Protecting residents from 

financial exploitation 

A manual for assisted living and nursing facilities

A MANUAL FOR ASSISTED LIVING AND NURSING FACILITIES 1 

About the Consumer Financial 

Protection Bureau

The Consumer Financial Protection Bureau, or the CFPB, is focused 

on making markets for consumer financial products and services work 

for Americans—whether they are applying for a mortgage, choosing 

among credit cards, or using any number of other consumer financial 

products. We empower consumers to take more control over their 

financial lives.

The CFPB Office for Older Americans is the only federal office 

dedicated to the financial health of Americans age 62 and over. Along 

with other agencies, the Office works to support sound financial 

decision-making by consumers to help them reach their own life goals, 

and to prevent financial exploitation of older adults. 

For more information about the CFPB, see consumerfinance.gov.

About this guide

To help assisted living and nursing facility managers and staff prevent 

and address elder financial exploitation of their residents, the Office 

for Older Americans contracted and worked closely with Iris Freeman, 

MSW, William Mitchell College of Law, to prepare this guide. The 

guide is not intended to provide legal advice or serve as a substitute 

for your own legal counsel. If you have questions or concerns about 

legal issues and responsibilities, we recommend that you seek the 

guidance of the appropriate legal professional.
2 PROTECTING RESIDENTS FROM FINANCIAL EXPLOITATION
A MANUAL FOR ASSISTED LIVING AND NURSING FACILITIES 3 

What’s inside

About the Consumer Financial Protection Bureau�������������������������������������������������������1

About this guide�����������������������������������������������������������������������������������������������������������������1

Introduction ������������������������������������������������������������������������������������������������������������������������5

What is elder financial exploitation? ������������������������������������������������������������������������������7

Understanding the laws��������������������������������������������������������������������������������������������������10

Warning signs that may indicate financial exploitation ��������������������������������������������13

Model response protocol: recognize, record & report����������������������������������������������16

Preventing and deterring financial exploitation: orientation, 

training, and facility policies ������������������������������������������������������������������������������������������23

Fraud and scams that target older people ������������������������������������������������������������������31

Review��������������������������������������������������������������������������������������������������������������������������������35

Resources for facilities, residents and families �����������������������������������������������������������36

Terminology and usage in this manual�������������������������������������������������������������������������39

Endnotes����������������������������������������������������������������������������������������������������������������������������40
4 PROTECTING RESIDENTS FROM FINANCIAL EXPLOITATION
A MANUAL FOR ASSISTED LIVING AND NURSING FACILITIES 5 

Introduction

Mr. R, age 77, suffered from Alzheimer’s and Parkinson’s diseases, diabetes and 

other ailments. His pastor persuaded the former church deacon to grant him 

authority to manage his finances and care decisions. The result of this misplaced 

trust included 130 ATM withdrawals from Mr. R’s bank account, nine months 

of unpaid nursing home bills, and the threat of discharge for nonpayment. The 

victim died at his facility. The perpetrator was charged and convicted of financial 

exploitation of a vulnerable adult. 

When an older person in an assisted living or nursing facility is the target of 

financial abuse, everyone suffers. Financial losses affect the resident, the facility, 

and the broader community. The primary victim is the vulnerable resident, robbed 

of economic security and placed at risk of involuntary discharge or loss of housing 

for nonpayment. 

Sadly, the people exploiting older adults are often family members or other trusted 

people who are handling the financial affairs of an incapacitated parent, relative or 

friend. The financial arrangement may be informal—or based on a formal grant of 

authority to a fiduciary (such as an agent under power of attorney or a guardian). 

The financial wrongdoing may have begun at the time of admission or may go back 

months or years. Intervention, however, rarely begins until the exploitation causes 

repeated non-payment and staggering over-due bills. While most family members 

or others in positions of trust are worthy of the confidence we place in them, you as 

a facility operator or staff member should act, promptly, when people violate that 

trust. 

As a care provider, you are in a unique position to help protect older residents from 

exploitation. You can prevent abuse or intervene early when the threat is from:

§ trusted persons handling financial affairs

§ stranger scams, and 

§ theft by staff or intruders. 

Your key role in the daily lives of residents enables you to stand guard and jump in 

when your resident is in jeopardy. This guide will help you be ready.
6 PROTECTING RESIDENTS FROM FINANCIAL EXPLOITATION

This manual focuses primarily on exploitation by trusted persons 

but also includes material about responding to scams and other 

types of theft.

Purpose and scope

This guide aims to help operators and staff of nursing facilities 

and assisted living residences protect the people in their 

care from financial exploitation through prevention and early 

intervention. The manual is for administrators as well as business 

office staff, social service personnel and any staff members 

involved in the admissions process. Much of the information 

about warning signs and building awareness among staff and 

residents may be useful in other residential settings for older 

people or for people with disabilities.

We outline ways to create awareness, policies and processes to 

protect the facility residents. State laws vary, so you should also 

become familiar with your state’s laws, regulations, mandates, 

reporting requirements and systems. We encourage you and 

colleagues in your state to add your state-specific requirements 

and processes to this manual. You can create your own statespecific manual by adding content about state laws, practices 

and resources.1

Four pillars of successful intervention

This manual will walk you through four key actions for 

protecting your residents from financial abuse:

§ Prevent – through awareness and training

§ Recognize – spot the warning signs and take action

§ Record – document your findings, and

§ Report – tell the appropriate authorities and trigger 

responses.

Stay tuned for the model response protocol on page 16.

Definitions

Assisted living is residential 

care offering 24-hour 

staffing and assistance with 

activities of daily living. 

Assisted living is regulated 

by states. Over two-thirds of 

the states use the licensure 

term “assisted living” or a 

very similar term.

A nursing facility is a 

residential care facility 

subject to state licensure 

requirements as a “nursing 

home,” “nursing facility,” or 

“intermediate care facility,” 

or providing similar levels 

of care. Most are also 

subject to federal standards 

as providers of Medicaid 

and/or Medicare covered 

services. Nursing facilities 

generally offer a higher 

level of care than assisted 

living facilities.
A MANUAL FOR ASSISTED LIVING AND NURSING FACILITIES 7 

What is elder financial 

exploitation?

A Prescott, Arizona resident was arrested for stealing over $100,000 from a 

74-year-old woman with dementia. The charges included felony theft, fraud, 

and misuse of a power of attorney. Police were alerted after the victim was 

approximately $20,000 behind in payments to her care facility. The investigation 

revealed that the alleged perpetrator sold the victim’s home to a relative for less 

than fair market value and took control of various other assets. 

Family, friends, neighbors, caregivers, fiduciaries, business people, and others 

may try to take advantage of an older person. They may take money without 

permission, fail to repay money they owe, charge too much for services, or just 

not do what they were paid to do. These are examples of financial exploitation or 

financial abuse.2 Financial exploitation is a form of elder abuse.

The crime of the 21st century

Here are some numbers that show the seriousness of the threat:

Losses are huge: one study estimated that older Americans lost at least 

$2.9 billion to financial exploitation by a broad spectrum of perpetrators 

in 2010, although many experts believe the true cost is much higher. 

Financial exploitation is the most common form of elder abuse—a recent 

study concluded that about five percent of Americans 60+ experienced 

financial mistreatment by a family member in a single year. 

This epidemic is truly under the radar: a 2011 study found that protective 

services agencies or programs for victims reached only one in 44 cases of 

financial exploitation. 

