On December 5, 2022, a 57-year-old South Carolina woman pleaded guilty to two counts of Exploitation of a Vulnerable Adult and two counts of Breach of Trust with Fraudulent Intent, value of $10,000 or more. She was sentenced to five years in prison, suspended to five years of probation for Exploitation of a Vulnerable Adult, and seven years in prison, suspended to five years of probation for Breach of Trust. She was also ordered to pay restitution in the amount of $30,000.
A South Carolina Medicaid Fraud Control Unit (SCMFCU) investigation revealed that between the dates of September 1, 2018, and November 30, 2021, the woman, as a power of attorney (POA) for the two victims, willfully made with fraudulent intent unlawful and improper use of the victims’ funds and assets. During the time of the alleged misconduct, both victims, vulnerable adults under South Carolina law, resided at an assisted living facility in Florence. The facility referred this matter to the South Carolina attorney general for investigation.
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.*
