Journalism in the Public Interest

Government Report Finds 92 Percent of Nursing Homes Employ Convicts

Though most states require nursing homes to conduct criminal background checks for prospective hires, 92 percent employ at least one worker with a criminal conviction, according to a report released today by the inspector general for the Department of Health and Human Services.

About 5 percent of nursing home workers—or one out of every 20—had at least one conviction, according to the report, which took a random sample of 260 nursing homes certified by Medicare and ran FBI background checks on their workers.

State rules differ regarding background checks: 43 states require nursing homes to perform background checks against state records, ten of those require an additional FBI background check, and eight states don’t require background checks at all.

The rules also differ on what types of crimes disqualify workers. The report noted that of the workers with convictions, 44 percent had committed property crimes such as theft, vandalism or writing bad checks. Some 16 percent had drug-related crimes, and 13 percent had committed crimes against people, including sexual offenses.

Federal regulations prohibit nursing homes from employing workers convicted of “abusing, neglecting, or mistreating residents,” but because FBI data do not show whether the victims of the crimes were nursing home residents, it’s unclear whether these rules were violated.

The New York Times noted that the current system for background checks—which Wisconsin Democrat Sen. Herb Kohl criticized as “haphazard, inconsistent, and full of gaping holes—has allowed people convicted of crimes in one state simply find jobs at nursing homes in another state.

We’ve noted a similar lack of oversight in the nursing field, which allowed problem nurses to cross state lines in order to keep working and avoid consequences. A national database was created decades ago to prevent this from happening, but reporting failures at both the state and federal level have left the database riddled with gaps.

The inspector general recommended that the federal government’s Centers for Medicare and Medicaid Services, or CMS, work with the states to develop background check procedures, including lists of convictions that would disqualify a potential hire.

CMS oversees nursing homes eligible for funding under Medicare and Medicaid. In a written response to the report, the agency agreed with the recommendation. CMS also runs Nursing Home Compare, a searchable database with ratings on nursing homes.

For more, read the full report

Lynn Shwadchuck

March 3, 2011, 4:45 p.m.

I’m just a naive Canadian, but in the US where 7.2 million people are in prison and the unemployment rate is high and rising, do you really want all those ex-cons unemployed? Sure, make sure their convictions and their records don’t put them at risk specifically for abusing residents, but a lot of incarcerated individuals work on themselves in prison and aspire to help others when they get out.

John Ginnetti

March 3, 2011, 5:27 p.m.

Such a shocking, breathless report!  How about some details?  Are these felonies, misdemeanors, whatever?  And don’t people who have had convictions and “served their time” have a right to employment?  Have any of these “ex-con employees” committed crimes in their employment?  Is this journalism in the public interest or merely Charlie Sheen sensationalism?  Shame on you and forget about any future support from me.  (p.s. - do you have any idea what nursing homes pay - and how handsomely their owners profit?).  Color me disgusted.

Carola Von H.

March 3, 2011, 5:28 p.m.

“..a lot of incarcerated individuals work on themselves in prison and aspire to help others when they get out.” Yes, and that’s why recidivism rates are so high. Sorry Lynn, when it comes to caring for the old and vulnerable, taking a chance on an ex-con isn’t a good idea. Physical abuse isn’t the only danger (though it’s the worst), financial fraud and theft are also concerns.


I am not surprised.  They hire very uneducated people who treat the residents horribly.  Some are good, but mostly what I’ve seen is uneducated workers. 

Once again, there needs to be stricter oversight and penaltirs for nursing home abuses.  Society says they respect older people, but this says otherwise…

FBI records did not show that Marian Wang- the author of a horribly thought out piece of irresponsible journalism for ProPublica- was a two-bit hack writer, peddling incendiary and mindless trope designed to disenfranchise ex-cons who aren’t even allowed to work the register of a taco-bell.

Marian Wang was also unavailable for comment to clarify her belief that all homeless people, ex-convicts, and mentally ill should be rounded up and put into stadiums where they can live their lives in “peace… and where we don’t have to know they exist”.


Not so fun when it’s you being made to look like a villian for trying to make ends meet, is it Marian?  Perhaps a little less fear-mongering and a little more responsible reporting is in order.

Just a thought.

Scott Griffith

March 4, 2011, 6:07 a.m.

That’s the most cheering bit of news I’ve seen today.  It is little short of wonderful that someone, somewhere is willing to give people another chance and at the same time to set an example to all the US American hand-wringers about how pernicious their criminal so-called ‘justice’ system is in practice.  Well done the nursing homes!

Burgette Mobley

March 4, 2011, 7:38 a.m.

What is your suggestion, Ms. Wang?  This is what happens when you incarcerate half your population.  People have records.  That doesn’t make them bad people.  It makes them people who made a bad choice at some point in the past.  And here’s a big surprise for you, people without criminal records do bad things too.  They just haven’t been caught yet.  Everyone has the capacity to do bad things.  Some get caught, others don’t.  Others get a pass, depending on how much money you have at your disposal.  For a supposedly Christian nation we don’t seem to have very much belief in redemption.

My son-in-law was convicted of a crime he committed when he was 18 when he was drunk and didn’t know what he was doing.  Now he can’t get a job, can’t get disability (he has physical problems) and my daugher and grandkids are paying the price…..sure, I know, marrying him was her crime.  I’m glad to hear nursing homes are giving people jobs…I’d rather see them working and supporting themselves and their families than to have them desparate over not being able to get a job.

