MALTREATMENT INVESTIGATION MEMORANDUM
Office of Inspector General, Licensing Division
Public Information

Minnesota Statutes, section 626.557, subdivision 1 states, “The legislature declares that the public policy of this state is to protect adults who, because of physical or mental disability or dependency on institutional services, are particularly vulnerable to maltreatment.”

License Number and Program Type:

1070479-H_CRS (Home and Community-Based Services-Community Residential Setting)
1070470-HCBS (Home and Community-Based Services)

Investigator(s):

Emily Kearns
Minnesota Department of Human Services
Office of Inspector General
Licensing Division
PO Box 64242
Saint Paul, Minnesota 55164-0242
651-431-6513

Suspected Maltreatment Reported:

It was reported that a staff person (SP) used four vulnerable adults’ (VA1’s, VA2’s, VA3’s and VA4’s) funds for personal use, including getting cash back from their debit cards at one or more retail stores.

Date of Incident(s): Multiple dates prior to April 2024.

Nature of Alleged Maltreatment Pursuant to Minnesota Statutes, section 626.557, subdivision 9c, paragraph (b), and Minnesota Statutes, section 626.5572, subdivision 15, and subdivision 9, paragraph (b), clause (1):

In the absence of legal authority a person willfully uses, withholds, or disposes of funds or property of a vulnerable adult.

Summary of Findings:

Pertinent information was obtained during a site visit conducted on April 25, 2024; from documentation at the facility, law enforcement records, banking records, and retail store records; and through ten interviews conducted with two facility supervisors (P1 and P2), VA1’s, VA2’s, VA3’s, and VA4s’ guardians, (G1, G2, G3, and G4, respectively), VA1, VA2, VA3, and VA4. Although attempts were made by phone and United States mail to contact the SP, the SP did not respond to those requests.

VA1, VA2, VA3, and VA4 each lived at the facility. The facility was a one-story residence with a lower level. A main floor consisted of a living room, a dining room, a kitchen, and a hallway with three bedrooms and a bathroom. A doorway to the right of a front door led to an attached garage. In the lower level was a bedroom, an office, a laundry room, and an open area.

According to each VA1’s, VA2’s, VA3’s, and VA4’s plans:

· VA1 was diagnosed with attention-deficit hyperactivity disorder (ADHD), anxiety, dysthymia (a mild, long-lasting form of depression), and a mild intellectual disability. VA1 enjoyed competing in the Special Olympics, shopping, dancing at a local club, and spending time with family members.

· VA2 was diagnosed with pervasive development disorder, ADHD, static encephalopathy, and a mild intellectual disability. VA2 enjoyed spending time with his/her family, looking at magazine, playing with Legos, and looking for bugs.

· VA3 was diagnosed with ADHD, a depressive disorder with psychotic features, anxiety disorder, intermittent explosive disorder, and schizoaffective disorder. VA3 enjoyed playing video games, eating at Culver’s, shopping at Wal-Mart, and dreamt of having a woodworking job.

· VA4 was diagnosed with schizophrenia, schizoaffective disorder- bipolar type, and organic personality disorder. VA4 enjoyed listening to music, watching TV, and going to church.

This investigation was conducted with law enforcement and a law enforcement officer (LEO).

Facility documentation and interviews with P1 and P2 showed that the SP worked at the facility from August 2022 until April 2024. The SP was typically in charge of the clients’ accounts and approving their purchases in advance. Each client had their own “pouch” which contained their debit card and any receipts from purchases. The SP would tell the staff person or client how much they were allowed to spend when they went out in the community. Clients were typically not to have cash in their pouch so if a client needed cash, the SP was supposed to fill out a cash tracking form to document this.

Generally, when the clients’ funds were spent, the staff person or client would bring a receipt back to the facility and the SP would record the purchase and balance the client’s account. The SP was responsible for the cleints’ debit cards “90% of the time” in a locked cabinet with several other staff persons having access to the debit cards after receiving permission from the SP. One of the SP’s responsibilities was to submit monthly reports of funds spent for each client to P2. The SP was not doing that and was several months behind.

