Failure to Safeguard Resident Credit Card Information Resulting in Misappropriation
Penalty
Summary
The deficiency involves the facility’s failure to safeguard a resident’s credit card information, which led to an unauthorized purchase by a staff member. The resident involved had a diagnosis that included frontotemporal neurocognitive disorder, and his brother/guardian managed his financial transactions. The guardian provided a copy or image of the resident’s pre‑loaded credit card, which contained the resident’s Social Security funds, to the Business Office Manager (BOM O) for payment of the resident’s bills. Because the card image could not be opened, BOM O forwarded it to the Administrator in Training (AIT R) at the direction of the former Nursing Home Administrator so that AIT R could format and print it. BOM O reported that, aside from herself, AIT R was the only other employee who would have had access to the resident’s credit card information. Subsequently, the resident’s guardian noticed an unauthorized charge on the card for a motorcycle battery purchased over the phone and shipped to the facility’s address. Store staff confirmed to the guardian that the purchase had been made via a phone order from someone at the facility, using the resident’s credit card. The guardian went to the facility intending to speak with BOM O about the charge but was instead approached by AIT R, who stated he could assist and took the information about the credit card transaction, telling the guardian he would follow up. According to the guardian, about a week or two later, AIT R contacted him and arranged to meet at a gas station, where AIT R reimbursed him in cash for the amount of the unauthorized charge, stating that the money came from a special fund and that such things happened all the time. No details of this situation were reported by AIT R to anyone else at the facility. When the resident’s August payment did not process, BOM O contacted the guardian, who explained that he had locked the card after discovering the unauthorized charge and described the reimbursement by AIT R. BOM O then reported the concern to the current Nursing Home Administrator (NHA A). Review of the credit card statement and an invoice from the store showed a phone purchase of a motorcycle battery using the resident’s Mastercard, billed under the facility’s name and shipped to the facility’s address. NHA A attempted to question AIT R, who had already resigned, but he declined to provide substantive answers, repeatedly stating he did not recall or did not know. The facility’s Advocate Rounds tool, which was used to ask residents about their experiences, did not include any questions about the safety or security of belongings or personal funds, and the Concierge reported they were instructed to ask the questions exactly as written. The new Business Office Manager (BOM M), who started later, had no knowledge of the credit card issue. The evidence gathered by the facility and surveyors supported that misappropriation of the resident’s funds occurred after the facility failed to adequately safeguard the resident’s credit card information. The facility’s internal interviews and documentation further established that the resident’s credit card image was handled in a way that allowed access beyond the business office. BOM O stated that normally they did not receive images of credit cards, but in this case, due to Medicaid application requirements and the unusual card type, an image was obtained and then forwarded to AIT R for printing. This process created an opportunity for misuse of the resident’s financial information. Additionally, the Advocate Rounds process, as described by NHA A and Concierge BB, did not include any structured inquiry into residents’ perceptions of the safety and security of their belongings or personal funds, limiting the facility’s ability to detect or prevent such misappropriation through routine resident interviews. These actions and omissions collectively led to the misappropriation of the resident’s credit card for a personal purchase by a staff member.
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