Failure to Protect Cognitively Intact Residents From Misappropriation of Funds by CNA
Penalty
Summary
The deficiency involves the facility’s failure to protect cognitively intact residents from misappropriation of their money by a staff member, CNA1. One resident reported waking from sleep to find CNA1 in her room taking money from her wallet. This resident had diagnoses including adult failure to thrive and heart disease and had a Brief Interview for Mental Status (BIMS) score of 15/15, indicating she was cognitively intact. Her electronic medical record, including progress notes from early August through mid-December, contained no documentation of her allegation of misappropriation of property. During the facility’s investigation into this initial allegation, three additional cognitively intact residents reported missing money and identified CNA1 as the suspected individual. One resident with morbid obesity and heart disease stated that $55 to $75 was taken from her wallet within the first few weeks after admission; her progress notes over several months contained no entries related to this allegation. Another resident with congestive heart failure and chronic kidney disease reported that $50 to $65 had been stolen from her in May, and she stated that “that lady” (CNA1) stole her money; again, her progress notes over many months did not reflect this allegation. A fourth resident with a history of stroke reported that money had gone missing “a while ago,” believed CNA1 took it, and later stated the money had been taken almost a year earlier; her progress notes similarly contained no documentation of the misappropriation allegation. The Administrator and DON confirmed to surveyors that the facility’s investigation into the reports from these four residents led them to conclude that CNA1 likely stole the residents’ money. The facility’s Abuse Prevention Program Policy defined misappropriation of resident property as the deliberate misplacement, exploitation, or wrongful use of residents’ belongings or money without consent, and stated that each resident has the right to be free from abuse, neglect, and misappropriation, and that the facility would provide a safe environment and protect residents from abuse. The policy also stated that training on abuse prohibition alone does not relieve the facility of responsibility to assure residents are free from abuse and that the facility would provide ongoing oversight and supervision of staff to ensure policies are implemented as written. Despite these policy provisions, multiple residents reported missing money associated with CNA1, and their records lacked documentation of these allegations in the progress notes.
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