P1 and P2 provided the following information:

· Approximately six weeks prior to this interview, P2 noticed “discrepancies” in the receipts of the VAs’ accounts at the facility. P2 asked the SP for receipts for those purchases. The dollar amount was “high” compared to what the VAs typically spent. The SP was asked to get receipts from Walmart and s/he “blew us off.” The SP was given “coaching” and s/he agreed to get the receipts, but never produced any after several weeks. P2 went to Walmart and started looking at the VAs’ receipts and saw that there were multiple “small” purchases where a candy bar or cupcake was purchased and there would be $100 cash back withdrawals on the purchase. There were multiple transactions like this involving the VAs at Walmart and at County Market in North Branch.

· Some of the transaction times of cash withdrawals were when the SP was not working according to his/her timesheets. The SP could not produce any cash tracking forms for the transactions in question. There were no missing receipts from occasions other staff persons took out the VAs and helped them to use their debit cards.

· On April 13, 2024, P1 and P2 cleaned up the office and removed all the VAs’ debit cards and checkbooks. On April 15, 2024, P1 and P2 asked the SP to talk at the facility. When P1 and P2 talked to the SP, s/he denied taking any money or using the VAs’ debit cards for personal use. The SP repeatedly said, “I don’t know,” when asked about the cash back purchases. After the conversation, when P1 and P2 went back into the office that day, one of the clients’ checkbooks was sitting in the office next to the desk. It had not been there two days prior.

The facility’s Internal Review showed that the SP was in a supervisor position at the facility overseeing the VAs’ finances. Several times, the SP was asked to provide receipts for one of the VA’s checkbooks as there were “larger withdrawals” with no receipts to back them up. The SP continued to tell the facility that s/he had the receipts or would go to the retail facility (Wal-Mart) to get the receipts. After several requests, the SP received “coaching.” The SP failed to bring in the receipts and so P2 went to Wal-Mart to get the receipts at which time, it was determined that there had been cash withdrawals on multiple VAs’ accounts. On April 15, 2024, the SP was called into the facility and was “questioned” about this. The SP could not explain why or how the funds were taken from the VAs’ accounts.

The LEO provided the following information:

· On April 13, 2024, the facility contacted law enforcement regarding suspicion of the SP’s improper use of VA1’s and VA2’s funds. The facility sent the LEO some receipts and gave the LEO information that the SP had made purchases that consisted of purchasing a small item and then making cash back withdrawals using the VAs’ debit cards. This occurred at Wal-Mart and County Market on dates or times outside of the SP’s work schedule. Initially, it was thought that VA1 and VA2 were the only clients at the residence whose funds were used because VA3 and VA4 “manage their own funds.” (Investigator’s note: It was later determined that the SP used VA3’s and VA4’s funds as well.)

· County Market did not have any video or still images of any of the transactions in question.

· Wal-Mart provided video and still images that showed the SP, who appeared to be alone, on multiple dates, at the machine where cash back was taken out of each of the VAs’ accounts using their debit cards.

· The SP used VA1’s debit card to obtain cash and make purchases in the amount of $940 that was not used for VA1.

· The SP used VA2’s debit card to obtain cash and make purchases in the amount of $340 that was not used for VA2.

· The SP used VA3’s debit card to obtain cash and make purchases in the amount of $260 that was not used for VA3.

· The SP used VA4’s debit card to obtain cash and make purchases in the amount of $780 that was not used for VA4.

VA1 provided the following information:

· VA1 went to the bank with the SP to withdrawal $900 cash for camp. VA1 said that the bank saw the SP’s ID and the next day, the SP still had $900 cash in his/her wallet. VA1 said that camp had not yet been paid for and wondered if the SP took the money to his/her house and “forgot to mail” it.

· VA1 received paychecks on direct deposit about every other week but gave the paystub to the SP when s/he was paid and the SP would document them on a computer program. When VA1 gave the SP his/her paystub, VA1 saw an open envelope with cash still in the SP’s possession. VA1 had only gone to the bank with the SP one time to get that money and s/he showed them his/her ID as well.

