WFAA had a troubling investigative report on the care provided at nursing homes in Texas. Part One is here. Part Two investigates the nursing home industry hiring criminals to care for our loved ones. A six-month WFAA investigation found 200 aides certified to work in North Texas nursing homes have serious or violent criminal histories.
The most troubling part is that current regulations in Texas allow many certified nurse aides (CNAs) with criminal histories to work in nursing homes legally. The WFAA investigation found CNAs who have been “convicted of crimes that should make them ineligible to work, yet slipped through the regulatory cracks — and continue to remain state certified and employable.”
The WFAA review found CNAs with arrests for crimes that include the following: aggravated assault with a deadly weapon; continuous violence against family; injury to a child; abandoning a child; aggravated robbery; aggravated sexual contact with a child; and burglary.
There are three major oversight flaws, according to the WFAA findings.
Loophole 1: Inadequate initial background checks
The first involves the initial certification.
The state requires DPS to conduct a criminal background check prior to an applicant being certified. That’s different from Texas requirements in other industries, for example, like child daycare in which a national background check using fingerprints is required.
The WFAA review found the DPS checks apparently fail to uncover various state convictions. That’s resulted in nurse aide applicants getting certified, though they should be barred for life.
Loophole 2: No background check on re-certification
A second flaw appears in the re-certification process. The state requires a nurse aide to get re-certified every two years, yet does not require regulators to re-check a CNA’s criminal background. Instead, any further background checks fall to the nursing homes.
WFAA found individuals who commit crimes that should bar them from work – and have their certification pulled – yet remain certified and employable.
Loophole 3: Deferred adjudication probation
The third and most common loophole WFAA found is buried in the state’s regulations. It says if you commit a serious or violent crime, you are eligible to become a CNA as long as you don’t have a “final conviction.” WFAA found dozens of nurse aides who pleaded guilty to violent crimes. But since they got probation, the law allows the nursing homes to keep hiring them.
That means a nurse aide can commit a serious or violent crime, gain deferred adjudication, and successfully fulfill the terms of their probation, to avoid a “final conviction.” The individual, though often pleading guilty to a serious or violent crime to gain probation, remains eligible to be a CNA.
This can be very dangerous to any resident but especially those with dementia. At minimum wage, a nurse aide must clean, bathe and feed as many as 30 residents at a time. That’s compounded by Texas’ lack of minimum staffing level requirements.
“They have dementia, Alzheimer’s, symptoms that cause them to have a lack of communication,” said Ernest Tosh, an attorney who handles nursing home abuse cases across the United States.
“They can’t express exactly what happened, which is why violent offenders should be screened out from working in these facilities,” Tosh said. “They can physically or sexually assault an individual and there be no repercussions because that individual can’t identify them or communicate what happened.”
“I think our state needs to recognize that nursing homes are not as poor as they claim to be,” said J.T. Borah, an attorney who specializes in nursing home abuse and neglect. “If the industry were to finance and staff at the level they were supposed to, they could afford better employees. They could have better applicants.”