Morselife Home Care Inc.

“Patient rights CFR(s): 484.50 Condition of participation: Patient rights. The patient and representative (if any), have the right to be informed of the patient’s rights in a language and manner the individual understands. The HHA must protect and promote the exercise of these rights. This Condition is not met as evidenced by: Based on the Home Health Agency (HHA)’s Policy review, personnel record review, patient record review, and interview, the Home Health Agency (HHA) failed protect and promote their patient’s rights for 1 of 1 sampled patient. Patient #1 was a vulnerable elderly adult who received non-skilled personal care services from Staff A, a Home Health Aide, who deposited monies from the bank account of Patient #1, into her own bank account. The HHA failed to ensure: Contact information for the HHA’s Administrator, including the Administrator’s name, business address, and business telephone number, in order to receive complaints, was provided to patients receiving non-skilled services through the HHA (G0414); Patient #1 was free from misappropriation of property and failed to complete an investigation of the misappropriation of funds upon knowledge of the occurrence from the patient’s family member (G0430); Their patients were advised of the State Toll Free Home Health Telephone Hot Line, its contact information, its hours of operation, and that its purpose was to receive complaints or questions about local HHAs, for all patients receiving non-skilled services through the HHA (G0444) and The reporting of the allegation of misappropriation of property of Patient #1 by Staff A to any State Agency or to Law Enforcement (G488). At the time of the survey 167 of the 209 current patients were receiving non-skilled services. The cumulative effect of these systemic practices resulted in the agency’s inability to protect their patients’ rights. The findings included: Review of the record reveals Patient #1 was admitted to the HHA’s services on 10/08/20 and was receiving Home Health Aide visits for 12 to 24 hours per day, seven days per week, to assist with personal care, bathing, dressing, toileting, and to maintain hygiene and environment. A “Medical History/Physical/Functional Assessment,” completed on 10/08/20 by the Admitting Nurse, documented Patient #1 required a trustee or family-appointed guardian to handle all financial arrangements and was not responsible for financial obligations. Further review reveals that it was determined Staff A, Home Health Aide, deposited additional monies from the checking account of Patient #1, into her own bank account, after having received a $200.00 “thank you gift” from Patient #1. The HHA failed to ensure Patient #1 was free from misappropriation of property. The HHA also failed to complete an investigation into the allegation, after the patient’s family member informed the HHA’s managerial staff of the event (refer to G430). After becoming aware of the allegation of misappropriation of property, the HHA failed to report the event to any State Agency or to Law Enforcement (refer to G488). The HHA also failed to ensure contact information for the Administrator was provided to patients receiving non-skilled services (refer to G414) and failed to ensure the State Toll Free Home Health Telephone Hotline Number was provided to patients receiving non-skilled services (refer to G444).”

“HHA administrator contact information CFR(s): 484.50(a)(1)(ii) (ii) Contact information for the HHA administrator, including the administrator’s name, business address, and business phone number in order to receive complaints. This Element is not met as evidenced by: Based on review of the Home Health Agency (HHA)’s Admission documents and interview, the HHA failed to ensure contact information for the HHA’s Administrator, including the Administrator’s name, business address, and business telephone number, in order to receive complaints, was provided to patients receiving non-skilled services through the HHA. At the time of the survey 167 of the 209 current patients were receiving non-skilled services. The findings included: During an interview on 03/07/24 at 1:35 PM, the Manager of Patient Services, who was the manager for those patients who received non-skilled services through the HHA, was asked how patients were made aware of the Administrator’s name and contact information, to voice a complaint or concern. The Manager of Patient Services obtained a “Client Information Booklet” and started looking through the booklet page by page. The Manager of Patient Services found the list of “Office Staff” and stated, during the interview on 03/07/24 at 1:35 PM, “Oh, the Administrator’s name is not here;” the Manager of Patient Services looked at each page and was unable to locate the Administrator’s name and or contact information; the Manager of Patient Services confirmed it was the most current Client Information Booklet, and it was provided to each non-skilled patient. During a supplemental interview at 03/07/24 at 1:45 PM, the Manager of Patient Services provided the Client Information Booklet provided to all skilled patients serviced by the HHA; this booklet contained a page titled, “Problem Solving Procedure” that contained information to include the Administrator’s name and contact information and the Manager of Patient Services stated she thought this page had been included with the non-skilled booklet as well.”

