Failure to Protect Resident From Financial Abuse by LVN
Penalty
Summary
The deficiency involves the facility’s failure to protect a resident from financial abuse and misappropriation of property by a staff member, contrary to its abuse prevention and gifts/gratuities policies. The resident was admitted with dementia and Alzheimer’s disease and had severely impaired cognition per the most recent MDS, requiring assistance with activities of daily living and using a wheelchair. The resident had both a debit and a credit card. Over a period in February, multiple charges appeared on the resident’s credit card, including purchases at a beauty enhancement provider, two small charges to an individual, two hotel charges in Las Vegas, and a dry-cleaning purchase located 34 miles from the facility. The resident did not authorize these purchases. In interviews, the resident stated that an LVN had been his nurse for several months, had brought him clothing, and had accompanied him to the bank four or five times. The resident reported giving the LVN his credit card to purchase a new cell phone, which the LVN said she would obtain for him. The resident later learned from facility staff, after they reviewed his bank statements, that the LVN had used his credit card for unauthorized purchases. The resident stated that he did not give the LVN permission to use his card for a trip to Las Vegas or for other personal expenses, and that he was upset that someone had accessed his wallet and taken the credit card. He also stated that the LVN never gave him the cell phone at the time, and that a cell phone arrived several days after the incident came to light. Another LVN reported that it was unusual for a charge nurse to insist on escorting a resident to the bank, noting that escorts were typically provided by activities staff or CNAs and that staff were regularly in-serviced not to accept money or gifts from residents because it could be considered financial abuse. In a phone interview, the LVN involved acknowledged escorting the resident to open a bank account after work, paying for transportation, and buying cigarettes for the resident. She stated that the resident insisted on giving her his card so she could buy items he wanted, including a phone and organizer, and admitted she did not promptly return the card. She further admitted using the resident’s credit card to reserve a hotel and stated she did not remember telling the resident about this use or the amount spent. The discharge planner discovered suspicious charges when assisting the resident with a call to his bank, and the administrator confirmed with the resident that he had not authorized the purchases. Facility records showed that the LVN had previously completed abuse prohibition training and signed acknowledgments of the abuse and gifts/gratuities policies, which define misappropriation and financial abuse as wrongful use of a resident’s money without consent and prohibit employees from accepting or giving anything of value to or from residents.
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