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I have a Federal Marker for abuse, neglect or misappropriation of funds. When may I go back to work in a nursing home or nursing agency?

If you are added to the EDL for an offense of abuse, neglect or misappropriation of funds or property while working in a nursing home that was certified to care for Medicaid/Medicare patients and you were a CNA, a permanent "federal indicator or federal marker” is also placed on the Missouri Certified Nurse Assistant Registry on your CNA. A CNA with a federal indicator is forbidden to work in any capacity in a nursing home that cares for Medicaid/Medicare patients.


A CNA may request in writing for the removal of a federal marker for neglect only. (If the findings were abuse or misappropriation there is no opportunity to remove the marker.) This is a one-time opportunity and must meet the requirements at 42 USC 1395i-3(g)(1)(D) (see below). The request must be in writing to:


Department of Health and Senior Services

Office of General Counsel

912 Wildwood

P.O. Box 570

Jefferson City, MO  65102


42 USC 1395i-3(g)(1)(D)

(D) Removal of name from nurse aide registry (i) In general

In the case of a finding of neglect under subparagraph (C), the State shall establish a procedure to permit a nurse aide to petition the State to have his or her name removed from the registry upon a determination by the State that—

(I) the employment and personal history of the nurse aide does not reflect a pattern of abusive behavior or neglect; and

(II) the neglect involved in the original finding was a singular occurrence.

(ii) Timing of determination In no case shall a determination on a petition submitted under clause (i) be made prior to the expiration of the 1-year period beginning on the date on which the name of the petitioner was added to the registry under subparagraph (C).

(E) Construction

The failure of the Secretary to issue…

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