Health inspection·December 28, 2023

F 0602 Protect each resident from the wrongful use of the resident's belongings or money. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review, resident and staff interview, review of a facility self-reported incident (SRI), review of witness statements, review of a local law enforcement report, review of bank records, review of Quality Assurance Performance Improvement (QAPI) notes, review of a signed acknowledgement, and review of the facility policy, the facility failed to ensure a resident was free from misappropriation of money. This affected one (#02) of three residents reviewed for misappropriation. The facility census was 46. Residents Affected - Few Findings include: Review of the medical record revealed Resident #02 was admitted to the facility on [DATE]. Diagnoses included multiple sclerosis, depression, anxiety, legal blindness, chronic pain, muscle weakness, lack of coordination, and tremors. Review of the quarterly Minimum Data Set (MDS) assessment, dated 11/14/23, revealed Resident #02 had a moderate cognitive impairment. Review of the nursing progress note dated 12/08/23 and timed 5:59 P.M. revealed Resident #02 stated he was missing money from his account. The resident's bank card was stopped and the police were notified. Review of a subsequent nursing progress note dated 12/08/23 and timed 6:35 P.M. revealed the resident's bank card was stopped and a new card was locked in the Director of Nursing's (DON) office. Review of the social service notes dated 12/08/23 and timed 7:31 P.M. revealed Resident #02 stated he was missing money. A police report was filed. The resident was upset but doing okay. Review of the nursing progress note dated 12/11/23 and timed 1:08 P.M. revealed Resident #02 requested to have his bank card. The bank card was given to the resident and the resident was instructed to keep the card in a safe place and not give it to anyone. The resident verbalized understanding. Review of the SRI dated 12/08/23 and timed 5:55 P.M., revealed on 12/08/23 at 3:00 P.M., Resident #02 was taken to the bank by Social Service Designee (SSD) #200 and Activities Director #201. The resident wanted to go to the bank to get statements, as his debit card was declined when he tried to use it. The statements were given to the resident while at the bank, and several withdrawals were made which the resident did not make. Upon returning to the facility, the Administrator and Director of Nursing (DON) were notified and the police were contacted. The resident's statement indicated Activities Assistant #105 made several unauthorized cash transfers and online store purchases from the resident's account. Activities Assistant #105 was contacted by the Administrator and DON for a written Page 1 of 4 365885 365885 12/28/2023 Concord Care and Rehabilitation Center 620 W Strub Rd Sandusky, OH 44870

F 0602 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few statement and was removed from the schedule pending investigation. The resident's card was stopped with a new one initiated. A bank new card was locked in the DON's office until the resident wanted it back. The police took a statement from Resident #02. The facility substantiated the allegation of misappropriation. Review of the written statement provided by SSD #200, revealed the staff member accompanied Resident #02 to the bank on 12/08/23 due to the resident being legally blind. The resident requested the bank teller cancel his previous debit card due to losing it. The resident also requested to withdraw money from his account and asked how much he had. The bank teller informed the resident there was $226.00 in his account. The resident stated he had not made any purchases during the month, other than at the vending machine a couple of times. The bank teller then showed SSD #200 the transaction history after obtaining permission from the resident to do so. SSD #200 noticed several cash transfers using an application called Cash App, as well as several purchases from an online retailer. SSD #200 asked the resident if he used Cash App or made purchases from the online retailer, and the resident responded he had not. The bank teller was able to pull up an individual Cash App transaction, which showed the first and middle name of Activities Assistant #105. A second name (Unknown Person #192) was also found on a transaction. SSD #200 notified the Administrator while at the bank that Resident #02's bank account was almost depleted and SSD #200 believed it was an due to an employee. Upon returning to the facility, SSD #200 took the resident and transaction history to the Administrator's office with the DON present as well. The Administrator and DON verified the name on the statement matched the employee. The police were called and a report was made. Review of the local law enforcement report, dated 12/08/23 and timed 4:55 P.M., revealed the police were called regarding a theft at the facility. The responding officer spoke with the Administrator and SSD #200. The staff members advised they were made aware of a possible theft. The staff members advised an activities assistant would assist residents in trips to stores and would have access to credit/debit cards in situations where residents could not typically shop alone. The staff advised they were made aware of possible bank fraud. The Administrator provided the officer with a bank statement which showed numerous transactions to a Cash App account. The statement also showed purchases from an online retailer, a women's clothing retailer, and partial Cash App transactions to another account. The officer then spoke with Resident #02, who advised he did not use Cash App in any way as he was legally blind and did not shop at the online retailer. Resident #02 reported all of the shopping he did was in person or with assistance by the activities aides. Resident #02 advised he did not authorize any transfers to either of the two Cash App accounts. The officer went over the statement and the resident advised which transactions could have been his. The resident advised he wished to pursue the matter criminally if possible, and was provided with a victim's rights form. The officer located at least nine transactions for the online retailer on the statement. The total value of the reported fraudulent transactions was $3,329.72, which was cumulative for both the online retailer and Cash App accounts. Review of the local law enforcement supplement, dated 12/12/23, revealed the officer received an emailed copy of requested bank statements. The officer reported the statements provided an accurate number of transactions and total of money misused from Resident #02's bank account via his debit card information. There appeared to be no fraudulent transactions in the month of September 2023. The total transactions made by Activities Assistant #105, beginning on 10/16/23 and ending on 12/08/23, included 59 withdrawals for a total of $2,771.00 and two deposits for a total of $155.41. The total transactions made by Unknown Person #192 included two withdrawals (one on 10/17/23 and one on 12/07/23) for a total of $70.75. The total transactions for purchases made from the online retailer included five purchases for a total of $283.99 and five deposits for a total of $96.35. The total 365885 Page 2 of 4 365885 12/28/2023 Concord Care and Rehabilitation Center 620 W Strub Rd Sandusky, OH 44870

