Since 1995, the Department of Health and Human Services’ Office of the Inspector General has published warnings and reports outlining the misuse of the hospice benefit. Last year, it listed hospice fraud as the government’s top area for criminal recoveries, after the pharmaceutical and home health sectors. “It’s an open secret that hospice is one of the poster children for fraud and abuse in Medicare,” said David Grabowski, a health policy professor at Harvard who serves on MedPac, the federal advisory panel on Medicare spending.

Some hospices boost profits by signing people up regardless of whether they are dying. Marketers present the program as free home health care or steal personal information to enroll “phantom patients.” Others target assisted living facilities and nursing home residents whose life expectancy exceeds six months.

This guide can help you research your hospice provider and spot common signs of hospice fraud. It is adapted from the Senior Medicare Patrol National Resource Center, a grantee of the Administration for Community Living at HHS, that assists Medicare beneficiaries, families and their caregivers to prevent, detect and report health care fraud, errors and abuse.

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FDIC Consumer News: Protecting Seniors from Financial Abuse
Federal Deposit Insurance Corporation -- FDIC Consumer News - April 2019

Click here for printable pdf version - April 2019 - PDF

Be organized, proactive, and aware to protect yourself, family and friends from financial abuseIt’s easier than ever to handle our finances without setting foot inside a bank with so many advances in technology, but these changes have also made fraud and financial abuse a prevalent problem for older adults. Most elder financial abuse involves scams, forgery, identity theft, or undue pressure to give someone access to property or funds by simply providing information over the phone. Older adults are often targeted for such exploitation because they may be perceived as trusting, they may be cognitively impaired, they may have more funds available after a lifetime of saving, and potentially less exposure to technological advances.


Tips for Protecting Finances

Seniors can protect themselves from financial abuse by making sure financial records are organized and being aware of how much money is in all accounts. In addition, you can protect your assets by talking to someone at your bank, an attorney, or a financial advisor to discuss your options for ensuring your wishes for managing your money and property are followed in the event you become incapacitated. Other activities to help protect yourself include:

• Carefully choosing a trustworthy person to share your financial planning matters with so they can assist you with tracking your finances if you are unable to do so yourself.


• Locking up your checkbook, account statements, and other sensitive information.


• Ordering copies of your credit report to review for suspicious activity. (You are entitled to a free copy of your credit report from each of the three major credit bureaus once every twelve months. To order your free annual reports, go to AnnualCreditReport.com or call toll- free 1-877-322-8228.)

• Never providing personal information, including your Social Security number, account numbers, or other financial information to anyone over the phone unless you initiated the call.


• Asking for details in writing and getting a second opinion from a financial advisor or attorney before signing any document you don’t understand.


• Paying with checks and credit cards instead of cash to have records of transactions.

Tips for Family and Friends

Family and friends can also help by being aware of the many ways in which an older person may be financially exploited. There are many scams and frauds that attempt to get bank account information or Social Security numbers from the elderly to steal their identity or money. Be on the lookout for signs of possible financial abuse, including:

• Unexplained account withdrawals.


• Another individual unexpectedly making financial decisions on the older person’s behalf.


• Disappearance of funds or valuable possessions.


• Unanticipated transfer of assets to another individual.


• Sudden changes to a will or other important financial documents.


• Suspicious signatures on checks.

If you suspect elder financial abuse, talk to the victim to determine what is happening and who is involved. For instance, you’ll want to know whether a new person in their life is helping them manage their money or a relative is using their credit card without permission. If financial abuse seems likely, you may want to contact your state’s adult protective services and the local police for assistance.

You should also contact any bank or other financial institution involved to notify them of the potential abuse, and they may be able to assist you. They may not be able to provide you with specific information about accounts or transactions due to privacy laws, but they have the ability to review information for potential abuse as well as the resources to report abuse.

Also be aware of consumer financial protection regulations that help protect funds withdrawn from an account without authorization. For example, most cases of fraud and identity theft are committed using an access device, such as when an individual steals an older person’s debit card and pin number to withdraw money from a checking account.

