42 CFR § 460.68 - Program integrity.
(1) Who have been excluded from participation in the Medicare or Medicaid programs;
(2) Who have been convicted of criminal offenses related to their involvement in Medicaid, Medicare, other health insurance or health care programs, or social service programs under title XX of the Act;
(3) If the PACE organization determines that an individual's contact with participants would pose a potential risk because the individual has been convicted of one or more criminal offenses related to physical, sexual, drug, or alcohol abuse or use;
(4) Who have been found guilty of abusing, neglecting, or mistreating individuals by a court of law or who have had a finding entered into the State nurse aide registry concerning abuse, neglect, mistreatment of residents, or misappropriation of their property; or
(5) Who have been convicted of specific crimes for any offense described in section 1128(a) of the Social Security Act.
(b) Direct or indirect interest in contracts. The PACE organization shall identify members of its governing body or any immediate family member having a direct or indirect interest in any contract that supplies any administrative or care-related service or materials to the PACE organization.
(i) Fully disclose the exact nature of the conflict to the board of directors and have the disclosure documented; and
(ii) Recuse himself or herself from discussing, negotiating, or voting on any issue or contract that could result in an inappropriate conflict.
(c) Disclosure and recusal requirements. A PACE organization must have a formal process in place to gather information related to paragraphs (a) and (b) of this section and must be able to respond in writing to a request for information from CMS within a reasonable amount of time.
The following state regulations pages link to this page.
- Ohio Admin. Code 173-9-01 - 173-9-01 - Background checks for paid direct-care positions: introduction and definitions.
- Ohio Admin. Code 173-9-02 - 173-9-02 - Background checks for paid direct-care positions: applicability.
- Ohio Admin. Code 173-9-03 - 173-9-03 - Background checks for paid direct-care positions: reviewing databases (except for the self-employed).
- Ohio Admin. Code 173-9-04 - 173-9-04 - Background checks for paid direct-care positions: when to check criminal records, inform applicants, charge fees, and use forms (except for the self-employed).
- Ohio Admin. Code 173-9-05 - 173-9-05 - Background checks for paid direct-care positions: conditional hiring.
- Ohio Admin. Code 173-9-06 - 173-9-06 - Background checks for paid direct-care positions: disqualifying offenses.
- Ohio Admin. Code 173-9-07 - 173-9-07 - Background checks for paid direct-care positions: hiring an applicant, or retaining an employee, who has a disqualifying offense on criminal record.
- Ohio Admin. Code 173-9-08 - 173-9-08 - Background checks for paid direct-care positions: confidentiality and retention of records.