Breaking Compliance News Blog

Nursing Home Residents Can Keep Stimulus Checks

Posted by Margaret Scavotto, JD, CHC on 7/16/20 8:45 AM

On June 11, CMS issued an alert warning nursing homes not to seize residents' CARES Act stimulus checks. Providers that do so could lose their Medicare and Medicaid contracts.

CMS cited resident rights laws in support of its warning:

  • 42 CFR 483.12, Freedom from Abuse, Neglect and Exploitation (prohibition against misappropriation of resident property): "the deliberate misplacement, exploitation or wrongful, temporary, or permanent use of a resident's belongings or money without the resident's consent."
  • 42 CFR 483.10, each resident has "the right to manage his or her financial affairs"; "The facility must not require residents to deposit their personal funds with the facility. If a resident chooses to deposit personal funds with the facility, upon written authorization of a resident, the facility must act as a fiduciary of the resident's funds and hold, safeguard, manage, and account for the personal funds of the resident deposited with the facility...."

The FTC issued a consumer alert advising Medicaid beneficiaries that nursing homes CANNOT require them to sign their CARES Act stimulus checks over to the nursing home. The FTC encourages residents who have been asked by nursing homes for their CARES Act checks to complaint to the state attorney general.

MPA has updated its Resident Rights Policy and Resident Rights Summary to reflect this alert. Subscribers to MPA's Nursing Home Compliance Program received an email with the new policy downloads today. Click here to subscribe.

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Topics: Resident Rights, compliance, Phase 3

Selfie Time: What Could Go Wrong?

Posted by Margaret Scavotto, JD, CHC on 8/3/17 12:00 PM

A nurse aide, lab tech, medical assistant – or any other healthcare employee  – is new on the job. They are excited about their new position and decide to take a selfie to memorialize the occasion, then send it off to Facebook, Instagram, Twitter and Snapchat, with the click of a button, in under 20 seconds. What could go wrong?

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Topics: HIPAA, Resident Rights

Guest Blog: Theft and Financial Exploitation

Posted by Margaret Scavotto, JD, CHC on 7/18/17 4:43 PM

Today's blog is a guest post by Dorrie J. Seyfried, Vice President of Risk Management Services, IPMG. Dorrie discusses the rising financial and identity theft risks to nursing home residents, when they can amount to abuse, and what you can do about it. If you do run into a theft that involves patient information, remember to analyze it from a HIPAA standpoint, too.

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Topics: HIPAA, Resident Rights

Broken trust: employee theft from resident trust funds

Posted by admin on 11/15/13 12:04 PM

Remember the romantic comedy-drama Say Anything? The film's iconic scene has broken-hearted Lloyd (John Cusack) wooing Diane (Ione Skye) from beneath her window, Romeo-style. He is holding aloft a boom-box (remember those?) blaring Peter Gabriel's classic In Your Eyes. Diane, the class valedictorian, had dumped slacker Lloyd at the "suggestion" of her father, Jim. But when Diane discovers that her father has been stealing from the residents of the retirement home he owns, Diane returns to Lloyd and bitterly rejects her father who winds up in a federal penitentiary. Apparently, some nursing home employees haven't seen this movie. Or perhaps they think they can avoid detection better than Jim Court did in Say Anything.

A recent front-page USA Today article revealed a number of cases of theft from nursing home resident trust funds. The article cited employee thefts at nursing homes in amounts as high as $350,000 prompting U.S. Senate Aging Committee Chairman Bill Nelson to request a federal investigation into oversight of nursing home management of resident funds.

The OIG views trust fund theft as a resident rights issue, and thus a compliance issue. Included in the OIG Compliance Program Guidance for Nursing Facilities is the "failure to safeguard residents' financial affairs" as a compliance risk area. Failure to safeguard resident funds can also result in violations of federal and state theft, and fraud and abuse statutes. Anaccounts-receivable clerk at a facility in Connecticut who wrote 36 checks from resident trust accounts in amounts from $500 to more than $6,500 received a seven-year prison sentence and must repay the $140,170 she stole. Other fallout from detected trust fund theft includesdamage to the reputation of the facility, and to the emotional status of the vulnerable residents who have relied upon and trusted the home and its staff.

The USA Today article indicated that embezzlement of resident trust funds goes undetected because the funds are often managed by a single employee who works without oversight. A better practice would be to broaden surveillance by assigning resident trust fund duties and responsibilities between at least two employees who are trained to look for irregularities. Implementing policies, procedures and training programs on anti-fraud and abuse that specifically mention trust fund theft can also help protect resident trust funds.

Another way to deter and detect resident trust fund theft is to add these funds to routine audits and unannounced probes performed by internal or external auditors. Adding audits and probes performed as part of accounting processes to compliance auditing and monitoring is a good example of leveraging existing functions to enhance and augment the nursing home's compliance status.

Another approach is to enhance the nursing home's culture of compliance. The OIG emphasizes the value of a culture of compliance in skilled nursing facilities. One benefit of a culture of compliance is that employee behavior, rather than being driven by the desire to avoid detection and penalty, is driven instead by the desire to do the right thing. Employees so driven tend to do the right thing when no one is looking. And most of the time, no one is looking.

compliance risk assessment annual review

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Topics: Resident Rights, Culture of Compliance

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