Professional Documents
Culture Documents
Laws Regarding Criminal Background in Nursing Homes
Laws Regarding Criminal Background in Nursing Homes
Laws Regarding Criminal Background in Nursing Homes
The presence of residents in long-term care facilities sex and other offenders in facilities and 5 have imple-
who are registered sex offenders, other predatory mented non-law policies. Because legislation is rela-
offenders, parolees, or inmates transferred by correc- tively recent, it is not possible to evaluate best
tional authorities is controversial and has raised practices at this time. Research should be a priority
concerns about how to care for this potentially dan- to determine best policies and practices to balance
gerous population who may jeopardize the safety the right to care with safety. (J Am Med Dir Assoc
of others. Although the present offender population 2011; 12: 481–486)
appears to be small, it is likely that demographic and
economic pressures will increase its size. Since 2004, Keywords: Criminal offenders; nursing homes; assis-
14 states have passed legislation about placement of ted living facilities; safety; state policies
Long-term care facilities have been increasingly challenged Although persons who have been arrested, convicted, or
by the admission of potentially dangerous individuals with incarcerated for violent crimes carry a risk of violence,1 no
criminal backgrounds who need long-term care but may be research has been conducted on their dangerousness in com-
a threat to the safety of other residents, staff, and family mem- munity long-term care facilities. The offender population has
bers. This population is characterized by heterogeneity, includ- a right to receive care, but it is reasonable to assume that some
ing registered sex offenders, offenders on parole or probation may pose safety risks. The type and history of offense(s), the
for nonsex violent crimes, prison and jail inmates transferred severity of medical problems, disability, mental illness, his-
by correctional authorities or the courts, violent offenders tory of substance abuse, and disruptive behavioral problems
found incompetent to stand trial, and convicted felons. are among those factors that would affect a facility’s decision
Because the residency of offenders is controversial, the about its ability to care for offenders. However, little is known
objectives of this article were to review state policies and about best practices and policies for risk assessment and abuse
practices dealing with the admission and care of residents prevention for this population in long-term care settings.
with offender backgrounds and to suggest recommendations This is the first national review of state policies dealing
for future consideration. Study methods included a review with the offender population.
of state legislative Web sites and interviews with staff in
aging, health, law enforcement, corrections, and other SIGNIFICANCE OF THE PROBLEM
agencies in the 50 states and District of Columbia to deter-
mine whether this issue is a concern and, if so, what actions National scrutiny of sex offenders and parolees in long-
have been taken or are pending. term care facilities was the focus of a Government Account-
ability Office (GAO) report2 following several investigations
by an Oklahoma-based disability and elder rights advocacy
organization.3 The GAO used the Federal Bureau of Investi-
University of South Florida, Tampa, FL (D.C., V.M.); L-3 Communications/D.P.
Associates, Jacksonville, NC (T.H.).
gation’s National Sex Offender Registry to identify 683 regis-
tered sex offenders living in nursing homes and intermediate
This work was supported in part by AARP. None of the authors have any
financial interests or conflict of interest. care facilities for persons with mental retardation (ICFs-MR)
during 2005, representing 0.05% of the 1.5 million residents
Address correspondence to Donna Cohen, PhD, Department of Aging &
Mental Health Disparities, Louis de la Parte Florida Mental Health Institute, of nursing homes and ICFs-MR. Approximately 88% of the
College of Behavioral and Community Sciences, University of South Florida, sex offenders lived in nursing homes. Fifty-seven percent of
Tampa, FL 33612. E-mail: cohen@fmhi.usf.edu
sex offenders in nursing homes were younger than 65, com-
Copyright Ó2011 American Medical Directors Association pared with 10% of the overall nursing home population,
DOI:10.1016/j.jamda.2010.09.002 and 30% were younger than 50. Ninety-nine percent of all
