New York Audited 10 Nursing Homes. 6 Missed a Background Check.
Summary
The HHS Inspector General reviewed background checks for 100 staff members across 10 New York nursing homes and found 6 of the homes had skipped, delayed, or failed to document one -- including a non-licensed staff member who provided direct care for 17 years before hers was finished. New York's failure rate was still the lowest of the three states audited so far in this national series: Connecticut failed all 9 of its sampled homes, and New Jersey failed 11 of 12.
How the check is supposed to work
Nursing homes that accept Medicare and Medicaid patients operate under a federal rule, 42 CFR § 483.12(a)(3)⧉, that bars them from employing or engaging anyone with a disqualifying background: a court finding of resident abuse, neglect, exploitation, mistreatment, or property misappropriation; an entry on the state's nurse-aide registry for the same; or a professional license pulled over such a finding. A 2010 Affordable Care Act provision, the National Background Check Program for Long-Term-Care Providers⧉, offered states federal help building the systems to run those checks -- but participation was voluntary, and New York, 's report notes, is among the states that never opted in.
View data as table
| Background check not performed or performed late | 6 |
|---|---|
| Background check may not have been performed before hire | 1 |
| No license verification before hire | 1 |
A window built into the state's own check
New York's oversight of nursing homes has close to the same blind spot the audit found inside the nursing homes themselves. State surveyors are required to inspect each home at least once every 15 months, and during that inspection they verify background-check paperwork for a sample of only 5 employees hired in the trailing 4 months. A worker hired just after one survey can go 11 months or more -- potentially an entire 15-month cycle -- before the state's own check-on-the-checkers could even possibly look at their file, and even then only if a surveyor happens to pick them out of that narrow sample.
That gap is not hypothetical. At one New York nursing home, a subsidiary of a larger parent company, a non-licensed staff member gave direct care to residents for 17 years before completing a single background check -- the parent company had outsourced the check to a third party that never filed it with the state as required. At another, an occupational therapist worked nearly 6 months before the home verified her professional license. Once both checks were finally run, OIG found⧉ neither employee had a disqualifying record -- matching the six other staff members flagged in the audit's first finding, all of whom likewise turned out clean once checked. The failure was a paperwork and monitoring gap, the report is careful to note, not a confirmed instance of a dangerous hire slipping through unnoticed -- though one of the eight flagged cases was never resolved either way: that home never supplied a hire date, so auditors couldn't determine whether its background check ran before or after the staff member started providing care.
View data as table
| New York (6 of 10) | 60% |
|---|---|
| New Jersey (11 of 12) | 91.7% |
| Connecticut (9 of 9) | 100% |
New York wasn't the worst in this series -- but it wasn't clean
New York's audit is one entry in a recurring series that has now examined background-check oversight in seven states since 2023. Against the two most recent state audits in that same series, New York actually posted the best record: Connecticut's audit⧉, released in May 2026, found all 9 of its sampled nursing homes had hired someone missing a required check, and New Jersey's audit⧉, released in December 2025, found 11 of its 12 sampled homes fell short. New York's 60% facility failure rate is real, but in this series so far, it is the low end, not the high end.
View data as table
| New York (8 of 100) | 8% |
|---|---|
| New Jersey (33 of 120) | 27.5% |
| Connecticut (46 of 270) | 17% |
It's also worth sizing the sample against the system it describes: 's 10 audited nursing homes are about 1.7% of the 597 Medicaid-certified nursing homes operating in New York as of April 2024. That is not a claim that the other 587 homes are in the clear -- did not review them, and the sample was chosen by geography and prior complaint history, not drawn to be statistically representative of the state.
What New York says it's doing
made two recommendations: strengthen monitoring of nursing-home compliance -- specifically, by expanding how much hiring history recertification surveys actually cover -- and reinforce guidance to nursing homes on completing checks and license verifications before staff start work. New York's Department of Health did not concur or nonconcur with either recommendation, but said it had investigated every sampled case and issued citations where warranted before the audit closed, and that in March 2026 it sent all providers a "Dear Administrator Letter"⧉ reminding them of their existing obligations. What the state has not done is adopt 's structural fix: OIG's closing response⧉ repeats, almost verbatim, its call to expand the survey timeframe -- with no date attached to when, or whether, New York will do it.
