WASHINGTON — As Baby Boomers enter retirement and the demand for nursing homes swells, sexual predators are among those needing care, putting others in the homes at risk.

Sandra Thurston Banning brought the story of her mother’s victimization to Capitol Hill on Wednesday. Her mother, Virginia Thurston, suffered from dementia and was 77 at the time of her assault.

“I placed my mother in a facility to keep her safe and out of harm’s way,” Banning said.

Thurston’s rapist, an 83-year-old resident who relied on a wheelchair, had been arrested 59 times and was placed in the nursing home by an Alachua County, Fla., judge “because he was a danger to himself and others in society,” according to Banning’s testimony before a House small business subcommittee.

If she had known there was someone with such a record in her mother’s nursing home, “I wouldn’t have left her there for one day,” Banning said. The man who committed the rape was found incompetent to stand trial and was relocated to another Florida nursing home, Banning said.

Demand for long-term care services is expected to more than double by 2040, according to National Investment Center for the Seniors Housing and Care Industry. Meanwhile, staff, residents and visitors may not realize there are registered sex offenders living in  nursing homes.

“Depending on state regulations, many long-term care facilities may not be aware of residents who are offenders,” testified Rep. Mary Fallin, R-Okla.

One issue is federal law, which requires states to pay for nursing home services for anyone eligible for Medicaid, whether or not they are convicted felons, according to Rep. Kris Steele, R-Okla.

When people with a criminal history require long-term care, “we are legally obligated to provide appropriate care and services,” said Tom Coble, president of Elmbrook Management Co. in Ardmore, Okla., who testified on behalf of the American Health Care Association.

What’s more, residents with a criminal background are often placed in facilities’ secure lock-down units, which may be the Alzheimer’s unit, said Wes Bledsoe, who said his grandmother was the victim of abuse in a nursing home.

Alzheimer unit residents “are typically the most vulnerable residents in long-term care facilities,” Bledsoe said.

Some patient advocates have called for federal requirements for background checks on all nursing home residents and employees and separate facilities for those deemed dangerous or predatory. 

“Why not make it a national requirement to check the background on everyone working or residing in a nursing home or long-term care facility?” Banning said.

Oklahoma created just such a requirement in 2005, mandating that nursing homes post public notification when a registered sex offender is admitted and requiring the Department of Corrections to notify local law enforcement about the location of sex offenders living in nursing homes, Steele said.

But requiring background checks for all nursing home residents isn’t as simple as it sounds, said Susan Feeney, spokeswoman for the American Health Care Association.

It might not be feasible, for example, for an institution to immediately run a background check on a resident coming from a hospital, Feeney said. Background checks also may lead to a false sense of security since some information may slip through the cracks.

An example of information caught between the cracks is the National Sex Offender Registry. Fallin noted in her opening remarks that even though all sex offenders are required to register, 25 percent of offenders do not.

Feeney said the onus should be on law enforcement to provide criminal background information. That information coupled with an overall patient assessment, including health and mobility, would help “determine expected behaviors.”

Oklahoma also has a bill that directs the Department of Health to request bids for operation of a stand-alone, long-term care facility to house registered sex offenders, according to Steele.

Fallin favored using that Oklahoma bill as a model for federal legislation, said spokesman Alex Weintz.