SD6 - Monitoring of Sex Offenders in Nursing Homes and Assisted Living Facilities


    Executive Summary:
    Senate Joint Resolution 120, introduced by Senator Kenneth W. Stolle and passed during the 2006 Virginia General Assembly Session, directed the Virginia State Crime Commission to study the monitoring of sex offenders in nursing homes and assisted living facilities. Specifically, the study was to examine:

    • Avenues to better protect residents from sex offenders;

    • Current procedures to protect residents from other residents who may commit sex offenses due to
    debilitating physical and mental self-control as a result of stroke and other illnesses;

    • The number of prisoners being released on geriatric parole;

    • The number of registered sex offenders housed in nursing homes and assisted living facilities in Virginia;

    • Notification and monitoring of sex offenders in Virginia's nursing homes and assisted living facilities;

    • Treatment options available to sex offenders housed in nursing homes and assisted living facilities in Virginia.

    A report by the U.S. Government Accountability Office issued in March of 2006 examined the subject of residents of long-term care facilities who are registered sex offenders. This report stated that in Virginia in January of 2005, there were seven registered sex offenders living in nursing homes and two living in ICF-MR facilities (Intermediate Care Facility for the Mentally Retarded).

    Staff independently examined this issue, obtaining from the Virginia Department of Health and the Virginia Department of Social Services lists of all registered nursing homes and assisted living facilities in the state. With the assistance of the Virginia State Police, 861 addresses were checked against the Virginia Sex Offender Registry. The State Police determined in this analysis that as of December 2006, there were only three registered sex offenders who could definitely be placed as living in nursing homes, and 16 who could be placed as living in assisted living facilities. It must be noted that the definition of an assisted living facility is slightly different, and broader, than that of an ICF-MR facility, which was the type of residential facility examined in the federal study. The State Police also identified an additional 13 registered sex offenders who could not be ruled out as living in a nursing home because the physical address of the nursing home was unclear and the sex offender was living in the same zip code as the facility. Staff concluded that it is extremely unlikely that in all 13 cases, the sex offender was actually living in the nursing home that was in the same postal area. Nevertheless, even with this over-inclusive assumption, the study revealed a maximum of 16 registered sex offenders living in nursing homes (the real number is probably somewhere between four and nine), and 13 offenders living in assisted living facilities. The most significant finding from staff research is that there are very few registered sex offenders in either nursing homes or assisted living facilities.

    Since 2000, very few inmates have been released by Virginia Department of Corrections (DOC) on geriatric parole. Based on data obtained from DOC in 2006, two inmates were released on geriatric parole and neither of these persons were convicted of sex offenses. Additionally, based on DOC data for the previous four years, only three inmates were released on geriatric parole and none of these individuals were convicted of sex offenses. The issue of sex offenders being released on geriatric parole does not appear to be a problem at this time.

    A Sub-Committee of the Crime Commission was created and convened in November 2006 to address the issues raised in the resolution and to review the staff findings. Delegate Robert B. Bell was appointed chairman of the Sub-Committee that included representatives from the Virginia State Police, Virginia State Parole Board, Virginia Department of Health, Virginia Department of Mental Health, Virginia Department of Social Services, Office of the State Long-Term Care Ombudsman, Virginia Health Care Association, Virginia Hospital and Health Care Association, and the Virginia Association of Nonprofit Homes for the Aging.

    Safety and treatment issues were addressed at the Sub-Committee meeting. Treatment options available for sex offenders residing in nursing homes and assisted living facilities were found to depend upon the resources of each individual facility. If the patient has a diagnosed psychological condition that requires treatment or counseling, the facilities attempt to provide that treatment. Resident safety at nursing homes and assisted living facilities is determined by both state regulations and individual facility policies. During the meeting, industry representatives indicated that all facilities attempt to monitor residents who are known to have violent or aggressive tendencies. Currently, nursing homes, but not assisted living facilitates, are part of the list of entities that can request automatic updates from the Virginia State Police, concerning the sex offender registry. Nothing in the current registration law excuses a sex offender from complying with his registry obligations because he has moved into a nursing home or assisted living facility.

    The Sub-Committee also addressed issues cited in House Bill 415, referred to the Crime Commission for review during the 2006 legislative session, that required notification of residents or guardians when there are sex offenders living in a facility. Many participants expressed concern that requiring such notification could cause unnecessary alarm, but because of HIPPA, the facility could not disclose that information. It was decided to follow the same procedure that has been implemented for residential real estate contracts by which buyers are advised of the existence of the sex offender registry.

    Based on this information and further discussion, the Sub-Committee suggested and the full Commission adopted the following legislative recommendations:

    • Before a nursing home or assisted living facility admits a person for a period of time that is anticipated to be longer than three days, it should be required to check the patient’s name on the State Police website to determine if he or she is a registered sex offender.

    • Assisted living facilities should be added to the list of entities that can request automatic updates from the State Police regarding sex offenders.

    • Nursing homes and assisted living facilities should be required to sign up for automatic notification from the State Police.

    • Nursing homes and assisted living facilities should provide general notice to residents, when they are admitted, about the sex offender registry and the State Police website.

    Finally, during the course of this study, evidence of a related problem involving nursing homes became apparent. Based on information presented to the Sub-Committee, there are a growing number of cases in which residents of nursing homes who suffer from dementia and other cognitive impairments assault or attack other residents. Although this is an issue that needs to be studied, it is primarily a public health care issue. Therefore, the Crime Commission has notified the Department of Mental Health, Mental Retardation and Substance Abuse Services and the Joint Commission on Health Care of the Commission’s findings.

    The Crime Commission does not intend to submit further reports for publication.