· VA1 went to Wal-Mart with the SP once for VA1’s personal needs and used his/her debit card him/herself unless s/he needed help using it. VA1 never got cash back and said that the SP would not let him/her get cash back. When the debit transactions would happen and the cash back question would pop up, the SP told VA1 not to get cash back and s/he would not get it. The SP should not have VA1’s debit card with him/her if VA1 was not with the SP. VA1 was not allowed to hold onto his/her own debit card, and it was stored in the staff person office or in the “med[ication] box” on the main floor of the facility. The debit card was stored in a blue pouch with a clear “window” which stored receipts in addition to the card. When the card was not in use, the pouch was kept at the facility. When VA1 went shopping with his/her family member, they also did not get cash back on debit purchases. When VA1 went out to eat with the SP, the SP paid for his/her own food.

· The LEO showed VA1 a picture of a person at Wal-Mart. VA1 stated that the person pictured was the SP. (Investigator’s note: The image was a picture of the person who used VA1’s debit card while at Wal-Mart.)

· One of the Wal-Mart receipts showed two candy bars purchased with cash back. When asked, VA1 recalled getting two candy bars with the SP as a “reward” but the SP took the cash back to the facility. VA1 could not remember when this occurred.

VA2 provided the following information:

· VA2 banked at Associated Bank and a new debit card had just been ordered for him/her, but s/he did not know what happened to the old one but it was no longer working.

· Staff persons kept VA2’s debit card in VA2’s files or the book. VA2 was shown a zippered pouch and stated that s/he had his/her own pouch with VA2’s name on it which was stored in a three-ring binder.

· VA2 thought that s/he had not been to Wal-Mart in two to three years and that s/he had been there since living in this facility for the last several years. When VA2 went to Wal-Mart, s/he generally bought snacks like candy, pop, or sometimes an action-figure or book. Staff persons who accompanied VA2 would use the debit card and would sometimes get cash back but would get cash back for “buying stuff” or s/he would give the cash directly to staff persons in case VA2 wanted to spend it on something else like a garage sale.

· VA2 had a wallet and used to bring it with him/her to the store but did not bring it anymore “at all.” VA2 did not keep cash in his/her wallet but kept coins that were given as change at times or coins s/he found on the ground. VA2 remembered a time that s/he went to Wal-Mart, got cash back, and gave it to a staff person but could not remember what happened with the cash afterwards. Another staff person (not the SP), who was one of the drivers for the facility, usually drove VA2 to Wal-Mart.

· When VA2 went to Wal-Mart, s/he typically bought “lots” of items. VA2 would not go to Wal-Mart to only buy a candy bar. There were stores that sold candy bars closer to the facility than Wal-Mart.

· VA2 did not do anything with his/her banking and staff persons took care of that for VA2. VA2 did not know that someone had been using his/her funds without permission. VA2 could not buy action figures in the last month because the SP stated that VA2 did not have enough funds.

· VA2 liked the SP and wanted the SP to come back and keep working at the facility. VA2 “trust[ed]” staff persons at the facility and did not have any issues with the SP.

VA3 provided the following information:

· Each client had their own financial “pouch.” Staff persons typically brought the clients’ financial “pouches” along when they went shopping. VA3 sometimes carried cash. A facility driver took VA3 to Wal-Mart and VA3 used his/her debit card which was held onto by whichever staff person brought VA3. VA3’s debit card was kept in the office drawer. Sometimes the SP would take VA3 to Wal-Mart and would assist VA3 with using his/her debit card. VA3 knew his/her debit card personal identification number (PIN), but usually the SP entered the PIN while VA3 got his/her stuff and grabbed the receipt. Sometimes the SP let VA3 get cash out but s/he would only “hold onto it” and tell VA3 what s/he could spend it on. VA3 would bring his/her wallet when they went shopping,

· The SP was holding on to VA3’s money for summer camp in the facility office desk drawer. Summer camp cost “a lot of money.” There was no cash or pouch belonging to VA3 in the facility office desk drawer.

