Reports of criminals in nursing homes beg for perspective
The new report about the criminal histories of nursing home workers from the Office of Inspector General for Department of Health and Human Services has prompted many bold statements.
"Turns out the odds of finding a crook working at a nursing home are alarmingly close to the odds of finding a criminal sitting in jail," wrote the Fort Worth Star Telegram.
"92% of Nursing Homes Staffed By Criminals," shouted a headline in HealthLeaders Media.
And, as I noted in my earlier post, Sen. Herb Kohl, a Wisconsin Democrat and the chairman of the Senate Aging Committee, told the New York Times, "Predators can easily evade detection during the hiring process, securing jobs that allow them to assault, abuse and steal from defenseless elders."
What has been missing from all the alarmist analyses of this report are a few key facts and a sense of perspective.
One good question to ask would be: How many criminals are there in the U.S.?
The Office of Inspector General, unfortunately, is incredibly vague about what it counted as a crime for the purposes of its review of nursing homes. We are told that it relied on FBI records. This means that it followed the standard criminal background check procedure that any employer can do, using the FBI's National Crime Information Center. The center itself is vague about how many people it tracks, but it does say that it has "15 million active records."
According to a detailed analysis by Christopher Uggen, Jeff Manza and Melissa Thompson in The Annals of the American Academy of Political and Social Science, more than 16 million Americans have felony records. That's equal to more than 10% of the 153 million-worker U.S. labor force.
Suddenly, 1 in 10 nursing home workers with a criminal record - which is what the OIG found - does not seem so stunning.
The next question is: How does the nursing home industry compare to other industries?
Antidote could not find a single story that made any mention of the odds that someone working in any organization might have a criminal background. Maybe some would find it stunning, but I can think of at least five different places where I have worked where someone had been convicted of a crime, often in the distant past. Be honest with yourself and ask whether you know anyone who has had a DUI conviction, for one.
And where is the perspective?
As the report notes, most of these crimes occurred before the employees were hired by the nursing facilities and, of those, 38% occurred a decade prior. Remember, neither the OIG nor the FBI can say whether any of these crimes victimized a nursing facility resident, and the vast majority of these crimes were driving offenses or property crimes.
If someone is convicted of a crime and serves the proper sentence, why should they be barred from working in a nursing facility? Should people with criminal records also be barred from working in restaurants where they might poison people's food? Should they be banned from driving trucks lest they drive into oncoming traffic and hit a school bus? Should they be banned from journalism?
The Center for Medicaid & Medicare Services (CMS), at least, appears to have the right. CMS told the OIG that "it will work with the States through the National Background Check Program to assist them in developing lists of convictions that disqualify individuals from employment, as well as defining whether any of those conviction types can be assumed to be mitigated because of the passage of time and which convictions should never be considered mitigated or rehabilitated."
Antidote hopes that list ends up being truly adequate to protect nursing home residents and also truly fair to protect the rights of people who have served their sentence from starting their lives over.
The data presented here show that literally millions of former felons are successfully living and working among us every day. Many of them pay taxes; raise their children and grandchildren; and, in states where they are permitted to do so, participate in democratic elections. As rising waves of men and women leave criminal justice supervision each year, the time has come for a reasoned reassessment of those sanctions that strip them of their rights as citizens.
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