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Who Can You Trust?

Should background checks on nursing home employees be mandatory?

Some sobering statistics: 92 percent of nursing homes in the U.S. employed at least one individual with at least one criminal conviction.  One facility that employed 164 workers had 34 with criminal convictions. And this occurs in the context of widespread abuse of nursing home patients by staff and fellow patients alike.

See also: An alternative to a nursing home.

These are among the results of an investigation ordered by the Senate Special Committee on Aging and executed by the Health and Human Services’ Office of Inspector General. The report entitled Nursing Facilities’ Employment of Individuals With Criminal Convictions was released in March 2011.

Current Federal regulation prohibits Medicare and Medicaid nursing facilities from employing individuals found guilty of abusing, neglecting, or mistreating residents by a court of law, or who have had a finding entered into the State Nurse Aide Registry concerning abuse, neglect, or mistreatment of residents or misappropriation of their property. Guidelines from Centers for Medicare & Medicaid Services for this regulation state that "[nursing] facilities must be thorough in their investigations of the past histories of individuals they are considering hiring."

Despite this guidance, Federal law does not require that nursing facilities conduct FBI or statewide criminal background checks. The issue is therefore left to the states to decide.

In 2006, Centers for Medicare& Medicaid Services began an 18-month (April 06 – Sep 07) pilot program of comprehensive criminal background checks of prospective nursing home employees in seven states. The pilot program resulted in the disqualification of 7,463 applicants.
Inside E Street profiles Barbara “Bee” Becker, a citizen advocate whose activism springs from the murder of her mother-in-law in a nursing home by a male resident in 1999. Bee is now a one-woman clearinghouse of media stories from around the country on abuse within nursing homes.  We also talk to Joshua Wiener, a scholar specializing in long term care issues at RTI International, a Washington think tank. Wiener points out that the problem of criminality among nursing home workers stems from the low pay, long hours, poor working conditions, and lack of benefits and absence of opportunity for advancement. These factors produce a very small pool of workers to choose from.

Lark McCarthy also hears from Sen. Richard Blumenthal (D-Conn.) and former Kansas governor Mark Parkinson, CEO of the American Health Care Association.  As Connecticut’s attorney general, Blumenthal took a special interest monitoring corruption in the nursing home industry.  Parkinson has helped develop 10 facilities in Kansas and Missouri. They include hundreds of rooms for skilled nursing, assisted living and dementia-related care, giving him a broad background in the continuum of care.

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