· The SP would take VA3 out to get food and the SP usually paid for VA3’s food. VA3 did not know if s/he ever got cash back when using his/her debit card.

· VA3 worked around the facility and facility property, picking up sticks to earn some income. When VA3 got a paycheck, it went into the bank “right away” and the SP would show VA3 how much money s/he had in his/her account.

· VA3 knew where s/he banked, but “could not read” so the facility took care of “that stuff.” VA3 trusted everyone at the facility with his/her funds.

· VA3 said that s/he remembered using his/her debit card “once” in November 2023 for a candy bar and $80 cash back. VA3 also remembered getting candy and pop and got $60 cash back. When the LEO again asked VA3 what s/he would do with his/her cash back, s/he stated that it was “free” and “you guys don’t have to pay me back.” The LEO asked VA3 about a time in March 2024 where crescent rolls were purchased and then $60 cash back was taken out. VA3 said, “Recently?!” and then stated that s/he never went there. VA3 next said, “Whomever is using my card is without my permission.”

· The LEO showed VA3 a photograph and asked who was in the photograph. VA3 stated that it was VA3 and the SP at Wal-Mart. VA3 asked why the SP “did that.” The LEO told VA3 that when someone was using his/her card and was getting cash back, it costs VA3 money. The LEO said that image was from January 2024. VA3 remembered going to Wal-Mart with the SP. The LEO explained to VA3 that there was a video where VA3’s debit card was “swiped” and when the cash came out, the SP took it and put it in his/her wallet. VA3 was surprised by this.

· All of the clients had a pouch with their own name on it. They were blue. VA3 said when they got receipts and cash back, the cash and receipts should go into their pouch. VA3 said that his/her summer camp money should be in the drawer and pointed to which drawer. There was no cash in an envelope in the drawer. VA3 wanted to know why the SP was “doing this to me.”

VA4 provided the following information:

· VA4’s last paycheck was $120.10 for two weeks and generally fluctuated by five or six dollars. VA4 would bring the paystub back to the SP at the facility but the SP did not work at the facility anymore.

· VA4 “got along with” the SP. Another staff person drove VA4 to go shopping. The SP would sometimes take VA4 out to go eat. VA4 paid for his/her own food and the SP paid for his/her own food.

· VA4 did not go to Wal-Mart with the SP because the SP did not have time and had another staff person who drove brought VA4 to the store. VA4 would buy snacks and drinks with his/her debit card. Staff persons would assist VA4 with using the debit card because s/he was “new” to using it. VA4 would get cash or change back but would give it to the staff person who drove VA4 and that staff person would give it to the SP so that it could go in the bank.

· Staff persons would bring VA4’s “pouch” along and receipts would go in the pouch. The pouch stored VA4’s debit card. Any money back would also go into the pouch.

· VA4 did not think that any staff persons took cash back from VA4 after any transactions and put it in their own wallets. VA4 had never seen any staff persons, including the SP “take” money and said most staff persons were “pretty honest.” VA4 did not think the SP was “taking” his/her money.

· VA4 had never been to the store County Market located in North Branch and was adamant about not ever having been there and stated that s/he would go to the Wal-Mart in Cambridge or if there was a medical appointment for a client, they would go to the Wal-Mart in Pine City. VA4 was “surprised” to hear that there was a debit card transaction at the North Branch County Market store in December 2023. VA4 was “not aware” of that transaction and thought that staff persons or G4 would have told VA4 if his/her card was used at County Market. VA4 could not remember if s/he went to an ATM in North Branch in December because VA4’s “memory back then is not good,” but was adamant that s/he had not been to County Market. VA4 would not go to Wal-Mart and get cash back, such as $100 because that might “overdraw” VA4.

· VA4 stated that s/he would not get $60 cash back after purchasing a $1 candy bar at Wal-Mart. VA4 was also not aware of multiple debit card transactions with cash back ranging from $60 to $100s. VA4 said that s/he would get a lot of things like movies or other snacks, not just one snack or beverage. It would be “ludicrous” for VA4 to get a ride to Wal-Mart just for one candy bar.