The Electronic Fund Transfer Act, which is implemented through Regulation E, protects consumers from losses that may occur as a result of certain unauthorized electronic financial transactions, such as unauthorized ATM withdrawals and point-of-sale terminal transfers in stores. If a debit card or the card number is used to make an unauthorized withdrawal from a checking or savings account, you can minimize your losses by contacting your bank as soon as possible. Your maximum liability under Regulation E is $50 if you notify your bank within two business days after learning of the loss. Additionally, many credit card issuers have zero-liability policies, meaning that customers typically do not pay for unauthorized transactions, so contact your credit card issuer as soon as you discover any.

For more information on elder financial abuse, visit:

https://www.consumer.ftc.gov/blog/2015/08/spotting-elder-financial-abuse

https://www.consumerfinance.gov/practitioner-resources/resources-for-older-adults/protecting-against-fraud/

For more help or information, go to FDIC.gov or call the FDIC toll-free at 1-877-ASK-FDIC (1-877-275-3342).

 We are launching a new “Tell YOUR Story” tool that will enable residents, families, ombudsmen, and those who work with them tell their story about nursing home or assisted living care.

The form is available on our website at https://nursinghome411.org/tell-your-story/.
 
One can fill out the form on the website, download it to fill out on a computer or phone, or print out a hard copy to mail in. All personal identifying information is kept confidential unless the individual provides specific permission otherwise.
 
Stories about resident care can have an enormous impact on advocacy for better care and dignity. We would appreciate any help you can provide in getting the word out and passing this along!
 
Other news from LTCCC…

1. Dementia Care & Antipsychotic Drugging.
   
2. We have just published the latest antipsychotic drugging rates for all U.S. nursing homes and citations for inappropriate drugging. Sadly, recent data indicate that drugging rates are no longer going down! https://nursinghome411.org/learning-center/dementia-care-antipsychotic-drugging/  [Please note that some facilities with a low resident population are not included in these data.]
   
3. Safe Staffing.
   
4. We recently published the staffing levels for all U.S. nursing homes in easy-to-use files. Staffing is critical to quality, yet too many nursing homes have insufficient staffing. For the first time, these files include city and county information, to make searching for your nursing home, or those in your community, even easier. https://nursinghome411.org/nursing-home-data-information/staffing/
   
5. Resident & Family Councils.
   
6. We have issued a new Issue Alert on family and resident council rights, https://nursinghome411.org/ltccc-issue-alert-resident-family-councils/ and have launched our new Family & Ombudsman Resource Center, https://nursinghome411.org/families-ombudsmen/.
   
7. Webinars on Quality of Care & Resident-Centered Advocacy.
   
8. Please join us for our next free “lunch-and-learn” program on November 20 at 1pm Eastern. Topic: Making Your Voice Heard in the Nursing Home… and Beyond. https://nursinghome411.org/upcoming-webinars-nursing-home-care-resident-centered-advocacy/
   
9. New Report on Assisted Living: Promising Policies and Practices. https://nursinghome411.org/ltccc-report-assisted-living-promising-policies-and-practices/
   

All of these resources are free to use and share. If you would like to sign up for future updates and alerts, please email info@LTCCC.org.
 
Sincerely yours, Richard
 
Richard J. Mollot, Executive Director
The Long Term Care Community Coalition
One Penn Plaza, Suite 6252
New York, NY 10119
Phone: 212-385-0355
www.nursinghome411.org

How Criminal Steal $37 billion a year from the elderly
by Nick Leiber, Bloomberg.

Marjorie Jones trusted the man who called to tell her she’d won a sweepstakes prize, saying she could collect the winnings once she paid the taxes and fees. After she wired the first payment, he and other callers kept adding conditions to convince her to send more money. 

As the scheme progressed, Jones, who was legally blind and lived alone in a two-story house in Moss Bluff, Louisiana, depleted her savings, took out a reverse mortgage and cashed in a life insurance policy. She didn’t tell her family, not even the sister who lived next door. Scammers often push victims to keep promised winnings a secret, says an investigator who helped unravel this sinister effort to exploit an 82-year-old woman.
 
Her family didn’t realize something was wrong until she started asking to borrow money, a first for a woman they admired for her financial independence. But by then it was too late, says Angela Stancik, one of Jones’s granddaughters. Jones had lost all of her life savings—hundreds of thousands of dollars.

