With nursing home neglect and abuse occurring with alarming frequency in Indiana and across the United States, the nursing home companies to whom families entrust their loved ones should be closely examining who they are putting in charge of taking care of the vulnerable patients for whom they are responsible. Unfortunately, the evidence shows they are not.
A report released earlier this month by the Department of Health & Human Services, Office of the Inspector General found that more than 90% of nursing homes in the US employ one or more people who have been convicted of at least one crime. The study was conducted to determine the extent that nursing facilities employed individuals with criminal convictions. According to federal regulations Medicare & Medicaid nursing facilities are prohibited from employing those individuals who have been found guilty of neglecting, or mistreating residents by a court of law, or who have a finding entered into the State nurses registry concerning abuse, neglect, or misappropriation of property.
The study found that 92 percent of the nursing home facilities sampled employed at least one individual with at least one criminal conviction. Additionally, it revealed that almost half of the facilities employed five or more individuals with at least one conviction. The crimes mainly fell into the categories of crimes against property, such as burglary, and drug related crimes, although some were convicted of crimes against persons, like assault. Unfortunately, there is currently no set standard mandating how a nursing home should conduct their background checks. Only 10 states currently require that nursing homes use both the FBI criminal background database along with state databases. Indiana currently falls among the 33 states that only require a background check using state databases. The lack of consistency is compounded when the fact that state requirements vary by who must be checked (e.g., direct-care workers only such as nurses and nurses aides or all staff which would include service personnel.) The study revealed that overall, five percent of a nursing facilities’ staff identified as ‘direct-care’ employees had at least one criminal conviction. The study’s author, Daniel Levinson, found that only relying on state databases left large holes in the background check, allowing individuals convicted of crimes in one state to obtain nursing home jobs in other states.
In a New York Times’ report on the same issue, Senator Herb Kohl, D-Wisconsin, who is chairman of the Aging Committee was quoted as follows: “The current system of background checks 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.”
Although most of the convictions found were for crimes committed prior to an individual’s employment, the study found that for nearly 16% of employees with criminal backgrounds the most recent had occurred after the start of their employment. Nursing facilities would need to perform periodic criminal background checks to identify these convictions. However, given the high rate of turnover in nursing home staff, it is unlikely to occur.
This problem was highlighted recently in Indiana when the Indianapolis Star reported in December of 2010 that the state Attorney General was seeking a monetary settlement against an Indianapolis based nursing home who had employed such individuals and then billed Medicare & Medicaid for their services.