Failure to Prevent CNA Financial Exploitation of a Resident
Penalty
Summary
The deficiency involves the facility’s failure to protect a resident from misappropriation of property when a CNA solicited and obtained money and used the resident’s debit card for personal use. The resident was admitted with anxiety disorder, depression, and limitations of activities due to disability, and had an intact BIMS score of 14. The resident reported a sudden depletion of funds from her bank account after being informed by the bank that her balance was low and that her debit card may have been used inappropriately. Facility staff assisted the resident in reviewing recent bank transactions and identified multiple transactions associated with food delivery services, and text messages between the resident and the CNA showed repeated requests for money. Progress notes and interdisciplinary team documentation indicated that the resident verbalized feeling upset, concerned, and emotionally distressed after discovering the financial transactions. The resident reported difficulty recognizing appropriate financial boundaries with staff, expressed that her trust had been violated, and stated she did not want to see the staff member involved. Over several days, activity and nursing notes documented that the resident was emotional, upset, hurt, disappointed in herself and the CNA, and that she found it hard to understand why someone would do this, making it hard for her to trust others. The resident was noted to be mostly in her room, sleeping much of the day, socially withdrawn, and not interested in activities. Interviews and record review confirmed that the CNA had requested and received money and gifts from the resident multiple times, including ATM withdrawals using the resident’s debit card. Text messages reviewed with the resident showed the CNA requested money on multiple specific dates over several weeks. The resident stated she had allowed the CNA to use her card but had not given permission to take money to the extent that occurred, and she reported feeling pressured to give money and that she had never been told by the facility not to give money to staff. Facility staff, including a nurse, another CNA, social services, and the DON, stated that staff are trained and expected not to ask for or receive money or gifts from residents and that such conduct could constitute financial abuse or misappropriation of resident property. The facility’s abuse prevention policy stated residents have the right to be free from misappropriation of resident property and exploitation and that administration will protect residents from abuse by facility staff.
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