About one week after calling Stancik at the family business in Ganado, Texas, to borrow $6,000, Jones committed suicide.

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ADRC is a FREE service to help people learn about public and privately paid options to address aging or disability needs, or to help families and caregivers.  Anyone in Oregon can use the service for themselves or their families.

To access the service, just call 1-855-673-2372, enter the elder's residence zip code, and get connected with the nearest ADRC office.  

Website:  www.ADRCofOregon.org
 
“When you are looking for information about services to address aging or disability needs, the Aging and Disability Resource Connection of Oregon can help you learn about public and privately paid options in your local community.  The ADRC has trained professional staff who can help you and your family with immediate needs, or help you plan for the future.  The ADRC of Oregon is a statewide resource for everyone, regardless of income level, and can be reached by calling a toll-free number, visiting a website, or by contacting a local ADRC office.”

Sep11
Vulnerable Nursing Home Patients Need Ability to Sue in Court as Government Agencies Fail to Protect Them
By Leslie Bailey, Staff Attorney, Public Justice

According to a new report just released by the Center for Investigative Reporting and reported by KQED, the failure of California regulators to adequately investigate and pursue claims of abuse and misconduct by nursing assistants and health aids is “putting the elderly, sick, and disabled at risk.” In fact, the regulators that are charged with protecting vulnerable patients in nursing homes and assisted living facilities are either conducting “cursory and indifferent” investigations, or simply closing cases without taking any action at all. The report underscores how critically important it is for people to have the ability to sue when loved ones are harmed by nursing home neglect—or worse.

Take Elsie Fossum. One morning in July 2006, the 95-year-old was found lying in a pool of blood, her arm broken and her face described by the registered nurse in charge at the nursing home as “beaten to a pulp.” Within a few weeks, Elsie died as a result of the wounds she’d suffered. A nurse suspected one of the nursing assistants, and a report was filed with the Department of Health. But according to KQED, the agency shelved the case for 6 ½ years and finally closed it without any investigation. 

The CIR report paints a grim picture. There are approximately 160,000 nursing assistants and in-home health aids working at hospitals, nursing homes, and mental health facilities throughout California. As of 2009, the backlog of reported abuse and theft cases was so high that is was deemed a “crisis.” But rather than prioritize investigating, according to the report, “the state Department of Public Health quietly ordered investigators to dismiss 1,000 pending cases … often without a single phone call.” While the number of cases closed without action is on the rise, the main tool by which the agency is supposed to protect patients from abuse—revoking the licenses of nursing home employees—has plummeted in recent years. In other words, the abusers are permitted to continue working at their jobs, where they can continue to commit more horrific abuse. It’s gotten so bad that even a former Public Health director warns Californians: “do not count on the government taking care of you.” 

Fortunately, we have the civil justice system, and anyone whose loved one is abused in a nursing home can file a lawsuit – right? Think again. As the Wall Street Journal reported, nursing homes—like pretty much all other businesses—are increasingly jumping on the forced arbitration bandwagon.  That is, they’re requiring everyone who checks in to sign a contract forfeiting their constitutional right to sue. Instead, per the fine print, any claims against the home or its employees must be brought in private arbitration, in a secret proceeding before a hired gun chosen by the nursing home. But of course, the last thing on your mind when you’re in the painful process of admitting an elderly parent to a home is the fine print of the nursing home’s multi-page contract. The nursing home, of course, knows exactly what it’s doing: a study done by the nursing home industry itself found that as arbitration has increasingly replaced court as the forum for dispute resolution, the amount of money recovered by abuse victims and their families has decreased—even as complaints about poor treatment have risen.  

If the government agencies charged with protecting our loved ones aren’t up to the task, then the only way to prevent more horrific abuses like that of Elsie Fossum is through private litigation. But the nursing homes know this, and they’re doing everything they can to use forced arbitration to exempt themselves from lawsuits. It’s time to fight back.

If you are facing an arbitration clause in a nursing home case, we can help. Email Leslie at lbailey@publicjustice.net or Paul Bland at pbland@publicjustice.net

For more information, you can also read our article, "Combating Abusive Arbitration Clauses in Nursing Home Contracts."