Evaluating the Effect of National Background Check Program on Nursing Home Deficiency Citations

Area of Science:

• Healthcare policy and regulation
• Geriatric care quality assessment
• Public health and safety

Background:

• Nursing home quality is a critical public health concern.
• Abuse, neglect, and exploitation remain significant issues in long-term care facilities.
• The National Background Check Program (NBCP) was implemented to enhance safety and accountability.

Purpose of the Study:

• To evaluate the impact of the National Background Check Program (NBCP) on nursing home health deficiencies.
• To assess the effect of NBCP on citations related to abuse, neglect, and exploitation in nursing homes.

Main Methods:

• Utilized a quasi-experimental Callaway and Sant'Anna Difference-in-Differences (CSDID) method.
• Analyzed facility-level data from US nursing homes (2009-2016).
• Included 18 states receiving NBCP grants (treatment) and 24 states not receiving grants (control).

Main Results:

• NBCP implementation correlated with a significant reduction in overall health deficiencies (-0.760, p < 0.01).
• Observed a decrease in the probability and number of citations for abuse, neglect, and exploitation (-0.029, p < 0.01; -0.048, p < 0.01).
• Effects were consistent across nursing homes with varying Alzheimer's Disease and Related Dementias census and in different geographic areas, but varied by state adoption timing.

Conclusions:

• The NBCP demonstrates effectiveness as a regulatory strategy for improving nursing home quality.
• NBCP implementation is associated with reduced health deficiencies and abuse-related violations.
• Further research is needed to explore resident-level outcomes to fully assess quality improvements.