Felon's dream job: scant screening, lots of easy marks

Seattle Times
Wednesday, December 15, 1999
by Kim Barker

Fourth of five parts.

Lie.

If you want to care for sick, disabled or elderly people and you have a felony record, just don't tell the state when you're asked.

You probably won't get caught, unless you mess up.

June Threlkeld, for example, was convicted of first-degree theft in 1991 while working at a kidney-dialysis center in Spokane. She opened up fraudulent lines of credit under the names of two patients.

Because of this conviction, Threlkeld wasn't supposed to be a nursing assistant, and she certainly wasn't supposed to run an adult family home. But she did both, outside of Spokane.

She went on to sign up one of her residents for credit cards. Edith Gina was dying. She was hooked up to oxygen, and she spent most of her time in a hospital bed. Threlkeld racked up more than $38,000 in charges in Gina's name, buying such things as a sewing machine, a pellet stove, Bengal cats and an appaloosa horse.

Gina's daughter, Flo Carrico, thinks that if her mother were still living, she would forgive Threlkeld. But Carrico does not.

"You assume because of their credentials, such as they are, that they are capable, willing, that your folks are going to be safe with them, and then you're handing them over to a criminal ," she said.

Unlike many people who commit crimes against residents of nursing homes, boarding homes and adult family homes in Washington state, Threlkeld was actually arrested and convicted for ripping off Gina. She was sentenced to three months in jail for first-degree theft.

She also lost her license to be a nursing assistant - but not until two years later.

"What is legal, if a person like this can carry on?" Carrico asked. "How do I know she isn't just one state over, doing it again?"

Dangerous felons, convicted of sex crimes, assault and theft, have been hired to work in long-term-care facilities, caring for some of the most vulnerable people in our society. They are lying about their records and getting away with it.

Most likely, this will not change in the foreseeable future.

Here are some reasons: Plodding agencies don't coordinate well with other plodding agencies. State laws say certain felons should not be able to hold these jobs, but the laws don't require complete background checks.

Although some health-care workers are required to undergo statewide criminal background checks, the system is flawed. And no health-care workers are required to undergo nationwide criminal background checks.

State officials say it's difficult to decide how extensive background checks ought to be: Just Washington, or the entire nation? There just isn't money to always do both, they say, especially now that Initiative 695 has passed.

Shocked? Heard this story before? TV does it. Newspapers do it. The Seattle Times did the story three years ago. And still, nothing changes. Criminals are still hired. They still hurt people.

Matt Ashworth, spokesman for the Department of Health, sounds almost resigned to the negative publicity, the stories he sees once or twice a year about the small number of rogue health-care workers.

"Our hands are tied," he said. "This is the system the Legislature has endorsed for us to use. We're doing the best we can."

Molester hired at nursing home

Here's how one person moved through that system:

When he lived in Texas, Eddie Arnold molested his girlfriend's 5-year-old daughter.

He was sentenced to three years in prison.

Arnold eventually moved to Washington state. He was a job-hopper, working a series of temporary gigs. He married a woman who later accused him of holding a gun to her head and threatening to kill her, civil court records show.

The next year, in October 1995, Arnold applied to work at the Pinewood Terrace Nursing Center in the Eastern Washington town of Colville. He said he'd never been convicted of a crime against another person, never been found guilty of sexually abusing anyone. He signed a disclaimer.

Nursing homes typically ask new applicants to fill out such forms.

Then Arnold filled out a background inquiry form for the state Department of Social and Health Services (DSHS), which regulates nursing homes, boarding homes and adult family homes. The department requires facilities to run background checks with the Washington State Patrol on new hires who work unsupervised with patients.

This background check didn't find a thing on Arnold: The State Patrol only checks for convictions and arrests less than 1 year old in Washington state. Sometimes, the State Patrol even misses those because of poor fingerprints or a lag in entering conviction data.

Arnold registered as a nursing assistant with the Health Department, which regulates the health-care workers who work in long-term-care facilities. He said he'd never been convicted of a felony or misdemeanor.

The Health Department didn't run any background check. It never does, relying instead on the honor system.

Arnold started work at the Colville nursing home that November.

Two months later, in January 1996, he was accused of sexually abusing a 41-year-old woman with developmental disabilities. She's severely retarded, and she can't speak, can't walk, can't go to the bathroom without help.

Someone called police. The complaint started moving through the social-services system, first to the DSHS office that looks at complaints in residential-care settings. The case was flagged as "Priority 1: Life Threatening."

That's how Arnold ended up as one of the more than 1,600 files of the Medicaid Fraud Control Unit, the arm of the Attorney General's Office that investigates allegations of patient abuse.

Background check after the fact

When investigators with the attorney general look at abuse cases, they first try to get to know their suspects.

Like police, these investigators often run background checks nationwide, to make sure they find every arrest, every misdemeanor, every felony, from Florida to the federal courts. It's smart law enforcement.

So far this year, the Medicaid Fraud Control Unit has asked for national background checks on 99 people. And 27 times, the check hit some kind of criminal record.

