SPOKANE, WA - Federal inspectors cited Touchmark on South Hill Nursing for failing to properly report potential theft of resident property to state authorities, putting vulnerable residents at continued risk of financial exploitation.
Missing Property Reports Not Escalated to Authorities
During an August 22, 2024 inspection, investigators found the facility failed to identify and report potential misappropriation of resident property for two residents who reported missing items shortly after admission. The violations occurred despite facility policies requiring staff to report suspected theft or misappropriation to the State Survey Agency.
Resident 2's Missing Wallet Incident: Just one day after admission on July 8, 2024, Resident 2 reported their brown wallet missing. The wallet contained $340 in cash (which family had taken home), but also included two debit cards, two silver credit cards, various insurance cards, photo identification, checks, a veteran card, and military discharge paperwork containing social security information.
The facility documented the incident on a "praise, concern, suggestion form" but failed to file it as a reportable incident or investigate it as potential misappropriation. Staff informed the family on July 12, 2024, that they could not locate the wallet and would only reimburse for a replacement wallet if provided a receipt, but "could not do anything about the loss of cards."
Resident 3's Missing Money Clip: Two days after admission on May 28, 2024, Resident 3 reported a missing military money clip containing approximately $75. The resident believed the money clip was accidentally discarded with clothing during episodes of incontinence. After searching multiple facility locations, staff could not locate the item and credited the resident's account $75 on June 13, 2024.
Federal Reporting Requirements Ignored
Under federal regulations, nursing homes must report suspected abuse, neglect, or theft to state survey agencies for investigation. The facility's own abuse policy, dated 2023, specifically defines financial exploitation and requires all alleged violations to be reported to the administrator, director of nursing, and the State Survey Agency hotline.
During interviews, multiple staff members acknowledged these incidents should have been reported as potential misappropriation. A nursing assistant stated the wallet incident "should have been reported to the State Survey Agency and investigated as an incident of potential misappropriation." A registered nurse similarly acknowledged that both incidents should have been reported because "bad things could happen when unauthorized individuals had access to that type of sensitive information."
The facility's Social Service Director admitted during the inspection that while both incidents were documented, they "were not identified, reported or investigated as potential misappropriation but should have been because of the wallet contents."
Pattern of Missing Items Raises Concerns
The administrator acknowledged that residents were "highly discouraged from keeping money, bank cards, insurance cards, credit cards or other items of value in their possession" due to theft risks, yet admitted "it appeared there was a pattern of missing items."
Both affected residents were cognitively intact and able to verbalize their needs, making their reports of missing items credible. The timing of both incidents - occurring within days of admission when residents are most vulnerable - heightened the concern for potential exploitation.
Medical and Safety Implications
Missing financial documents pose significant risks beyond monetary loss. Access to social security numbers, military identification, and financial cards can enable identity theft, unauthorized account access, and fraudulent benefit claims. For elderly residents with limited mobility, replacing essential identification documents creates additional hardship and potential barriers to accessing healthcare and services.
The facility's failure to properly investigate these incidents as potential crimes meant that any patterns of theft or exploitation went undetected, leaving other residents vulnerable to similar incidents.
Facility Policies Exist But Weren't Followed
The facility maintained comprehensive policies addressing personal property protection and mandatory reporting requirements. The Personal Property Policy encouraged residents to bring belongings for familiarity but acknowledged vulnerability to theft. The Abuse Policy specifically identified staff as mandatory reporters trained to recognize and report "disappearance or misappropriation of resident's personal property."
However, the investigation revealed a disconnect between written policies and actual practice. Staff used a grievance system designed for general concerns rather than following mandatory reporting protocols for potential criminal activity.
Industry Standards for Property Protection
Professional nursing home standards require facilities to maintain detailed inventories of resident belongings, secure storage options, and clear procedures for investigating missing items. When personal property contains financial instruments or identification documents, immediate reporting to appropriate authorities allows for protective measures such as account monitoring and document replacement.
The facility provided residents with locking drawers for secure storage but appeared to rely on residents to self-protect rather than implementing systematic safeguards and proper incident response protocols.
Investigation and Enforcement
The inspection was conducted as part of a complaint investigation, suggesting concerns about missing property had been raised through other channels. Federal inspectors interviewed multiple staff members, reviewed facility policies, and examined documentation spanning several months to establish the pattern of unreported incidents.
The citation carries a "minimal harm" designation but affects multiple residents, indicating the potential for broader impact on facility operations and resident safety protocols.
Recommendations for Improvement
Industry best practices recommend immediate reporting of any missing items containing financial instruments or personal identification, regardless of suspected cause. Facilities should maintain clear distinctions between general grievances and incidents requiring mandatory reporting to authorities.
Staff training should emphasize that potential misappropriation includes any unexplained disappearance of valuable items, not just obvious theft scenarios. Regular auditing of incident reporting can help identify gaps in compliance with federal requirements.
The facility must now develop corrective action plans to address the identified violations and prevent future failures to report potential misappropriation. This includes staff retraining on mandatory reporting requirements and revision of incident classification procedures to ensure proper escalation of concerning incidents.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Touchmark On South Hill Nursing from 2024-08-22 including all violations, facility responses, and corrective action plans.
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