Most exploitation complaints to long-term care ombudsmen involve 

perpetrators from outside the facility. 
8 PROTECTING RESIDENTS FROM FINANCIAL EXPLOITATION

While everyone, regardless of age, is a potential victim of theft 

and other financial crimes, older Americans are at greater risk 

than the general population. Cognitive impairment diminishes 

the ability of older adults to make financial decisions and to 

detect frauds and scams. Many older people have cognitive 

impairments: an estimated 22% percent of Americans over 

age seventy have mild cognitive impairment, and one in eight 

Americans aged 65+ has Alzheimer’s disease. The percentage 

of congregate care residents with cognitive impairment is much 

higher than the general older population: about half of nursing 

facility residents—and over 40% of residents in assisted living 

and board and care homes—have dementia. Finally, new brain 

research suggests that the risk of financial exploitation in later life 

may occur even when older people do not have mild cognitive 

impairment or dementia. 

As family and other trusted persons step in or are brought 

in to manage an elder’s finances, some elders succumb to 

victimization, leaving them destitute and their care facilities 

unpaid.

Financial exploitation takes many different forms. Someone with 

a legal obligation to handle the vulnerable person’s finances may 

fail to use the funds for necessities like food, clothing, shelter and 

health care, putting the vulnerable adult at risk of harm. People 

with legal obligations to handle finances include fiduciaries such 

as agents under power of attorney, trustees, guardians, Social 

Security representative payees and VA fiduciaries.

In other cases, the perpetrator may have no legal obligation to 

take care of a vulnerable person’s money. Someone may take 

possession of and control the vulnerable resident’s property by 

pressuring, misleading or lying to the vulnerable person, or gain 

the vulnerable adult’s trust by professing to love and promising to 

care for him/her if they can just share a bank account. 

Elder financial exploitation cases are complex. Financial 

exploitation often occurs in relationships where the vulnerable 

person has placed his/her trust and confidence in another 

person. (Confidence, in this sense, is the origin of the phrase, “con 

game.”) When family members are perpetrators, the subtleties 

of family history, sibling conflicts, and expectations concerning 

Definitions

Elder abuse, often referred 

to as “abuse, neglect and 

exploitation,” includes many 

types of mistreatment of 

older adults. The National 

Center on Elder Abuse 

describes seven types of 

elder abuse:

§ Physical Abuse

§ Sexual Abuse

§ Emotional or 

Psychological Abuse

§ Neglect

§ Abandonment

§ Financial or Material 

Exploitation

§ Self-neglect.

Terminology for these types 

of elder abuse varies in 

state law.

Vulnerable adult, person, or 

resident—an individual who 

is at risk of abuse, neglect 

or exploitation because of 

age or disability.
A MANUAL FOR ASSISTED LIVING AND NURSING FACILITIES 9 

estate management and inheritance may surface. Financial abuse may be 

accompanied by other types of mistreatment, such as emotional abuse or neglect 

of care.

For the victim, the losses are more extensive than dollars and property. Financial 

exploitation can cause severe emotional distress, depression, deterioration of 

physical health, loss of independence, and a shortened lifespan. Despite the 

exploitation, the victim may continue to feel dependent on and protective of the 

perpetrator. 
10 PROTECTING RESIDENTS FROM FINANCIAL EXPLOITATION

Understanding the laws

When Mrs. B was 72 she sold her mobile home and moved in with her daughter 

and granddaughter in Monterey, Calif. She decided she didn’t want to deal 

with her finances any longer and let the two take control. But her daughter and 

granddaughter drained Mrs. B of jewelry, furniture, and an annuity worth almost 

$90,000, and abandoned her at a nursing facility, according to court documents. 

They were convicted of grand theft and financial elder abuse, both felonies. 

State Laws and Response Systems

Your state’s laws include definitions of financial exploitation, reporting mandates (if 

any), criminal sanctions and other important guidance. The primary agencies that 

investigate reports of suspected elder financial exploitation are Adult Protective 

Services (APS), licensing agencies, law enforcement, and the long-term care 

ombudsman. Nearly all states require health care providers to report suspected 

abuse, neglect and exploitation (referred to as mandatory reporters in this guide) 

to APS or another public authority. APS, however, does not carry out facility 

investigations in every state, so you should know which agency is responsible for 

investigating financial exploitation of residents in your care setting.

Adult Protective Services

Frequently, APS workers are the first to respond in cases of abuse, neglect or 

exploitation. APS workers evaluate two things before opening an investigation:

§ whether the alleged victim is eligible for protective services, and

§ whether the information reported meets the legal definition of abuse, neglect or 

exploitation in their state or locality. 

Eligibility for protective services. Your state’s law specifies whether the alleged 

victim meets the definition of an adult eligible for protective services. In some 

states, for example, APS will investigate alleged abuse of adults aged 18 or older 

who are vulnerable due to a physical or mental impairment. In other states, APS 
A MANUAL FOR ASSISTED LIVING AND NURSING FACILITIES 11 

investigates abuse allegations when the alleged victim is over a 

certain age, e.g. 60 or 65, regardless of disability. However, most 

states have both criteria: an age criterion as well as a condition 

criterion (e.g. physical or mental impairment, dementia, etc.).

Definition of mistreatment. Similarly, APS workers look at whether 

the allegations in a given case meet the state’s definition of 

financial exploitation. You should know how your state defines 

elder financial exploitation. Your APS agency can provide this 

information. This definition helps you to know what to watch out 

for and what facts to include when reporting suspected abuse to 

a local or state agency.

If APS finds that the person has experienced or is at risk of 

experiencing financial exploitation, APS decides what services, if 

any, are necessary for the vulnerable adult’s safety or well-being 

and recommends a service plan.

While everyone in every state should report suspected 

financial exploitation to APS, almost all states have some form 

of mandatory reporting of elder financial exploitation. Some 

states require reporting by specific categories of professionals 

and providers. Other states require “any person” to report. It is 

important to review your state laws to learn whether you—and 

members of your staff—have a mandatory obligation to report.4

Talk to your facility lawyer or corporate compliance department 

to get updated information about reporting requirements. 

Even if reporting is not mandated, any concerned person may 

and should voluntarily make a report when he or she suspects 

financial exploitation. 

Individuals who are offered APS services have the legal right to 

decline help (if they have decision-making capacity). The victim 

has a right to refuse services even when a mandated reporter, 

service provider, advocate, and the APS investigator believe 

services may be appropriate. Talk to APS personnel in your state 

about how they determine whether a victim has the capacity to 

decline help.

Law Enforcement

Reporting suspected exploitation to law enforcement also is 

Definitions

Adult protective services 

(APS) are social services 

programs provided by 

states nationwide, serving 

seniors and adults with 

disabilities who are 

in need of assistance. 

Adult protective services 

is a generic term, not 

necessarily the name of 

the agency in your state.3

APS workers frequently 

serve as first responders in 

cases of abuse, neglect or 

exploitation. The National 

Adult Protective Services 

Association website 

provides information about 

how to report suspected 

abuse in each state. www.

napsa-now.org/get-help/

help-in-your-area. 

Long-term Care 

Ombudsmen are advocates 

for residents of nursing 

facilities, board and care 

homes, assisted living 

facilities and similar adult 

care facilities, in programs 

administered by the 

federal Administration 

on Aging/Administration 

for Community Living. 

