Purpose: This document outlines the procedure for investigating allegations of abuse, neglect, fraud and theft made against health care personnel (such as Nurse Aide I, home health aide or any personal care aide) in North Carolina, pursuant to Article 15, Chapter 131E of the North Carolina General Statutes. Rules in Title 10A of the North Carolina Administrative Code (10A NCAC 13O) apply. Broad responsibilities of the health care facility and of the state are described: more specific guidelines for facilities to follow when investigating allegations are available from the N.C. Division of Health Service Regulation.
The N.C. Health Care Personnel Registry is a comprehensive listing of personnel who have committed abuses or who are under investigation, whether the facility is a nursing home, hospital, adult care home, home care agency, nursing pool, hospice or mental health residential facility, and mental health hospital. As required by federal law, abuses in nursing homes are also listed on the Nurse Aide I Registry.
The information regarding findings listed on the Nurse Aide I Registry or pending allegations or findings listed on the Health Care Personnel Registry is accessible to any inquirer 24 hours a day seven days a week on the Division's telephone voice response system. The telephone number for this system is 919-715-0562. Nursing homes may not employ a nurse aide who has a finding of abuse, neglect or misappropriation of resident property listed on the Nurse Aide I Registry.
Contacts: For questions regarding any part of this process, please contact the Health Care Personnel Registry Section of the N.C. Division of Health Service Regulation at 919-855-3968.
Procedures:| Step | Process followed |
|---|---|
| 1.0 | Reports of Abuse: Nursing Homes |
| 1.1 | Nursing homes are required to report all allegations of resident abuse, resident neglect and misappropriation of resident property to the Health Care Personnel Registry Section within 24 hours of the allegation or as soon as practicable. |
| 1.2 | The nursing home investigates the allegation and reports to the Health Care Personnel Registry Section within 5 working days, whether the allegation is substantiated or not. Guidelines for the investigation are available from the section. |
| 2.0 | Reports of abuse, all facilities: |
| 2.1 | For adult care homes, hospitals, home care agencies, nursing pools, hospices, and nursing homes, reports of substantiated allegations are due within 5 working days. Allegations may include resident abuse, resident neglect, misappropriation of resident property, misappropriation of facility property, diversion of drugs from a resident, diversion of drugs from a facility, fraud against a resident, and fraud against a facility, perpetrated by health care personnel. The report to the Section should include the results of a thorough investigation. Guidelines for investigations are available from the Section. |
| 3.0 | Review and Listing of Pending Allegation(s) |
| 3.1 | The Health Care Personnel Registry Section reviews each reported allegation to determine whether to conduct an investigation. |
| 3.2 | If the section decides to investigate, the accused aide is notified by certified letter of the pending allegation investigation and is provided due process rights information. |
| 3.3 | The section lists the pending allegation on the Health Care Personnel Registry. The pending allegation remains on the Health Care Personnel Registry until it is either unsubstantiated or substantiated and listed as a finding. |
| 4.0 | Investigation and Listing of Findings |
| 4.1 | An on-site visit or an in-office investigation is conducted to gather sufficient evidence to substantiate or unsubstantiate the allegation. Investigations are conducted primarily by Health Care Personnel Registry Investigators. (In some cases, a local law enforcement agency or the Medicaid Investigations Unit of the Department of Justice may conduct an investigation instead.) |
| 4.2 | At the completion of the investigation, the Health Care Personnel Registry Section notifies the accused individual of the outcome. If the allegation is substantiated, the accused is notified by certified letter of the intent of the Division to enter a finding onto the Health Care Personnel Registry and, if the facility is a nursing home, the Nurse Aide Registry. The accused is provided due process rights information. |
| 4.3 | If the aide does not exercise due process rights by filing a petition for contested case hearing with the Office of Administrative Hearings, the finding is listed. If the aide does file a petition for a contested hearing, the finding is not listed until after the case is heard by an Administrative Law Judge and a final decision is made by the Division Director. |
| 4.4 | After a finding is listed on the Health Care Personnel Registry (and, if applicable, the Nurse Aide I Registry), the specific allegation, the evidence summary, the date of the hearing (if the individual chose to have one) and the outcome are available to any inquirer. If the individual chose to make a rebuttal statement, it is also included on the registry and provided to inquirers. |
This page last updated on August 6, 2007.