“Be free from abuse CFR(s): 484.50(c)(2) Be free from verbal, mental, sexual, and physical abuse, including injuries of unknown source, neglect and misappropriation of property; This Element is not met as evidenced by: Based on the Home Health Agency (HHA)’s policy review, personnel record review, patient record review, and interview, the HHA failed to ensure 1 of 1 sampled patients, a vulnerable elderly adult, was free from misappropriation of property by their Staff A, a Home Health Aide, who after receiving a “gift check,” from Patient#1, deposited ten checks, from Patient #1’s checking account into her own bank account. The HHA also failed to complete an investigation of the misappropriation of funds upon knowledge of the occurrence from the patient’s family member. The findings included: Review of the HHA’s policy titled, “Gratuities” dated 01/2019 documented, “II Policy: No employee or volunteer, under any circumstances, may solicit or accept tips from patients, their families, or friends for any service rendered by the employee/volunteer in the course of their duties.” Review of the HHA’s policy titled, “Assessment of Possible Abuse/Neglect” dated 12/2018 documented, ... “(Name of HHA) will investigate complaints regarding treatment or care, mistreatment, neglect, or verbal, mental, sexual, and physical abuse, including injuries of unknown source, and/or misappropriation of patient property by anyone furnishing services on behalf of the (name of HHA). … Definitions: 4. Exploitation: Unexplained loss of social security or pension checks, any evidence that material goods are being taken in exchange for care, any evidence that personal belongings of patient (house, jewelry, car) are being taken without consent or approval of patient. … Occurrences may include but are not limited to: Exploitation of money misuse or money theft.” Record review reveals Patient #1 was admitted to the HHA services on 10/08/20 and was receiving Home Health Aide visits for 12 to 24 hours per day, seven days per week, to assist with personal care, bathing, dressing, toileting, and to maintain hygiene and environment. “A Medical History/Physical/Functional Assessment,” completed on 10/08/20 by the Admitting Nurse, documents Patient #1 required a trustee or family-appointed guardian to handle all financial arrangements and was not responsible for financial obligations. During an interview on 03/06/24 at 9:35 AM, the Manager of Patient Services confirmed Patient #1 received non-skilled Home Health Aide services from their Home Health Agency; the Manager of Patient Services explained the family member of Patient #1 telephoned the Home Heath Agency’s office in June 2023, and reported she was going through financial paperwork for Patient #1 when she noticed ten checks that looked identical; the family member e-mailed copies of the checks to the Manager of Patient Services, who noted the checks were made out to a Home Health Aide, who had not worked for the HHA since February 2023, due to personal reasons; the Manager of Patient Services informed the Director of Home Care; they reached out to Staff A, the Home Health Aide whose name was on the checks; Staff A told the managers she had received a check in January 2023 that she had taken a photo of to do an electronic deposit, and then ripped up the check while at the home of Patient #1; the Director of Patient Services stated she asked Staff A why she did not report the gift to the (HHA’s) office as they have a policy against accepting gifts, and Staff A responded that she was unaware of that policy; the Director of Patient Services stated the situation was reported to Human Resources (HR). Staff A went to the HHA’s office later that day, was shown the checks in question, and Staff A stated she did not know how the checks got into her account; Staff A was shown that some of the checks were endorsed by another person, unknown to the Home Health Agency, and Staff A denied knowledge of that person. Staff A was terminated for not following HHA’s policy. Review of the “Client Monthly Schedule” of verified home care hours from 10/01/22 through 06/30/23, reveals Staff A, Home Health Aide, worked from 8:00 AM to 8 PM every Saturday from 10/01/22 through 12/10/22, and from 01/07/23 through 02/04/23. The Director of Home Care and the Manager of Patient Services were asked to provide evidence of an investigation into the allegation of misappropriation of funds for Patient #1 by Staff A, voiced by the patient’s family member. The managers provided a “ ... Record” (type of record documentation),” copies of the front and back of nine checks, two additional e-mails, and a “Notice of Conclusion,” from another State Agency. Review of the ... Record, dated 07/03/23, and provided as part of their investigation, documents, in part that on 06/29/23 it was reported Staff A accepted a check for the amount of $200.00 in January 2023. This record documented as a result of accepting payment from a patient, Staff A was terminated, effective immediately. Review of the nine checks reveals they were identically made out to Staff A for $200.00, all dated 06/23/23, all documented “Happy New Year” on the memo line, all signed by Patient #1, but had different check numbers. Review of the first e-mail dated 06/29/23 at 3:29 PM from the Manager of Patient Services to the HHA Administrator, documented in part that the family member of Patient #1 e-mailed photos