If Concerned About Abuse and Neglect, Why Is The Nursing Home Industry Hiring Convicted Criminals To Care For Our Elders?

A society is judged on the basis of how it treats its weakest members.  This truth has been stated in many ways over the years by religious leaders, scholars, and others, but the core principle remains the same:  those responsible for the care of the sick, the vulnerable, and the elderly have a choice in how they go about this responsibility.    Unfortunately, the manner in which our nursing home patients are being treated says a lot about the priorities of today’s powerful, profit-driven nursing home industry.

In the U.S. today, the corporations making up the nursing home industry compete for the business of taking care of more than 1.3 million patients.  The number of elderly patients dependent upon the nursing home industry will certainly increase as more and more Baby Boomers reach the age of needing long-term care.  As a result of this enormous profit potential, nursing home facilities are being taken over by the large, for-profit nursing home chains that proudly tout this growth industry in the marketing and investor materials that can be found on their websites.

In order to fill their beds and increase revenues, nursing homes sell patients and their families on the promise that, in return for the significant payment the nursing home will receive, the nursing home can be “entrusted” with the responsibility of protecting and providing for the patient’s care needs.

Most nursing homes receiving funding from Medicare and Medicaid to provide care to its patients.  In an effort to help ensure that nursing home patients are receiving proper care in return for these payments, both state and federal regulations require that facilities provide adequate staffing, training, and quality assurance oversight to ensure that each patient’s individual care needs are met.  Moreover, these regulations specifically prohibit any form of patient abuse or neglect.  Yet tragically, some form of nursing home abuse, including sexual assault, is inflicted upon patients by nursing home employees each and every day in U.S. nursing homes.   In addition, too many nursing home patients dependent upon the nursing home staff for assistance with activities of daily living are neglected, leading to dehydration, malnutrition, and/or pressure sores (often to the bone) due to the failure by the staff to ensure adequate hydration, nutrition, and adequate turning and repositioning.

The question is: in light of the profitability of the nursing home industry, why are these corporations failing to ensure that the elderly and vulnerable patients are being protected and cared for?

It is well recognized that one primary reason is that nursing homes simply choose not to hire enough staff to take care of their patients in order to save on labor expenses and therefore maximize their profitability.  But, another significant factor is that nursing homes choose to hire individuals who have demonstrated through their prior actions that they should not be entrusted with taking care of vulnerable, sick patients.

A study was conducted by the Department of Health & Human Services, Office of the Inspector General to determine the extent to which nursing facilities employed individuals with criminal convictions.  According to the report, more than 90% of U.S. nursing homes employ one or more people who have been convicted of at least one crime.   The study also revealed that nearly half of the nursing home facilities employed five or more persons with at least one conviction.

Unfortunately, there is currently no national requirement mandating how a nursing home must conduct background checks.  Only 10 states currently even require that nursing homes use both the FBI criminal background database along with state databases.    The study’s author found that only relying upon 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.

It is hard to imagine that any family would knowingly allow an unknown convicted criminal into their home, much less allow them to administer medication to a loved one, or permit them to assist that loved one with bathing and other hygiene activities.  Yet unbeknownst to patients and their families, the nursing home industry allows this to occur every day, in most every nursing home in the country.

So what can you do if you have had to place a loved one in a nursing home and are concerned about whether the staff can be trusted to provide proper care?  You can ask the nursing home administrator directly how they go about checking the background of their employees.  Among the questions you can ask are:

• • How do they check the background of their employees?  If they only use state databases, then they may not know if the employee was convicted of a crime in another state.
• • How often do they run background checks?  If they only check prior to their hiring, then they may have employees who have been convicted of crimes since their hiring still rendering care to patients.
• • Are they currently employing any employee with a criminal conviction?  The facility may run background checks on direct care-givers (eg. nurses and nurse aides), but do they also run background checks on the janitorial staff, food service workers, independent contractors who work in the building, etc?

Finally, you can raise the issue with your state legislator.  If there were public greater awareness of the fact that more than 90% of nursing homes are staffed with one or more convicted criminals, there would surely be support for legislation to ensure adequate background checks and to prohibit the hiring of such individuals.

Now is the time for society to hold accountable the nursing home industry that reaps great profits from its promise to protect and care for our society’s weakest individuals, then chooses to entrust the care of its vulnerable and dependent patients to convicted criminals.

If you suspect a loved one has been the victim of nursing home abuse or neglect, understanding the signs is an important first step in getting help.