Bill Would Prevent Abusive Employees From Work In Nursing Homes And Home Health Care

senate.gov, Jul 13, 2005

WASHINGTON - U.S. Senator Herb Kohl today introduced comprehensive legislation that addresses the protection and care of elderly and disabled patients in nursing homes and home health care. Kohl's legislation, the "Patient Abuse Prevention Act," will establish a national background check system for workers who care for the elderly and disabled to weed out known abusers and people with violent criminal backgrounds. Kohl, a member of the Senate Special Committee on Aging, has introduced the legislation in past sessions of Congress, and it has received bipartisan support, including support from Secretary of Health and Human Services Tommy Thompson. "There is absolutely no excuse for abuse or neglect of the elderly and disabled at the hands of those who are supposed to care for them. Our parents and grandparents made our country what it is today, and they deserve to live with dignity and the highest quality care," Kohl said. "Unfortunately, this is not always the case. We know that the majority of caregivers are dedicated, professional, and do their best under difficult circumstances. However, it only takes a few abusive staff to cast a dark shadow over what should be a healing environment. It is those abusive employees who my legislation seeks to keep from getting work." Current state and national safeguards have been inadequate to prevent abuse of patients by those who are supposed to care for them. All states are required to have nurse aide registries, but these registries are not comprehensive or efficiently maintained. Many states limit their registries to nursing home aides, failing to cover home health and hospice aides. Most states fail to require criminal background checks of long-term care workers.

Further, due to lengthy appeals and the threat of lawsuits, states often hesitate to document problem workers who may be abusive. There are no federal requirements or guidelines on sharing information about abusive workers and -- as a result -- few states share information. Because no national registry of abusive health care workers exists, people who have histories of abuse or serious crimes in one state can simply travel to another state to find work. Abusive workers can also move from working in nursing homes to home health agencies or to hospitals without ever undergoing a criminal background check. Kohl's initiative would create a national registry of abusive health care workers and require criminal background checks. This would enable states and employers -- either by computer or by phone -- to check if a potential employee has a criminal record or other problems in their past that should preclude them from caring for the vulnerable. A national registry would also create a coordinated information network between states so that violators could not simply travel to another state to find work in a nursing home or other setting. Additionally, the bill provides a second line of defense to protect patients from violent criminals. If the national registry does not contain information about a prospective worker, the facility is then required to initiate an FBI background check. Any conviction for patient abuse or a relevant violent crime would bar that applicant from working with patients. A disturbing number of cases have been reported where workers with criminal backgrounds have been cleared to work in direct patient care, and have subsequently abused patients in their care. In 1998, at Kohl's request, the Senate Special Committee on Aging held a hearing that focused on how easy it is for known abusers to find work in long-term care and continue to prey on patients. At that hearing, the Department of Health and Human Services' Inspector General presented a report which found that, in the two States they studied, between 5-10 percent of employees currently working in nursing homes had serious criminal convictions in their past. They also found that among aides who had abused patients, 15-20 percent of them had at least one conviction in their past. Additionally, in July 2001, the House Government Reform Committee's Special Investigations Division of the Minority staff issued a report which found that in the previous two years, over 30 percent of nursing homes in the U.S. were cited for a physical, sexual, or verbal abuse violation that had the potential to harm residents. Even more striking, the report found that nearly 10 percent of nursing homes had violations that caused actual harm to residents.