to the Home Health Agency’s office, that included 9 of the 10 checks that were reportedly, “fraudulently written on my ... (Patient #1)’s checks” as per the family member. The tenth check would not download electronically. This e-mail documented the total of the checks was $2,000.00, and the family member would be contacting the police department to file a police report. The second e-mail provided by the managers of the HHA, dated 07/10/23 at 4:39 PM, was from the family member of Patient #1 to the Manager of Patient Services. This e-mail simply contained a photo of the business card from an Adult Protective Investigator from another State Agency. Review of the “Notice of Conclusion,” dated 09/05/23, from the other State Agency, documented the maltreatment of exploitation toward the vulnerable adult ... (name of Patient #1) by Staff A, Home Health Aide, was verified. During an interview on 03/06/24 at 11:22 AM, the Manager of Patient Services stated she had several conversations with the family member of Patient #1 and two conversations with the other State Agency, but she was unable to locate or provide any documented evidence of these conversations; when asked about the four additional staff who had received monetary gifts from Patient #1, the Manager of Patient Services stated she was unaware of any other staff involvement; when asked again if they had completed an investigation, the Manager of Patient Services stated she had provided all the documentation she had for the investigation. On 03/06/24 at 1:08 PM, during an interview, the Director of the Home Health Agency provided what she referred to as “an investigation completed by the Human Resources (HR) Department; the Director of the Home health Agency stated HR felt it was just an HR issue and terminated the employee.” Review of this ... Record for Staff A, Home Health Aide, dated 07/03/23 documents in part on Sunday 06/25/23, the ... (family member) of a home care client noticed a large amount of money had been deducted from her ... (Patient #1’s) checking account on 06/23/23. The family member requested copies of the deposited checks from the bank. On 06/29/23, the family member called the Home Health Agency’s office to report that nine checks, all in the amount of $200.00 had been deposited into the account of Staff A, who had not cared for the client since 02/04/23. The family member reported that her ... (Patient #1) had written a check to Staff A for the same amount in December 2022 as a gift. All of the checks deposited into the account of Staff A on 06/23/23 appeared very similar in nature to the check that was gifted (in December 2022), except that the check numbers were different, and they were also all dated 06/23/23. The endorsements on the back of the checks were signed either by Staff A, or another unknown person. On 06/30/23, the Managers reached out to Staff A, who did not answer. On 07/03/23, managerial staff at the Home Health Agency’s office reached Staff A via telephone, explained what the family member reported, and Staff A denied knowing how the checks were deposited into her account. Staff A went to the Home Health Agency’s office later that same day, spoke with Human Resources, and was terminated effective immediately related to a violation of the Home Health Agency’s policy regarding not reporting/accepting money from a client. During a telephone interview on 03/07/24 at 11:46 AM, when asked what services she provided to Patient #1, Staff B, home health aide, stated she would make the patient breakfast, do household chores, and took Patient #1 to the main dining room, to an activity, or to the doctor’s office; when asked if she would help her with paying for anything or involved in the patient’s finances, Staff B explained that whatever was needed went through the patient’s family member, who took care of all the finances; when asked if she was one of the caregivers who received a monetary gift from Patient #1 back in December of 2022 or January of 2023, Staff B stated she wasn’t sure, but that they can receive gifts “for like Christmas; Staff B stated she may have gotten something a couple of years ago. When asked if she received a $200 check, Staff B stated, “I don’t know about $200” and refused to answer directly. During an interview on 03/07/24 at 2:02 PM, when asked if she questioned any of the other caregivers of Patient #1 about receiving monetary gifts, after becoming aware of the gift to Staff A, the Manager of Patient Services stated she had not, because they were focused on Staff A; when asked if she would consider the alleged removal of funds from Patient #1’s account, with deposits into the account of Staff A, abuse, neglect, or exploitation, the Manager of Patient Services stated she did. Review of the report by the other State Agency reveals the same occurrence as noted above on the ... Records, with the exception the other State Agency confirming there were 10 checks dated 06/23/23, bearing likeness to the gifted check, visible on the victim’s account (Patient #1) that were deposited into the alleged perpetrator’s account (Staff A). This report documented Patient #1 issued checks to her caregivers in January 2023 as “thank you gifts.” This report also documented Patient #1 stated she had about four different caregivers who assist her and gave each caregiver a check as a gift. The report again documented the checks in question were made out to Staff A.”