Ombudsman staff and 

volunteers work to resolve 

problems and concerns 

of individual residents. 

Every state has an Office of 

the State Long-Term Care 

Ombudsman, headed by a 

full-time state ombudsman.
12 PROTECTING RESIDENTS FROM FINANCIAL EXPLOITATION

critically important. In some states, reporting to law enforcement 

is mandatory. Financial exploitation may violate an array of 

criminal laws. Some states have enacted laws making elder 

financial exploitation a specific crime. But generally law 

enforcement personnel investigate and prosecutors charge 

people with other crimes such as theft, larceny, embezzlement, 

forgery, fraud and money laundering. 

Your facility or company lawyers or compliance officers should 

be able to provide details about your state’s criminal code 

provisions. Local law enforcement agencies and local prosecutors 

also may be able to help. Communicating and coordinating with 

law enforcement will help ensure that you report suspected 

criminal acts. You can also get help with training your staff and 

enhance working relationships.

Federal Reporting Requirements

In addition to state mandatory reporting laws, federal law5

requires long-term care facilities6 that receive at least $10,000 

in federal funds during the preceding year to report suspected 

crimes against a resident to state survey agencies and to local law 

enforcement. 

Specifically, the law requires that the owner, operator, employee, 

manager, agent, or contractor of a covered facility report 

“any reasonable suspicion of a crime,” as defined by local law, 

committed against a resident of, or someone receiving care 

from, the facility. If the victim has serious bodily injury, covered 

individuals must report immediately upon suspicion, but no later 

than two hours after the suspicion occurs. Other reports must be 

made no later than 24 hours after forming the suspicion. 

Covered individuals are subject to penalties for failure to fulfill 

these obligations. Facilities must notify covered individuals (e.g. 

employees and contractors) of their duties annually. In addition, 

facilities must post conspicuous notice of employees’ rights, 

including protections from retaliation for carrying out their 

responsibilities under this law.7

Definitions

Mandatory reporters are 

people required by law 

to report their suspicions 

about elder abuse to a 

specified public authority.
A MANUAL FOR ASSISTED LIVING AND NURSING FACILITIES 13 

Warning signs that may 

indicate financial exploitation

Mr. C was charged with stealing more than $315,000 from his elderly mother’s 

retirement accounts over the course of five years. According to the criminal 

complaint, he was named as his mother’s agent under a power of attorney. Prudent 

investment and funds from long-term care insurance should have been sufficient to 

cover his mother’s care for the rest of her life, yet she was evicted from her assisted 

living residence for nonpayment. In the process of searching for a less expensive 

facility, another of the victim’s children uncovered the theft. Over the years, the vast 

majority of withdrawals had been made at a casino. 

A variety of things you observe or detect may signal that a resident is a victim of 

financial exploitation. Here is a list of many of the “red flags” that you might spot.

Things a resident tells you or that you observe 

concerning the resident

§ Resident, regardless of cognitive impairment, complains or reports that 

someone is misusing or stealing his/her money or property

§ Resident reports missing checkbook, credit card, or important papers

§ Resident is agitated or distraught prior to or after a family member or friend 

visits

§ Resident is agitated or distraught prior to or after a family member or friend 

takes him/her out for a visit or appointment

§ Resident becomes secretive and suddenly starts hiding possessions or hoarding 

papers
14 PROTECTING RESIDENTS FROM FINANCIAL EXPLOITATION

Things you observe in or about a resident’s room 

or apartment

§ Disappearance of possessions 

§ Replacement of possessions in resident’s room with those of lesser value

§ Resident lacks basics (e.g. underwear) but personal needs account is depleted

§ Blank deposit slips or withdrawal forms in conspicuous places for easy taking

§ Missing or unaccounted for medications

Family dynamics and other observations when the 

resident is with visitors

§ Observing/hearing a resident pressured to make a decision or sign a document 

“now”

§ Observing/hearing a resident being threatened by family or other visitor that 

unless the resident agrees to or signs a document, the visitor will stop taking 

care of the resident

§ “Chaperoning” – suspected person lets others visit only when he/she is present 

and insists on speaking for the resident

§ New acquaintance showing intense affection for resident, isolating her/him from 

others

§ Previously uninvolved persons claim authority to manage resident’s care and/or 

finances but do not provide documentation

§ Agent or family member declines or pressures resident to decline prescribed 

treatment(s) on the basis of cost, overriding the resident’s wishes

§ Family members or fiduciaries avoiding care plan meetings or failing to return 

calls from facility staff

§ Known gambling, drug or alcohol problem of resident, family member or visitor

§ Conflicts concerning finances between resident’s adult children or others with 

close relationships to the resident 
A MANUAL FOR ASSISTED LIVING AND NURSING FACILITIES 15 

Billing issues

§ Unpaid facility bills

§ Unpaid pharmacy bills

§ Stalling or broken promises from person handling resident’s money

§ Abrupt or repeated changes in responsibility for paying resident’s bills

§ Bills paid in cash

§ Communication from a family member, friend, fiduciary or partner that he or 

she plans to move the resident after questions arise about suspected financial 

exploitation

Power of Attorney Matters

§ Agent under power of attorney failing to provide necessary documentation

§ Multiple agents under powers of attorney in conflict over responsibility to pay 

the facility bill

§ Resident who appears to lack decision-making capacity signs new power of 

attorney document

Checks and Imbalances

§ Checks or other documents signed/dated when resident is no longer able to write

§ Suspicious signatures (e.g. many versions of a resident’s signature or one that 

was shaky is suddenly firm or vice versa)

§ Resident’s checkbook or check register shows checks made out to “cash” 

frequently and/or check numbers out of sequence

§ Telephone card or telephone bill fees for calls not made by the resident or 

otherwise unauthorized by the resident (called “cramming”)

§ Credit card charges for items not purchased by the resident

§ Erratic use of personal needs allowance by family member or fiduciary

§ Gifts (either frequent or costly) to staff or volunteers

§ Sales of valuables to facility staff or volunteers.
16 PROTECTING RESIDENTS FROM FINANCIAL EXPLOITATION

Model response protocol: 

recognize, record & report

Mrs. A, who suffered a series of strokes, had named her daughter as agent under 

a power of attorney to pay her nursing home bills. Instead, her daughter, Lisa, 

wrote checks to herself and to pay for her own groceries and personal items. 

The daughter then moved her mother from one skilled nursing facility to another 

because of arrearages. An ombudsman, who became involved during the victim’s 

second placement, noted that the second home similarly discharged the resident 

and wrote off the bills. At the third nursing home, the ombudsman, adult protective 

services and the police directly addressed the financial exploitation of the resident 

and arranged stable housing for her. Prosecutors charged the daughter, and she 

pleaded guilty to one count of theft by swindle for taking $22,000. 

Establish and maintain a team approach to 

financial security.

Prevention of financial exploitation is the number one goal, and awareness and 

training are keys to prevention. However, your other top priorities should be early 

recognition, documentation and reporting. In fact, these activities also contribute 

to prevention—since financial abuse is often ongoing, early identification of a 

problem can help “stop the bleeding.”

Assemble a team that will form your facility’s frontline on financial exploitation. The 

team should include at least the administrator, business office representative, and 

social work representative as team members. The team should implement a system 

for early, effective responses to perceived financial exploitation through regular 

periodic meetings, case review, and coordinated action. Consider adding other 

staff, such as your Admissions Coordinator, to the group. The system should be 

part of any corporate compliance plan.

