The case of a woman sentenced to jail for stealing elderly patients’ morphine has raised questions about how employees are screened for jobs in Kansas nursing homes.

At the time she was hired as a nursing aide at Pioneer Ridge Retirement Community in late 2004, Erica A. Bay was on probation in Cowley County for felony cocaine possession. The staff at the nursing home – which doesn’t require pre-employment drug screens – learned of the conviction after her hire but allowed her to continue working there.

An admitted drug addict, Bay eventually began squeezing morphine gel out of patients’ skin patches and giving it to herself.

“I don’t understand how a facility employs a felon with a history of drug abuse and then placed this person where they could have contact with drugs being administered to patients,” Dist. Atty. Charles Branson said in a statement after Bay’s sentencing earlier this month.

Elder-law attorney Margaret Farley said she wasn’t surprised to hear about the case, given the prevalence of painkiller drugs in nursing homes.

“Coupled with a vulnerable population, many times these facilities don’t really have strong supervision and sufficient staff for somebody to be watching the other person,” she said. “They are a high-risk type of institution for access to drugs that can be stolen from patients.”

Deanne Bacco, executive director of Kansas Advocates for Better Care, said the state should broaden its list of roughly 60 crimes that disqualify people from working in nursing homes. The list includes sex crimes, violent felonies and mistreatment of a dependent adult but does not include drug-related crimes.

“It’s too lenient,” Bacco said. “Obviously, something needs to be tightened up.”

Enough regulations?

But Cindy Luxem of the Kansas Health Care Assn., a nursing home industry trade group, said she was wary of more regulation. Already, federal law prohibits someone with a conviction after 1996 “relating to the unlawful manufacture, distribution, prescription or dispensing of a controlled substance” from working in a nursing home that participates in Medicare or other federal health care programs, which most do.

“I’m not really one to promote a lot more regulations and rules because of one individual being stupid enough to steal someone’s morphine patches,” she said.

Pioneer Ridge’s administrator, Helen Frye, said the system could be improved by speeding prospective employees’ background checks from the state, which she said can take up to two months to receive.

Bay, 29, was convicted in 2003 of felony possession of cocaine. She was hired at Pioneer Ridge on Oct. 12, 2004, as a certified nurse aide, a job that typically pays $10.50 per hour.

“This company doesn’t have drug screens,” Frye said. “Other ones I’ve worked for do.”

In early November 2004, the Kansas Department of Health and Environment sent the nursing home the results of a background check that found Bay had no convictions that would prohibit employment.

Pioneer Ridge’s business manager, Melody Keirns, said that shortly after that, the home received a separate mailing containing Bay’s detailed Kansas Bureau of Investigation criminal history, including the drug conviction.

Keirns said she notified the home’s administrator and director of nursing at the home, 4851 Harvard Road.

“They said there’s no law that prohibits her from working there. She was a CNA, didn’t pass meds and didn’t deal with meds, so that was fine,” she said.

Incident brought changes

Keirns said it was shortly afterward that Bay was caught stealing morphine from two patients. The victims included 96-year-old Evin “John” Dillard, who died shortly afterward.

Dillard’s family members have said they don’t believe the lack of morphine contributed to his death, although it caused him more discomfort in his last days. Except for Bay’s actions, they said, they were pleased with Pioneer Ridge.

The administrator and director of nursing who worked at Pioneer Ridge at the time have since left. Keirns said the home is now conducting more extensive interviews and checks of personal references.

Frye, Pioneer Ridge’s new administrator, said she would not have let Bay continue working at the home after learning of her criminal background, and she would not allow people with similar backgrounds to work at the home in the future.

“I would not because of the precedents in that building,” she said.