Provider Signals™Exclusion screening for nursing homes & SNFs
Skilled nursing facilities turn over roughly 94% of their nursing staff in a year, which means the roster you screened last quarter is largely gone today. That churn is exactly where an excluded aide, nurse, or therapy contractor slips back onto the payroll. Provider Signals checks every employee, contractor, and vendor against 50+ federal and state lists, on a continuous loop.
When nineteen nursing homes wrote one check
On May 29, 2025, nineteen skilled nursing facilities settled with the HHS Office of Inspector General for $1,565,374. The allegation was not fraud in the usual sense. The government said the facilities employed people they knew, or should have known, were excluded from federal health programs. A clean diagnosis, careful billing, attentive care: none of it mattered, because an excluded person had touched the work.
That pattern repeats up and down the long-term care sector. On April 2, 2026, five California facilities settled the same kind of allegation for $52,943, and individual buildings show up across the OIG settlement log most months. The dollar figures swing widely, but the trigger is always the same: someone on the roster was on a list, and nobody caught it in time.
Screening lives inside the survey-and-certification world you already run
Nursing facilities are unusual among healthcare providers in how closely they are watched. To keep Medicare and Medicaid certification, every building sits under a recurring state survey process, gets a public Five-Star rating, and reports staffing through Payroll-Based Journal. Exclusion screening is woven into that same compliance fabric. The OIG's Nursing Facility compliance program guidance names checking employees and contractors against exclusion lists as a core risk area, and treats a real screening process, not a one-off lookup, as the expectation.
So this is not a new obligation bolted onto your operation. It is one more recurring control in a setting that already runs on them. The real question is whether your screening cadence keeps pace with a workforce that rebuilds itself every year, because the surveyor and the payer both assume it does.
What an exclusion does to a facility's payments
An OIG exclusion is total. No federal health program will pay for any item or service an excluded person furnishes, whether they bill directly or simply contribute to care that gets billed. The moment such a person is on your roster, the exposure compounds:
- A civil monetary penalty of up to roughly $25,595 per item or service the excluded individual furnished, under the inflation-adjusted Section 1128A authority.
- An assessment of up to three times the amount claimed, applied in place of the damages the program absorbed.
- Overpayment recovery on everything the person touched, with potential False Claims Act liability layered on top.
Because a SNF leans so heavily on Medicaid, the state Medicaid exclusion lists carry as much weight as the federal LEIE. Reinstatement at the federal level does not erase a state sanction, and a person clear in one place can still be barred in another. Most screening tools treat all-state Medicaid coverage as a paid upgrade. On Provider Signals it ships on every plan, including the free tier.
A 94% turnover roster cannot be screened once
Federal payroll data puts median annual nursing-staff turnover at roughly 94%, with the average building higher still. A name verified clean at hire tells you little three months later, and the LEIE itself refreshes monthly, so even a stable hire can become excluded between checks. Provider Signals is built around that reality:
- Continuous re-screening. New hires are checked the day you add them, and your full roster runs again on every refresh, so a clean result at onboarding never quietly turns into a liability.
- Contract and agency staff on the same roster. The temp nurses, rehab contractors, dietary vendors, and medical director you do not employ directly still create liability, so they belong in the same screen.
- One view across many buildings. Multi-facility operators manage a single roster, with alerts routed to the right people before a claim ever leaves the building.
- A standing audit trail. Every screen is dated and exportable, ready for a surveyor, a payer audit, or your own compliance file.
Sized for facilities, not enterprise procurement
The legacy exclusion-screening vendors are priced for hospital systems, often $15,000 to $200,000 a year, and they still tend to bill state Medicaid coverage as an extra. Provider Signals delivers the same continuous, all-source monitoring as self-serve software, priced to the size of your roster rather than the size of your contract.
| Category | Provider Signals | Typical incumbent |
|---|---|---|
| All state Medicaid lists | Included, every plan | Often an add-on |
| Continuous re-screening | Yes | Varies / batch |
| Self-serve sign-up | Free in minutes | Sales cycle |
| Entry pricing | Free up to 10, then from $120/mo | ~$15K–$200K/yr |
The OIG's stated expectation is screening at hire and again each month. Provider Signals simply keeps the loop running so the check is never stale. Walk through the mechanics on the exclusion screening overview, see how other segments compare on the industry hub, or size your own roster on the pricing page.