Establish which member has the lead responsibility for record-keeping and 

reporting cases of suspected financial exploitation. In nursing facilities, the 

compliance officer would most likely have that role. The administrator should 
A MANUAL FOR ASSISTED LIVING AND NURSING FACILITIES 17 

designate a back-up person in case the lead person is unavailable.

Provide training for the team on your objectives for preventing and responding to 

financial exploitation, the jurisdictions and boundaries of pertinent agencies, as 

well as the interactions among these agencies.

Without a solid team approach, led by the administrator, hectic days in a 

facility and periodic changes in staffing can allow a bad situation to endure and 

exploitation to continue. An effective team promotes the safety of the resident and 

the financial security of the facility.

Investigate and record as soon as warning signs 

appear

§ When suspicions arise, call a meeting of the team. The trigger might be an 

account that is delinquent for sixty days—or any of the red flags listed above. 

§ Consult with other staff members who may have observed relevant behavior 

and be sure that they document each instance of that behavior with the 

date, time, what was observed, and the names of and contact information for 

witness(es). 

§ Direct care and housekeeping or maintenance staff may be the most familiar 

with the resident. Encourage them to talk with you about their concerns and 

include their observations in the record.

§ Document all pertinent communications such as phone calls, meetings, and 

letters. Investigators will need dates, times, locations, behaviors/statements, 

physical evidence, and the names of witnesses. 

Advocate for the vulnerable resident

§ Talk with the resident separately from the individual(s) suspected of exploitation. 

Note inconsistencies in their stories. Ask open-ended questions. Take note of 

nonverbal cues in your conversation, as well as those you observe when the 

resident and suspected exploiter(s) are together. The resident may be hesitant 

to acknowledge a loved one’s financial missteps due to guilt, fear of retaliation, 

or sympathy for the exploitative person, particularly when the resident has 

rescued the person from trouble repeatedly. However, with support from a 

trusted advocate, a victim who refuses to acknowledge abuse or exploitation 

may later develop the courage to talk about the experience.
18 PROTECTING RESIDENTS FROM FINANCIAL EXPLOITATION

§ The social worker or other designated staff member should inform the resident 

about the regional or local Long-term Care Ombudsman Program and assist 

the resident with contacting that office. If there is an ombudsman visitor 

who comes to the facility periodically, the resident may prefer talking to that 

individual instead of making a call for help. Facility staff should not contact the 

ombudsman solely because the resident is at risk of discharge for nonpayment. 

ú The ombudsman’s role is to respond directly to the resident and to act 

on behalf of residents, not providers. If you reach out to the ombudsman 

for assistance when a resident is cognitively or physically unable to make 

the request, you should document the resident’s incapacity to contact the 

ombudsman and the actions you have taken to protect the resident from 

exploitation.

ú When a resident cannot consent and does not have a legally authorized 

surrogate—or the local ombudsman determines that a legal representative 

is not acting in the resident’s best interest—the local ombudsman takes 

guidance from the state ombudsman director on how to proceed. The 

state ombudsman uses an established protocol to take action on behalf of 

a resident who cannot make or communicate decisions.

Understand reporting requirements

§ Be aware of your state’s laws about reporting suspected financial exploitation. 

Learn the following things about your state’s laws:

ú whether you—and members of your staff—are mandatory reporters to APS 

or another public authority

ú whether you have additional reporting obligations to law enforcement 

and/or licensing agencies

ú who is eligible for protective services

ú which agency investigates financial exploitation in your type of facility.

§ Understand the immunity provisions in your state’s laws—and reassure your staff 

that there are “safe harbors” for reporting suspected abuse. Almost all states 

have provisions providing immunity for good faith reporting of suspected elder 

financial exploitation. This means that you can’t be held liable if it turns out that 

the activity you observed wasn’t exploitation, as long as you made the report 

in good faith (or a similar standard spelled out in your laws). In most states, 

this immunity extends to civil, criminal, or administrative actions. Generally this 
A MANUAL FOR ASSISTED LIVING AND NURSING FACILITIES 19 

immunity also applies to other activities that may stem from those reports (such 

as testifying in a court or administrative proceeding).

§ Remember that federal law requires nursing home providers and specific 

“covered individuals” to report suspected crimes against a resident to local law 

enforcement. Understanding how your state defines crimes involving financial 

exploitation will help you fulfill this reporting obligation.

§ Document your information as thoroughly as you can, but remember that you 

are reporting a reasonable suspicion, not investigating a crime or proving a 

case. Think of the reporter’s role as that of a traditional newspaper reporter. 

Keep notes to the degree possible on who, what, where, when, and how. 

Make a report: who, what, where, when and how

§ Report financial exploitation of a vulnerable resident in accordance with state 

and federal law.

§ When you report suspected elder financial exploitation to local authorities, state 

that you are requesting an investigation of financial exploitation of a vulnerable 

resident or whatever terminology your state uses.

§ Your allegation should include facts that support and illustrate the report. Your 

state’s law may list the things you should include in your report. Here are some 

basic components of a complete report to authorities of any kind: 

ú the time and date of the report

ú the name, address, email address and telephone number of the person 

reporting

ú the time, date, and location of the incident(s)

ú the name(s) of the persons involved, including but not limited to the 

alleged victim, alleged perpetrator(s) and witness(es)

ú whether you believe there is a risk of imminent danger to the alleged 

victim

ú a description of the suspected financial exploitation and signs of any 

other type of abuse or neglect

ú the alleged victim’s disability and/or health condition including any 

information on cognitive status
20 PROTECTING RESIDENTS FROM FINANCIAL EXPLOITATION

ú the relationship of the alleged perpetrator to the alleged victim, if known

ú whether a report has been made to any other public agency, and 

ú whether the facility has conducted an internal investigation and the 

contact information for the individual(s) responsible for the investigation.

§ While there are specific federal requirements for nursing homes to report 

financial crimes directly to law enforcement, staff in any facility should report 

suspected exploitation, theft and any other financial crime directly to local law 

enforcement, just as you would in your own home.

Fact or fiction?

Sometimes staff at a protective services, law enforcement or licensing 

agency will claim that a discharge notice is required before you may 

make a report. This is not true. Regardless of whether a resident has a 

delinquent account or is facing discharge from the facility, the agency 

should accept a report and assign the case for investigation.

Follow-up makes a difference

If you are unsatisfied with a public agency’s response to your report, you may be 

able to make headway with additional information. Ask directly whether additional 

information would help in the investigation. Ask to discuss the case with a 

supervisor. Contact your state’s provider or professional organization for advice on 

how to work more effectively with the public agency. You may not have to accept 

NO as the one and only answer. Be aware, however, that the agency may be bound 

by confidentiality restrictions that preclude it from sharing the information. APS 

may not be able to share any information about a case without the client’s express 

permission. It may appear to you and others in the community that APS did not 

respond, offer or provide services, when in fact the agency did as much as it could.

Document each conversation you have with agency officials for future reference, 

noting the names of contacts and the dates and times of your conversations.

Unfortunately, national trends indicate an increasing demand for APS services without 

growth in investigative staff. In response, APS agencies may prioritize case types 

and may not have the capacity to respond to all reports. The resulting triage of cases 

inevitably causes frustration for people whose reports do not trigger an investigation. 

