Failure to Investigate Alleged Misappropriation and Exploitation of Resident Funds
Penalty
Summary
The facility failed to thoroughly investigate multiple allegations of misappropriation and exploitation of resident funds, affecting at least five residents. The Nursing Home Administrator (NHA) discovered a bank account under the facility's name, which was unknown to them, containing suspicious withdrawals and transactions. The Business Office Manager (BOM) was identified as having access to this account, and there were indications that resident payments intended for care and room and board were deposited into this account and potentially used for personal purposes. Despite these findings, the NHA was directed by the Director of Operations (DOO) and the facility owner not to report the incident to the State Agency or law enforcement, and no thorough investigation was initiated at that time. Several residents and their families reported concerns about missing payments, uncredited funds, and unexplained depletion of resident accounts. For example, one resident's family received bills despite having made payments, another resident's Social Security checks were unaccounted for, and a resident with severe cognitive impairment had checks written from their account with signatures that did not match their handwriting. In each of these cases, the concerns were either not investigated or only minimally reviewed, with no follow-up to determine the extent of the misappropriation or to identify all affected residents. Interviews with staff, residents, and family members confirmed that concerns about financial discrepancies were raised but not addressed. The NHA acknowledged being aware of the issues and sharing them with upper management, but was instructed not to alert authorities or conduct a full investigation. The lack of action allowed the misappropriation and exploitation to continue, and the facility did not ensure that residents were protected or that a thorough analysis of the situation was conducted, as required by facility policy.
Removal Plan
- Provide training to the NHA, DON, new BOM and members of the governing body about the intent of F610 and their responsibility to identify and investigate allegations of misappropriation of residents' funds.
- Conduct interviews of interviewable residents to identify concerns related to mishandling, misused and/or misappropriation of their funds. Report any identified concern to the state agency and law enforcement, and conduct an investigation. For residents unable to participate, interview resident representatives.
- Audit all residents' status of benefits (Medicaid and Managed Care) to identify concerns. Conduct an investigation if any concern is identified. Report any identified misappropriation of residents' funds and exploitation to the NHA, state agency and law enforcement.
- Complete assessment of all residents to identify any negative outcome. Notify the attending physician/NP of any negative findings.
- Initiate investigations while ensuring residents are protected from further misappropriation of property and exploitation.
- Provide training to the RDO, NHA, DON, and members of the governing body related to the intent of F610, facility policy related to investigation of allegations of misappropriation of resident property and exploitation, and staff responsibility to assure thorough investigation and implement measures to prevent further mishandling of finances and/or exploitation and to safeguard residents' finances.
- Provide training to department heads (Activities, SSD, BOM, Dietary Manager, Therapy Director, Environmental Services and Maintenance staff) related to the intent of F610, facility policy related to investigation of allegations of misappropriation of resident property and exploitation, and staff responsibility to assure thorough investigation and implement measures to prevent further mishandling of finances and/or exploitation and to safeguard residents' finances.
- Provide staff with training about their responsibility to participate/cooperate with the administration when conducting an investigation. Staff who are not available will receive their education prior to starting their shift upon return to work.