The majority of unlicensed health care workers who provide services in health care are capable and caring individuals. However, when certain allegations are suspected involving unlicensed health care workers, health care employers are required to submit reports to the Health Care Personnel Registry (HCPR) Investigations Branch. The Investigations Branch receives reports of allegations from health care facilities, investigates allegations, takes administrative actions against unlicensed health care workers, and lists these actions on the Health Care Personnel Registry. The Health Care Personnel Registry contains information available to health care employers about potential employees who are under investigation or have substantiated allegation findings listed on the registry.
Investigations of unlicensed health care workers began in 1992, as a result of federal nursing home reform legislation (OBRA), which required states to receive, review, and investigate allegations of resident abuse, neglect, and misappropriation of property of nursing home residents. It also required each state to list substantiated allegations as “findings” onto the state’s Nurse Aide I Registry if the accused individuals were nurse aides.
When the Health Care Personnel Registry law [N.C. § 131E-256 (PDF) ] was passed in 1996, it incorporated the investigations and “findings” of the Nurse Aide I Registry and expanded the types of reportable allegations and health care facilities reporting allegations. It also added the requirement that the names of individuals who were under investigation for any reportable allegation to be listed on the registry. In 1998, 1999, 2000, and 2008, expansions of the HCPR law increased the types of unlicensed health care personnel reported and the types of health care facilities that must report allegations.
Individual names listed on the Health Care Personnel Registry have either "pending" allegation investigations or substantiated allegation "findings". Health care employers can check the HCPR for information about potential employees using the verify listings page. Available information includes the nature of a finding or allegation and the status of an investigation.
All of the health care facilities listed above must access the Health Care Personnel Registry before they hire unlicensed staff. Facilities must report all allegations, and injuries of unknown source, to the HCPR Investigations Branch [N.C. §131E-256 d2 ].
The unlicensed health care worker’s due process rights related to administrative actions are respected for a “pending” listing and a substantiated “finding” listing. The unlicensed health care worker’s due process rights include an opportunity to file a petition for a contested case hearing and have the matter heard by a fair and impartial body – the Office of Administrative Hearings – a separate state agency.
A “pending” allegation investigation listing is added to the Health Care Personnel Registry at the time the Investigations Branch determines that an investigation will be done. A “pending” listing is temporary and is removed from the registry when the allegation is either unsubstantiated or a substantiated “finding” is listed.
A substantiated “finding” is listed after an opportunity is provided for due process rights. A “finding” listing is permanent and remains listed on the registry.
The HCPR law [N.C. § 131E-256(i) ] allows one exception to a permanent “finding” listing. Individuals with certain neglect allegation “findings” may petition the Department to have his or her name removed from the registry. However, a petition requesting removal of a neglect allegation “finding” does not automatically result in removal of the “finding”. A determination must be made that the conditions specified in N.C. § 131E-256(i) are met before a neglect allegation “finding” listing may be removed from the registry.