There has been an ongoing debate about conducted more comprehensive background checks for home care workers.  As studies have revealed significant numbers of abuses, there is a greater incentive to screen home care workers who tend to the needs, usually, of older citizens and children.

However, the economic downturn has given some governmental agencies pause.   With the economy lagging, administrators just don’t want to spend the extra money.  An article in the Washington State The News Tribune, reflects the ongoing quandary while calling for expanded background checks for home care workers….”Three years ago, Washington voters overwhelmingly supported federal background checks and increased training for the people who care for our seniors and citizens with disabilities. After the implemen-tation of these needed reforms was postponed, we have seen the risk to our seniors grow…….

………………….I-1163 requires home care workers, who provide the same type of care as nursing home workers but in a more isolated setting, to pass a full federal background check. Our current, state-level check misses crimes committed outside the state of Washington, leaving our seniors and disabled citizens vulnerable to felons from other states. Common sense dictates that we close this background check loophole.”

I would venture while extended background checks for home care workers can be costly, so can lawsuits over liability issues should a home care worker assault and injure or even kill one of his charges.  While it is commonplace for legislators to dismiss the background checks as being too costly and apply what limited funds they have to what they consider greater priorities, in certain cases the dollars spent on extended background checks may prove cost effective.

Look, either way, with limited budgets in a bad economy and state hurting for revenue, this is a very tough call.  It is an honest dilemma and perhaps, besides the obvious threat of theft and injury on the part of home care workers, further study has to be done on whether the bucks spent up front would prove a bargain in the long run.

For the complete article and additional information–Read more: http://www.thenewstribune.com/2011/10/19/1870622/should-broader-checks-be-required.html#ixzz1bGHWx8vS

The  News Tribune in the Seattle area just reported that the most violent job in the metropolitan district is not a police officer or fireman.  No, cops and fireman are relatively safe compared to what is really the most violent job in the city.   A nurse’s aid.  That’s right. A nurse’s aid.

According to the article….”

Seattle public radio station KUOW-FM made that finding as part of an investigative series on workplace safety airing this week. The station found that violence strikes health care workers in Washington at six times the state average for all workplaces, and frontline caregivers in emergency rooms and psychiatric wards get assaulted even more than that.

The single most violent workplace in the state is Western State Hospital, where criminal defendants are taken when they are found incompetent to stand trial. Workers at psychiatric hospitals are assaulted on the job more often than anybody else — 60 times more than the average worker in Washington state.”

That is truly remarkable.  As I recently did an interview segment with Donna El-Armale, a professor at California State University, Dominguez Hills, and as the co-founder of an employment screening concern, I try to stay current on all workplace violence issues.   But this is really nuts.  At the Washington State Hospital there were more than three hundred assaults last year.   Causes one to think that maybe a Taser should be standard issue.

Apparently, when patients can’t get the services they need they snap out and act violently.   The objects of their frustration are the nurse’s aides.  While metal gates may prevent some of the violence, three hundred incidents of assault can hardly make one sanguine.    A shame.  Since most nurse’s aides and healthcare personnel enter the industry to help people, it’s a shame they have to be so abused.

The quantity of abuses found in healthcare are legion.   It’s really kind of nuts when you allow for abuses against the elderly and children,  theft, be it stealing for patients or stealing drugs.   There is physical abuse and mental abuse.   In some cases, patients enter healthcare facilities and emerge perhaps in worst shape than when they first came in.

Mot healthcare workers are conscientious and got into the industry because of their desire to help people.   They are patient souls for the most part, because many of them are also subject to abuse from their patients.   It’s a two way street working here.   Patients who are frustrated with the facility, healthcare, or maybe their lives lash out at the staff that is trying to help them.   Most healthcare workers, according to recent reports, may not like the abuse but accept it as part of the job.   Must be something going to work everyday knowing some frustrated patient will want to take it out on you.  As a matter of fact, the Tacoma New Tribune recently reported the most violent job in Washington State isn’t a cop or fireman.   It is a nurse’s aide.

For the complete article go to Recruitingblogs.com.  Here is the...link

As the controversy on employment credit reports and their discriminating effects as a background check continues around the country, the State of Maryland has  imposed restriction on employment related credit reports.  House Bill 29 has been combined with Senate Bill 132 will restrict an employer’s use of the employment credit background check as a consideration for hiring.

