Did you know there are only a few states that require both a criminal background check and routine audits of nursing home trust funds? It’s surprising considering the growing number of fraudulent activities against the elderly.
USA Today recently conducted an in-depth investigation into these trust funds and found that nearly half do not require background checks for nursing home office workers who handle their residents’ trust accounts. Worse, even fewer require routine audits of the funds and how they’re being spent and by whom.
In New Hampshire, there are currently no background checks required for office workers in nursing homes – including those who may have access to those funds. Further, there is only a minimum requirement for routine audits of these types of accounts.
Caregiving vs. Administration
Many may assume that because nearly every state requires background checks for nursing home staff in caregiving roles, it also means their office workers or administration undergo those same background checks. In 20 states, that’s not the case and unless these employees have direct contact with patients, they’re not prone to those types of investigations as a matter of routine.
The USA Today study found “thousands” of nursing home residents who are victims of theft due to the access some have to their trust accounts and who use that access to their illegal advantage. It makes sense then that these crimes go undetected for long periods of time. In fact, it’s difficult to even ascertain how much has been stolen and from how many victims.
For perspective, consider the U.S. has more than 16,000 nursing homes – and that’s not counting other assisted living facilities. The opportunities are plentiful.
CMS Oversees Nursing Home Trust Funds
In late 2013, the U.S. Centers for Medicare and Medicaid Services acknowledged nursing home regulations were the responsibility of those same workers who are in charge of the funds with no oversight. “We are aware of this situation and are reviewing the (inspection) procedures used to detect these kinds of problems,” agency spokesman Aaron Albright said when asked about USA TODAY’s findings. “CMS takes safeguarding nursing home patients very seriously.”
Florida Senator Bill Nelson, who is the Chairman of the Senate Special Committee on Aging, penned a letter to the Inspector General with the Department of Health and Human Services in late October. He noted that these accounts are not earning interest nor are their insured to protect against theft or loss. He cited those states where audits were required were rarely conducted and states that there have been more than 1500 citations issued in the past three years to nursing homes for “mishandling these trusts in some manner”. The embezzlement efforts of just one person can easily surpass the $100,000 mark and that when they are caught, it’s typically by accident.
As a result of these facts, he’s requested CMS to “recommend corrective actions for any shortcomings…and should include state law enforcement officials”.
If the senator can manage to turn attention to this important near-crisis, it could mean that those seniors who are relying on nursing homes to oversee their monies could soon start seeing a bit of interest being tacked onto their accounts.
Of course, this is a deeply embedded problem within the elder law sector and is going to take time, especially considering the uncertainties associated with the new healthcare laws.
DeBruyckere Law Offices will continue to monitor these proceedings and in the meantime, we welcome the opportunity to provide for all of your estate planning and elder law needs.