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MALTREATMENT INVESTIGATION MEMORANDUM 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: 1095674-H_CRS (Home and Community-Based Services-Community Residential Setting) Investigator(s): Thomas Nixon/Alice Percy 651-431-2155 Suspected Maltreatment Reported: It was reported that a check for $3,000 was written from a vulnerable adult’s (VA’s) bank account to a staff person (SP) with a forged signature. It was also reported that another check for $2,500 was written from the VA’s bank account. Date of Incident(s): April and December 2024 [The Department of Human Services did not receive the report until June 27, 2025.] 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 for this investigation was obtained remotely, including documentation from the facility; and through five interviews conducted with a facility supervisory staff person (P1), a staff person (P2), the SP, the VA, and the VA’s guardian (G). The VA enjoyed playing basketball, bowling, playing games, watching movies, and spending time with his/her friends and family members. The VA’s diagnoses included bipolar disorder, mild cognitive delays, and fetal alcohol syndrome. Law enforcement was notified about the allegations but did not open an investigation. The VA’s Individual Abuse Prevention Plan (IAPP) stated that the VA was at risk of financial exploitation and did not have a good understanding of his/her finances, including budgeting and banking. The VA would not recognize mismanagement of his/her finances. The VA’s Funds and Property Authorization form stated that the facility was authorized to assist the VA in safekeeping of his/her funds and property. The staff persons were not allowed to borrow money from the VA and were required to keep the VA’s funds separate from that of the facility or the staff persons. The G provided the following information: · Each month, the G provided the VA with $120 for his/her personal needs. The VA did not provide receipts for the items s/he purchased with the money. The VA recently found out that s/he had a checking account which s/he and the facility had “forgotten” about. The G believed that “a couple years earlier,” the bank stopped sending monthly statements through the mail and went to on-line banking. · Recently, a staff person told the G that the VA found out about the bank account and made two withdrawals. The G then went to the bank and put restrictions on the VA’s bank account so the VA was unable to withdraw additional money. The G discovered that a check for $3,000 was written on the VA’s bank account to a staff person. The handwriting on the check was not the VA’s handwriting and the check appeared to be a “temporary check” that was gotten at the bank. The following day, $3,000 was deposited back into the VA’s bank account. · There were also several automatic withdrawals from the VA’s bank account for a cell phone company and cable television services, but the VA was not responsible for paying for those services. The G believed if the VA withdrew $2,500 from the bank account, s/he or the staff persons would find items that the VA purchased with that money and that was not the case. A review of the VA’s bank statements provided the following information: · On March 29, 2024, an electronic withdrawal of $160.49 was paid to T-Mobile. · On April 5, 2024, an electronic withdrawal of $226.22 was paid to Comcast. · On April 8, 2024, a check dated April 4, 2024, and made out to the SP for $3,000, was cashed. The notation in the memo line of the check was “Vehicle Service.” [Note: The VA was unable to fill out a check due to his/her diagnoses and did not have a vehicle.] · On April 9, 2024, a deposit of $3,000 was made into the VA’s checking account. · On May 23, 2024, an electronic withdrawal of $152.22 was paid to Comcast. · On June 11, 2024, an electronic withdrawal of $115.83 was paid to Comcast. · On June 14, 2024, an electronic withdrawal of $99.99 was paid to Comcast. · On June 17, 2024, an electronic withdrawal of $226.22 was paid to Comcast. · On December 20, 2024, $2,500 in cash was withdrawn from the VA’s checking account. The signature on the withdrawal slip was illegible. Comcast was contacted for information regarding whose account was paid with the VA’s bank account. Comcast refused to provide the information. The VA provided the following information: · Recently the VA received a check from his/her bank that included his/her bank account number. When the VA checked the account, there was $6,733.17 in the account. At some point, the G went to the bank and moved the money to another account. The facility’s administrative staff persons knew about the bank account. The VA did not believe that any of the staff persons had access to the VA’s bank account. The VA did not have a debit card and did not use online banking. · The VA never wrote checks and did not know how to fill out a check. The VA did not have a cell phone and did not pay for cell phone service. The VA never purchased anything from T-Mobile. The VA did not have Comcast service and did not pay for any Comcast services. · The VA never gave any of the staff persons money and had no complaints about the staff persons. P1, P2, and P3, and the facility’s Internal Review provided the following information: · The SP worked at the facility for approximately three weeks. On March 31, 2024, the SP quit his/her job at the facility. · The VA did not pay for cell phone service or cable television service. P1 stated that the VA did not have access to the internet and the cable television at the facility was paid by the facility. The VA had 2:1 staffing