conduct, prostitution, resisting arrest, weapons violations. 
 
                                                 
20 To gain access to criminal history record information, we entered into an Information Transfer 
Agreement with FBI.  Our Information Transfer Agreement governs the terms of OIGs access to FBI 
criminal history records for research purposes. 
21 FBI did not provide any matches for 759 individuals; therefore, we did not perform further analysis on 
these individuals. 
22 The identifiers of 100 individuals did not match the identifiers that the State nurse aide registries 
provided (e.g., different date of birth, different SSN).  For the remaining 411 individuals, the criminal 
history records contained information on charges, but not convictions. 
23 We consulted FBI definitions of crime to assist us in categorizing offenses.  Accessed at 
http://www2.fbi.gov/ucr on June 7, 2012.  
Criminal Convictions for Nurse Aides With Substantiated Findings (OEI-07-10-00422)    Page 7  Marilyn Tavenner 
 
Comparison of Conviction Rates and Types for Nurse Aides With Substantiated Findings 
in 2010 and for Nurse Aides Employed in Nursing Facilities in 2009.  We compared the 
rate and types of convictions for nurse aides with substantiated findings in this evaluation 
with an estimate of the rate and types of convictions for nurse aides employed in nursing 
facilities in 2009.  For the latter, we used data received for the March 2011 OIG 
evaluation entitled Nursing Facilities Employment of Individuals With Criminal 
Convictions (OEI-07-09-00110).  This allowed us to determine whether statistically 
significant differences existed at the 95-percent confidence level between the two groups 
of nurse aides with criminal convictions:  (1) nurse aides who had received substantiated 
findings of abuse, neglect, and/or misappropriation in 2010, and (2) nurse aides who were 
actively employed in nursing facilities as of June 1, 2009.  Because nursing facilities are 
prohibited from employing nurse aides with substantiated findings, we assumed that the 
nurse aides who were actively employed as of June 1, 2009, did not have substantiated 
findings.  Although the periods of review are different (calendar year 2010 for this 
evaluation versus the single day of June 1, 2009, for the earlier evaluation), we are 
unaware of any nursing facility-related changes that would invalidate the comparison of 
these groups of nurse aides with criminal convictions. 
 
Limitations 
State nurse aide registries do not identify nurse aides dates of employment; nurse aides 
dates of registration are not necessarily the same as the dates they began employment.  
Therefore, we are unable to determine whether employers could have been aware of 
nurse aides criminal conviction(s) prior to their employment.24  We examined the timing 
of convictions in relation to nurse aides dates of registration.   
 
FBI-maintained criminal history records do not contain the necessary information, such 
as whether the victim of a crime was a long-term-care facility resident, to determine 
whether a conviction disqualifies an individual from long-term-care facility employment 
under Federal regulation.  Therefore, we limited our use of the FBI data to determining 
whether nurse aides with substantiated findings had criminal convictions, but not for 
determining whether these individuals were employed in violation of Federal regulation. 
 
At this time, we do not know how many and which States will participate in the 
background check program.  Therefore, we provide information in this memorandum 
report on all States.  In the final evaluation report, we will report results specific to the 
States that participated in the background check program. 
 
Standards 
This study was conducted in accordance with the Quality Standards for Inspection and 
Evaluation issued by the Council of the Inspectors General on Integrity and Efficiency. 
 
 
                                                 
24 We acknowledge that the data obtained for this memorandum report and the March 2011 OIG evaluation 
(Nursing Facilities Employment of Individuals With Criminal Convictions, OEI-07-09-00110) are related 
solely to nursing facilities, whereas the background check program includes nursing facilities as well as 
other types of long-term-care providers (e.g., home health agencies, hospices). 
Criminal Convictions for Nurse Aides With Substantiated Findings (OEI-07-10-00422)    Page 8  Marilyn Tavenner 
 
RESULTS 
 
Nineteen Percent of Nurse Aides With Substantiated Findings Had at Least One 
Conviction Prior to Their Substantiated Findings 
Our analysis of FBI-maintained criminal history records revealed that 19 percent 
(300 of 1,611) of nurse aides who received substantiated findings of abuse, neglect, or 
misappropriation in 2010 had at least one conviction prior to their substantiated findings.  
This result suggests that the maximum possible reduction in substantiated findings of 
abuse, neglect, and misappropriation of resident property at the completion of the 
background check program would be 19 percent in comparison to 2010 baseline data.  
However, we acknowledge that the reduction will be less than 19 percent because not all 
nurse aides with criminal convictions are prohibited from employment and not all States 
plan to participate in the background check program.   
 
Overall, the 300 nurse aides with criminal convictions before their substantiated findings 
had a total of 622 convictions.  The number of convictions per nurse aide ranged from 
1 to 14, averaging 2.1 convictions per nurse aide.   
 
