Screening Employees and Residents at Residential Care Facilities

Your residents and employees are the heart of your residential care facility. By being selective about the people you let into your community, you can create a safe and comfortable environment while limiting your liability. Comprehensive screening is therefore a critical risk management tool.

Screening Employees

Hiring the right people is critical to the success of any assisted living community. When screening employees, consider using:

• Background checks. States often require criminal background checks for assisted living employees. Even if this is not a requirement in your state, it’s a good idea. Unfortunately, elder abuse is common: the World Health Organization says two in three staff members at institutions such as long-term care facilities admit to having committed abuse in the past year. Assisted living residents are particularly vulnerable. Since dishonest employees could take advantage of them, criminal background checks are an important safeguard.
• Drug testing. Employee drug use could harm your residents in two ways. First, employees who are under the influence of drugs may be unable to provide adequate care, which puts your residents at risk. Second, employees who use drugs may steal prescriptions from residents to feed their addictions, preventing residents from receiving the medicine they need. According to Yahoo News, a clinic manager at a senior living facility was recently fired for allegedly stealing liquid morphine syringes that were meant for hospice patients. Pre-employment drug testing can help protect your residents.
• Driving record checks. If a position involves driving, a pre-employment driving record check can ensure you’re not hiring anyone who has a history of dangerous driving.
• References checks. Checking references helps you verify information while gaining a better sense of a job candidate.
• Skills checks. When labor is in short supply, finding experienced workers may not always be possible. Even if you’re planning to train new workers, it’s worth looking for candidates with the skills necessary for success, such as good people skills and organizational skills.

Screening Residents

To stay in business, residential care facilities need to accept residents. However, accepting the wrong residents can hurt in the long run. By screening residents, you can maintain a comfortable community for your residents. In particular, screen for two issues:

• Violent or sexual criminal history. A violent resident could put other residents at risk and expose your facility to liability.
• The correct level of care. Providing residents with the correct level of care is critical. If your facility can only provide care for residents who need little to no assistance with the activities of daily life but you start accepting residents who need higher levels of care, your workers may be overwhelmed. Worse yet, residents who need more care than you can provide may be at risk of falling and incurring other injuries.

What You Can’t Screen For

Although screening is an important tool for any residential care facility, there are some things you are not allowed to screen for. The following laws may prohibit the use of certain types of information when making employment or housing decisions:

• EEOC-enforced laws. Under the EEOC, it is illegal to discriminate against applicants or employees on the basis of their race, color, religion, sex, gender identity, sexual orientation, pregnancy, national origin, age, disability, or genetic information.
• The Fair Housing Act (FHA). The FHA prohibits discrimination against protected classes. According to the Fair Housing Center for Rights & Research, it is not permissible to deny housing based on arrest records, or to apply blanket bans on anyone with a criminal record, or to conduct background checks inconsistently.
• The Americans with Disability Act. This law prohibits discrimination on the basis of disability and applies to both employment and housing.
• State and local laws. Your state may have additional laws that prohibit discrimination against certain groups. For example, there may be restrictions around pre-employment drug testing for cannabis or requirements that you provide a drug testing policy ahead of testing. State laws regarding criminal background checks also vary. The National Employment Law Project says 37 states and more than 150 cities have passed “ban the box” laws that prevent employers from asking about an applicant’s criminal history on the initial application.

Consistent screening can reduce your facility’s liability exposure, while keeping both residents and employees safer.

Insurance coverage is another important risk management tool. Tangram provides insurance for residential care facilities through the Personal Care & Assisted Living Insurance Center (PCALIC). Learn more.