But keep at it when you believe your resident has been victimized and needs help.
A MANUAL FOR ASSISTED LIVING AND NURSING FACILITIES 21 

Additional avenues for action when you suspect 

financial abuse of a resident

Contact the local Social Security office if you suspect that a representative payee is 

misusing a resident’s Social Security benefits. You may also call the Social Security 

Administration to report possible misuse at Social Security’s toll-free number, 

1-800-772-1213, between 7 a.m. and 7 p.m. on business days. 

If the resident needs a new payee, make an effort to assist in identifying 

an alternative family member or trusted person who can offer to serve as 

representative payee. Representative payee applications are available at the local 

Social Security office. As a last resort, the provider can be the representative 

payee, unless prohibited by state law. As a general principle, there is an inherent 

conflict of interest when one entity has the simultaneous authority to bill for 

payment and to pay the bills. For more information, consult the Social Security 

Administration’s guide for organizational representative payees. www.ssa.gov/

payee/NewGuide/toc.htm. 

Contact the Department of Veterans Affairs if you suspect financial abuse by a 

VA fiduciary. The Department provides contact information at https://iris.custhelp.

com/app/answers/detail/a_id/3029 or you can use the “contact us” feature at 

https://iris.custhelp.com/app/ask. For more information about the VA fiduciary 

program, check www.benefits.va.gov/fiduciary/. 

Contact the court that appointed the resident’s guardian or conservator if you 

suspect that a guardian or conservator is misusing the resident’s funds or property.

Contact the vulnerable resident’s bank, credit union or other financial services 

provider. Your notification may trigger an internal investigation and further action 

by the financial institution, but recognize that without authorization by the owner 

of the account or a legally authorized fiduciary, you are not entitled to receive any 

information or follow-up to your “report.” Direct your call to a security officer at 

the bank or financial institution. Also remember that your first call should be to 

the local authorities who investigate suspected financial exploitation of vulnerable 

adults in your state and your type of facility.

If the suspected perpetrator is a staff member, 

contractor or volunteer in the facility

This manual does not include procedures for handling personnel issues when the 

suspected perpetrator is a staff member. However, be sure to have protocols and 
22 PROTECTING RESIDENTS FROM FINANCIAL EXPLOITATION

processes for responding to suspected cases of exploitation by a staff member, a 

contractor or a volunteer.

State civil laws

In some states, there are remedies beyond local APS intervention and criminal 

sanctions. These states have laws to help victims of financial exploitation and 

their attorneys bring cases in civil court and recover assets. Some states have 

processes to freeze remaining assets or make it impossible for property transfers 

to proceed. Learn about the legal options available in your state, and provide 

general information to victims of financial exploitation and others acting on their 

behalf. Suggest that victims and those acting on their behalf consult an attorney to 

explore whether they have civil remedies. Local civil legal services programs (often 

known as “legal aid”) may be able to represent the resident, or the resident may 

need private counsel.

Getting advice in your community

There will be times when, short of making a formal report, you are looking for 

information and advice from an ombudsman, adult protective services agency or 

law enforcement agency. Agency and organizational policies differ on whether 

these agencies accept and respond to requests for consultation or whether they 

will accept only formal reports. In addition to their legal counsel, every facility 

needs someone who is a dependable source for advice and assistance in issues 

concerning financial exploitation. You should try to identify one useful source in 

your community or state for advice in handling difficult cases.
A MANUAL FOR ASSISTED LIVING AND NURSING FACILITIES 23 

Preventing and deterring financial 

exploitation: orientation, training, 

and facility policies

“There is a time I was working in a nursing home and one lady was admitted 

there. I worked with her for several months and she explained to me how her 

family and investment advisers had colluded and she lost all her money and was 

now on welfare. She expressed how she missed a lot of things she wanted to do 

or buy. One thing she really missed was a good deodorant. I took it upon myself 

to be buying her deodorant and lotion which is liked and missed...I was happy 

that I added joy and happiness to the life of an old lady who was suffering from 

depression.“

Building awareness through staff orientation and 

training

Educating staff can help prevent financial exploitation of your residents and 

encourage compassionate responses. Facility management sets the tone that 

encourages good faith communication between staff and administration. This 

guide provides content, such as warning signs, to use as you train your staff. In 

addition, you can use other resources from the Consumer Financial Protection 

Bureau, such as Money Smart for Older Adults and the Managing Someone Else’s 

Money guides. You can find information about those materials on pages 24 and 26.

Invite a police officer or other law enforcement official (particularly one with 

special knowledge of older victims or financial crimes) and/or an ombudsman 

to participate in training and answer questions. APS representatives and social 

service providers also can make good trainers. These are opportunities to open 

up communication on these difficult topics within the facility as well as between 

facility staff and local service providers. These events establish a culture in which 

staff members feel safe in expressing suspicions to facility administrators. 
24 PROTECTING RESIDENTS FROM FINANCIAL EXPLOITATION

Money Smart for Older Adults

Money Smart for Older Adults (MSOA) is an instructor-led training 

curriculum developed by the Consumer Financial Protection Bureau 

(CFPB) and the Federal Deposit Insurance Corporation (FDIC). The 

program raises awareness among older adults and their caregivers on 

how to prevent elder financial exploitation and encourages advance 

planning and informed financial decision-making. The module includes:

§ Common types of elder financial exploitation

§ Identity theft and medical identity theft

§ Scams that target veterans benefits

§ Planning for unexpected life events

§ How to be financially prepared for disasters.

To download the MSOA module or find upcoming train-the-trainer 

events, go to www.fdic.gov/moneysmart .

To download the participant/resource guide, go to http://files.

consumerfinance.gov/f/201306_cfpb_msoa-participant-guide.pdf and to 

order hard copies, go to www.promotions.usa.gov/cfpbpubs.html .

Topics for staff orientation and in-service training about 

financial exploitation

§ Provider’s commitment to preventing and responding to financial exploitation

§ Definitions and warning signs

§ Risks of permitting financial exploitation to escalate

§ When and how to make reports to Adult Protective Services, licensing agencies 

and law enforcement

§ Overview of financial crimes as defined by your state’s laws

§ Consequences for perpetrators of financial exploitation under your state’s laws

§ Provider’s policies prohibiting accepting money and loans from residents

§ Provider’s policies and internal processes for documenting and reporting 

suspected financial exploitation
A MANUAL FOR ASSISTED LIVING AND NURSING FACILITIES 25 

§ The role of the compliance officer 

§ Applicable state laws and facility policy for releasing money from personal accounts

§ Sales people – how your facility has an “open door” for community involvement 

while protecting residents from unsuitable or deceptive sales presentations 

§ Visitors – how your facility balances residents’ rights to have visitors with security 

to protect residents from unlawful intruders

§ Financial powers of attorney and health care advance directives

§ Role of the Long-Term Care Ombudsman Program

Train everyone on your staff who come in contact with potential victims of elder 

financial exploitation. This includes nursing staff, social service staff, housekeepers 

and maintenance workers. Sometimes those without direct care responsibilities 

may be the first to notice warning signs of trouble. 

Sometimes a facility employee suffering from “burnout” or a personal crisis can 

be more prone to misappropriating resident funds or property. Evaluate your 

personnel policies and staffing patterns, making changes that reduce stress in the 

work environment. Develop ways to recognize and respond to staff burnout and 

personal crisis. Employee assistance programs provide a resource for addressing 

these challenges. Train managers and provide resources about signs of staff 

burnout or personal crisis so that they can be alert for risks to residents. Provide 

clear guidance to prevent behavior that may hurt the employee, the residents in his 

or her care, and the facility. 