Maryland has signed into law the Job Applicant Fairness Act (HB 87) which will significantly limit employers’ use of credit history for making hiring and other employment-related decisions. The Act goes into effect on October 1^st 2011–

Under the Act, an employer may not use an applicant’s or an employee’s credit report or credit history in making certain kinds of employment decisions unless it meets certain conditions.

The Act prohibits decisions determining:

• First, whether to deny employment to the applicant;
• whether to discharge the employee, and
• compensation, or
• the terms, conditions or privileges of employment

As with most state that have passed similar statutes, the law doesn’t provide a detailed definition as  to what is “job related” justification for conducting the employment credit report.   However, the law does define several absolute categories where the employment credit report can be mandated as a background check.

They are–

1.     Managers who have the authority to set the direction or control of a business or a department, division, unit, or agency of a business;

2.     Those that involve access to personal information of a customer, employee, or employer (including an individual’s first and last name, and his or her social security number, driver’s license number, or financial account number) and involve access to more personal information than is customarily provided in retail transactions;

3.     Those that involve a fiduciary responsibility to the employer, including the authority to issue payments, collect debts, transfer money, or enter into contracts;

4.     Those that are provided an expense account or a corporate debit or credit card, or

5.     Those that have access to trade secrets or other confidential business information

5.     Those that have access to trade secrets or other confidential business information

Additionally,  the employer must disclose the purpose for using the credit history to the applicant or employee in writing. The statute provides no guidance on what an acceptable disclosure would be.  The two problematic areas are the actual text of the disclosure and the timing of the disclosure.  Does the employer notify the candidate subsequent to running the credit report or simultaneously?

Good questions, which I am sure will be answered over time.  Or not.

Working in healthcare can be a dangerous occupation.  Maybe it is not like a cop or a fireman, but healthcare workers are subjected to a lot of violence.   A recent article in the Wall Street Journal attested that healthcare workers are often subjected to assault.  While there have been documented episodes of shootings, it is the physical assault that seems to be the more prominent hazard.

Now I have in the past written about various malfeasance among healthcare workers.  Some healthcare workers have undergone shoddy employment screening only to later to discover that they were themselves convicted, felons, sex offenders, or suffering from substance abuse.   These revelations, of course, came largely after the worker acted out and attracted undue attention by stealing or physically or psychologically assaulted a patient left in their care.   I have written about this a number of times.  One such article was entitled, Fake Nurse Conviction and the Need for Healthcare Background Checks.  This was where someone posed as a nurse but lacked the requisite credentials.

So, yes, there have been award winning  studies about healthcare malfeasance and the need for more comprehensive background checks  from groups like Pro Publica and Newspapers like the Los Angeles Times.  There have been innumerable articles  about violence, theft, and substance abuse that has not benefited the industry as a whole.  But, let’s face it, most healthcare workers are diligent and reputable and really don’t need to face potential violence by sheer virtue of showing up for the job.

According to the article in the WSJ, shooting are pretty rare.   But physical assault is on the increase.  According to the WSJ,  the authors of the study maintain that physicians are not perceived with the historical reverence that was once so prominent among the public at large.    As health care is a business that appears to some as more concerned about profit and monetization,  patients become increasingly frustrated with the bureaucracy.  And then there is the ugly fact that civility ain’t what it used to be and violence is a more acceptable solutions.  Not good, but probably accurate.

So while some lament healthcare and call for reform where all patients should be treated, perhaps the increased incidence of assault against healthcare workers should be taken into consideration.  Maybe if you are a patient and choose to act out, you go to the back of the line.  I don’t know.  But no one should have to be in the business of treating people and risk injury or death.

A woman is going to jail for practicing nursing without a license.   According to an article  on the NBC Connecticut website, the woman staged a dinner where she honored herself as “Nurse of the Year.”   The Connecticut Nursing Association was the supposed responsible host for the Nurse of the Year Award.  Thing is, this organization does not exist.    Talk about some chutzpah.

As it turns out the women’s ruse wasn’t discovered until the doctor for who she was working for thought she had behaved unprofessionally.  He instigated an investigation that turned up the fact that his employee did not possess a nursing license.   Apparently, among other things, the convicted woman had been writing drug  prescriptions for herself.  So now she will be a guest of the state for approximately nine months.

I would like to think of this as a rare situation, a deviation from the norm.  It probably is.  However, on deeper levels the nursing and entire healthcare industry has been rife with complaints that those employees who have been hired have in their past convicted felonies, drug abuse issues, and numerous disciplinary actions taken against them.   The felonies included sex offenses, theft, battery, forgery…the list goes on.   Disciplinary actions have included anything from drug theft to abuse of the elderly patients or younger patients left in their care.

