Lawmakers: Sex offenders in nursing homes issue begs for answers

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Lawmakers: Sex offenders in nursing homes issue begs for answers

Laws on sex offenders in nursing homes

California: If a person on the sex offender registry is being released into a nursing home, the Department of Corrections or other government agency must notify the home. Otherwise, the registered offender must self-report before becoming a client of any care facility. Homes must notify all residents and employees.

Illinois: Nursing facilities must do a “needs” screening prior to admission that includes a mental evaluation and a criminal background check. That assessment is reviewed by a forensic psychologist who creates an “Identified Offender report” detailing risk level and security concerns. That report goes to the home, local police, an ombudsman and the Department of Public Health, which must track offenders in nursing homes and report to lawmakers annually. Sex offenders can’t have roommates in care facilities.

Iowa: A bill to require notification of nursing home residents about sex offenders died in legislature. Another to create a specialized facility for Tier II and Tier III offenders was introduced in 2015 but hasn’t moved out of committee.

Massachusetts: Law bars anyone classified as a level III offender — based on a risk assessment — from living in any care facilities. At least one resident has successfully challenged this law in court.

Minnesota: Registered offenders must notify nursing homes of their status. Additionally, a law enforcement officer must prepare a “fact sheet” for the facility stating the offender’s criminal history, risk level, and profile of likely victims. That sheet must be distributed to all residents if the offender is admitted.

Ohio: Nursing homes must check the sex offender registry before admitting a new resident and must notify other residents or their family members about the care plan for that offender.

Oklahoma: Passed law in 2008 to create specialized nursing home for offenders, but no bids were submitted and it was never built. Notification law requires homes to check registry, notify the state health department if an offender is moving in and post conspicuously a notification that a resident is a registered sex offender.

Oregon: Registered sex offenders must inform a nursing home of their status prior to admission.

Virginia: Care facilities must register with the state police to recieve notifications if a sex offender moves within the same or contiguous ZIP code; determine prior to admission if a potential resident is a registered offender; and have every resident sign an acknowledgement that they know how to check the registry. There is no law that requires a home to tell residents about offenders being admitted. In a fact sheet, the department of health said, “If a facility determines that a sex offender is already a resident of the facility, affirmative notice to other residents is not required by law; nor is it advised.”

Ohio lawmakers want to take a closer look at how the state monitors sex offenders living in nursing homes, and some advocates support changes to how those on the offender registry are classified.

“You brought a problem to light that I really didn’t think about. I just want to look at what other states are doing and what Ohio can do to protect the other residents of the nursing homes and also to protect the individual that’s (on the registry),” said state Rep. Ron Maag, R-Lebanon.

Dayton Daily News investigation published last week found that 136 sex offenders are living in 43 nursing homes in Ohio. The newspaper identified failures in the safety net intended to balance the needs of all patients with a responsibility to shield them from danger.

Others responding to the investigation said it’s a complicated issue in need of more study.

“The question is what do we do with these people,” said state Sen. Peggy Lehner, R-Kettering. “You obviously have people who are in need of nursing home care who happen to be sexual predators. And what is the alternative for them?”

The investigation explored an idea other states have proposed but none have implemented — creating specialized nursing homes for those on the sex offender registry.

Critics said that approach would isolate offenders from family and friends while creating a prison-like setting.

“I’m of the belief that when a person serves their time that should be the end of it,” said Derek Logue, who is on the Ohio registry for a first-degree sexual abuse conviction involving a juvenile in Alabama. He advocates for the rights of those on the registry through his website OnceFallen.com.

“(Registered citizens) should go to the same place everybody else gets to go,” when it comes time for nursing home care, he said.

State Rep. Jim Butler, R-Oakwood, said he’d like to explore changes that could address safety concerns without creating totally separate facilities, including potentially a higher licensure level for homes housing the most at-risk offenders.

“Those would have increased security and oversight, and there might be a higher level of reimbursement for those facilities,” he said.

Logue, who lives in Cincinnati, argues for doing away with the registry completely. Other advocates for reform say there are best practices that would decrease the number of offenders publicly labeled for life, while ensuring that those who pose the greatest dangers are properly monitored.

“I think the push has to be for more and better information on fewer registrants,” said Barb Wright, a member of the Ohio chapter of Reform Sex Offender Laws.

Risk levels

The reform group has pushed for a model similar to those used in Minnesota and Massachusetts, where offenders are placed into tiers not based solely on their crimes, but on an assessment of a number of risk factors.

Minnesota assigns registered individuals to levels I (low risk of re-offending) to level III (high risk) based on an assessment performed when they leave prison or move in from another state.

A committee considers multiple factors including criminal history, behavior while incarcerated, and relationship to the victim. They also can consider “whether the offender demonstrates a physical condition that minimizes the risk of re-offense, including but not limited to advanced age or a debilitating illness or physical condition,” according to the state statute.

An offender may appeal the decision or request that their risk level be changed after three years, so those who become ill or disabled can petition to get a lower level assignment.

Only those labeled as level III, or most at risk of re-offending, are listed on Minnesota’s online public registry and are subject to community notification.

According to the Minnesota Department of Corrections, about half of all registered offenders living in the state have been assigned risk levels. Of those, approximately 57 percent are level I; 31 percent are level II; and and 12 percent (about 360 individuals) are level III.

“It’s sort of a problem I think we have with dealing with sexual predators in general. There’s such a wide range of behavior that what might be appropriate for one group is not appropriate for others,” Lehner said of the current tier system in Ohio, which puts offenders into tiers I through III based solely on the crime they committed.

