Monday, October 15, 2007

Lawmakers seeking stricter caregiver rules

By DARREN BARBEE - Star-Telegram staff writer - Oct. 14, 2007
Nurse aides let back into jobs despite ban
A state senator says she wants to improve the background screening of nurse aides and other caregivers after gaps that allow criminals to work in nursing homes were identified in a recent Star-Telegram report.

Advocates for nursing home residents and the industry also expressed concern that some workers banned by the Texas Department of Aging and Disability Services for abuse, neglect and theft have been certified as nurse aides by the same department. Some found new jobs caring for the elderly and disabled. Sen. Judith Zaffirini, D-Laredo, said she was troubled to learn that crimes barring employment in nursing homes, such as murder and rape, don't prevent aides from being recertified. Aides and other such workers give the vast majority of care at nursing homes and also work at doctors' offices and hospitals.

Zaffirini, who created key legislation in 1999 designed to bar abusive but unlicensed workers from nursing homes, said her staff is drafting legislation to prevent criminals from being certified. She also wants to deal with workers banned for abuse who are recertified.

"We believed they were being barred from being recertified as a nurse aide. ... That's an aspect of the problem that [the newspaper] pointed out, and we have to go back and address," said Zaffirini, a member and former chairwoman of the state Senate Committee on Health and Human Services.

The senator said she is also considering a bill that would require workers to be rescreened annually. Currently, homes check criminal history just once, before workers or aides are hired. That can allow subsequent convictions to go undetected. For instance, a McAllen aide passed his pre-employment check but later pleaded guilty to indecent exposure. His employers uncovered the conviction only after he was accused of molesting a nursing home resident. The aide denied doing anything wrong, according to state documents.

Tim Graves, president of the Texas Health Care Association, said he supports a periodic recheck of employees' criminal histories. But such checks could financially burden homes, which often operate on tight budgets. Texas ranks 45th out of the 50 states in Medicaid funding for nursing home care, according to the association, which represents long-term-care facilities and professionals.

Graves said the newspaper report also showed problems in the oversight of long-term-care workers. In one case, a worker was banned for failing to perform CPR on a resident who later died. The state recertified her as a nurse aide, and she found another job. She was fired only after the Star-Telegram asked a Plano home about her status.

Sen. Jane Nelson, R-Lewisville, had asked officials to review policies on criminal-background checks across health and human services agencies, her spokesman said. Nelson, leader of the Health and Human Services committee, was unavailable for an interview.

Nelson said in a statement that nurse aides with serious criminal records should not have access to the frail and elderly. In the past session, Nelson authored a bill that added new criminal offenses, such as indecent exposure and cruelty to animals, to those that bar long-term-care workers from employment in state-regulated facilities. But workers won't be rescreened for the new convictions, the department said.

Checking out workers

The Texas Department of Aging and Disability Services provides an online database that allows a search for workers, nurse aides, administrators and others who have been designated as unemployable. Because Texas has more than 118,000 active certified nurse aides, verifying the status of a nurse aide or worker, especially one with a common name, can be difficult without a Social Security number. If you suspect an aide shouldn't be working, bring concerns to the attention of the nursing home or the department at 1-800-458-9858. To perform a search, go to www.dads.state.tx.us/providers/nf/credentialing/sanctions

Checking out nursing homes

The department also maintains basic inspection information about nursing homes online. Additionally, nursing homes must make their most recent inspection reports public. The surveyor's notes can sometimes provide insight into how well residents are treated and how clean things are kept. To look up a home, go to facilityquality.dads.state.tx.us
Read more in the Fort Worth Star Telegram.

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