Federal law requires each State to maintain a Nurse Aide Registry (NAR) with specific individual data, the format in which the data is retained and the requirements to access the data vary greatly from State to State. The updated CMS survey regulations state that the nursing home must not employ or otherwise engage individuals found guilty of abuse, neglect, exploitation, misappropriation of property, or have a finding entered into the State nurse aide registry (42 CFR ยง483.12(a)(3)).

The National Background Check Program (NBCP) as described in the Affordable Care Act (ACA) requires that participating States check the State NARs of all States where a long term care (LTC) applicant has previously worked or lived. Currently, because no national NAR exists, a State’s ability to meet this requirement depends on the information that the applicant provides. NBCP States have the ability to manually check other State’s NARs, but this requires that each individual State NAR be checked, requiring re-entry of applicant demographic data.

Numerous media accounts make it clear that LTC applicants who have a disqualifying history do not always provide their prior residence or employment information to potential employers. One solution to obtaining potential adverse findings when an applicant does not disclose them is to send an automatic electronic inquiry to all other States’ NARs, closing the gap of potentially missing data. Language was included within the ACA (Section 1150B) calling for a study to design and implement a national nurse aide registry. The study was to be completed within 18 months. The mandate was unfunded and the report was never completed.

Several NBCP States have implemented an NBCP NAR to allow those States to check each other's NARs electronically. The forum also surveyed several states about their participation in the NBCP NAR and the challenges/barriers to implementation. The State Survey Results were compiled by the Forum.


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