Building awareness among residents and their 

loved ones

Programs for staff should be coupled with programs for residents, family 

members, and groups such as resident and family councils. For these meetings, 

too, invite a police officer, ombudsman, APS representative or social service 

provider to assist with training and answer questions. These sessions can begin an 

ongoing education process and dialogue.

Topics for resident and family programs about financial 

exploitation

These sessions should include topics listed above for staff training, with a few 

additions:
26 PROTECTING RESIDENTS FROM FINANCIAL EXPLOITATION

§ The person to contact when residents or family members have a concern

§ Safeguarding private documents and valuables

§ Applicable federal and state laws and facility’s policy on releasing money from 

residents’ personal accounts

§ Managing someone else’s money.

One way to start the conversation is by discussing a financial exploitation case 

from a newspaper story. The case vignettes in this manual may be a starting 

point. These opportunities can also encourage a resident or family member to 

confide concerns about financial exploitation to staff and initiate steps to prevent a 

situation from worsening.

Help for friends and family managing someone else’s 

money

Millions of Americans are managing money or property for a family 

member or friend who is unable to pay bills or make financial decisions. 

This can be very overwhelming. You can provide resources for them as 

they manage money for your residents.

The CFPB Office for Older Americans released four easy-to-understand 

booklets to help financial caregivers. The Managing Someone Else’s 

Money guides are for fiduciaries—people named to manage money for 

someone else. There are separate guides for agents under powers of 

attorney, court-appointed guardians, trustees, and government benefit 

fiduciaries (Social Security representative payees and VA fiduciaries).

The guides help people acting as fiduciaries in three ways:

§ They walk them through their duties. 

§ They tell them how to watch out for scams and financial exploitation, 

and what to do if their loved one is a victim.

§ They tell them where to go for help.

The guides are available to download on the CFPB website at www.

consumerfinance.gov/managing-someone-elses-money. 

You can also place free bulk orders at http://promotions.usa.gov/

cfpbpubs.html#special. You could distribute the guides at a family or 

resident program at your facility.
A MANUAL FOR ASSISTED LIVING AND NURSING FACILITIES 27 

If your facility has a newsletter, use a resident or family program as an occasion 

to write an article about preventing financial exploitation. For even wider impact, 

a resident or family council can sponsor a community forum on preventing, 

recognizing and reporting financial exploitation at the facility or elsewhere. For 

example, a “shred-a-thon” event to target identity theft may spur both heightened 

awareness and local recognition for your resident or family council.

Prevention from day one: 

facility financial policies and practices

Admission to facility

The time of admission can be confusing and emotional for new residents, families 

and surrogates. But it’s important to provide tools for financial protection of 

residents at the outset. Give the resident or someone acting on the resident’s 

behalf the following information written in plain language:

§ The person on staff who will answer billing or coverage questions and how to 

reach that individual

§ The provider’s process for responding to late or missed payments 

§ In appropriate situations, information on serving as a fiduciary (such as the 

CFPB’s Managing Someone Else’s Money guides—see page 26)

§ Policies and procedures for receiving and handling cash from residents or 

families

§ Facility policies regarding theft of personal property and systems for reporting 

and responding to allegations

§ Recommendations for safeguarding checkbooks and ATM cards, including 

federal benefit debit cards.

If the resident has a fiduciary, the facility should obtain and keep on file 

documentation of the fiduciary’s authority. Examples include power of attorney 

instruments, court documents naming a guardian, Social Security representative 

payee authorization, VA fiduciary appointments and trust documents. 

Unless you expect the resident’s stay to be short, the resident or resident’s 

representative should file a change of address notice with the Social Security 

Administration and any other entities that mail benefits. 
28 PROTECTING RESIDENTS FROM FINANCIAL EXPLOITATION

Recommend that residents safely destroy ATM cards that they are no longer using 

and that they change the Personal Identification Number (PIN) on a card they 

intend to use. 

Recipients of Social Security and other federal benefits are now required to 

receive their benefits electronically, either by direct deposit to a bank or credit 

union account or to a Direct Express Debit MasterCard card account, with 

certain exceptions. For information on electronic payments and how to protect 

people in your care, see the Department of the Treasury and the Social Security 

Administration websites.8

Monitoring residents’ payments to the facility for room and 

board and other services

Monitoring payments to the facility is critical, because unpaid bills may be a result 

of financial exploitation of the resident. Early detection and intervention are keys to 

preventing the worst-case scenarios of drained resources and imminent discharge. 

Sometimes non-payment has another cause, such as confusion, inaction on an 

application for public benefits, or a glitch in a third-party payment. Stay on top of 

all cases where payment is behind, so residents’ needs are met whatever the cause. 

A few weeks after move in, review the information discussed at admission with the 

resident or the resident’s fiduciary (when the resident cannot engage in meaningful 

conversation about financial matters). Answer questions, and identify any problems 

to address. 

Maintain and update documents to track resident payments in the business office. 

Delinquent account tracking documents will be important support for reports of 

financial abuse to APS and law enforcement.

Establish a process for examining all accounts that are delinquent for sixty days/

two payment cycles. Be alert for warning signs of exploitation, but intervene even if 

you don’t spot those red flags. 

Monitoring residents’ funds

Establish and follow policies for releasing funds from residents’ personal needs 

(trust) accounts. Policies should clarify when it is appropriate to release funds to 

someone other than the resident.

Perform periodic quality control reviews on a sample of withdrawals from personal 

funds or personal needs allowance accounts maintained by the facility.

Be alert to depleted accounts of residents who are without basic necessities, such 
A MANUAL FOR ASSISTED LIVING AND NURSING FACILITIES 29 

as undergarments, or who say they cannot participate in special facility outings, 

such as baseball games, because they cannot afford a ticket or fee.

Exploitation or confusion?

Unpaid bills may be a result of financial exploitation. However, they also 

may be a sign that families are caught in a maze of rules and paperwork. 

You can help minimize confusion—and avoid overdue payments—by 

working with these family members and other nonprofessionals who are 

assisting the resident. People who are confused or uncertain may be 

more likely to work with you than those who may be misappropriating a 

resident’s funds. 

Provide support and encouragement at admission and follow-up 

to people who seem to be overwhelmed and bewildered by their 

situation or their fiduciary duties. Family members and other authorized 

representatives often have little knowledge about programs that affect 

the resident’s financial well-being, including Medicare, its limitations, the 

Medicaid program, and the Medicaid application process. Also, they may 

not understand their duties when managing someone else’s money and 

may benefit from reading the CFPB’s guides (see page 26).

For resources to share with residents and those who assist them, see page 36.

Resident gifts to staff or volunteers

Have and communicate policies that prohibit gifts from residents to staff, with 

exceptions for small tokens of gratitude or holiday gifts.

Have systems to monitor such transactions and assure compliance. Explain these 

monitoring procedures to staff and volunteers. 

Sales calls and presentations to residents

Establish and follow policies that provide a welcoming “open door” to the 

community, but be alert for salespeople who pose threats to residents.

