INDEPENDENCE, Mo. -- When Kim, who didn't want FOX4 to use her last name, moved into Redwood of Independence, she didn't know that three of her fellow nursing home residents were registered sex offenders.
"No, no, they don't tell you anything," she said, now out of the nursing home after a 30-day stint to rehab from a minor stroke.
In Missouri, Kansas and most other states, they don't have to tell you. Indeed, there's no requirement in the laws of those states that patient background checks be completed and shared with staff.
In a 3-month investigation, FOX4 investigative producer Lisa McCormick cross-checked the Missouri sex offender registry with the state's long-term care facilities and found at least 200 registered sex offenders living in the homes.
Two attorneys who specialize in elder care law and nursing home cases said that's shocking to them, and they worry the number may be too low.
"We know from the state auditor's recent report that there's quite a few offenders that have gotten lost in the system," Rachel Stahle said. "And we don't know where they are. They could be in a nursing home."
The offenses FOX4's investigation found ranged from child porn possession to more serious felonies, including child molestation and aggravated sexual abuse.
"These individuals perpetrated against children because the opportunity was there," former sex crimes prosecutor Jill Kanatzer said. "You place those individuals around the frail and elderly, they're equally vulnerable."
Kanatzer also pointed out that the re-offending rate is high among sex crimes offenders.
But Harvey Tuttlebaum, the lobbyist for the Missouri Healthcare Association, said incidents are rare, and the sex offender population numbers our investigation found are small in comparison to the total population of long-term care facilities.
"I don't see this as a problem," Tuttlebaum said. "Nursing homes have all kinds of people living in them. They're a reflection of the communities in which they're located."
The attorneys argue it's time that state laws mandate background checks and notice to residents and potential clients that sex offenders are in the population, and how they are being cared for to protect the safety of staff and clients.
Several Missouri lawmakers have told FOX4 they were startled by the findings and are considering looking into legislation that would require notification.
In the meantime, Kim said she hopes she doesn't have to return to the nursing home she was in.
But she said, "A person in my situation, sometimes there's no options."
Before you place a loved one in a nursing home or other long-term care facility, experts tell FOX4 you should:
- Visit the facility. Talk to the administrator, nurses, and staff. Ask other families about the care their loved one receives in the facility.
- Tell the home's administrator and staff about your loved one's needs. Ask how they can and will meet those needs. Ask what policies are in place to ensure all residents' needs are met. Does it have enough staff to meet everyone's needs?
- Ask what systems are in place to protect residents. How does the home ensure the safety of every resident?
- If the home cares for patients with mental illnesses, ask if those residents are in a secured unit. Ask what policies are in place to ensure their safety and the safety of others in the facility. What are the home's policies regarding residents with aggressive behaviors.
- Check health inspections, first safety inspections and other records about nursing homes and long-term care facilities on the Medicare website. Review the website's information about the facilit'`s staffing. "Higher staffing levels in a nursing home may mean higher quality of care for residents,' according to the website.
- Ask if the home has any registered sex offenders living there. If it does, ask if they are in a secured unit or in the general population. Find out what safety measures are in place to protect all residents. Ask if the home has additional staff to care for residents who are registered sex offenders.
- If the home won't tell you if it has sex offenders living there, check the facility's address on the state sex offender registry: find Missouri's here; find Kansas' here; and find the national registry here.
The National Consumer Voice for Quality Long-Term Care, an organization formed in 1975 because of concerns about poor care in nursing homes, has a free, online webinar about sex abuse in nursing homes:
FOX4 discovered other states have taken the following action to address concerns regarding sex offenders living in nursing homes:
California: The Department of Corrections or other governmental agency must notify a nursing home if a registered sex offender is released into a facility. Otherwise, registered sex offenders must self-report their status before becoming a resident of a long-term care facility.
Nursing homes must notify all residents and employees that a registered sex offender lives in the facility.
Illinois: Nursing facilities are required to do a criminal background check and mental health evaluation on residents prior to admission.
A forensic psychologist reviews those reports and creates a report that describes patients' risk level and possible security issues. The nursing home, local police, an ombudsman and the Illinois Department of Public Health receive that report.
Sex offenders are not allowed to have roommates in nursing homes and other long-term care facilities.
Massachusetts: State law prohibits anyone who is a Level 3 sex offender from living in nursing homes. The level is based on a risk assessment. At least one nursing home resident has successfully challenged this law.
Minnesota: State law requires registered offenders to notify nursing homes of their status. The police must also prepare a fact sheet for the home, which includes information about the offender's criminal history, risk level and profile of potential victims.
All residents in the home must be given a copy of that fact sheet when the offender is admitted.
Ohio: Nursing homes must check the state's sex offender registry before admitting a new resident. The facilities are also required to notify other residents or their families about how the home will care for the offender.
Oklahoma: In 2008, the state passed a law to create a nursing home just for registered sex offenders. No one, however, bid on that project.
Nursing homes are required to check the sex offender registry before admitting residents. Nursing homes must notify the state health department if an offender moves in the facility. Nursing homes are also required to post notifications that a registered sex offender lives in the facility.
Oregon: Registered sex offenders are required to inform nursing homes of their status before admission.
Virginia: Nursing homes must check to see if potential residents are registered sex offenders. All residents must sign a document stating they know how to check the sex offender registry.
Nursing homes, however, are not required to disclose that a registered sex offender lives in the facility.