at all times and the SP would not have been alone with the VA at any time. · P1 stated that the VA received a check for $40 from the G three times each month for his/her personal needs. Two staff persons took the VA to the bank, where the VA cashed each check and then held on to the money him/herself. The staff persons typically took the VA through the bank drive-up window and the VA showed his/her identification card to cash the checks. P1 did not understand how anyone could access the money in the VA’s bank account without the VA’s identification card. The VA preferred to spend the money on games and snacks. · P3 stated that the VA’s bank account was opened when the VA lived at another licensed residential program several years ago and deposits to the account stopped in 2017. The bank account was left untouched for several years until the VA received a bank statement and saw that there was several thousand dollars in the bank account. A check for $3,000 was cashed and the money was returned to the VA’s account the following day. An additional $2,500 was withdrawn but not returned. P3 stated that the handwriting on the $3,000 check “looked very similar” to the SP’s handwriting. The signature on the check did not look like the VA’s handwriting. · P2 stated that the VA did not write checks and did not have a bank debit card. P1 stated that the staff persons kept a weekly budget sheet that tracked the VA’s spending and receipts. The VA did not always provide receipts. The VA did not use a bank debit card or write checks. The VA received bank statements in the mail, which the staff persons placed in a box in the staff office because the G did not request them. The staff persons did not open the bank statements, but all of the staff persons had access to them. P2 stated that s/he saw one of the VA’s bank statements, but was uncertain why it was at the facility. P3 stated that the VA received the bank statements but never opened them. P1 was on leave from the end of March to May 2024. · P1 stated that the VA did not make any large purchases in December 2024 and P1 was not aware of any staff person withdrawing money from the VA’s account. The SP provided the following information: · The SP worked at the facility for approximately three weeks and typically only worked with another client (C) at the facility. Although the SP might have played cards with the VA, s/he typically did not take the VA on community outings or to the bank. The SP believed s/he and another staff might have taken the VA shopping on one or two occasions. The SP did not recall who handled the VA’s money at those times. · The SP stated that s/he did not have access to the VA’s money, checks, or bank accounts. The SP did not take $3,000 from the VA’s bank account in April 2024, and s/he stated that any check made out to him/her was “counterfeit” because s/he did not fill out the check and did not write his/her signature on the back of any check from the VA in order to cash it. The SP had nothing to do with withdrawals made from the VA’s bank account to make payments to Comcast or T-Mobile. The SP was “concerned” that his/her name was connected to the withdrawals made from the VA’s bank account. Facility documentation showed that the SP, P1, P2, and P3 each received training on the Reporting of Maltreatment of Vulnerable Adults Act, on the facility’s policies, and on the VA’s plans prior to the incidents. Conclusion: A. Maltreatment: On April 8, 2024, a check made out to the SP from the VA’s bank account for $3,000 was cashed but the following day, the $3,000 was deposited back into the VA’s bank account. Although the SP’s name was on the $3,000 check, the SP denied taking the money. Between March and June 2024, five electronic withdrawals were made from the VA’s bank account to Comcast and one withdrawal to T-Mobile totaling $980.97. The VA did not have a Comcast or T-Mobile account and information regarding whose accounts were paid with the VA’s money was not able to be obtained. In December 2024, a cash withdrawal of $2,500 was made from the VA’s bank account. The signature on the withdrawal slip was illegible. The VA did not have access to checks and no information was provided that the VA withdrew the $2,500. Given that that the VA was at risk of financial exploitation and did not have a good understanding of his/her finances, including budgeting and banking, and would not recognize mismanagement of his/her finances; and that only staff persons had access to the VA’s accounts and funds, there was a preponderance of the evidence that in the absence of legal authority a person willfully used, withheld, or disposed of the VA’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. For the following reasons the responsibility for the financial exploitation of the VA was inconclusive: · All staff persons had access to the accounts and funds; · Although the SP’s name was on the $3,000 check written on the VA’s bank account, the SP stated that s/he did not take any money from the VA’s bank account and the $3,000 was returned to the VA’s bank account the next day after the withdrawal; · No information was obtained regarding who the Comcast and/or T-Mobile accounts belonged to; and · The signature on the withdrawal slip for the $2,500 in cash was illegible. Action Taken by Facility: The facility completed an internal review and determined that the facility’s policies were adequate and were followed by the staff persons. The SP no longer worked for the facility. Action Taken by Department of Human Services, Office of Inspector General: No further action taken.
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