We started with separate open records requests to the state Department of Human Resources (DHR) and the Department of Corrections (DOC). DHR maintains a database of all certified nurse aides, both past and current. DOC keeps track of all criminal convictions, both felony and misdemeanor. We got the complete DOC database without any trouble, and no charge. Our first roadblock came in getting what we needed from DHR.
What intrigued us here in Georgia is a unique twist in our law. The state certifies nursing home workers, called certified nurse aides (CNA). Then, Georgia nursing homes must do a criminal background check before they are hired. But the law doesn't preclude the nursing home administrator from hiring a convicted felon. With staffing shortages so critical, we suspected CNAs with criminal records were still being hired. Turns out, we were right.
We've worked long-term investigations here before, but nothing compares to my station's first venture into computer-assisted reporting. As it turned out, the story was well worth the wait. Even if it took nearly a year.
Our investigation began with an issue some reporters in other parts of the country have already tackled: people with criminal records working in nursing homes.
We felt Social Security numbers provided the most accurate way to match up names between the two databases. No problem, DOC told us. They gave us everything. But DHR balked at the idea of providing us what they considered private information. Our state's open records law does not directly address this issue. It took four months of phone calls to the attorney general's office and DHR before we finally convinced them the information was subject to the open records law. The disk cost us only $10. But by then, our plans for a May sweeps series were gone.
Dirty data
It didn't take long, though, for us to realize that the hard work hadn't even begun. The data from both sources were dirty. In one table, the Social Security numbers were separated by dashes. In the other, the numbers weren't separated at all. First and last names were in separate fields in one but combined in the same field in the other. That's why we turned to NICAR. They were able to clean up the data and do the match between databases. Of the 73,410 nursing aides, NICAR found 5,595 had a criminal record. But there was more work to do. The CNA database included people who hadn't been certified in years. We didn't want them included in this investigation. Secondly, some of the CNAs committed their first crime after they were certified. Can't blame a nursing home for that. Yet they still showed up as a match. So, we began eliminating matches. Using Microsoft Access, we first kicked out all CNAs whose certification expired before 2000. That gave us a list of current criminal CNAs. Then we took out all CNAs who were convicted after their certification date. That eliminated all those CNAs who had clean records when they were hired, but committed a crime later on. We wound up with 219 felons and 2,942 probationers currently allowed to work in Georgia nursing homes. Now it was time to find them.
We felt Social Security numbers provided the most accurate way to match up names between the two databases. No problem, DOC told us.
Georgia does not keep track of where certified nurse aides actually work. So it was impossible for us to say how many of the criminal caregivers actually had access to the elderly. The DHR database did include the CNA's address at the time of certification. So, we started there. Thanks to the Web site healthgrades.com, we used those addresses to get a list of every nursing home nearby. Then we started calling asking to speak to someone to verify employment. When we got a hit, we confirmed it by Social Security number. We focused on the small communities that didn't have as many nursing home choices. We found more than a dozen criminal caregivers that way.
Crimes at nursing homes
The other part of our investigation looked at whether criminal caregivers are actually more likely to commit crimes once they get inside the nursing home. The state Department of Human Resources also maintains an abuse registry. When a CNA harms a resident, they wind up on the registry. We merged the registry with the Department of Corrections table and found 82 criminals. Many of them committed the same crime inside the nursing home that they had on their record when they were hired: burglary, assault, theft, etc.
It took us even longer to track down those victims or their families. By law, they're not listed in the abuse registry. That meant contacting local police departments and asking for incident reports of those crimes. But often, the nursing home didn't bother to call the police. Months later, we managed to find family members to react to our investigation. They had no idea the nurse aide who had harmed their elderly relative was a criminal before he was ever hired.
Our series finally aired November 8 and 9, 2000, nearly a year after we made our first request for the data. The investigation is expected to prompt a change in the law when the state general assembly meets in January. Unfortunately, in an ironic twist, state lawmakers may also vote to make Social Security numbers exempt from the open records law. If you're planning a similar investigation, fight for that key data. Without it, our investigation would certainly have taken even longer.
Randy Travis can be reached by e-mail at rtravis@fox5atlanta.com