Accepting residents with dementia without proper licensure and the ability to prevent their elopement from the facility and requiring staff to create inaccurate documentation may result in charges of neglect and fraud, with the submission of false claims
Compliance Perspective – Elopement
Policies/Procedures: The Compliance and Ethics Officer with the Director of Nursing will review the policies and procedures for admitting and caring for residents with dementia and other cognitive impairments, and for accurate documentation of resident information.
Training: The Compliance and Ethics Officer with the Director of Nursing will ensure that staff are trained to respond in a timely manner to concerns about elopement by residents with diminished cognitive capability. Staff will also be trained regarding documentation requirements and avoiding false documentation, even if instructed to change medical record content.
Audit: The Compliance and Ethics Officer with the Director of Nursing should personally conduct an audit of residents’ elopement risk assessments and care plans to ensure they are current and appropriate for the residents’ diagnoses and cognitive capabilities. They should also assign appropriate staff to conduct random chart audits, comparing diagnoses contained on admission documents from other settings to the active diagnoses listed in the residents’ current medical records to ensure those with dementia are recognized and receive appropriate levels of care.
A state prosecutor told the jury in the trial of the accused owner of an assisted living center that the owner knew the center was not certified to admit residents with dementia, but he admitted them anyway in order to “fill the beds.” The center received citations previously for having residents with dementia when it was not licensed to care for them.
The owner and his former executive director have both pleaded not guilty to charges stemming from the 2014 death of a 67-year-old resident who wandered away from the facility, was struck by a car, and died. The resident liked to jog and was resistant to attempts to curtail his jogging. Staff attempted unsuccessfully to have the resident wear an ankle bracelet in order to keep track of him.
The center’s owner and director have been charged with involuntary manslaughter and elder abuse. They are being tried separately.
Knowing the facility was not licensed to care for residents with dementia, the state alleges that the two men devised a scheme to admit residents with dementia; and, at the same time, reduced the staffing levels.
Some staff are expected to testify that the owner had a list of potential residents with dementia and requested that they remove the “dementia” diagnosis from their records to allow them to be admitted.
The defendant’s attorney argued that the resident did not have dementia, but rather a mild cognitive impairment that the State’s Title 22 regulations allowed the facility to accept. He also pointed to the fact that the California Highway Patrol and the State Department of Social Services did not cite a crime or violation related to the resident’s death.
