Failure to Investigate and Report Suspected Financial Abuse by Conservator
Penalty
Summary
The deficiency involves the facility’s failure to implement its abuse, neglect, and exploitation reporting and investigation policies in response to a reasonable suspicion of financial abuse of a resident under conservatorship. The resident was admitted with diagnoses including metabolic encephalopathy, dementia, and a need for assistance with personal care, and an MDS cognitive assessment indicated the resident was rarely or never understood. A complaint letter from the Department of Justice stated that the resident’s sister, who was the conservator, had not paid the resident’s share of cost since March 2024, while bank records showed the sister withdrawing the resident’s full monthly income minus bank fees. The Business Office Assistant and Business Office Manager confirmed that the resident’s share of cost had not been paid since it began generating and that repeated calls to the resident’s sister/responsible person went unanswered. The Business Office Manager documented that she suspected financial abuse and, through the facility’s internal communication system, requested that the Social Services Director complete a financial abuse report for the resident. The Social Services Director acknowledged being contacted about the issue and stated that she reached out to the county Public Guardian’s Office because the facility could not reach the conservator and there were outstanding balances, but she reported that she did not suspect financial abuse at that time and confirmed that no investigation was conducted by the facility regarding this resident’s case. The Administrator stated 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 all allegations of resident abuse, neglect, exploitation, or misappropriation to be reported to appropriate agencies and thoroughly investigated. The Administrator acknowledged that the lack of response from the conservator and nonpayment of the share of cost for months were red flags but stated there was no evidence of fiduciary abuse, and therefore the issue was not reported as abuse. The Administrator further confirmed that the resident’s share of cost started in March 2024 and was not paid by the conservator, that multiple attempts were made to contact the conservator, and that after contact with the Public Guardian’s Office, the facility did not conduct its own investigation into possible financial abuse. The Director of Nursing stated that all suspicions of abuse should be thoroughly investigated to prevent further abuse, underscoring that the facility did not follow its own policy and procedures in this case.
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