· When LEO showed VA4 a photograph, VA4 identified the SP and VA4 as persons in the photograph and stated that they were at Wal-Mart at the time that a mint candy was purchased with VA4’s debit card and $100 cash back was given. Other photographs were shown of the SP at Wal-Mart that corresponded with dates and times and Wal-Mart surveillance footage when cash back was taken out. VA4 said that the SP was probably helping VA4 or VA4 was in the electronics section of the store at that time. The LEO asked VA4 if s/he would purchase two small snacks and get $60 cash back and later do another transaction of a soda with $100 cash back. VA4 said s/he “didn’t even know it.” VA4 could not tell what color pouch the SP was holding.

· VA4 was saving his/her funds to buy a plane ticket to see family in a few months. VA4 had $340 for the plane ticket, then said that the SP was going to buy the ticket and then “boom, [the SP] was gone.”

· VA4 stated that if money was missing, s/he would call the bank him/herself or the SP would tell him/her. When another staff person drove VA4 to the store, s/he would find out how much money VA4 could spend by asking P1 or P2. Sometimes the SP would say how much VA4 could spend.

· VA4 did not carry cash in his/her wallet unless it was “change.” If dollar bills were returned as change, VA4 would return it to a staff person so that it could go back into VA4’s bank account. One example of when VA4 would get change back would be when using a drive through at a restaurant but could not explain why s/he would use cash to pay for food when s/he usually had a debit card for paying for food.

G1 provided the following information:

· VA1 had a representative payee that managed VA1’s finances. The facility used to be the representative payee, but that changed to a third-party company about six months prior. VA1’s debit card was stored in a locked cabinet and G1 thought that “all” of the staff persons at the facility had access to the cabinet keys. When receipts were returned, G1 figured that the facility would track the receipts on a ledger. G1 had not had previous concerns with the facility’s management of VA1’s funds.

· VA1 had “wants and needs” items that s/he would buy for him/herself. When G1 took VA1 shopping, s/he would get the debit card from the facility and hold onto the card until it was time to pay. G1 “always” saved the receipts, and VA1 also knew to save the receipts, often saying, “I need a receipt for that,” after spending money and would put the receipt into a bag to bring back to the facility. It was the facility’s responsibility to track what was spent, so G1 made sure to turn in receipts each time after shopping.

· G1 “never” had VA1 get cash back from debit transactions because VA1 “didn’t need” to carry cash around. VA1 was “allowed” to carry about $20 and was not sure if there was a policy in place regarding the $20 limit. There would not be a reason to carry cash because VA1 could just use the debit card for purchases. VA1 knew the PIN for the debit card but did not have unsupervised time in the community and was not able to shop without G1 or staff persons. Since VA1 did not shop with cash, everything s/he purchased would be shown on his/her monthly bank statements.

G2 provided the following information:

· When VA2 moved into the facility several years prior, the facility was VA2’s representative payee and was responsible for managing VA2’s finances. In the last six months or so, the facility was no longer VA1’s representative payee and G2 was asked to get a “rep payee” for VA2.

· The facility now “controlled” VA2’s checkbook but VA2 did not have it in his/her possession. When VA2 used the checkbook, facility staff persons would write out the check and VA2 would sign it. G2 did not think the facility would allow VA2 to write a check for cash back because it was “encouraged not to have money” in his/her wallet. The checkbook was kept in the SP’s office.

· VA2 was capable of providing information but would sometimes say “I don’t know” if s/he did not trust the person s/he was talking to. As long as a person asked VA2 to “think about it,” VA2 might pause, but then tell you. G2 did not know what VA2 knew about his/her finances.