Prohibit—or develop vigilant screening processes for—sales events at the facility, 

including those described by the outside entity as informational. Any time you 

see a retirement or senior seminar advertised as “educational” or as a “workshop,” 

beware. The true goal may be to sell investment, insurance, or financial products 

at the seminar or in follow-up calls. (The Consumer Financial Protection Bureau’s 
30 PROTECTING RESIDENTS FROM FINANCIAL EXPLOITATION

consumer brochure, Know your financial adviser, may be helpful to residents and 

is available to download at http://files.consumerfinance.gov/f/201311_cfpb_flyer_

senior-financial-advisors.pdf.)

Suggest that residents and families share their concerns with you about telephone 

calls or visits from salespeople. Encourage them to say NO whenever they feel 

pressured to make a decision or a purchase.

Hiring policies

Criminal background checks are one tool for determining whether an applicant 

for a staff or volunteer position may pose a risk of financial exploitation. When 

orienting and training new employees, communicate your expectations and 

policies on abuse prevention and that each resident’s person and property will be 

protected in your facility.

Responding as a community

Addressing elder financial exploitation would be considerably more 

straightforward if each community, county and state shared universal 

protocols and resources. The reality is that procedures and sources of 

help vary widely. Providers and agencies at the local level should come 

together to understand one another’s mandates and limitations. 

These conversations can serve as a springboard to creating effective 

local methods for responding to cases of financial exploitation in 

residential care. 

Find out whether there is a local elder justice coalition, task force 

or coordinated response group working on abuse, neglect, and 

exploitation issues. If not, consider working with others to assemble 

a summit meeting to build cooperative approaches to financial 

exploitation cases. Joint training events are another effective approach 

to create and spread promising practices and to dispel myths about 

state laws and agency mandates. 
A MANUAL FOR ASSISTED LIVING AND NURSING FACILITIES 31 

Fraud and scams that target older 

people

Mrs. N began receiving sweepstakes offers in the mail shortly after her husband 

entered the nursing home. “They’d tell me I won and that all I had to do was 

send in $50 and I’d get free prizes, so I kept playing,” she said. “They’d call me, 

too, and they were very nice on the phone.” Pretty soon, Mrs. N was getting two 

or three calls a day and a grocery sack full of mail each week—news of “prizes” 

she had “won,” but could collect only by sending anywhere from $50 to $2,000 

by overnight mail. One day she asked a bank employee how she could send a 

large amount of cash through the mail. When the clerk heard what it was for, she 

examined Mrs. N’s account transactions and found the elderly woman was writing 

as many as 90 checks a month to participate in sweepstakes games offering “free 

prizes.”

Scams and fraud by strangers arise even in protected settings like assisted 

living and nursing facilities. Predators with a convincing story are as close as 

the telephone and the mailbox. For residents who use a computer to remain 

connected with family and friends, the computer can also be a source of scams.

Scams are always changing. This year’s romance scam or grandparent fraud will be 

replaced by a new and creative scheme next year. The table on page 33 describes 

consumer scams that are common now, but keep your eyes open for new ones. 

The Federal Trade Commission has a “scam alert” page with information about the 

ever-changing ways that scam artists target consumers, at www.consumer.ftc.gov/

scam-alerts. 

Residents of assisted living and nursing facilities may be targets of predators 

who take advantage of victims’ memory loss or their fear of a failing memory. 

For example, scammers may claim to be following up on a bogus order with a 

“payment” due. This is a double whammy. The victim is demeaned for “forgetting” 

and then robbed.
32 PROTECTING RESIDENTS FROM FINANCIAL EXPLOITATION

Here are some warning signs that scammers are victimizing a resident. 

§ The resident receives news about a prize or other windfall that requires payment 

of fees or taxes up front. 

§ The resident is pressured to keep good news a secret until a transaction is 

complete or risk losing out on this one-time opportunity.

§ A caller constantly seeks more information and pressures the resident to 

comply.

§ A third party claims to be from a government agency, financial institution or 

other entity and asks for information that they should already have.

§ A resident receives a lot of mail or email for sweepstakes, contests or other 

sources suggesting that he or she has already been scammed.

Preventing predatory crimes requires our best efforts to raise awareness and 

ensure prompt response. To avoid identity theft, add safety features, such as 

antivirus software and password protection, to all facility-owned computers that 

are available to residents for personal use. Don’t confiscate mail or monitor phone 

calls—those activities violate residents’ rights. Use other strategies. Distribute 

alerts, bulletins, pamphlets and other resources to warn seniors and their families 

about scams, especially those that are prevalent nearby. These resources may be 

available from your state Attorney General’s office, senior centers, ombudsman 

programs, national organizations and federal agencies. Conduct in-person 

programs for residents and families, such as Money Smart for Older Adults (see 

page 24).

If you believe that specific residents are the target of a telephone, mail, or 

computer scam, consider talking with their families or surrogates about your 

concern so that they can provide support and help to the resident in sorting the 

mail and discarding deceptive “offers.”
A MANUAL FOR ASSISTED LIVING AND NURSING FACILITIES 33 

Common Consumer Scams

Relative in need Someone who pretends to be a family member or friend calls or 

e-mails you to say they are in trouble and need you to wire money 

right away.

Charity appeals You get a call or letter from someone asking for money for a fake 

charity—either the charity does not exist or the charity did not call or 

write to you.

Lottery or 

sweepstakes

You get a call or e-mail that you have a chance to win a lot of money 

through a foreign country’s sweepstakes or lottery. The caller will offer 

tips about how to win if you pay a fee or buy something. Or the caller 

or e-mail says you already have won and you must give your bank 

account information or pay a fee to collect your winnings.

Home 

improvement

Scammers take money for repairs and then they never return to do the 

work or they do bad work. Sometimes they break something to create 

more work or they say that things need work when they don’t.

Free lunch Scammers invite you to a free lunch and seminar, and then pressure 

you to give them information about your money, and to invest the 

money with them. They offer you “tips” or “guaranteed returns.”

Free trip Scammers say you’ve won a free trip but they ask for a credit card 

number or advance cash to hold the reservation.

Government money

You get a call or letter that seems to be from a government agency. 

Scammers say that if you give a credit card number or send a money 

order, you can apply for government help with housing, home repairs, 

utilities, or taxes.

Drug plans

Scammers pretend they are with Medicare prescription drug plans, 

and try to sell Medicare discount drug cards that are not valid. 

Companies with Medicare drug plans are not allowed to send 

unsolicited mail, emails, or phone calls.

Identity theft

Scammers steal personal information—such as a name, date of birth, 

Social Security number, account number, and mother’s maiden name—

and use the information to open credit cards or get a mortgage in 

someone else’s name.

Fake “official” mail Scammers send letters or e-mails that look like they are from a 

legitimate bank, business, or agency to try to get your personal 

information or bank account number.
34 PROTECTING RESIDENTS FROM FINANCIAL EXPLOITATION
A MANUAL FOR ASSISTED LIVING AND NURSING FACILITIES 35 

Review

Together, we can work to combat financial exploitation of vulnerable adults, 

wherever they live. Here are the keys to success in congregate facilities.

§ Understand what elder financial abuse is and the warning signs.

§ Provide practical information to staff, residents, their families and others 

involved in their care about prevention and response to suspected exploitation.

§ Respond quickly to delinquent accounts—i.e. 60 days/two billing cycles—and 

to unauthorized use of funds intended for the benefit of the resident (such as 

personal needs allowance accounts).

§ Establish and maintain a well-coordinated team approach to financial security.