Many of these infractions wouldn't disqualify someone from working at a long-term-care facility. A person convicted of second-degree burglary or driving drunk or possessing drugs, for instance, can still work as a nursing assistant. Someone convicted of fourth-degree assault can work as a nursing assistant after three years. It's up to the facility whether to hire the person.

But Arnold, convicted of sexually abusing a minor, should never have qualified to be a nursing assistant.

The national checks caught his record. But Colville Police closed the new complaint of abuse as "unfounded." Once that happened, the investigator with the Medicaid Fraud Control Unit also closed the case.

It's tough proving sex abuse when the alleged victim can't even talk and when an emergency-room doctor didn't find any trauma. But the doctor also said he still suspected that something had happened to the woman.

Arnold was fired after the nursing home found out about his conviction.

State Attorney General Christine Gregoire says the state should perform national checks before health-care workers are even allowed in a facility. That way, people such as Arnold would never be hired. And there might be fewer victims.

Contrast the screening of health-care workers with the screening of school staff members: Lawmakers have passed so many laws on background checks for people who work in schools that even janitors need them. Each applicant must be fingerprinted and pay up to $59 for local and national background checks.

In 1998, the Washington State Patrol found 739 of the 26,424 people who applied to work in schools had criminal records in this state. But when the FBI did nationwide background checks on the same group, it found 1,755 - more than twice as many - had criminal records. There was some overlap. The FBI identified some of the same people the state checks identified.

"I don't see how anybody could not do them nationally," said Linda Harrison, an investigator for the Office of Professional Practices in the Office of the Superintendent of Public Instruction. "To protect the vulnerable people of our society, we need to take these precautions. Absolutely."

Bill to expand screening failed

Most people who regulate health-care workers say they'd like to have national background checks. But such screening costs money. A lot of money.

The Office of the Superintendent of Public Instruction was given $4 million in 1996 to expand its checks.

The state has studied the cost of doing national background checks on health-care workers. A check on a new worker could cost up to $82, the most recent study showed.

That doesn't sound like much. But consider the 59,750 registered nurses, the 13,788 licensed practical nurses, the 27,847 certified nursing assistants. The money adds up.

"Well, in an ideal world, we would be doing both the state and the federal checks," said Sue Shoblom, the acting director of the Health Professions Quality Assurance Division in the state Department of Health. "Clearly that's going to provide the most aggressive check. But, you know, the bottom line on that is there are trade-offs for what you get and what you expend."

This year, lawmakers failed to pass a bill that would have required the Department of Health to run state and national background checks for health-care workers.

The wheels of government started turning: Officials formed a group to study the idea. Just who should be checked? Where should the checks be? Should there be a time limit, a way to appeal, a way to show that a person can overcome a drug addiction, a violent past?

This group was getting somewhere, officials said. And then it was run over by a car bill: Initiative 695, which slashed the licensing fees for vehicles, also put a stop to increasing state fees, at least temporarily.

Advocates for criminal background checks worry that I-695 means the state won't be able to require health-care workers to pay more money for licenses in order to cover expanded background checks. That frustrates state Sen. Jeanne Kohl-Welles, who has worked on so many bills on criminal-background checks they're starting to blur.

"There are some things that cost money, but they're worth it," she said. "I don't think anybody likes thinking about their parents or grandparents in a nursing home as prey for someone who should not be working there."

Not-so-fast action

If the Medicaid Fraud Control Unit finds out a health-care worker has a hidden criminal record, the unit is supposed to alert the Health Department.

This is what sends the department into fast action. But it's apparent the communication sometimes breaks down.

In January 1996, the state knew Arnold was a sex offender. But he didn't lose his license until January 1999.

That is unusual. On average, the Health Department revokes a license 18 months after a legitimate complaint is made.

The department is trying to move faster, Shoblom said, and has been developing time limits for investigating cases.

Shoblom also points out that relatively few nursing assistants have criminal records.

It's true, of course. Most don't. And they have hard jobs. They are the health-care workers who directly care for most patients in long-term-care facilities.

They are punched, slapped and pulled like bread dough. They are yelled at and called names. They bathe patients, wipe them, dress them. The job is so demanding and pays so little, it's amazing anyone is willing to do it.

Still, they care for such vulnerable people. Advocates say it's amazing the state doesn't do more to check them out.

People who have run into the felons - the victims, the relatives, the advocates, the lawmakers who hear horror story after horror story - say society needs to pay as much attention to the elderly and disabled as it pays to schoolchildren. The same precautions are needed, they say.

As of a year ago, June Threlkeld was making minimum wage working in a doughnut shop. By the time she lost her license to be a registered nursing assistant, Edith Gina - her credit-card-scam victim - was dead. Gina had felt sad over her betrayal until she died, said her daughter, Carrico.

"Unless you've been touched by it, unless this has happened to you, you aren't going to pay attention to it," Carrico said. "You think, `Yeah, yeah, this is just another old lady.' But we are all getting older. What are we going to do?"

Kim Barker's phone message number is 206-464-2255