Crime details

Ohio used to perform a risk assessment to determine whether a sex offender was likely to repeat an offense, said Wright. In 1997, Ohio began listing offenders according to offense.

“So a teenager who has consensual sex with his minor girlfriend is listed on the same register as a serial rapist,” she said.

Minnesota’s public registry gives more detailed descriptions of criminal histories than Ohio’s.

For example, instead of just listing the offense of criminal sexual conduct with a minor,  one man’s profile says “Offender has a history of sexual conduct and contact with minor male victims (age 9-12). Contact included sexual touching and penetration. Conduct included taking photos of victims in various stages of undress. The offender was previously known to some victims and unknown to others.”

Massachusetts’ system is similar, with offenders placed into tiers I through III based on a risk assessment.

Only those in tiers II or III are on the public registry in that state. Massachusetts also passed a law that bans tier III offenders from living in nursing homes and other long-term care facilities, but it’s been challenged successfully in court at least once.

Supporters of reform say these risk-based approaches would give nursing homes more information about a potential resident, while making sure that only those who pose the greatest risk to others are subject to the public stigma and collateral damages of the registry — including patients in need of care being rejected from nursing homes.

Rep. Butler said he’d like to see more details on the registry, including age ranges of victims.

In one case examined by this newspaper, a Stark County nursing home acknowledged it would have handled the care of a registered sex offender differently if staff had known that he previously attempted to rape a 92-year-old in a Cleveland facility. One week into his stay at the second home he raped an 85-year-old resident and is now in prison.

Butler also approves of a more risk-based tier system and said the Ohio Criminal Justice Recodification Committee currently is studying something similar. The committee is expected to make recommendations for changes to Ohio’s criminal code early in 2017.

“It’s better to have the judge or corrections officials, who know the situation, have the discretion so it’s not a cookie-cutter type approach,” he said.

Unsafe homes?

Roger Evans, of Brookville, said he’d never thought about the issue of sex offenders in nursing homes, but has seen how vulnerable his loved ones have become as they age while he’s navigated the complicated world of nursing facilities.

“We’re still working our way (as a society) through how to deal with aging,” Evans said.

His father spent the last year of his life in a VA nursing facility and his mother-in-law is currently a resident at Walnut Creek Nursing and Rehabilitation Center in Kettering.

Evans, 70, worries that the rising costs of high-quality facilities mean many without the economic means are left in understaffed, and possibly unsafe, homes.

The newspaper’s investigation found nearly half of the Ohio homes that currently house sex offenders have a rating of 1 (on a 5-point scale) on the Medicare.gov nursing home comparison tool. Lower ratings indicate repeated health and safety citations on state inspections and can indicate inadequate staffing levels.

Although there are many regulations in place designed to hold nursing homes accountable for quality care, Evans wonders how much monitoring actually is going on when most homes are understaffed.

“You’ve got 25-to-30 people on a floor and each of them needs, in some cases, 24-hour care,” he said.

Rep. Maag also questioned what can be done to make sure those who could pose a risk are properly monitored.

“OK, so I know this person’s a sex offender, I’ve notified the residents of the home, but it looks like there should be some other method of monitoring that patient to make sure they don’t (re-offend),” he said.

“That sounds good when they say they’re doing (hourly checks) but they’re not doing that, I’m sure, because they’re not getting paid for it.”

Staying with the story

I-Team reporter Katie Wedell conducted a months-long investigation that uncovered problems involving sex offenders living in nursing homes. We will provide updates on this issue as lawmakers explore potential changes to Ohio law.

Laws on sex offenders in nursing homes

California: If a person on the sex offender registry is being released into a nursing home, the Department of Corrections or other government agency must notify the home. Otherwise, the registered offender must self-report before becoming a client of any care facility. Homes must notify all residents and employees.

Illinois: Nursing facilities must do a “needs” screening prior to admission that includes a mental evaluation and a criminal background check. That assessment is reviewed by a forensic psychologist who creates an “Identified Offender report” detailing risk level and security concerns. That report goes to the home, local police, an ombudsman and the Department of Public Health, which must track offenders in nursing homes and report to lawmakers annually. Sex offenders can’t have roommates in care facilities.

Iowa: A bill to require notification of nursing home residents about sex offenders died in legislature. Another to create a specialized facility for Tier II and Tier III offenders was introduced in 2015 but hasn’t moved out of committee.

Massachusetts: Law bars anyone classified as a level III offender — based on a risk assessment — from living in any care facilities. At least one resident has successfully challenged this law in court.

Minnesota: Registered offenders must notify nursing homes of their status. Additionally, a law enforcement officer must prepare a “fact sheet” for the facility stating the offender’s criminal history, risk level, and profile of likely victims. That sheet must be distributed to all residents if the offender is admitted.

Ohio: Nursing homes must check the sex offender registry before admitting a new resident and must notify other residents or their family members about the care plan for that offender.

Oklahoma: Passed law in 2008 to create specialized nursing home for offenders, but no bids were submitted and it was never built. Notification law requires homes to check registry, notify the state health department if an offender is moving in and post conspicuously a notification that a resident is a registered sex offender.

Oregon: Registered sex offenders must inform a nursing home of their status prior to admission.

Virginia: Care facilities must register with the state police to recieve notifications if a sex offender moves within the same or contiguous ZIP code; determine prior to admission if a potential resident is a registered offender; and have every resident sign an acknowledgement that they know how to check the registry. There is no law that requires a home to tell residents about offenders being admitted. In a fact sheet, the department of health said, “If a facility determines that a sex offender is already a resident of the facility, affirmative notice to other residents is not required by law; nor is it advised.”

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