|
|
Criminal Checks Protect Elderly: State Requires Nursing Homes to Screen Workers
Meaghan M. McDermott, Democrat and Chronicle
July 5, 2005
When Jeffrey Lewis needed to find nursing care for his grandmother earlier this year, he had plenty of things to worry about.
He worried about ensuring she'd be well-fed and clean, that her financial affairs would stay in order, that her room would be bright and airy, that she'd get the medical attention she needs and that if she rang her call bell, staff would hustle to take care of her.
The last thing he wanted to worry about was whether the nursing home workers had questionable criminal backgrounds.
That's why the 42-year-old Rochester man strongly supports a new state Department of Health regulation requiring nursing facilities and home health care agencies to run pre-employment criminal background checks on nonlicensed personnel who work directly with patients.
Such checks are already standard in New Jersey, Massachusetts, Pennsylvania, Texas, California and Florida.
Under the new rule, people who have been convicted of the most serious felonies are barred from ever getting a job in the health care industry, while lesser felons are barred for 10 years after conviction.
The rule is welcomed by advocates for the elderly and the disabled and by care providers and families.
"I don't think it's a panacea, but it's a good idea," said Rich Landers, director of communications for the state Association of Health Care Providers Inc., a coalition of more than 500 home health agencies and hospices. "A lot of patients can be quite vulnerable, and you clearly don't want someone working there with criminal tendencies."
But some say the checks don't go far enough, make employers wait too long for results and don't include enough background information.
Pending legislation could close some of those loopholes. The bill passed the state Senate on June 23 and the Assembly on June 24, but it still needs to be signed by the governor.
Since 1999, a coalition of local homes has run its own checks through the Monroe County Sheriff's Office. Since then, more than 22,000 potential hires have been checked, with nearly one-quarter showing a prior brush with the law, ranging from minor violations to serious felonies, said Charlie Runyon, chairman of the Rochester Area Association of Homes and Services for the Aging, or RAHSA.
The program is a vital safeguard, said Loren Ranaletta, president and chief executive officer for Episcopal Senior Life Communities, which offers a variety of elder care options in the Rochester area.
"More and more people are entering long-term care who have disabilities, including judgment problems," he said. "When you have people who can't best represent themselves, you want to ensure you're hiring the best people."
Hiring the best
Making sure the best people get hired is why the 15 member agencies of RAHSA instituted their background checks program in 1999. "We really wanted to be proactive and get ahead of the curve," said Runyon, who is also president of St. John's Home in Rochester and chairman of the state Association of Homes and Services for the Aging.
The local checks program was created after a heinous case of patient abuse: In 1995, nurse's aide John Horace raped and impregnated a comatose woman at the former Westfall Health Care Center in Brighton.
Horace had a history of sexually related run-ins and arrests dating back to 1970. He was under investigation for assaulting another patient in a different home when the woman's pregnancy was discovered.
Lewis, who ultimately chose St. Ann's Home for his grandmother, said the Horace case still burns in his memory.
"I'm a grown man and I'm (still) in tears over that," he said. "I wouldn't have wanted a loved one there, lying helpless and have someone do that to them."
Kit Pollicove, RAHSA's director of marketing, said the Westfall case "was a real wake-up call for us, so we put our heads together and said, 'How can we help prevent this?'"
The RAHSA checks, which are run on all potential employees, not just the nonlicensed ones, were designed to weed out the obvious bad candidates - those with criminal histories that include sexual abuse, violence or victimizing the elderly.
But participation in the program is voluntary - 13 of RAHSA's 15 members participate, as do about 20 of the 30 for-profit homes in the local Genesee Health Facilities Association - and hiring decisions are left to individual homes.
And it hasn't always worked out as RAHSA would hope.
In March, Westgate Nursing Home nurse's assistant Gerard T. Singleton, 34, of Lakeview Terrace was charged with two misdemeanors for alleged sexual contact with a fellow employee while on the job. He had previously been convicted - and served time in prison - during the 1990s for separate incidents of robbery and criminal possession of a weapon. Police said the home had been notified of Singleton's history through RAHSA. Westgate is a member of the Genesee Health Facilities Association, and does use RAHSA checks.
It's unclear why or when Singleton was hired. Officials from Westgate did not return repeated calls seeking comment. Singleton's case is still pending in Gates Town Court.