Pro Publica, the award winning media watchdog, has published numerous articles related to nursing and healthcare abuses.   The one article, a study in conjunction with the Los Angeles Times, about Nursing Abuses in California, earned them a Pulitzer Prize.  I have written about healthcare abuse on a number of occasions.   One such article was entitled, The Increased Need for Hospitals to Conduct Background Checks.  Others, in  fact many others have also written about abuses and shoddy practices in the healthcare industry.

Even state and public service agencies are hardly immune.   It seems at least once a week there is a new report about one state agency or public service organization being sued and otherwise embarrassed for hiring healthcare workers who are serious convicted felons or have committed abuses.   Usually, the employee in question is caught at committing a wrongful act and is subsequently investigated.  Then it is revealed either passed abuses, serious felonies, substance abuse issues.  Some healthcare workers are discovered on the sex offender registry.   These are people around the fragile and the vulnerable, including children.

You would think that after all this public exposure it would make sense to have a comprehensive employment screening program in place.   You would think that it would be prudent to conduct background checks on potential employees.   And you would think, if you did conduct background checks those responsible would review them thoroughly once the report was returned.   You know, as in read it and see whether or not you are hiring  a potential problem.

Even with the lousy economy it would be more economically feasible to conduct rigorous employee screening.   Yes, it may cost a few bucks, but it goes a long way in avoiding serious liability issues, including costly lawsuits, public embarrassment, and possible disciplinary actions from enforcement agencies.   But staffing groups, healthcare recruiters, and even hospitals have been remiss in conducting the necessary background checks and then reviewing them carefully once the reports are completed.   While some information for whatever reason slips through the cracks, in many cases the damning evidence is in the report.  Only no one bothered to read it or perceive it as a relevant issue.   It’s amazing.

So now we have advanced to the point where healthcare industry workers not only have a checkered past, or an expired license, a revoked license, taken away for disciplinary action.   But they may not have ever had a license at all.

So while we debate healthcare, its pros and cons, whether this new program will be working or not, perhaps we should also take a better look at the healthcare industry itself.    It could use some tightening up.    Because at the end of the day, where you are PPO, HMO, in a group plan or government plan, you want to be sure the employees assigned to take care of you will not end up causing any harm.

I don’t know much about this list other than certain employers that are on it.  For certain employers listed here, we have conducted employment screening at one time or another.   Or for their affiliates.   As for how these fifty employers make the list for the top fifty employers, or the best companies to work for, I am not really sure.   As with the best cities to live in, the best places to retire, the best places for romance, and the best pizza, I am sure there is some criteria that guides companies, in this case, like  glassdoor.com to arrive at their conclusions.

In this case the employees of these companies were making the choice.   But then, in tough times, are employees really willing to bad mouth the companies they work for?  Maybe.   At any rate, it is an interesting list.   I certainly looked it over.  The side list, by the way, is the Best Cities to Work In.    Contrary to most other cases, I don’t find that list surprising.  With other lists one wonders why Squawking Duck, Wherever It Is, was chosen as the best city to work.  As Corra Group is headquartered in Los Angeles in number six on the list of Best Cities to Work In, I can certainly live with that.

Enjoy the list, as put out by GlassDoor.Com.  Here is a link to the website.

Pro Publica and the Los Angeles Times recently issued a joint study where it was claimed that temporary staff agencies are a magnet for the unfit nurses and healthcare workers.   That is to say that nurses with previous criminal convictions or were disciplined for anything from stealing illegal drugs from the hospital dispensary to falling asleep on the job are attracted to the temporary staffing agencies looking to take advantage of the shortage in nursing and healthcare personnel.

These temporary employment staffing firms take advantage of the staff shortages and hire nurses and healthcare people of questionable character and damning background histories.   These staffing firms either fail to conduct background checks or they overlook the results of these background checks.  As it can take up to years to discipline a nurse engaged in criminal, abusive, or negligent practices, these temporary staffing agencies may actually may be aware of criminal or professional violations when they submit nurses as job candidates.

The nursing staffing business is a $4 Billion a year industry.  And nurses who are well paid, even the ones who screw up or who have criminal backgrounds, can move from state to state a step ahead of the disciplinary actions that take so long to impose.     So it is a matter for nurses convicted for crimes or slated for disciplinary action to stay just out of reach.  In one case, a nurse moved from one state to another, four states in all, helping herself to the illicit drugs in every place she worked.

