Healthcare Compliance Perspective – Defraud:
A healthcare provider which uses independent contractors to provide services must conduct criminal background checks, OIG exclusion checks, enter into a Compliance and Ethics Code of Conduct, and ensure that its agreement with the contractor includes indemnification for wrong-doing. There is no substitute, however, for periodically auditing the financial integrity of independent contractors while performing services by interviewing patients.
A 30-year-old Certified Nurse Aide, working as an independent contractor for a home care company under an assumed name, is accused by the Florida DOH of using her license to care for elderly people as a license to steal and defraud a married couple and a financial institution of $179,000. The state issued an Emergency Suspension Order on the aide to cause the immediate suspension of her license.
The suspended aide is charged with multiple counts for the “exploitation of an elderly adult from a position of trust for between $20,000 and $100,000.” Another similarly worded charge was also issued at the higher level of over $100,000 for her “scheme to defraud a financial institution and organized fraud for $50,000 or more.”
The aide started out her exploitation scheme after she worked about two months for the couple and earned their trust. Both the man and woman had been diagnosed with dementia. Her scheme to steal their money involved telling the man that she had spent her own personal money to buy his wife different things and he would then write her a check to reimburse her. She worked this con for a year from October 2016 to October 2017 and managed to steal $23,073.91 from the couple.
Next, she went after a potentially larger amount of money by completing an American Express application over the phone using the couple’s personal information and then making herself a signatory for the account. This was done without the couple’s knowledge or approval. The aide was also able to get American Express to issue a supplemental card on the couple’s account but in her own name.
The home care company fired the aide in November 2017 and she was arrested on May 8. She posted a $15,000 bond on May 9. The woman was known by these two names: Sophia Brown and Sophia Shepherd.