F 0602 for all fraudulent transactions made from Resident #02's account was $3,131.74. Level of Harm - Minimal harm or potential for actual harm Review of the written statement provided by the DON, revealed Activities Assistant #105 called the facility on 12/11/23 at approximately 2:00 P.M. and reported Resident #02 had given her his bank card to transfer money into her account because the resident was appreciative of all she had done. Activities Assistant #105 reported she transferred $50.00 into her account using Resident #02's debit card. Activities Assistant #105 stated her Cash App account, used for cash transfers, had been hacked in the past. Activities Assistant #105 stated she got a new Cash App account in August 2023 and thought she had deleted Resident #02's information. Activities Assistant #105 stated she would pay any money back. Activities Assistant #105 was informed she was taken off the schedule pending investigation. Residents Affected - Few Review of the undated written statement provided by Activities Assistant #105 revealed Activities Assistant #105 and Resident #02 went on an outing, possibly in October 2023. At that time, they went to the store to shop for winter clothing items. Afterwards, Resident #02 wanted to stop for food and cigarettes, so they did. While they were out, Resident #02 offered to give Activities Assistant #02 $50.00 for being kind. Resident #02 did not have cash so he told Activities Assistant #105 they could use an automated teller machine (ATM). Activities Assistant #105 reported there were not any ATMs around and suggested using Cash App. Resident #02 agreed and Activities Assistant #105 performed the transaction. Activities Assistant #105 then disconnected the card and gave the physical card back to Resident #02. Activities Assistant #105 reported her phone glitched at times and her Cash App account had been hacked in the past. Activities Assistant #105 reported she thought all of the transactions she had been making were with her own funds and had not been paying attention to any other cards linked to her account. Review of the QAPI notes dated 12/11/23, revealed a meeting was held due to a concern of misappropriation of resident funds. The facility identified the system to keep residents safe from misappropriation had failed. During interview on 12/27/23 at 9:28 A.M., Resident #02 confirmed he had money come up missing and found out a staff member had taken his bank card and was using it. During interview on 12/27/23 at 12:50 P.M., the Administrator confirmed the staff member had misappropriated funds using Resident #02's bank card. The Administrator reported Unknown Person #192 was Activities Assistant #105's [AGE] year-old daughter. During a phone interview on 12/27/23 at 2:16 P.M., Activities Assistant #105 reported Resident #02 had allowed her to take $50.00 from his bank account via Cash App a couple of months ago. Activities Assistant #105 reported thinking the resident's bank card from been removed from Cash App and did not realize she had been continuing to make charges from the resident's account. Review of the signed acknowledgment, dated 06/23/23, revealed Activities Assistant #105 signed acknowledging receiving and agreed to abide by the policy titled Residents Right to Freedom from Abuse, Neglect, and Exploitation Policy and Procedure. Review of the undated facility policy titled, Residents Right to Freedom from Abuse, Neglect, and Exploitation Policy and Procedure, revealed residents had the right to be free from abuse, neglect, misappropriation of their property, and exploitation. 365885 Page 3 of 4 365885 12/28/2023 Concord Care and Rehabilitation Center 620 W Strub Rd Sandusky, OH 44870

F 0602 This deficiency represents non-compliance investigated under Complaint Number OH00149286. Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few 365885 Page 4 of 4