How we match your roster
Exclusion screening is only as good as its matching. We match each person or entity against every source using the full identifier set together — NPI, first name, last or organization name, city, state, and ZIP — never one field alone. NPI alone misses records (the OIG LEIE and many lists don’t carry an NPI for every entry); a name or a location alone produces false matches on common names. When a source record has no NPI, we fall back to name plus location.
Because accuracy depends on your input, provide complete, correct details for every roster entry. When more than one possible match is found, we show you all candidates with their source records so you can confirm, select, or merge — we never auto-flag anyone as excluded. Always verify a match against the primary source before taking any action.
Frequently asked questions
How do you match my roster to the exclusion lists?
We match on the full identifier set together — NPI, first name, last or organization name, city, state, and ZIP — not on any single field. NPI alone misses entries (the LEIE and other lists don’t include an NPI for every record), and names or locations alone cause false matches, so when a source has no NPI we fall back to name plus location. The more complete and accurate your roster details, the more precise the match.
What happens when there’s more than one possible match?
We present every candidate match with its source record and let you select or merge the correct one — we never automatically mark a provider as excluded. A potential match is a prompt to verify against the primary OIG or SAM source, not a final determination. This keeps a human in the loop and protects against acting on a misidentification.
Is monthly screening actually required, or just a recommendation?
The OIG frames screening at hire and monthly thereafter as the standard of an effective compliance program, and state Medicaid programs are directed to check the LEIE monthly. Provider Signals runs your roster on a continuous loop and flags any match, so you clear that monthly bar without scheduling anything.
Our agency nurses are on a staffing firm's payroll. Are we still exposed?
Yes. The penalty attaches to whoever furnishes items or services that get billed, not to who signs the paycheck. Contract nurses, rehab and therapy contractors, dietary and housekeeping vendors, and your medical director all create liability, so they go on the same roster as your W-2 staff.
If someone is clear on the federal LEIE, why check state Medicaid lists?
Federal and state exclusions are separate. A person can be reinstated federally and still sit on a state sanction list, and many exclusions appear at the state level first. For a Medicaid-dependent facility that gap is real money, which is why every state list is included on every Provider Signals plan, not sold as an add-on.
An aide turned out to be excluded for two months. What's the realistic exposure?
Each item or service that person furnished can draw a civil monetary penalty of up to roughly $25,595, plus an assessment of up to three times what was claimed, plus repayment of the underlying amounts and possible False Claims Act liability. Across two months of shifts the count adds up quickly, which is how recent SNF settlements reached six and seven figures.
We already re-screen at every new hire. Isn't that enough?
Screening at hire catches the people you bring on, but it misses anyone who becomes excluded while already employed, and the LEIE updates monthly. Continuous re-screening closes that window by re-checking your entire roster on every refresh, not just the newcomers.
What would a 90-bed building actually pay?
Pricing follows the number of providers you monitor. The first 10 are free, and paid plans start at $120/mo. A single building's staff and vendor roster typically lands in the lower tiers, while multi-facility operators can model the whole footprint on the pricing page.
Sources: KFF, number of nursing facilities · Health Affairs, nursing-home staff turnover · HHS-OIG, $1.56M 19-facility settlement · HHS-OIG, California SNF settlement · OIG Nursing Facility compliance guidance · Federal Register, CMP inflation adjustment · OIG Exclusions Program.
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Provider Signals™ Risk — part of NPI Data Services, a product of VBC Risk Analytics, Inc. — does not provide legal advice. We are not a consumer reporting agency, and our screening tools are not FCRA background checks; use them as part of, not a substitute for, your own compliance program and counsel’s guidance. See our Terms.
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