Nursing homes, it seems, have lately become less about safety, comfort and good care—as the term might imply—and more about saving money. So, not surprisingly, standards are being dangerously compromised—that is assuming they’ve been established. Case in point, an investigative report by CBS News last week cited a government report which found that over 90 percent of nursing homes hired employees with criminal records—convictions.
Apparently, the government ran background checks on all employees who worked at some 260 nursing homes on June 1, 2009, and found 92 percent employed at least one person with a criminal conviction. The report also found that nearly half of the nursing homes had five or more individuals employed who had criminal convictions.
The report, by the Inspector General for Health and Human Services, revealed seven registered sex offenders gainfully employed at five separate facilities, while 43 percent of the convictions were for crimes including burglary, shoplifting, and writing bad checks.
According to CBS News, 43 states currently require nursing homes to run some kind of criminal background check. However, “only 10 states require both a state and FBI background check that would detect convictions in multiple states.”
“On its face, it’s shocking,” Janet Wells, director of public policy for the National Consumer Voice for Quality Long-Term Care told CBS News. “People move from state to state and they may have an abuse record at another health care facility, that’s why we would prefer to see a national mandatory program.”
Well, yes. That would seem the obvious solution, because here’s the real consequence of not having such a system: in January, LAS reported on a shocking incident in Santa Clara, CA, in which a Mexican man living in the US illegally was sentenced to 17 years in jail for elder abuse after he attacked a 94-year old woman who lives in a nursing home in Northern California.
Forty-three year old Roberto Recendes pled guilty to sexual penetration by force and elder abuse. The attack happened eight years ago in Palo Alto. Eight years ago!
Recendes reached a plea deal to avoid spending 25 years to life had he been convicted of rape and burglary. According to a report in the San Jose Mercury News, Recendes was linked to the crime from a DNA sample taken from him after he was convicted of charges of domestic violence in Sunnyvale in 2004.
This episode begs the question—if 98 percent of nursing homes run ‘some kind’ of background check, as the government report found, how did Recendes slip through the cracks—and—where are the cracks?
Back to the article on CBS, where Wells explains, “If you are not looking across state lines you wouldn’t pick up any criminal convictions,” says Wells. And, Mark Parkinson, President and CEO of the nursing home industry association known as the American Health Care Association told CBS News in a statement that contrary to what you might think, criminal databases are not always reliable. “Because of the patchwork system of background checks and variation in what each state law considers a “relevant crime,” employers trying to hire caregivers may not always know which applicants have records of abuse or criminal history as only specific, “relevant crimes” would bar a potential applicant from employment in a facility,” he wrote.
He added that the industry has been trying to get a system of national background checks put in place for over 20 years. No comment.
The other piece in this is damage control—the covering up of crimes that take place in nursing homes across the country. Again, to quote the CBS piece, Janet Wells said, “One of the problems we see is the cover up of crimes occurring in nursing homes and that is an overwhelming concern.”
In that scenario, all it takes is one family member to come forward and file a suit. In December of last year, a $62.8 million settlement was approved in California in a class action lawsuit against Skilled Healthcare Nursing Homes. The suit alleged that the company failed to provide sufficient staffing levels for its patients at all 22 of its facilities.
Up to $26 million of the settlement is expected to go to individuals represented by the class action lawsuit. The lawyer representing the plaintiffs said his office has received about 4,000 claims since it distributed news of the settlement over one month ago. Four thousand complaints? That’s a big problem.
As part of the settlement, Skilled Healthcare will pay $12.8 million to comply with an injunction that requires the company to maintain state-mandated staffing levels, which is 3.2 nursing hours per patient day. But that could mean hiring more less than suitably qualified people—to keep costs down.
So what, if anything, is being done to try and rectify this situation before you and I find ourselves in one of these facilities? The new health care law under President Obama, has created a national program for states to standardize federal and state background checks for nursing home employees who interact with residents. So far 10 states have received federal funds to begin implementing the new program, including Florida and Missouri. The government funds the cost of the background checks. But, there is problem, of course. State participation is optional.
As AARP spokesman, Jim Dau, wrote in his statement to CBS News, “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.” He added that while the new health care law is an improvement, “more should be done to build on this work.”
The fact that every state is not requiring these types businesses to run thorough background checks on nursing home employees is outrageous. This is especially unacceptable considering the number of respected companies, such as Proforma Screening Solutions, that offer affordable and comprehensive criminal background checks: proformascreening.com
I agree that every state should be held to the same standard. More than likely the reason some states haven't adopted the requirement to have all nursing home facilities and home health care providers have their employees run criminal background checks, is financial. They may believe it will bring hardship on a struggling industry. The financial burden, should something happen in their state and to each individual elderly care business, would be far greater. Not just the litigation costs, but the abuse that could have been avoided, has to be a priceless dividend. There are many database service companies that can help this industry. Besides Proforma other well respected companies like Realsearch.com which also provide these types of background checks within their web portal or with custom API solutions. Identity verification should no longer be an option especially in an industry that cares for our elderly.