Advantages/disadvantages
Under the new state rule, which went into effect April 1, someone with a history like Singleton's should never have been hired: For the first time, those convicted of sex abuse, drug trafficking and grand larceny are forever barred from finding employment in nursing homes or home health agencies.
There's also a 10-year ban from the date of conviction on those who've committed assault, other sex offenses, robbery and endangering the welfare of a vulnerable elderly person.
For Gap Mangione of Greece, whose 91-year-old mother Nancy Mangione lives at St. John's Home, such rules are common sense.
"I think it's absolutely necessary to run these checks," said Mangione, the jazz pianist and band leader. "I think you would be no less diligent about the background of these people than someone you'd have working in a school: They have responsibility for those who cannot protect themselves."
The state regulation covers nonlicensed employees, who include nurse's aides, home health aides and personal care aides. Licensed workers such as nurses and doctors undergo background scrutiny through the agency that issues their licenses.
"This regulation provides families throughout New York and their loved ones with some of the strongest health care protections in the nation," said Jeffrey W. Hammond, spokesman for the Department of Health.
Ronni Abramovitz, manager of the ombudsman program with Lifespan, a nonprofit advocacy group for the elderly and disabled, said it's about time all care agencies in New York were running the same checks.
"It's not just the nursing homes, it's the home care agencies, certified personal care services," she said. "To me, this is really good and I appreciate that everyone, across the board, is subject to the same regulation."
Abramovitz noted that the local RAHSA check in some ways is more stringent than the state check, which gathers an employee's history through the Federal Bureau of Investigations. That can take weeks to complete and the record only lists convictions.
The RAHSA check, which takes two or three days to complete, shows not only convictions but also the original charges at the time of arrest. "Then, we're able to see if someone was arrested on a more serious charge, but pleaded their case down to something else," said Runyon.
The state check eliminates one loophole in the local check, however: It shows out-of-state convictions. The RAHSA check shows only local ones, said Abramovitz. "If someone comes up from Texas and has convictions, (the state check) can find out that information. Or more importantly, someone from Genesee or another New York county."
Runyon said St. John's and other RAHSA agencies would run both checks.
"The new system allows agencies to provisionally hire people while waiting for the FBI check, but we don't believe it's a good idea to hire someone and wait four to five weeks to find out if they're suitable," he said.
The FBI check system is more costly than the local check. There is a $24 per-person fee plus an additional $13 in administrative fees.
"We will be reimbursed for those, but like all reimbursements, it will be well after we've spent the money," said Runyon, who said the cost of a RAHSA check for St. John's Home is about $7 per person, although that is not reimbursed.
Taking more action
Pending legislation could tie up some of the regulation's loose ends. Bills sponsored by Assemblyman Joseph Morelle, D-Irondequoit, and state Sen. James Alesi, R-Perinton, would codify the state Health Department regulation into law and create an annually updated statewide registry of health care workers run by the state Department of Criminal Justice. It would also waive the $24 fee.
"This is a bill that's taken far too long to get through the process," said Alesi, adding that a statewide registry of health care workers would make the checks process more effective and efficient.
Landers, of the state Association of Health Care Providers, agreed.
Current rules prohibit one home or agency from sharing the FBI background check information with another. Because there is a fairly high turnover rate for some health care workers, he said, "you can end up with the same worker being checked again and again."
According to the Department of Health, average turnover rates for nonlicensed employees runs somewhere between 40 percent and 50 percent annually.
Indeed, the potential for duplication is apparent even locally: The 22,899 potential employees checked here since 1999 were run through RAHSA's system 38,698 times.
Is this enough?
Cynthia Rudder, executive director of the Long Term Care Community Coalition, a statewide advocacy group for nursing home patients, said the background checks are a good start, but there's still plenty to do to ensure patient safety and security.
Rudder would like to see all care employees undergo the same check, so the lower-paid, unlicensed employees don't feel that they're being singled out. However, all the checks in the world wouldn't solve what her group sees as a critical staffing shortage. "I didn't feel there were a large number of felons stalking around in nursing homes," she said.
But without adequate staffing, patients "can't possibly get the care they deserve and the staff can't give the care they want to give."
What Rudder would love to see is "a bill pass that requires minimum ratios of nursing aides and nurses in homes."
Lewis also said he'd like to see things go a little further to help protect his grandmother and the state's 700,000 other elderly who depend on nursing homes or home health aides.
"I would prefer if everybody working in these places had a totally professional background that was clean," he said.
|
|
