Most Nursing Homes Employ Individuals with Criminal Records: Report

Nearly all nursing homes in the United States employ workers with criminal convictions, according to a new government report. 

The Department of Health and Human Services’ Office of Inspector General (OIG) has released a report titled “Nursing Facilities’ Employment of Individuals With Criminal Convictions”, finding that 92% of all nursing homes hire people with criminal records to work in close quarters with vulnerable elderly residents. In addition, nearly half of the surveyed facilities employed five or more people with criminal records.

According to the OIG, 42 states and the District of Columbia currently have requirements that nursing homes conduct criminal background checks on new employees. The background checks are meant to prevent people with a history of violence from working with the elderly and possibly committing nursing home abuse. However, just having any criminal conviction is not an automatic disqualifier.

States that do not require criminal background checks on nursing home employees include Alabama, Colorado, Connecticut, Hawaii, Montana, North Dakota, South Dakota and Wyoming. Hawaii has a statute that requires FBI background checks, but rules to implement the statute have never been written, and the state’s retirement homes are not yet required to perform the checks.

OIG researchers looked at a random sample of 260 nursing facilities from the nation’s 15,728 Medicare-certified nursing homes and looked at all employees who worked in those facilities on June 1, 2009. They found that 92% employed at least one person with a criminal conviction. In some cases, facilities had dozens of employees with criminal records, going as high as 66 at one facility.

The largest percentage of the employees with criminal histories were convicted of property crimes, like burglary and shoplifting. A little more than 13% had been convicted of crimes against persons, like assault and battery. The researchers found that, overall 5% of nursing home employees nationwide who had “direct-care” positions, meaning they directly dealt with elderly residents, had criminal convictions.

OIG researchers and officials from the U.S. Centers for Medicare and Medicaid Services (CMS) recommend the development of uniform standards for background check procedures. They also recommended that the health department work with states to create a definitive list of what criminal convictions should disqualify potential nursing home employees.