A federal grand jury returned an indictment charging an Indiana woman, 49, with five counts of Social Security number fraud, three counts of aggravated identity theft, and one count of Social Security disability benefits fraud. The indictment was unsealed May 31, 2023, following her arrest and initial appearance.
As alleged in the indictment, between February 26, 2020, and March 23, 2022, the woman submitted five fraudulent applications for employment to Indianapolis area nursing homes and assisted living facilities. She used a stolen Social Security number on all five of the applications. She was receiving Social Security disability insurance benefits under her true Social Security number, and she knew that those benefits would be reduced or eliminated if the Social Security Administration found out she had a job. Additionally, the woman knew that she might not be able to pass an employment background check if she applied to a healthcare facility using her true Social Security number.
In some of the job applications, the woman also used a stolen Licensed Practical Nurse (LPN) license number to trick the employers into believing she was an LPN even though she has never received any type of nursing license in the state of Indiana. Of the five job applications, four were for LPN positions. The woman applied for these positions despite not having a nursing license. She worked as an LPN at one facility from January 21, 2021, to April 27, 2021, and at a second facility from May 10, 2021, to November 23, 2021. At a third facility, she worked as a Memory Care Program Coordinator from February 26, 2020, to April 16, 2020.
Between December 3, 2019, and December 2, 2022, the woman received approximately $54,991.30 in Social Security disability benefits under her true Social Security number. On two separate occasions, in August 2021 and October 2022, she submitted Work Activity Reports to the Social Security Administration. In those reports, the woman declared, under penalty of perjury, that she had not earned any income since May 2019. She did not disclose that she had been earning wages at healthcare facilities.
The FBI, Social Security Administration, Office of Inspector General, Indiana Attorney General’s Office – Medicaid Fraud Control Unit, and the Indianapolis Metropolitan Police Department investigated this case. If convicted on all counts, the woman faces up to 5 years in federal prison.
Compliance Perspective
Issue
Healthcare settings are required to conduct extensive background checks on all employees. These should be comprehensive in order to ensure that each potential employee is qualified and permitted to be employed in a healthcare facility that receives government funds. Before an employee is officially hired into a position, a criminal background check and sex offender registry search must be completed, and the individual must be cleared in the databases. Additionally, an identification verification check, past employment history, education verification, and OIG’s List of Excluded Individuals and Entities (LEIE) check must be completed for all employment candidates. For positions that need certifications or licenses, verification of these credentials must be conducted and documented in the individual’s personnel file. After hire, it is essential that the databases are continually monitored to ensure that no current employee has recently been placed on an exclusion list or had a license or certification suspended or revoked since the last check. Routine monitoring will ensure that employees are legally permitted to practice healthcare in your facility.
Discussion Points
- Review policies and procedures for verifying the status of professional licenses and monitoring the OIG’s LEIE. Update as necessary.
- Train appropriate staff to follow protocols for verification of licenses and certifications of employees at the time of hire and on an ongoing basis to ensure that those licenses remain up to date and are unencumbered. Ensure that training is provided to licensed personnel about their responsibility to maintain an active license and to notify administration should their license be suspended, expire, or if they are added to the OIG’s LEIE. Document that these trainings occurred, and file the signed documents in each employee’s education file.
- Periodically audit to verify that the licensing and certifications of employees are valid and up to date and that OIG LEIE checks are routinely conducted. Immediately address any negative findings.
*This news alert has been prepared by Med-Net Concepts, LLC for informational purposes only and is not intended to provide legal advice.*