- New York's own check on nursing homes is structurally narrow. Recertification surveys, which happen at most every 15 months, verify background-check paperwork for only the 5 most recently hired staff at each home -- a design that can leave any employee hired outside that 4-month window effectively unchecked by the state until, and unless, a future survey happens to sample them.
- The clearest failure took 17 years to fix. One nursing-home employee provided direct resident care for 17 years before a background check was ever completed, after a parent company's third-party vendor never filed the required paperwork with the state -- a gap that persisted through the very oversight window designed to catch it.
- No confirmed harm resulted from these specific gaps (high confidence in this narrow claim): verified that 7 of the 8 flagged New York staff members had no disqualifying record once checked; the 8th case was never resolved either way, because the nursing home never supplied a hire date, leaving auditors unable to determine whether that check even happened before the staff member started providing care. The finding is about a control that could have missed a dangerous hire, not evidence that one occurred.
- New York compares favorably within a still-troubling series (moderate confidence): its 60% facility failure rate is the lowest of the three most recent state audits in this recurring program, behind New Jersey (92%) and Connecticut (100%) -- context that narrows the finding without erasing it.
All facility and staff figures for New York, New Jersey, and Connecticut come from nonstatistical samples selected by each state audit's own methodology (geography and prior survey findings, in New York's case) -- none are statistically projectable rates for an entire state's nursing-home industry, and the three states' underlying samples differ in size (10, 12, and 9 homes respectively; 100, 120, and 270 staff respectively). The 1.7% and 11-month figures are this publication's own arithmetic from the audit's stated facts, not numbers itself published. New York's report was accessed directly from oig.hhs.gov; a Wayback capture request for the New York PDF and the New York/Connecticut landing pages had not indexed as of publication, so the capture links point at the live federal document, which this newsroom independently confirmed loads.
Sources(3) ▾
- HHS Office of Inspector General, Office of Audit Services, New York Should Improve Its Oversight of Nursing Homes' Compliance With Background Check Requirements (A-02-24-01012) (2026-07-01) — The primary audit: whether the New York Department of Health ensured, for calendar year 2023, that a sample of nursing homes complied with the federal rule barring employment of individuals with disqualifying backgrounds. Fetched and read in full (all 19 pages, including both appendices and the State agency's comment letter). Direct fetch succeeded; a Wayback save-page-now request was made at read time and indexed shortly after. oig.hhs.gov · original document
- HHS Office of Inspector General, Office of Audit Services, Connecticut Did Not Always Ensure Selected Nursing Homes Complied With Federal and State Background Check Requirements (OAS-25-01-035) (2026-05-21) — The companion state audit in the same background-check series (listed in doc-ny-oig's Appendix B), used here only for its topline sampled-facility and sampled-staff non-compliance counts, for comparison against New York's result. Read via the report's own Highlights page. oig.hhs.gov · original document
- HHS Office of Inspector General, Office of Audit Services, New Jersey Should Improve Its Oversight of Nursing Homes' Compliance With Background Check Requirements (A-02-23-01011) (2025-12-11) — The other companion state audit in the same series (also listed in doc-ny-oig's Appendix B), used here only for its topline sampled-facility and sampled-staff non-compliance counts, for comparison against New York's result. Read via the report's own Highlights page. oig.hhs.gov · original document
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The Office of Inspector General -- the federal watchdog for Medicare, Medicaid, and the agencies that run them -- audited whether New York ensured nursing homes complied with the federal rule barring the employment of staff with disqualifying backgrounds. Its report⧉, released July 2026, sampled 100 staff members across 10 nursing homes hired or working during 2023 and found 6 of the 10 homes had skipped, delayed, or failed to document a required check for at least one employee -- 8 staff members in total. One of them, a non-licensed staff member, provided direct care to residents for 17 years before any background check was ever completed. Once finished, 7 of the 8 were confirmed to have no disqualifying record on file; the 8th case's timing couldn't even be pinned down. The audit's real finding is structural: New York's own surveyors check only the 5 most recently hired staff at each home during a recertification review that can come as much as 15 months apart, a system built to miss almost anyone hired outside a narrow window.