South Carolina Attorney General Alan Wilson announced on June 13, 2023, that his office’s Medicaid Fraud Control Unit (SCMFCU) had arrested a 39-year-old man for allegedly exploiting a resident in an assisted living facility.
An SCMFCU investigation revealed that between May 2022 and October 2022 the man unlawfully and without consent accessed the resident’s bank account and converted $6,390 of the resident’s funds to his own use. Specifically, investigators allege that the man, while disguised in a blond wig, sunglasses, and surgical mask to obscure his face, forged the resident’s signature on multiple withdrawal slips while submitting them to a drive-up teller at a bank. It is further alleged that in November of 2022, the man forged power-of-attorney (POA) documents on the resident and submitted them to a credit union to further the exploitation scheme.
The man was charged with one count of Exploitation of a Vulnerable Adult, one count of Financial Identity Fraud, one count of Forgery, value less than $10,000, one count of Obtaining Property or Signature under False Pretenses, value more than $2,000 but less than $10,000, and one count of Forgery, no dollar amount.
According to South Carolina law, Exploitation of a Vulnerable Adult is a felony and, upon conviction, has a penalty of up to five years in prison, a fine not exceeding five thousand dollars, or both. Financial Identity Fraud is a felony and, upon conviction, has a penalty of up to ten years in prison, a fine at the discretion of the court, or both. The court may order restitution to the victim. Forgery, value less than $10,000 is a felony and, upon conviction, has a penalty of up to five years in prison, a fine at the discretion of the court, or both. Obtaining signature or property under false pretenses, value more than $2,000 but less than $10,000 is a felony and, upon conviction, has a penalty of up to five years in prison, a fine at the discretion of the court, or both. Forgery, no dollar amount, is a misdemeanor and, upon conviction, has a penalty of up to three years in prison, a fine at the discretion of the court, or both.
Pursuant to federal regulations, the SCMFCU has authority over Medicaid provider fraud; abuse and neglect of Medicaid beneficiaries in any setting; and the abuse, neglect, and exploitation of individuals residing in assisted living facilities or nursing homes.
Compliance Perspective
Issue
Financial abuse takes many different forms. Someone with a legal obligation to handle a resident’s finances may fail to use the funds for necessities like food, clothing, shelter, and healthcare, putting the resident at risk of harm. People with legal obligations to handle finances include fiduciaries such as agents under power of attorney, trustees, guardians, conservators, Social Security representative payees, and Department of Veterans Affairs (VA) fiduciaries. If family or other individuals step in to manage a resident’s finances, some may try to take money or assets for themselves, which can seriously impact the resident’s finances and may result in an inability to pay their nursing home or assisted living community bills. A facility is required to report any allegations of misappropriation or exploitation of a resident’s funds or personal property to the State Agency and to appropriate local authorities.
Discussion Points
- Review your policies on misappropriation of residents’ belongings or funds. Also review your policies and procedures for working with residents’ financial caregivers. Ensure that your policies are reviewed at least annually and updated when new information becomes available.
- Train all staff about abuse, neglect, and exploitation of residents, including misappropriation of personal belongings or funds. Also train appropriate staff to monitor payments to the nursing home or assisted living community, as unpaid bills may be a result of financial abuse of the resident. Document that the training occurred, and place the signed document in each employee’s education file.
- Audit to ensure that residents’ bills are being paid, and that resident financial caregiver documentation is on file, such as copies of a power of attorney instrument, Social Security representative payee authorization, or a guardianship court order. Staff should be aware of compliance and ethics concerns and understand their responsibility to report any violations to their supervisor, the compliance and ethics officer, or via the anonymous hotline.
*This news alert has been prepared by Med-Net Concepts, LLC for informational purposes only and is not intended to provide legal advice.*