Table 1. Characteristics of Legislation Regarding Residency of Criminal Offenders in Long-Term Care Facilities Passed in 14 States
State Bill Year Facilities Background Notification Types of Other Agencies
Passed Covered Check of Residents Offenders Involved
Arkansas HB 2258 2005 Nursing homes, No No Defendants convicted of Department of
rehabilitation facilities, felony or misdemeanor Corrections and
or settings providing who are chronically or Community Corrections
a similar level of care terminally ill may be
incarcerated in nursing
home detention
program
California AB 217, Chapter 466 2005 Nursing facilities No No Registered sex offenders Department of Mental
Health, Division of
Addiction and Recovery
Services
Illinois HB 4785 2006 (Amended Nursing homes, Yes Yes Violent offenders and Department of Public
Nursing Home Care Act) residential long-term registered/convicted Health, Office of Health
care facilities sex offenders Protection, Office of
Health Care and Family
Services
SB 326 2010 Nursing homes,
residential long-term
care facilities
Louisiana HB 121/SB 272 Act No. 341 Nursing homes, long-term Yes No Sex offenders Department of Health
2005 care residential and Hospitals,
facilities Department of Public
Safety and Corrections
Maryland HB 568 2009 HB 879/SB Nursing facilities, assisted Yes Yes Sex offenders Sexual Offender Advisory
776 (Assisted Living and living facilities Board
Nursing Home
Residents Protection
Act of 2010)
Massachusetts SB 386, Act 680 2005/2006 Convalescent or nursing No Sex offenders No Admission of Level 3 sex Department of
MGL – Chapter 6, homes, infirmaries required to offenders prohibited Corrections
Section 178k maintained in a town, self-disclose
rest homes, charitable
Cohen, Hays, and Molinari 483
Table 1. (Continued)
State Bill Year Facilities Background Notification Types of Other Agencies
Passed Covered Check of Residents Offenders Involved
Minnesota Omnibus Public Safety Bill Nursing homes, boarding No Yes Predatory offenders Department of Health
Chapter 136, Article 3. § care homes, hospitals, Department of
63-1-1946 2005 supervised living Corrections
facilities, residential
facilities for adult foster
care, adult mental
health treatment,
chemical dependency
for adults, or persons
with developmental
disabilities.
Nebraska LB 713 2005 Health care facilities with No No Level 2 & 3 sex offenders Law Enforcement
vulnerable adults
LB 1119 2006
North Dakota HB 1482 2007 Nursing homes, basic care No Yes Chronically ill or Department of
facilities, assisted living terminally ill sex and Corrections and
facilities other violent offenders Rehabilitation
given early release,
pardon, or parole
Oklahoma HB 1963 2005 Long-term care facilities, No No Offenders registered Department of
including nursing pursuant to the Sex Corrections, State
homes, residential care Offenders Registration Bureau of
homes, and adult day Act or any person who Investigations, FBI,
care centers is registered pursuant Department of Health
to the Mary Rippy
Violent Crime
Offenders Registration
Act
HB 2704 2008 Long-term care facilities, No No This bill directs the Department of Health
including nursing Department of Health
homes to request bids for
a stand-alone, long-
term care facility that
will house only
registered, elderly sex
offenders
JAMDA – September 2011
Oregon SB 106 Section 11. Long-term care facilities, No No Predatory sex offenders Peace officers, County
ORS 181.586 2005 residential care on parole or post-prison Health Departments,
facilities supervision Department of
Corrections,
Department of State
Police, Department of
Human Services, Aging
Services
must provide facilities with the offender’s personal and
criminal history, including a photograph.
Department of State
Virginia Parole Board,
State budget constraints have been a barrier to building
AB, assembly bill; FBI, Federal Bureau of Investigation; ICFs-MR, intermediate care facilities for persons with mental retardation; HB, house bill; LB, legislative bill; SB, senate bill.
a dedicated long-term care facility for older registered sex
Department of
offenders designated in HB 2704.
State Police,
Corrections
Rhode Island
Senate Bill 2415 stipulates that long-term care facilities
cannot admit sex offenders or offenders on parole or proba-
tion unless they can comply with safety and security measures
parole due to chronic or
Yes
No
and procedures.
Health, retardation,
Ohio
In 2005, Ohio expanded the definition of residence in its
restrictions for sex offenders to include nursing homes, adult
S2415 Chapter 540 2006
Texas
HB 125 2006
Washington
Virginia