Now it goes without saying, but I’ll say it anyway, that most nurses and healthcare workers are diligent, responsible , and caring people.   Most nurses and healthcare workers serve along careers with unblemished records.    But there is always the proverbial bad apple or in some cases the entire basket of rotten apples that stink up the greater majority.   To say the least, disciplinary measures should be taken far more quickly than they are.    No time should be wasted in listing incompetent nurses or corrupted nurses on the Sanctions list,  or OIG/GSA.   This is the list where  healthcare institutions that depend on federal funding and subsidies can lose that funding if they hire nurses or healthcare workers on the OIG/GSA.

So while most nurses have adequate to spectacular on the job records, with no criminal convictions or disciplinary actions taken against them, there are enough that do that would warrant a thorough check of the Healthcare Sanctions OIG/GSA or FACIS search.   It would warrant a comprehensive background check of their criminal records, and probably a Motor Vehicle Driving Report, or MVR, to make sure there are no substance issues or the type of driving behavior that may raise red flags.   But many of the temp staffing agencies conduct shoddy or incomplete background checks and are in it for the money.   There are nice commissions involved in placing nurses in high paying jobs.

I hope this joint study will not be ignored.   I hope the powers that be will crack down on the temp staffing agencies and, more importantly, on the nurses with criminal convictions, substance abuse issues, or a legacy of disciplinary actions.   Perhaps it is time to standardize the background checks that nurses must undergo before being hired at a federally funded agency.   But something must be done.  This joint report can’t go ignored.   Even in a bad economy.

Check them out before you hire.

An interesting editorial in the St. Petersburg Times wisely advocates background checks for caregivers in Florida.  The editorial cites, among other things,  the vast amount of transients who come to Florida.  Many of these transients end up working in the healthcare industry.   Some have serious criminal record.  Some are listed on the sexual offender’s registry.

The editor notes a six month study conducted by the South Florida Sun-Sentinel.  The fact that this newspaper conducted this sort of study, by the way, is but one more justification for the survival of newspapers.     The study claims that literally thousand of ex-felons are working in healthcare.   While the study demonstrates that nearly four out of five caregivers are law abiding and free of criminal records, there are a number who have been convicted of theft and sex crimes, some of which are violent.

The study gives the opinion that nationwide criminal background records should be conducted on all job applicants in the healthcare industry, but cautions that the threshold should not be so stringent that the reformed criminals should be denied work and a new start in life.

As we always say, check them out before you hire.

Among other things, this economic meltdown has called the question in certain industries as to which segments are becoming obsolete.   Perhaps the hardest hit in this manner are the newspapers, followed by the print media, in general.   Old time news outlets are finding themselves out of fashion as public preference is for the digital media.   Another reason that is often cited are the citizen journalists, the bloggers and others who flood the Internet with news bits and political, financial, and social commentary.    When you have amateurs doing the work, then professionals are not in demand.

Book publishing is another segment that has taken a hit.  With the advent of Kindle, more books are being produced digitally and being downloaded to the Kindles and Sony Digital Readers.   While some still prefer having  book in their hands, others believe the digital downloads are lot more convenient, especially for traveling.

Certain segments of advertising are becoming outdated, outmoded, if not completely obsolete.   Print media advertising and even some television advertising has been on the decline.  Part of the reason may be the economic downturn, and  part of it is a sign of the shifting market and the advancement of  digital technology.

Now marketing faces its challenges.  As consumer driven marketers and opinion makers increase in influence and presence, there is less need for professional marketers.  At least, that is the opinion of some as expressed in a recent article in AdAge.com.    Whether this prevailing opinion is prevailing wisdom is another story.   Social media is the word of the day, and the impact of social media is remarkable.  But whether social media will sustain itself in setting marketing trends is another issue.   There are mitigating factors, and some will not be resolved for some time.

When it comes to our consumer tastes, we are a fickle nation.  We can grow bored with social media or become overloaded by the surfeit of information.   We may tire of sorting through the mediocre content in order to discern the meaningful content.    Too many false reports, or inaccurate reports, by wannabe marketers, can instill skepticism and lack of credibility.

It is time for marketers, as well as journalists and publishers to reinvent themselves.  It is time for advertising to adapt to the new media and the outlets involved.   Those who do will prevail.   Those who don’t will fall by the wayside.  But to believe as many do that amateur will take over these roles and maintain the disciplines and skill sets of professionals is wishful thinking.   Professionals are usually professionals because they are better trained.   Because they do it better