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Accusations of theft by employees increase
Proper hiring, supervision reduces risk to agency
"Hospice nurse arrested for theft." ... "Family accuses hospice nurse of stealing from patient."
All hospice managers cringe when they see the increasing number of headlines that proclaim hospice nurses or aides as guilty of stealing from patients. Are these headlines aberrations, or is there a real, growing trend in the industry?
"The risk of theft by employees has always been a problem in home health care," admits Elizabeth E. Hogue, Esq., a Burtonsville, MD-based attorney. The increase in news coverage of this potential problem is a reflection of the increased awareness of the industry, she explains. "When I started my law practice 30 years ago, I would tell people I worked with home health agencies, and they would ask what a home health agency was," she says. "Now, I mention home health, and most people say that their father, mother, or friend had a home health nurse."
An increased awareness of the industry as well as an increased willingness to press charges probably are more to blame for the headlines than an increasing number of employees who steal, suggests Hogue. While some patients might have been reluctant to report employees in the past, because they did not want to cause trouble for someone they considered part of the family, others did not report for fear of retribution by the accused employee, she says. Today, family members and patients might not see the same person day after day, and they also realize the agency can stop scheduling the accused employee at their home.
"The first step to take when an allegation of theft is made is to remove the employee from the home," points out Hogue. This is not only done to preserve the trust between the patient and the agency and to protect the agency, but also to protect the employee, she says. "Remember that your employees have rights, and it is important to investigate the allegation fairly," Hogue adds. "In many case, the home health employee is not the only other person coming into the home." Family members, church volunteers, friends, durable medical equipment employees, and even Meals-on-Wheels volunteers may come in and out of the home on a regular basis, she points out.
"Document all of your conversations," Hogue emphasizes. Ask what is missing, when and where it was last seen, and who else has been in the home, she suggests. Talk to as many family members as possible, and ask if they have looked for the item or if someone else might have moved it.
If your investigation cannot prove the employee's guilt or innocence, be sure to tell the patient and family that they can file a police report if they wish, stresses Hogue.
Whether they file a report or not, be sure not to send that employee back to the home, even if the family requests the nurse or aide, she says. "People will ask for the nurse again, because they found the item they thought was taken," she says. "You don't want to put your employee back into a situation in which the family didn't trust him or her," she explains.
Be careful, too, about the way your agency gift policy is written, suggests Hogue. "Patients and family members want to give gifts to employees, but other family members may not realize it was given as a gift," she points out.
Of course, the best way to reduce the risk of allegations of theft is to be careful about who you hire, says Greg Solecki, vice president of Henry Ford Home Health Care in Detroit. Although interviews do confirm that the potential employee has the skills and experience, most of the time spent in an interview is to discover what type of person the potential employee is, he explains.
"We engage the applicant in a conversation, and then listen to what we can learn when they are comfortable," Solecki says.
Applicants prepare for standard questions such as goals and previous work experience, but interviewers can get a sense of the applicant's opinions, philosophies, and ethics in a conversation, he adds.
Make welcome call to patients
Supervision of the employee and communication with the patient also can help reduce complaints about employees, or will let the agency know early if there is a potential problem, says Solecki. "Within the first 24 hours of admission, we make a welcome call to the patient and encourage them to call us if they have any questions or concerns," he says. Another call is made seven to 10 days into the episode of care to see how the agency staff members are doing and identify any patient needs that are not being met.
"The patient feels comfortable talking to us, and this is how we identify problems," he says.
While Solecki can count on one hand the number of times that a patient has accused an employee of theft during his 20 years at Henry Ford, other issues, such as missed visits, can be discovered with these calls. The key is to set up a line of communication outside the employee in the home to reassure the patient that there is someone else with whom he or she can talk, he adds.
Although employee theft may be rare in your agency, be aware that it does happen, says Hogue. While your investigation may not uncover any wrongdoing, and the patients might decide that they just misplaced the items, theft by hospice employees does happen. The employees are not always smart about hiding their theft either.
"My favorite story is of the home health employee who worked for a family that repeatedly reported missing items but the agency, and the family could never substantiate the allegations," she recalls. "About a year later, the employee held a garage sale to prepare for a move, and the items she was accused of taking were included in the sale."
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