An Oklahoma nurse aide pleaded guilty to abusing a nursing home resident and was placed on a deferred sentence probation for three years under the supervision of the Oklahoma Department of Corrections. As a condition of his probation, he was ordered to serve 10 consecutive weekends in the Oklahoma County Jail, surrender his nurse aide certification, hold no employment involving care of elderly or vulnerable adults while on probation, and pay $940.00 toward the cost of the investigation to the Office of the Attorney General Medicaid Fraud Control Unit (MFCU), $300.00 to the Victim Compensation Fund, and the costs of the action.
The MFCU investigation began after a referral was received from the Oklahoma City Police Department regarding the report of potential abuse by caretaker at an Oklahoma City nursing home. During the investigation, MFCU agents obtained witness statements and other evidence confirming the aide had grabbed a resident who was sitting on the floor in a cafeteria area, dragged the resident by his hoodie across the cafeteria, and dropped him on the other side of the room. The witness statements and other evidence confirmed that, after releasing the resident, the aide returned twice to confront the resident by yelling and making physical gestures at the resident.
The Oklahoma Attorney General’s Office MFCU has statewide jurisdiction to investigate and prosecute violations of state and federal laws pertaining to provider fraud in the administration of the Medicaid program. Additionally, the MFCU pursues and monitors whistleblower litigation both at the Oklahoma level and on a national level in conjunction with other state’s MFCU and US Attorneys’ offices. The MFCU can recover Medicaid funds by pursuing criminal sanctions, civil judgments, or administrative recoveries. The MFCU also investigates and prosecutes cases of abuse, neglect, drug diversion, and financial exploitation involving residents in long-term board and care facilities and in residential care settings in some circumstances. In this role, the MFCU serves as a safeguard against caretakers that abuse, neglect, or exploit vulnerable Oklahomans.
Issue:
Abuse is the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain, or mental anguish. Instances of abuse of all residents, irrespective of any mental or physical condition, cause physical harm, pain, or mental anguish. According to F600 in the State Operations Manual, Appendix PP, the resident has the right to be free from abuse, neglect, misappropriation of resident property, and exploitation. Reporting abuse, neglect, and exploitation is mandatory for all nursing facilities. It is crucial that each nursing facility have a process in place for reporting violations. Staff members should understand their role in identifying, reporting, and investigating abuse. Failure to report in the appropriate time frame is a violation of F609 Reporting of Alleged Violations, and can result in citations at the immediate jeopardy level. Substantiated violations may be considered provision of substandard quality of care, resulting in sanctions and civil or criminal charges.
Discussion Points:
- Review your policies and procedures on preventing, identifying, and reporting abuse. Update them as necessary.
- Train all staff on what is considered abuse, and the steps that should be taken when it is suspected. Offer the training during new employee orientation, repeat at least annually, and more often if needed. Document that the training occurred, and record in each employee’s education file.
- Periodically audit staff understanding to ensure that they are aware of the steps that should be taken if they suspect abuse, and their reporting options, including the use of the anonymous hotline.
