By Barbara Fuente, USIS

· Wichita, Kan. - Man Faces Three Allegations of Rape at Local Nursing Home: The suspect, an employee of the facility, would follow co-workers into the rooms of incoherent patients and sexually assault them. Further investigation has revealed that the suspect is on probation for domestic violence convictions and has separate cases pending for DUI and other driving violations.

· Jacksonville, Fla. - Nursing Home Resident, 83, Raped by Fellow Resident: After the attack, the perpetrator, who lived down the hall from the victim, was discovered to have had a history of sexual assaults dating back to the 1940s and had been placed in the home after being released from jail. Studies have shown that this isn't an isolated case: more than 50 sex offenders have been found to be living in Florida nursing homes — over 1,000 nationwide.

· Boston, Mass. - Nursing Home Worker Caught Stealing From Residents: Boston police arrested and charged the worker with theft after setting up a video camera in a patient's room to determine who was stealing money from residents. A total of $143 was found in the worker's purse and she was charged with four counts of larceny of a person over 65.

Unfortunately, reports like these seem to be appearing more frequently in local newspapers across the country. Members of the nation's oldest generation, just when they should be feeling their safest in our care, are somehow being subjected to an element intent on harming them. Our staffs, too, should find their workplaces safe and secure, allowing for optimal care for patients and freedom from harm. Still we see what appears to be an increase in crimes, violent and otherwise, in homes for the aging. The truth is that these headlines reflect only those incidents that are discovered — not those that may be happening, but are undetected in our facilities. What can be done to ensure that our homes are the safe havens that both our residents and our staff expect them to be? Steve Walls, Director of Healthcare for USIS, suggests rethinking your background screening strategy.

"Even though some states don't require background screening for employees and even fewer require it for residents, you shouldn't assume that you're safe just because you're compliant," Walls says. "Nursing home administrators have a responsibility to keep their facilities safe for both workers and residents. A careful screening process can mitigate the risk of workplace safety negligence lawsuits, loss of community goodwill and, ultimately, harm to those you serve." He also emphasizes that in a highly competitive market, employee and resident background screening serves as a quality of service differentiator.

AASHA members can develop a robust screening process by taking the following steps to develop both employee and resident screening program:

Employee Screening Program

1. Develop clear job/position descriptions — include detail about the types of interactions the employee will have with residents in each position.
2. Conduct interviews — have trusted staff at multiple levels within the facility conduct interviews with candidates and then compare notes.
3. Call references — ask position appropriate questions, including "Would you feel comfortable if Sally was helping to care for your grandmother at Manor House?"
4. Consult a Fair Credit Reporting Act (FCRA) — compliant background screening service provider to help develop and provide position-appropriate background screening packages, that could include:
   • National Criminal Search
   • National Sex Offender Search
   • State Sex Offender and Adult Abuse Registry Search
   • I-9 Verification Services
   • County and State Criminal Searches
   • Verification Services: Employment, Professional, Personal, Education, License and Certifications
   • Drug and Alcohol Testing
   • Social Security Number Checks
   • Previous Address to Criminal Record Checks
   • Credit Reports
   • Motor Vehicle Records
   • FACIS, OIG and GSA Sanction Searches (for Professional Positions)
5. Develop a comprehensive orientation and training program — be sure to provide complete orientation on proper conduct in your facility, as well as sufficient position-appropriate training
6. Establish a three to six-month supervision rule — consider requiring supervision of employees who work directly with residents, especially those in lower level positions

Resident Screening Program

1. Keep abreast of your state's regulations with regard to resident screening — many states have already or are considering mandatory screening of long-term facility residents. Be sure to consult your attorney about the applicable regulations in your state(s)
2. Consider making background screening a part of your intake process — prospective residents and their families might find comfort in the fact that you include screening as a part of your facility's security program. Once again, be sure to consult with your attorney about state regulations and any implications of screening to Health Insurance Portability and Accountability Act of 1996 (HIPAA) compliance
3. Perform screens that will help mitigate risk and keep residents safe — simply conducting a national criminal search may or may not be enough to identify a risky individual. Consider including some or all of the following:
   • National Criminal Search
   • National Sex Offender Search
   • State Sex Offender and Adult Abuse Registry Search
   • County and State Criminal Searches
4. Partner with a company that specializes in background screening — maneuvering screening regulations can be complex, especially when they fall under the Fair Credit Reporting Act. Working with a company that focuses on your industry and one that is considered a "consumer reporting agency" by law ensures that you'll be compliant with the intricacies of FCRA.

Living out life in peace and security is the least your residents deserve. Be sure to take the necessary steps to avoid the tragedy and public backlash that can strip your facility of the good service it provides to our aging population and to your community.

USIS offers the most comprehensive suite of background screening and drug testing services available, including USIS Guardian™, which searches the online sex offender registries of 49 states plus the District of Columbia. Contact Steve Walls at (800) 331-9175 x2199 or e-mail steve.walls@usis.com for more information on USIS Guardian or for assistance in developing an effective background screening program for your facility.

Sources:

• US Government Accounting Office Report: Long Term Care Facilities - Information on Residents Who Are Registered Sex Offenders or Are Paroled for Other Crimes
• A Perfect Cause
• Non-Profit Risk Management Center
• USIS