“State toll free HH telephone hotline CFR(s): 484.50(c)(9) Be advised of the state toll free home health telephone hot line, its contact information, its hours of operation, and that its purpose is to receive complaints or questions about local HHAs. This Element is not met as evidenced by: Based on review of the Home Health Agency (HHA’s) Admission documentation and interview, the HHA failed to ensure patients were advised of the State Toll Free Home Health Telephone Hot Line, its contact information, its hours of operation, and that its purpose was to receive complaints or questions about local HHAs, for all patients receiving non-skilled services through the HHA. At the time of the survey 167 of the 209 current patients were receiving non-skilled services. The findings included: During an interview on 03/07/24 at 1:35 PM, the Manager of Patient Services, who was the Manager for those patients who received non-skilled services through the HHA, was asked how patients were made aware of the State Toll Free Home Health Telephone Hot Line, to voice a complaint or concern; the Manager of Patient Services obtained a “Client Information Booklet” and started looking through the booklet page by page; the Manager of Patient Services looked at each page and was unable to locate the State Hot Line Information; the Manager of Patient Services confirmed it was the most current Client Information Booklet, and it was provided to each non-skilled patient. During a supplemental interview at 03/07/24 at 1:45 PM, the Manager of Patient Services provided the Client Information Booklet provided to all skilled patients serviced by the HHA; this booklet contained a page titled, “Problem Solving Procedure” that contained information to include the State Toll Free Home Health Telephone Hot Line information and the Manager of Patient Services stated she thought this page had been included with the non-skilled booklet as well.”

“Immediate reporting of abuse by all staff CFR(s): 484.50(e)(2) Any HHA staff (whether employed directly or under arrangements) in the normal course of providing services to patients, who identifies, notices, or recognizes incidences or circumstances of mistreatment, neglect, verbal, mental, sexual, and/or physical abuse, including injuries of unknown source, or misappropriation of patient property, must report these findings immediately to the HHA and other appropriate authorities in accordance with state law. This Element is not met as evidenced by: Based on the Home Health Agency (HHA)’s Policy review, personnel record review, patient record review, and interview, the HHA failed to report 1 of 1 sampled patient’s allegation of misappropriation of property by Staff A, Home Health Aide, deposited ten checks from Patient #1’s checking account into her own bank account. Patient #1 is a vulnerable elderly adult. Managerial staff became aware of the allegation and failed to report it to any State Agency or to Law Enforcement. The findings included: Review of the HHA’s policy titled, “Assessment of Possible Abuse/Neglect” dated 12/2018 documented, “The ... (name of HHA) will report all suspected cases of abuse, neglect, or exploitation to the appropriate authorities. … Definitions: 4. Exploitation: Unexplained loss of social security or pension checks, any evidence that material goods are being taken in exchange for care, any evidence that personal belongings of patient (house, jewelry, car) are being taken without consent or approval of patient. … Occurrences may include but are not limited to: Exploitation of money misuse or money theft.” Record review reveals Patient #1 was admitted to the HHA services on 10/08/20 and was receiving Home Health Aide visits for 12 to 24 hours per day, seven days per week, to assist with personal care, bathing, dressing, toileting, and to maintain hygiene and environment. “A Medical History/Physical/Functional Assessment,” completed on 10/08/20 by the Admitting Nurse, documented Patient #1 required a trustee or family-appointed guardian to handle all financial arrangements and is not responsible for financial obligations. During an interview on 03/06/24 at 9:35 AM, the Manager of Patient Services confirmed Patient #1 received non-skilled Home Health Aide services from the HHA; the Manager of Patient Services explained the family member of Patient #1 telephoned the HHA’s office in June 2023, and reported she was going through financial paperwork for her ... (Patient #1) when she noticed ten checks that looked identical; the family member e-mailed copies of the checks to the Manager of Patient Services, who noted