A stunning number of the nation's nursing facilities – 92% in fact – employed at least one individual with a history of at least one criminal conviction, and one in 20 nursing employees had one criminal conviction or more.
That's according to a report released Wednesday by the Office of Inspector General, which reviewed criminal history records maintained by the Federal Bureau of Investigation, a database called the FBI Interstate Identification Index.
The OIG urges the Centers for Medicare and Medicaid Services to define employee classifications that are direct patient access employees and work with participating states to develop a list of state and local convictions that would disqualify an individual from employment in a nursing facility.
The report focused on a stratified random sample of 260 nursing facilities from 15,728 facilities certified to receive federal reimbursement for proving care to Medicare or Medicaid beneficiaries as of June 1, 2009. The OIG compared employee data with FBI criminal history records.
In one case, a nursing facility with 164 employees had 34 employees with at least one conviction each and all 34 had a total of 102 convictions which ranged from crimes against property, crimes against others, drug-related convictions, and drug-related offenses involving motor vehicles.
Federal law does not require that nursing facilities conduct state or federal background checks on their prospective or current employees, but federal regulations do prohibit Medicare and Medicaid eligible nursing facilities from employing individuals found guilty by a court of law of "abusing, neglecting, or mistreating residents."
Here are some other statistics from the report:
• 44% of employees with convictions were convicted of crimes against property, such as burglary, shoplifting or writing bad checks, the most common category of crime among these nursing home staff.
• The number of individuals with at least one criminal conviction employed by these nursing facilities ranged from one to 66.
• Most of the convictions occurred prior to the employees' first date of their current employment.
• These employees were hired despite the fact that most nursing facilities reported conducting some type of background check, and some states require it.
• Hospice and other types of long-term care settings were not included, nor were contract employees.
• The offenses included crimes against persons, such as assault, battery, murder, rape and robbery; crimes against property such as burglary, larceny, possession of stolen property, shoplifting, theft, vandalism and writing bad checks; driving under the influence of drugs or alcohol; other driving related crimes such as leaving the scene of an accident or transporting an open container of alcohol in a vehicle; drug-related crimes such as possession or sale of controlled substances and disorderly conduct, prostitution, resisting arrest or weapons violations. Sex offender registries were also included in the search.
• The OIG characterized its estimate as "conservative" because it did not include criminal convictions if the agency could not conclusively identify the individual, that is if the identifiers were similar but did not exactly match.
The report says that 10 states require FBI and statewide background checks but 33 only require statewide checks and eight – Alabama, Colorado, Connecticut, Hawaii, Montana, North Dakota, South Dakota and Wyoming don't require any checks.
The criminal check landscape has been altered, however, by the passage of the Affordable Care Act in March 2010. It requires the Department of Health & Human Services to carry out a nationwide program to conduct national and statewide criminal background checks for direct patient access employees of nursing facilities and other providers similar to the pilot program established by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.
The report was requested by a member of Congress.