MIRA VILLA CARE CENTER
9246 Avenida Miravilla Cherry Valley, CA 92223
Citation Number: 25000690
Citation Date: 05/13/2014
Violation Date: 9/1/2012
Class: B
Penalty: $2,000

CLASS B CITATION-- ABUSE/FACILITY NOT SELF REPORTED

483.13(c) F224 42

CFR 488.301

"Misappropriation of resident property" means the deliberate misplacement, exploitation, or wrongful, temporary or permanent use of a resident's belongings or money without the resident's consent.

The facility failed to ensure for Residents J and K:

1. The safe keeping and security of each resident's trust fund account(s).

2. Implement a policy of prevention and prohibition of financial abuse with resident ('s) monies.

3. Demonstrate and implement a check and balance protocol to prevent widespread financial abuse of resident's trust funds, affecting Residents J and K.

4. Reconcile (verify) trust fund balances for resident(s') family members/responsible parties who had a relative had pass away at the facility. The facility failed to ensure residents were free from financial abuse.

The facility failed to ensure residents' trust fund monies were free from financial abuse affecting Residents J and K.

The facility's failure to safeguard the resident trust funds for Residents J and K, had the potential to cause misappropriation of resident property- which means the deliberate misplacement, exploitation, or wrongful, temporary or permanent use of a resident's belongings or money without the resident's consent. These failed practices placed the safety and security of resident trust funds in jeopardy; resulting in the theft of the resident trust account of $1,167 with interest of $43.71 combined total $1,210.71 by the former Business Office Manager (BOM) from November 2011 to August 2013.

An interview was conducted with the facility Administrator (ADM) on October 3, 2013, at 2 p.m. The ADM stated that she had employed a BOM (Business Office Manager) whom she had "suspicion of an employee who may have done fraud ... "The BOM was hired September 1, 2011, and her last day of employment was August 17, 2013, in which the BOM did not show up for work. The ADM continued to state that it was reported to her by a nearby facility manager (owned by the same company as this facility), where the BOM had also worked, that there was speculation that something had happened in the payroll department regarding financial inconsistencies at that facility.

On October 3, 2013, at 2:45 p.m., the ADM stated, "We were doing bank reconciliation (verification) on September 30, 2013 ... some checks were questionable ... something was irregular with the (resident trust) funds." The ADM further stated, "I immediately contacted a third party auditor to research the matter." The Governing Body (people who represent the facility) was then alerted to this information.

The ADM further stated, "On October 3, 2013, at 2:45 p.m., a report was made to the Riverside District Office and a police report was made. "The same day the ADM continued to state, "The main bank [Name Withheld] that handles the Resident Trust fund ... the account was put on hold."

An interview was conducted with the ADM on October 3, 2013, at 2:50p.m., a phone call was placed on speaker phone by the ADM. A lawyer representing the facility governing body was on the phone and stated that the BOM was in his office and confessed to misappropriation of resident trust funds. The lawyer stated, "She (the BOM) confided to me she acted alone in the misappropriation of funds from the resident trust account...she is to come up with her own accounting of what may be missing on our (facility's) end. "The lawyer stated he was working with the former BOM to come to an recommend related to trust and accounts and balances ... we are not responsible for overseeing accounts on a month to month basis." The auditor stated she was recently hired on October 7, 2013 to complete the audit of the facility's resident trust funds and stated so far "Most of the resident's trust fund accounts were transferred to a [Name Withheld] personal bank account belonging to the former BOM." The auditor continued to state, "Look at the discharge dates ... (There) were multiple residents who expired she (BOM) took money from." The auditor further stated the former BOM also took the residents' interest from the trust fund accounts.

A record review of the auditor's final report was conducted on October 17, 2013. The auditor listed 45 residents in spread sheet format in which the former BOM had conducted financial abuse. There were originally 17 checks made out to the personal bank account of the former BOM while she was employed at the facility from September 1, 2011 and to August 17, 2013. Additional checks were found by the auditor and were listed on the final spread sheet dated October 14, 2013. Of the 45 residents in which the former BOM took funds from, 12 passed away at the facility. The families and or responsible person of the deceased did not receive those refunds within 30 days of the former residents' death.

During an interview conducted with Resident H's daughter on October 14, 2013, at 3:30 p.m., the daughter stated, "I did not receive any trust statements from the facility and was not reimbursed within thirty days after my mother's death."

A record review was conducted on October 14, 2013, of the residents affected by the alleged financial abuse conducted at the facility. Of the 45 residents affected with the alleged financial abuse, 12 had a psychiatric diagnosis, 11 residents had dementia (brain decay), or Alzheimer's disease (progressive loss of mental capacity), and three residents had mental disorders consisting of mental retardation, traumatic brain injury, and brain cancer.

During an interview with Business Office Worker 1 on October 10, 2013, at 12:40 p.m., the worker stated the monthly reconciliation (verification of accounts) was done by the ADM and forwarded to the accounting office. She stated all the numbers added up (with the resident trust fund). She stated, "We put too much trust in [Name Withheld] (former BOM). The worker stated the facility did not follow through with a (formal) month to month follow through of the resident trust account. Individual ledgers to reconcile (verify) with Patient Trust control Account were not taking place. Families of deceased residents did not receive their trust fund money. There were no formal one to one meetings with the Administrator and staff, as per facility policy. There was no documentation brought to the surveyor to show there were meetings that took place with time and date of reconciliation (verification) of the trust accounts. Office Worker 1 acknowledged that the facility's business office was now printing out on a monthly basis, all monthly checks made. She continued to stated, the checks now have to match the monthly reconciliation statement. Office Worker 1 further stated (there) is no authorization (now) by any workers except the administrator to sign any checks or to use a check stamp.

The facility policy and procedure titled, "Policies and Procedures in Handling Patient Trust Fund," indicated the following:

3. "A custodian shall be designated by the Facility/Administrator to handle petty cash withdraws, withdraws by checks, and to make deposits to the account. All checks will be signed by the custodian and administrator ...

c. Recordings and postings to the trust fund ledgers should be done daily.

d. Postings should be reconciled with the Control account (on-going accounting sheet) immediately after postings."

Under Disbursements the policy indicated: " ...

b. Patient refunds should be made payable to the resident. Refunds other than for residents should be authorized & supported.

4. Bank Reconciliation a. Monthly Bank reconciliation should be prepared.

b. Bank balance to reconcile with controller/ledger account.
c. Individual ledgers to reconcile with Patient Trust control Account.
d. Monthly interest income earned should be posted/accrued to the individual ledgers of the Residents."

The policy further indicated,

"6. When a resident is discharged, refunds should be made within three (3) days upon discharge and within (30) days upon death. Upon discharge, residents/authorized representative should be given a current statement of their trust account balance ... "

Under Residents Moneys or Valuables:

"... 2. Should be adequately safeguarded and accurately accounted for and documented ...

... 6. Of dead residents without a representative or known heirs (relatives), are given to the County Public Administrator and a copy of notice is given to the department of Health."

The facility's failure to safeguard the resident trust funds for Residents J and K had the potential to cause misappropriation of resident property- which means the deliberate misplacement, exploitation, or wrongful, temporary or permanent use of a resident's belongings or money without the resident's consent. These failed practices placed the safety and security of resident trust funds in jeopardy; resulting in the combined theft of $1,210.71 by the former Business Office Manager (BOM) from November 2011 to August 2013.

The facility's failures to manage, protect, and verify resident funds had a direct relationship to the health, safety, and security of patients."