Based on an OIG analysis of FBI criminal history records and nursing facility employee data for 2009, the OIG estimates that most nursing facilities (92%) employed at least one individual with one or more criminal convictions, and 5% of nursing facility employees had at least one criminal conviction. In the report, "Nursing Facilities’ Employment of Individuals With Criminal Convictions," the OIG also observed that while there is no federal requirement for nursing facilities to conduct criminal background checks, most states required and/or nursing facilities reported conducting some type of background check. The OIG recommends that CMS develop background check procedures that (1) clearly define the employee classifications that are direct patient access employees and (2) work with states to develop a list of convictions that disqualify an individual from nursing facility employment and timeframes for disqualification from employment. CMS agreed with the OIG.