How do I report fraud and neglect?

Specialties Private Duty

Published

Please let me know what you think of this. I know it's long, but here's the info I have, PLEASE read:

Fraud??: I've been a home care PCA for several years now for many different families. One particular client I worked with had autism. She was sweet, gentle, and wouldn't hurt a fly. However, her mother admitted to, and even showed me paperwork, where she proposed that her daughter was violent and had a massive list of diagnoses in order to get her 'round- the-clock PCA care. Later she "started" up a non-profit organization, so she learned how to write grants. She then would write grants for her non-profit organization for money, electronics, etc. She got a few grants, and one of them was for an iPad and other devices, which she claimed her daughter would benefit from. As I worked with my client in their home, my poor client RARELY got to use "mom's" iPad. She's milking the system to get electronics and money for herself!!

More fraud??: Furthermore, this woman has a reputation for having "too many" PCA's and taking advantage of them (treating them like babysitters, having them work overtime so she can go to "meetings" (which were outings with friends by the way)). This is not what the state wants you to use PCA's for. I worked for her and took care of her daughter for over 5 years (simply because I truly cared for my client) and numerous times she was LYING on my time cards so the state would pay for money she had me spend while working with her daughter. She would have me take her to get school clothes, take her out to dinner, and use my own money so she could "add a few hours" on my time card and just let the state "reimburse" me so she didn't have to pay for anything for her daughter. On top of this, the autistic client is now 18 and I am hearing from her current PCA's that her daughter is not benefiting from one dime of her social security disability benefits. The mother is apparently suddenly going on vacations, getting botox, and spending more on herself in general (most likely with her daughter's social security).

Neglect??: Finally, I believe she neglected her autistic daughter. Who cooked for her/took her out to eat, bathed her, dressed her, brought her to and picked her up from school and activities on a daily basis??? Her PCA's did. This was because she had no patience to deal with her own autistic child and cared more about her social life. She's a stay-at-home mom by the way. Once, she had me work later than I was supposed to so she could go to a wine tasting with her friend. Several hours after my scheduled clock-out time she arrived home, via taxi, drunk as a skunk and told me she'd "tuck" her daughter in so I could go home. She was caring for her daughter while intoxicated! I was also stuck between a rock and a hard place several times when she'd call home and say "I'll be home late tonight after your're scheduled to leave, but you can go home. Just lock up before you leave." Should I leave her daughter home alone so I can get a couple hours of study time for my nursing exam in the morning, or should I stay and ensure the safety of my client??!!

Her daughter was 17 when I quit. She still had a bedroom decorated from when she was a baby, she still had a teeny tiny bed which she was too tall for, and only received up-to-date teen fashions so she could fit in because of hand-me-downs and presents from myself and her other PCA's! She clearly would not buy her anything or get her updated or adult things because her daughter "would not know the difference." It's true, she probably wouldn't, but she would get excited and want to wear my old Hollister shirts that I gave her while she was in high school, probably because she saw that's what her classmates were wearing.

Is any of this true neglect?

Anyways, I'm just frustrated with this issue and I have not yet been able to figure out how to properly report her, or if I even can. Is any of this actual and reportable fraud and neglect? If so, how do I report it? Who do I report it to?

Also, I am hoping to pass my NCLEX within the next month so I am also curious about whether or not if I did report her with an active nursing license if the state would take my report more seriously? I do not wish for her mother to serve time or for her daughter to be taken away or anything like that, but I do hope that some justice be served for all the other families out there who deserve home care, but aren't getting any because they aren't being fraudulent like she is and aren't neglecting their special needs children in any way! Maybe just pay a hefty fine, community service, and get PCA hours reduced. That would be the justice!

Please, any advice would be appreciated!

Specializes in Peds(PICU, NICU float), PDN, ICU.

CloudySue, that's reasonable. :-)

I guess with all the red flags there, it's just over the top.

Specializes in Peds/outpatient FP,derm,allergy/private duty.

That was really fair of you, Cloudy Sue. I will just say that Ashley seems to be a person of above-average intelligence and already has a bachelor's degree according to her posts, but you're right. There is more to nursing than academics.

Ashley, since you have stated you are communicating with people who are currently working with this mother and her child you should encourage them to take steps to report neglect in the care of her daughter.

I still feel trying to pin falsifying hours worked etc. on her would be a really bad idea and one that you would probably ultimately lose, along with an investigation leaving a trail that might diminish your reputation as an ethical person in the process.

Specializes in Pedi.
The issues with her nonprofit and grants are really none of your business. You are not an expert on that and I wonder why you even have knowledge of it.

If you let someone else fill out your time sheets nobody will take your claims of fraud seriously.

Not having cute or age appropriate bedroom decorations isn't neglect. The mom may have had PCAs do things she could have done, but the child had the care so was not neglected.

If you and your friends are hell-bent on pursuing a vendetta against this mother I know every state has tip-lines or what-have-you for that reason. I have to be honest though. Your apparent outrage a year after you've left this case after working there for 5 years just doesn't sound above-board.

Yes, this. The child was fed, clothed, brought to and from school, etc. She was not neglected. Just because it was someone other than the parents doing it wouldn't make it neglect. Leaving a 17 yr old home alone is also not neglect. Neither is not decorating a teenager's room or not buying her trendy clothes.

You left this case a year ago. I do not think the state would take a report of neglect seriously at this point in time. In my state, mandated reporters are required by law to notify DCF IMMEDIATELY of suspected abuse/neglect. Doing so a year after the fact would A) not be taken seriously and B) put you in hot water.

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