the checks were made out to a Home Health Aide, who had not worked for the HHA since February 2023, due to personal reasons; the Manager of Patient Services informed the Director of Home Care; they reached out to Staff A, the Home Health Aide whose name was on the checks; Staff A told the Managers she had received a check in January 2023 that she had taken a photo of it in order to do an electronic deposit, and then ripped up the check while at the home of Patient #1; the Director of Patient Services stated she asked Staff A why she did not report the gift to the (HHA’s) office as they have a policy against accepting gifts, and Staff A responded that she was unaware of that policy; the Director of Patient Services stated the situation was reported to Human Resources (HR); Staff A went to the HHA’s office later that day, was shown the checks in question, and Staff A stated she did not know how the checks got into her account; Staff A was shown that some of the checks were endorsed by another person, unknown to the Home Health Agency, and Staff A denied knowledge of that person; Staff A was terminated for not following HHA ‘s policy; the Manager of Patient Services continued and stated about a week or so after the family member’s initial telephone call, she received a call from the family member, who was very upset, and wanted to know who sent out ... (name of another State Agency), who made an unannounced visit to Patient #1 over that weekend; the Manager of Patient Services stated they had not reported the occurrence to any agency. On 03/06/24 at 1:08 PM, during an interview, the Director of Home Care provided what she referred to as an investigation completed by the Human Resources department; the Director of Home Care stated HR felt it was just an HR issue and terminated the employee.” Review of this ... (type of) Record for Staff A, dated 07/03/23, documented in part on Sunday 06/25/23, the family member of a home care client noticed a large amount of money had been deducted from her ... (Patient #1’s) checking account on 06/23/23. The family member requested copies of the deposited checks from the bank; on 06/29/23, the family member called the HHA’s office to report that nine checks, all in the amount of $200.00 had been deposited into the account of Staff A, who had not cared for the client since 02/04/23; the family member reported that her ... (Patient #1) had written a check to Staff A for the same amount in December 2022 as a gift. All of the checks deposited into the account of Staff A on 06/23/23 appeared very similar in nature to the check that was gifted (in December 2022), except that the check numbers were different, and they were also all dated 06/23/23. The endorsements on the back of the checks were signed either by Staff A, or another unknown person. On 06/30/23, Managers reached out to Staff A, who did not answer. On 07/03/23, Managerial staff at the HHA’s office reached Staff A via telephone, explained what the family member reported, and Staff A denied knowing how the checks were deposited into her account; Staff A went to the HHA’s office later that same day, spoke with Human Resources, and was terminated effective immediately related to a violation of the HHA’s policy regarding not reporting/accepting money from a client. During an interview on 03/07/24 at 2:02 PM, when asked if she would consider the alleged removal of funds from Patient #1’s account, with deposits into the account of Staff A, abuse, neglect, or exploitation, the Manager of Patient Services stated she did; when asked why she did not report the allegation of abuse, neglect or exploitation to a State Agency and or Law Enforcement, the Manager of Patient Services stated she had encouraged the family member to call the police, but the family member stated she needed to deal with the bank; when asked again if she reported the allegation to any State Agency, the Manager of Patient Services said she did not. Review of the report by the other State Agency reveals the same occurrence, with the exception the other State Agency confirmed there were 10 checks dated 06/23/23, bearing likeness to the gifted check, visible on the victim’s account (Patient #1) that were deposited into the alleged perpetrator’s account (Staff A, home health aide). This report documented Patient #1 issued checks to her caregivers in January 2023 as thank you gifts. This report also documented Patient #1 stated she had about four different caregivers who assist her and gave each caregiver a check as a gift. The report again documented the checks in question were made out to Staff A.”