G3 provided the following information:

· The county was VA3’s representative payee and G3 did not handle anything financial for VA3 but made suggestions or approved of things VA3 would ask to purchase. VA3 would only ever be given approximately $10 in cash at the time of an outing without access to credit cards. VA3 only did cash transactions as far as G3 knew. G3 said that if VA3 had a debit card, that it would be “secured” in the facility office and only to be used with staff persons, and not kept in VA3’s possession. VA3’s representative payee would sometimes send checks to be cashed, and those funds would be “secured” by staff persons. G3 did not know how VA3 or the facility went about getting out the cash for VA3’s spending. G3 did not think that VA3 would remember his/her debit card PIN. VA3 had never talked to G3 about getting cash back from a debit transaction and G3 did not think VA3 would ever get cash back on something like that. G3 also directed VA3 to save $7 from each check to use for “wants” and the SP went over “wants” versus “needs” with VA3.

· G3 felt as though VA3 was “picking up on” something going on with the SP and the facility, but later, the SP was still working at the facility, so G3 wasn’t sure how to evaluate that information. VA3 was “75% capable” of “reporting accurately” but s/he might not be able to give info accurately with “every situation.” VA3 might “know something [was] wrong,” but would not know “what [was] wrong.”

G4 provided the following information:

· G4 was VA4’s representative payee but did not have anything to do with VA4’s personal needs or bank account. The facility notified G4 of the misuse of VA4’s funds and asked G4 to cancel VA4’s debit cards, but G4 was unable to. G4 sent “personal needs” money and VA4’s paycheck also went into that account. VA4’s social security funds went to G4, so that was “safe.” VA4 got around $100-$125 a month for personal needs based on his/her social security check which s/he typically spent on snacks, bowling, hygiene products, and saving for a flight to visit family. VA4 recently asked G4 to set $25 aside for him/her each month to save for the flight. VA4’s paychecks ranged from $20 - $100, twice per month. G4 was unsure if the facility had a policy about not carrying cash but stated that the facility had to get approval for any spending over $100.

· G4 typically got quarterly “petty cash” statements for VA4 but had not gotten those from the facility for “a while.” Sending the quarterly statements was the SP’s responsibility. The SP typically would send G4 VA4’s check stubs each month to report to social security. The SP filed VA4’s 2023 income taxes. G4 thought that VA4 would get a tax refund but was not sure. G4 would not have seen the refund if it deposited into VA4’s personal checking account because s/he did not manage the personal checking account. The SP helped VA4 set up his/her personal checking account. G4 “approved” of the SP helping with this and recommended which bank to use.

· VA4 had a “really good” memory, would “tell the truth,” and did not like to get “anyone in trouble.”

· According to VA4’s plans, VA4 had limited “budgeting skills” and limited understanding of financial matters. VA4 did not recognize situations where s/he was at risk of financial exploitation and would not report financial mismanagement. VA4 could carry $20 cash on his/her person for special occasions. Staff persons would help him/her maintain all receipts and track cash. If VA4 requested, s/he could carry one of his/her blank checks when staff persons were present and could write out the check with staff person’s assistance. VA4 could sign his/her own checks. The facility was responsible for monitoring VA4’s checking account, savings account, and cash on hand.

Facility information showed that the SP and all staff persons interviewed for this investigation were trained on the VAs’ plans and the Reporting of Maltreatment of Vulnerable Adults Act.

Conclusion:

A. Maltreatment:

Information showed that on multiple dates prior to April 2024, the SP used the debit cards of VA1, VA2, VA3, and VA4 for purchases and cash withdrawals which was not used for the VAs. The SP took $940 of VA1’s funds, $340 of VA2’s funds, $260 of VA3’s funds, and $780 of VA4’s funds.

Although he SP denied using the VAs’ debit cards, given that the SP was seen on video using VA1’s, VA2’s, VA3’s, and VA4’s debit cards for purchases and cash withdrawals not for the VAs, that the SP could not explain how or why the funds were taken from the VAs’ accounts, and that the SP was unable to produce receipts for the purchases, there was a preponderance of the evidence that the SP, in the absence of legal authority, used VA1’s, VA2’s, VA3’s, and VA4’s funds.

