Failure to Report Suspected Financial Exploitation to Required Agencies
Penalty
Summary
The deficiency involves the facility’s failure to follow its abuse, neglect, and exploitation reporting policies and procedures when staff suspected financial exploitation of a resident. The resident was admitted with diagnoses including metabolic encephalopathy, dementia, and a need for assistance with personal care, and an MDS assessment indicated the resident was rarely or never understood. The business office identified that the resident’s conservator, who was also the resident’s sister and responsible person, had not paid the resident’s Medi-Cal share of cost since it began generating, while the Public Conservator’s office later found that the sister had been withdrawing the resident’s full monthly income except for bank fees. Despite these circumstances, no report of suspected financial abuse was made to the state agency, local ombudsman, APS, or law enforcement as required by facility policy and section 1150B of the Act. The Business Office Assistant stated that she called the resident’s sister weekly or every other week without response and suspected financial abuse, which she reported to the Social Services Director (SSD). The Business Office Manager confirmed that the share of cost had not been paid since March 2024 and documented an internal communication to the SSD requesting a financial abuse report for the resident. The SSD acknowledged difficulty reaching the sister and documented contacting the county Public Guardian’s Office to ask if a referral was appropriate, learning that the court had already initiated a process to transfer conservatorship. However, the SSD stated she did not suspect financial abuse at that time and confirmed that no abuse report was made regarding this resident. The Administrator reported that the facility’s process for any suspicion of abuse was to notify him first, then report the suspicion and conduct an internal investigation, and that the facility’s policy required reporting all suspicions of abuse, including financial abuse, to specified agencies. The Administrator agreed that the lack of response from the conservator and the nonpayment of share of cost for months were red flags, and confirmed that the resident’s share of cost started in March 2024 and was not paid by the conservator. The Director of Nursing stated that all suspicions of resident abuse should be reported so they can be thoroughly investigated. Review of the written policy confirmed that suspected abuse, neglect, exploitation, or misappropriation must be reported immediately to the Administrator and to state licensing/certification, the ombudsman, APS, and law enforcement, but no such reports were made in this case despite staff suspicions and internal communications referencing possible financial abuse.
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