According to a government report, more than 90 percent of nursing homes have employees with criminal records. The current patchwork system of criminal-background checks may contribute to the high number of individuals with criminal convictions working in nursing homes, and it leaves vulnerable nursing-home residents at risk of harm.
Government Investigation
At a senator's request, the U.S. Department of Health and Human Services' Office of Inspector General investigated the number of individuals with criminal records working in nursing homes. To conduct the investigation, the OIG selected a stratified random sample of 260 nursing homes from more than 15,000 Medicare-certified nursing homes and performed Federal Bureau of Investigation background checks on the employees of those 260 nursing homes. Long-term care facilities like hospices were not investigated, and contract workers at nursing homes were also not considered.
Criminals in Nursing Homes
The analysis revealed that, in 2009, 92 percent of the nursing homes employed at least one person with a criminal conviction. Further, almost half of the nursing homes employed five or more people with criminal convictions.
At one facility with a total of 164 employees, 34 employees had at least one conviction each, said Daniel R. Levinson, Inspector General of the U.S. Department of Health and Human Services.
Seven registered sex offenders were working at five different nursing homes, and 13 percent of the employees with criminal convictions were convicted of crimes against people. Most of the employees' convictions, 44 percent, were for crimes against property such as shoplifting, burglary or writing bad checks.
Medicare and Medicaid Regulations
Federal regulations declare that nursing homes that receive Medicare and Medicaid payments cannot employ people convicted of "abusing, neglecting or mistreating" nursing-home residents and cannot employ people entered in state nurse-aide registries for neglect, abuse or mistreatment of nursing-home residents, including theft of resident property.
The Centers for Medicare and Medicaid Services' guidelines state that nursing homes "must be thorough in their investigations of the past histories of individuals they are considering hiring." However, criminal-background checks are not required by federal law. Individual states may create their own background-check standards, but the lack of centralized screening of nursing-home employees puts nursing-home residents in danger.
Patient Safety Risks
Currently, only ten states require pre-employment state and FBI criminal-background checks. Because only the FBI background check reports criminal convictions in multiple states, someone with a conviction in one state may find employment in a nursing home in a different state that does not use FBI criminal-background checks.
Senator Herb Kohl, D-Wisconsin, Chairman of the Senate Special Committee on Aging, said the present background-check system is "haphazard, inconsistent and full of gaping holes in many states. Predators can easily evade detection during the hiring process, securing jobs that allow them to assault, abuse and steal from defenseless elders."
In addition, AARP spokesman Jim Dau said, "There are still potentially-dangerous gaps in the system used to determine who will be responsible for providing care for many people during vulnerable points in their lives."
Since nursing-home employees often work unsupervised in close contact with people who are less able to protect their property and defend themselves, a background-check system - or lack thereof - that allows people with criminal convictions to slip through the cracks puts loved ones at risk for theft and, even worse, maltreatment or nursing-home abuse.
National Background Check Program
On March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care Act. According to the OIG report, the Patient Protection and Affordable Care Act requires the Secretary of Health and Human Services to implement a nationwide program for individual states to conduct both state and FBI background checks for nursing-home employees with direct access to nursing-home residents.
Because criminal convictions are sometimes under different names, the National Background Check Program will perform fingerprint-based searches of state and federal criminal-conviction records. However, FBI records generally do not indicate whether the victim of a crime was a nursing-home resident. Therefore, additional information on a potential nursing-home employee's criminal conviction is necessary.
Improvements to nursing-home employee screening should be made quickly so elderly and vulnerable residents are not harmed by people with criminal convictions. If you suspect that a relative or loved one in a nursing home may be suffering neglect, abuse or maltreatment from nursing-home employees, contact an experienced nursing home attorney in your area to discuss your legal options.