Timing of Convictions.  Of the 300 nurse aides with at least one conviction prior to the 
dates of their substantiated findings, 170 nurse aides had at least one conviction prior to 
their date of registration as a nurse aide.25  The remaining 130 nurse aides who received 
substantiated findings of abuse, neglect, or misappropriation in 2010 each had at least one 
conviction after the date of their registration as a nurse aide, but before a substantiated 
finding.   
 
The 300 nurse aides who each had at least one criminal conviction prior to the dates of 
their substantiated findings include 43 nurse aides who each had both at least one 
conviction before the date of their substantiated findings and at least one conviction 
afterward.26  For example, one nurse aide had an embezzlement conviction in 
January 1997 and a shoplifting conviction in July 1998.  After receiving a substantiated 
finding of misappropriation on February 25, 2010, this individual had three convictions in 
October 2010 for crimes against property:  two convictions of identity theft and a 
conviction for fraudulent conversion of leased goods.  Table 2 shows the percentage of 
nurse aides with convictions prior to their substantiated findings by the amount of time 
elapsed between the most recent conviction and the date of the substantiated finding. 
                                                 
25 The 170 nurse aides include 54 nurse aides who each had both at least one conviction before the date of 
registration as a nurse aide and at least one conviction afterward.   
26 Forty-one nurse aides had convictions only after the date of their substantiated findings. 
Criminal Convictions for Nurse Aides With Substantiated Findings (OEI-07-10-00422)    Page 9  Marilyn Tavenner 
 
Table 2:  Percentages of Nurse Aides With Convictions Prior  
to Substantiated Findings by Elapsed Time Between  
Most Recent Conviction and Date of Substantiated Finding 
Percentage of Nurse 
Elapsed Time Before  Aides With Convictions 
Substantiated Finding Date  Prior to Substantiated 
Findings (n=300) 
Less than 1 year  28.0% 
1 year to less than 5 years  30.7% 
5 years to less than 10 years  15.7% 
10 years to less than 15 years  11.0% 
15 years to less than 20 years  7.0% 
20 years to less than 30 years  5.0% 
30 years or more  2.7% 
   Total*  100.0% 
Source:  OIG analysis of FBI criminal history records and data on nurse aides with 
substantiated findings, 2012. 
 
*Percentages do not sum to 100 percent due to rounding. 
 
Types of Convictions.  Among the 300 nurse aides who each had a conviction prior to a 
substantiated finding, the most common conviction (53 percent) was for crimes against 
property (e.g., burglary, shoplifting, and writing bad checks).  Table 3 shows the six 
categories of crime and the corresponding percentages of convictions for nurse aides with 
substantiated findings. 
 
Table 3:  Percentages of Convictions Received by Nurse 
Aides With Substantiated Findings by Category of Crime 
Percentage of Convictions 
Category of Crime 
(n=622) 
Crimes against property  52.9% 
Crimes against persons  14.3% 
Other  9.3% 
DUI  9.3% 
Drug-related crimes  7.2% 
Driving-related crimes other than DUI  6.9% 
   Total*  100.0% 
Source:  OIG analysis of FBI criminal history records and data on nurse aides with 
substantiated findings, 2012. 
 
*Percentages do not sum to 100 percent due to rounding. 
 
In our analysis of FBI-maintained criminal history records, we identified five nurse aides 
with substantiated findings in 2010 who were registered sex offenders.  Three nurse aides 
had sex offender registration dates prior to the dates of their substantiated findings, and 
two were registered as sex offenders subsequent to the dates of their substantiated 
findings. 
 
Among Nurse Aides With Convictions, Nurse Aides With Findings of Abuse or 
Neglect Were More Likely to Have Convictions of Crimes Against Persons; Nurse 
Aides With Findings of Misappropriation Were More Likely to Have Convictions of 
Crimes Against Property 
We examined relationships between the type of substantiated finding(s) (i.e., abuse, 
neglect, and/or misappropriation) and the type of conviction (e.g., crimes against 
persons).  Nurse aides with substantiated findings of either abuse or neglect were 
3.2 times more likely to have convictions of crime against persons than nurse aides with 
Criminal Convictions for Nurse Aides With Substantiated Findings (OEI-07-10-00422)    Page 10  Marilyn Tavenner 
 
substantiated findings of misappropriation.27  Conversely, nurse aides with substantiated 
findings of misappropriation were 1.6 times more likely to have convictions of crime 
against property than nurse aides with substantiated findings of abuse or neglect.28 
 
Nurse Aides With Substantiated Findings Had a Higher Rate of Criminal 
Convictions Than Nurse Aides Employed in Nursing Facilities Overall 
When we consider convictions occurring either before or after substantiated finding 
dates, 21 percent (341 of 1,611) of nurse aides with substantiated findings had criminal 
convictions.  According to data for the 2011 OIG evaluation entitled Nursing Facilities 
Employment of Individuals With Criminal Convictions,29 6 percent of nurse aides 
employed in nursing facilities overall had criminal convictions.30  Both groups of nurse 
aides averaged approximately two convictions per nurse aide.   
 
