F0602

E

Failure to Prevent Misappropriation of Residents’ Personal Property by RN

Ralls, Texas Survey Completed on 01-14-2026

Penalty

Fine: $25,480

Summary

The deficiency involves the facility’s failure to protect multiple residents from misappropriation of personal property by a staff member, RN D. Several residents had intact or impaired cognition and varying levels of dependence for activities of daily living, including residents with paraplegia, Alzheimer’s disease, depression, anxiety, and other psychiatric and visual conditions. One cognitively intact resident reported that personal items such as a decorative wine bottle with flowers, signs, containers with flowers and markers, and unopened face cream were missing from her room. Another resident reported a missing wallet and ID, and staff assisted in searching for these items before they were later found among property returned in trash bags.

Video footage and staff interviews revealed that RN D used a code to unlock and enter a side gate, placed bags in a wheelchair, moved around the building with bags in hand, and exited and re-entered through the gate while carrying bags. The Administrator and Business Office Manager described that large trash bags were later found outside the facility near gates and around the exterior, and that these bags contained clothing, jewelry, electronics, shoes, perfume, cologne, and other items. An inventory list documented that items in the bags were identified as belonging to five residents, including perfume, skin care products, a cash app card, ID card, Social Security card, iPad, phone, wallet, clothing, shoes, and a razor with guards and bag.

Interviews with the DON, Administrator, Business Office Manager, and other staff established that residents, other than the one who reported a missing wallet and personal items, generally did not know their belongings were missing and had not reported losses. Staff stated they had received training on resident rights and understood that residents should not be forced to do anything against their will and that staff should not borrow, use, or take residents’ personal items. Despite this, RN D, who had documented training on resident rights and abuse, neglect, exploitation, and misappropriation, wrongfully took residents’ belongings over a period of time while working night shifts and transporting items out of the building, resulting in misappropriation of property for at least five residents.

Law enforcement involvement confirmed that RN D was found in possession of stolen property and identification belonging to an elderly resident, and he was to be charged with multiple counts of theft and a felony related to possession of an elderly person’s identification. The facility’s own policies defined misappropriation of resident property as the deliberate misplacement, exploitation, or wrongful use of a resident’s belongings or money without consent and stated that residents have the right to be free from misappropriation and exploitation. The events described show that, despite these policies and staff training, the facility did not prevent RN D from taking and wrongfully using residents’ personal property, resulting in the cited deficiency for failure to protect residents from misappropriation of their belongings.

Safe surveys conducted with residents after the incident documented that residents reported feeling safe and did not identify concerns or fear of staff, and multiple staff interviews reiterated their understanding that taking residents’ belongings was prohibited. However, these measures and understandings did not prevent the misappropriation that had already occurred. The deficiency centers on the fact that residents’ personal property, including identification and personal effects, was taken without their knowledge or consent by a nurse employed at the facility, and the facility only became aware of the scope of missing items when they were returned in trash bags and identified as belonging to specific residents.