It was determined that financial exploitation occurred (in the absence of legal authority a person willfully uses, withholds, or disposes of funds or property of a vulnerable adult).

B. Responsibility pursuant to Minnesota Statutes, section 626.557, subdivision 9c, paragraph (c):

When determining whether the facility or individual is the responsible party for substantiated maltreatment or whether both the facility and the individual are responsible for substantiated maltreatment, the lead agency shall consider at least the following mitigating factors:

(1) whether the actions of the facility or the individual caregivers were in accordance with, and followed the terms of, an erroneous physician order, prescription, resident care plan, or directive. This is not a mitigating factor when the facility or caregiver is responsible for the issuance of the erroneous order, prescription, plan, or directive or knows or should have known of the errors and took no reasonable measures to correct the defect before administering care;

(2) the comparative responsibility between the facility, other caregivers, and requirements placed upon the employee, including but not limited to, the facility’s compliance with related regulatory standards and factors such as the adequacy of facility policies and procedures, the adequacy of facility training, the adequacy of an individual’s participation in the training, the adequacy of caregiver supervision, the adequacy of facility staffing levels, and a consideration of the scope of the individual employee’s authority; and

(3) whether the facility or individual followed professional standards in exercising professional judgment.

The SP was trained on the Reporting of Maltreatment of Vulnerable Adults Act. The SP was responsible for the financial exploitation of VA1, VA2, VA3, and VA4.

C. Recurring and/or Serious Maltreatment:

The Office of Inspector General is required to evaluate whether substantiated maltreatment by an individual meets the statutory criteria to be determined as “recurring or serious.”  Individuals determined to be responsible for recurring or serious maltreatment are disqualified from providing direct contact services. 

Minnesota Statutes, section 245C.02, subdivision 16, states:

“Recurring maltreatment” means more than one incident of maltreatment for which there is a preponderance of evidence that maltreatment occurred and that the subject was responsible for the maltreatment.

Minnesota Statutes, section 245C.02, subdivision 18, states:

"Serious maltreatment" means sexual abuse, maltreatment resulting in death, neglect resulting in serious injury which reasonably requires the care of a physician whether or not the care of a physician was sought, or abuse resulting in serious injury.  For purposes of this definition, "care of a physician" is treatment received or ordered by a physician, physician assistant, or nurse practitioner, but does not include diagnostic testing, assessment, or observation; the application of, recommendation to use, or prescription solely for a remedy that is available over the counter without a prescription; or a prescription solely for a topical antibiotic to treat burns when there is no follow-up appointment.  For purposes of this definition, "abuse resulting in serious injury" means: bruises, bites, skin laceration, or tissue damage; fractures; dislocations; evidence of internal injuries; head injuries with loss of consciousness; extensive second-degree or third-degree burns and other burns for which complications are present; extensive second-degree or third-degree frostbite and other frostbite for which complications are present; irreversible mobility or avulsion of teeth; injuries to the eyes; ingestion of foreign substances and objects that are harmful; near drowning; and heat exhaustion or sunstroke.  Serious maltreatment includes neglect when it results in criminal sexual conduct against a child or vulnerable adult.

It was determined that the substantiated financial exploitation for which the SP was responsible was “recurring” maltreatment because the SP took funds from VA1, VA2, VA3, and VA4 on more than one occasion.

The SP was disqualified from providing direct contact services.

Action Taken by Facility:

The facility completed an Internal Review and determined that its policies and procedures were adequate, but not followed. There was no similar incident previously. P1 and P2 were monitoring the VAs’ funds more closely. The facility changed the locks, canceled the VAs’ debit cards, and obtained new debit cards for each VA. The SP no longer worked for the facility.

Action Taken by Department of Human Services, Office of Inspector General:

The SP was disqualified from a position allowing direct contact with, or access to, persons receiving services from programs, organizations, and/or agencies that are required to have individuals complete a background study by the Department of Human Services as listed in Minnesota Statutes, section 245C.03. The determination that the SP was responsible for maltreatment and the disqualification of the SP are each subject to appeal.

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