Barry Schmittou

March 4, 2011, 11:07 a.m.

This should be no surprise because the U.S. Government allows insurance companies and doctors’ they pay to ignore life threatening medical conditions and violate numerous laws in five types of insurance as evidenced at

Looking at ProPublica’s mission statement below it hurts tremendously that you will not cover this story !!

“To expose abuses of power and betrayals of the public trust by government, business, and other institutions, using the moral force of investigative journalism to spur reform through the sustained spotlighting of wrongdoing.”

Barry Schmittou

March 4, 2011, 11:09 a.m.

The website did not post correctly. Here it is

Dr. Stephen R.Keister

March 4, 2011, 12:45 p.m.

One reads this article with mixed feelings. Certainly not ALL ex-convicts would be a hazard in a nursing home. Those merely jailed for raising pot in their garage, possession of pot, and other crimes where no harm to others were involved should not interfere with gainful employment.  My problem with the nursing home cartels (as opposed to church run homes) is that they are basically intended to make profit for their executives with patient care a secondary issue; hence, employ anyone that they can get for, or near, minimum wage.

I have been retired for 20 years but I still see from my past experiences the unattended old lady, strapped in a wheelchair gazing blankly at a TV. I fear much of the so-called nursing home care is merely ware-housing of the elderly. One wonders how many days prior notice the homes are given of a pending inspectors visit?

I think the editors of ProPublica did a huge disservice to the public and ProPublica’s reputation with this publication.  The scope of this story is far too narrow and thus is sensationalist, and, in addition, it is racist.  The story defaults to a de facto acceptance of the validity of the convictions rendered by the criminal justice system.  This is a lie.  There is a massive overrepresentation of poor black and Latino people saddled with a felony conviction, compared with whites and Asians, in any given population sample.  Far more poor black and brown people are arrested and charged, very most often under very dubious circumstances; precious few, if any, ever see a jury (5%, nationally) or a judge.  The editors could have hyperlinked this story, as one example, to a story to show how those who live with a felony conviction are often permanent pariahs, including data already in existence proving this fact.  Has ProPublica even begun to cover the often permanent mark a felony conviction allows potential employers legally to deny even considering someone for work; potential landlords legally to deny even considering someone for housing; potential lendors legally to deny even considering someone for a loan; legally to allow government to deny access to public housing, food stamps, et al.?  What about examining the “Ban the Box” idea, or anything similar?  The mis-identified “ex-felon” is now a Returning Citizen, and will be identified as such by those who care to look at the data to be gleaned from research of the criminal justice system.  (Tangentially, The War on Drugs is a way of funneling poor people of color through the ever-expanding, increasingly private prison system, and, incidentally, increasing the public debt.)  This was a very irresponsible act by ProPublica’s editors.  This story definitely gives me pause about trusting ProPublica in future.

^Ben speaks the truth.

You know… I thought after letting it sit for a while, that I would not be so mad about it, but actually… it still angers me that such an irresponsible story as this would’ve gotten past the editors’ and writers’ conscience.

I mean, seriously… this deserves at the minimum a follow-up piece.

Seems like appropriate karma to me.

Jailhouse Rock

March 6, 2011, 4:06 p.m.

So many people concened about the poor misbegotten ex-convicts!

I suggest these concerned souls all get together and lock themselves in a nursing home run as a prison work release program.  It’ll be great!

I’ll be the one holding the keys.

Hi Zach and others,

Actually, I am available to comment, and I agree with much that has been said here.

I certainly think it would be a mistake to interpret this post to say that all people with criminal convictions should be ineligible to work in nursing homes by default. That was not the intent of the post, and I believe it was not the intent of the inspector general’s report.

By pointing out the breakdown in crimes—some property, some drug-related, but others against people—I hoped readers would make the connection that not all the crimes were of the same severity, and not all would have implications for how these individuals would perform on the job at a nursing home. I apologize for not making that clearer.

The post intended to point out that the federal government, in its own survey, found that this is the current state of affairs: Given how many workers in the system do have criminal histories, states need to work on figuring out what types of crimes should disqualify someone from working with a vulnerable population.

There are certainly two things to keep in balance: 1) No one wishes to impose a form of extended punishment or additional hardship on an individual who committed a past crime but has already paid his/her debt to society, and 2) There is an obvious interest in protecting an elderly population that has all too often faced abuse and neglect.

The challenge, of course, is for each state to craft its rules so as not to do a disservice to one population without putting the other at risk. Hope this helps clear things up.

Thanks as always for your comments,

“... No one wishes to impose a form of extended punishment or additional hardship on an individual who committed a past crime but has already paid his/her debt to society. ...”

actually… given severe discrimination that ex convicts face, and the general apathy the public has for them trying to obtain work, I would say that there *is* a large desire to punish ex-cons.  That’s why the outrage over this article.  There’s already a very large amount of momentum of against this demographic, why add to it?

In an age where the media villianizes whatever is convenient, us readers are incredibly skeptical of anything that comes out of any mass-media outlet.

haha…now I’m curious how many of those interred in the old folks home…are convicts!  rofl

so some;)

Another big problem is that States refuse to give other states information. If an employee commits a crime in one state, they can just go work in a nearby state, without worry. Nursing Homes do not check sex offender registries for their employees.

Many nursing home fill their empty beds with homeless people. Patients do not have to provide background checks. Many residents in nursing homes around the country are sex offenders and criminals, and intimidate the other residents

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