Types of Convictions.  We compared the percentages of each group of nurse aides with 
each conviction type.  The percentages of nurse aides with convictions of crimes against 
persons and property were higher among the nurse aides with substantiated findings in 
2010 when compared with nurse aides employed in nursing facilities overall.31  Table 4 
shows the percentages of nurse aides with these two conviction types. 
 
Table 4:  Percentages of Nurse Aides With Convictions 
By Category of Conviction 
  Convictions of  Convictions of 
Crimes Against  Crimes Against 
Persons  Property 
Nurse aides with substantiated 
23.5%  63.6% 
findings in 2010 
Nurse aides employed in nursing 
12.9%  47.4% 
facilities in 2009 
Source:  OIG analysis of FBI criminal history records and nurse aides with 2010 substantiated 
findings data and 2009 nursing facility employee data, 2012. 
 
CONCLUSION 
 
The results presented in this memorandum report provide baseline information on the 
extent to which nurse aides had substantiated findings (1,611) and the extent to which 
nurse aides with substantiated findings of abuse, neglect, and/or misappropriation had 
previous criminal convictions (19 percent) and the nature of those convictions.  The 
                                                 
27 Fifty-one nurse aides with substantiated findings of either abuse or neglect had convictions for crimes 
against persons; 16 nurse aides with substantiated findings of misappropriation had convictions for crimes 
against persons. 
28 Ninety-seven nurse aides with substantiated findings of misappropriation had convictions for crimes 
against property; 59 nurse aides with substantiated findings of either abuse or neglect had convictions for 
crimes against property. 
29 OEI-07-09-00110, March 2011. 
30 Appendix A presents the point estimates and confidence intervals for all population estimates. 
31 Differences are statistically significant at the 95-percent confidence level.  We found no statistically 
significant difference in the percentages of nurse aides with convictions of drug crimes and driving-related 
crimes other than DUI.  There were statistically significant differences in the percentages of nurse aides 
with convictions of DUI and other crimes; however, for these two categories of crimes, the percentage of 
nurse aides employed in nursing facilities in 2009 was higher than the percentage of nurse aides with 
substantiated findings in 2010. 
Criminal Convictions for Nurse Aides With Substantiated Findings (OEI-07-10-00422)    Page 11  Marilyn Tavenner 
 
percentage of nurse aides with criminal convictions and substantiated findings is higher 
than the percentage of nurse aides with criminal convictions employed in nursing 
facilities; however, it is important to note that approximately 80 percent of nurse aides 
with substantiated findings had no criminal convictions in FBI-maintained criminal 
history records.  To determine trends, we will repeat this analysis for nurse aides with 
substantiated findings as the background check program progresses.  We will present the 
results in the mandated report entitled Nationwide Program for National and State 
Background Checks for Long-Term-Care Employees (OEI-07-10-00420). 
 
CMS may wish to provide the information in this memorandum report to States that 
participate in the background check program as well as to the Long-Term-Care Criminal 
Convictions Workgroup.  This report is being issued directly in final form because it 
contains no recommendations.  If you have comments or questions about this report, 
please provide them within 60 days.  Please refer to report number OEI-07-10-00422 in 
all correspondence. 
Criminal Convictions for Nurse Aides With Substantiated Findings (OEI-07-10-00422)    Page 12  Marilyn Tavenner 
 
APPENDIX A 
 
Table A-1:  Point Estimates and Confidence Intervals for Data Used in March 2011 Report 
(Nursing Facilities Employment of Individuals With Criminal Convictions, 
OEI-07-09-00110) 
Sample  Point  95-Percent 
Estimate 
Size  Estimate  Confidence Interval 
Percentage of nurse aides employed in nursing facilities in 
12,239  6.4%  5.18.0% 
2009 with convictions 
Average number of convictions among nurse aides 
12,239  2.0  1.82.2 
employed in nursing facilities in 2009 
Percentage of nurse aides employed in nursing facilities in 
12,239  12.9%  9.916.6% 
2009 with convictions of crimes against persons  
Percentage of nurse aides employed in nursing facilities in 
12,239  47.4%  41.253.3% 
2009 with convictions of crimes against property 
Source:  Office of Inspector General analysis of Federal Bureau of Investigation criminal history records and 2009 data on nursing facility 
employees, 2012. 
 
Criminal Convictions for Nurse Aides With Substantiated Findings (OEI-07-10-00422)