§ Become skilled at recording and organizing information about suspected 

exploitation.

§ Understand the responsibilities of mandated reporters, how to make a report, 

and how to follow up on reports.

§ Learn to spot scams that can target any vulnerable people, especially those in 

care facilities.

§ Know the roles of the long-term care ombudsmen, legal services programs and 

other service providers in your area.

§ Have resources and contact numbers close at hand—and use them to prevent, 

recognize, record and report.
36 PROTECTING RESIDENTS FROM FINANCIAL EXPLOITATION

Resources for facilities, residents 

and families

In your community and state

Adult Protective Services

Find the state or local agencies that receive and 

investigate reports of suspected elder or adult 

abuse, neglect, or exploitation by contacting 

the national Eldercare Locator.

1-800-677-1116

www.eldercare.gov

Area Agency on Aging/Aging and Disability 

Resource Center

Find the local agencies that can give you 

information about aging and disability services—

including local legal services programs and 

resources for caregivers—through the national 

Eldercare Locator.

1-800-677-1116

www.eldercare.gov

District attorney or prosecutor

Find your district attorney, city attorney or other 

prosecutor through the resources on the federal 

government’s web portal.

www.answers.usa.gov/system/templates/

selfservice/USAGov/#!portal/1012/article/3232/

Locating-a-State-District-Attorney

Police or Sheriff

Find a law enforcement agency by checking the 

local directory. 

Attorney General

Find a listing of state attorneys general on the 

website of the National Association of Attorneys 

General. Attorneys general can take action 

against consumer fraud.

www.naag.org 

Elder care mediation

Mediation can help resolve disputes about 

caregiving and finances. Local attorneys, 

mental health professionals and mediation 

organizations may be able to provide listings of 

local mediators. 

Long-term Care Ombudsman Program

The National Long-term Care Ombudsman 

Resource Center has detailed information on its 

website about ombudsman roles and programs 

at www.ltcombudsman.org. Find state and 

local long-term care ombudsman programs by 

contacting the national Eldercare Locator.

1-800-677-1116

www.eldercare.gov 
A MANUAL FOR ASSISTED LIVING AND NURSING FACILITIES 37 

Legal services

Free legal services for people over age 60 

Find local programs that provide free legal 

help to people over age 60 by contacting the 

national Eldercare Locator.

1-800-677-1116

www.eldercare.gov

Free legal services for low-income people 

Find local programs that provide free legal help 

to low-income people on the website of the 

Legal Services Corporation.

www.lsc.gov/find-legal-aid

Fee-for-service lawyers 

A web page sponsored by the American Bar 

Association provides information about how to 

find a lawyer in each state.

www.findlegalhelp.org

Information on legal issues affecting residents

The National Legal Resource Center has 

information on financial security, guardianship, 

capacity and related topics.

www.nlrc.aoa.gov 

Benefits

Benefits Check-up

BenefitsCheckUp, a free service of the National 

Council on Aging, helps adults age 55 and over 

identify benefits that could save them money 

and cover the costs of everyday expenses.

www.benefitscheckup.org

Medicaid/Medical Assistance

Find a listing of state agencies that provide 

Medicaid/Medical Assistance on the federal 

Benefits.gov website.

www.benefits.gov/benefits/browse-bycategory/category/MED

Social Security

Find information about Social Security benefits, 

appeals, and representative payees.

www.socialsecurity.gov

Veterans Benefits

The Department of Veterans Affairs provides 

information about eligibility, health and longterm care benefits, and in-home care.

www.benefits.va.gov/benefits/ 

www.va.gov/opa/publications/benefits_book.

asp
38 PROTECTING RESIDENTS FROM FINANCIAL EXPLOITATION

Resources for protecting 

residents against scams

Do Not Call Registry 

The National Do Not Call Registry gives people 

a choice about whether to receive telemarketing 

calls (although scam artists may ignore the 

rules).

1-888-382-1222

www.donotcall.gov

Resources for health care professionals 

at your facility

The North American Securities Administrators 

Association provides links to information and 

resources to help identify elder fraud and 

financial exploitation—including a screening tool 

for clinicians.

www.nasaa.org/1733/eiffe/

Consumer Financial Protection Bureau

The CFPB takes complaints about consumer 

financial products and services, including 

credit cards, bank accounts and services, credit 

reporting and debt collection. 

1-855-411-2372 

www.consumerfinance.gov/complaint/

Stolen Social Security numbers

Report them to the Social Security 

Administration Fraud Hotline.

1-800-269-0271 

Identifying and responding to scams

The Federal Trade Commission (FTC) website is 

a plentiful source of information for identifying 

and responding to scams, including those that 

target older people. 

www.consumer.ftc.gov

Internet crimes

The FBI’s Internet Crime Complaint Center has 

a two-page tip sheet on international internet 

scams at www.ic3.gov/media/MassMarketFraud.

pdf and accepts complaints about internet 

crime.

www.ic3.gov

Scams by mail

Contact the United States Postal Inspection 

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A MANUAL FOR ASSISTED LIVING AND NURSING FACILITIES 39 

In this manual, we use the words and phrases 

defined below. Your state’s terminology 

may differ regarding long-term services and 

supports, definitions of financial exploitation, 

and adult protective services (APS). 

Adult protective services—social services 

programs provided by states nationwide, 

serving seniors and adults with disabilities 

who are in need of assistance. APS workers 

frequently serve as first responders in cases of 

abuse, neglect or exploitation. The National 

Adult Protective Services Association website 

provides information about how to report 

suspected abuse in each state. www.napsa-now.

org/get-help/help-in-your-area. 

Assisted living—residential care offering 24-hour 

staffing and assistance with activities of daily 

living. Assisted living is regulated by states. 

Over two-thirds of the states use the licensure 

term “assisted living” or a very similar term. 

Elder abuse, often referred to as “abuse, 

neglect and exploitation,” includes many types 

of mistreatment of older adults. The National 

Center on Elder Abuse describes seven types of 

elder abuse:

§ Physical Abuse

§ Sexual Abuse

§ Emotional or Psychological Abuse

§ Neglect

§ Abandonment

§ Financial or Material Exploitation

§ Self-neglect.

Terminology for these types of elder abuse 

varies in state law. 

Long-term Care Ombudsmen—advocates for 

residents of nursing homes, board and care 

homes, assisted living facilities and similar adult 

care facilities, in programs administered by the 

federal Administration on Aging/Administration 

for Community Living. Ombudsman staff 

and volunteers work to resolve problems of 

individual residents. Every state has an Office of 

the State Long-Term Care Ombudsman, headed 

by a full-time state ombudsman.

Mandatory reporters are people required by law 

required to report their suspicions about elder 

abuse to a specified public authority.

Mistreatment—abuse, neglect or exploitation, 

singly or in combination

Nursing facility—residential care facility subject 

to state licensure requirements as a “nursing 

home,” “nursing facility,” or “intermediate care 

facility,” or providing similar levels of care. 

Most are also subject to federal standards as 

providers of Medicaid and/or Medicare covered 

services. Nursing facilities generally offer a 

higher level of care than assisted living facilities.

Vulnerable adult, person, or resident—an 

individual who is at risk of abuse, neglect or 

exploitation because of age or disability.

Terminology and usage in this manual
40 PROTECTING RESIDENTS FROM FINANCIAL EXPLOITATION

Endnotes

1 Manuals with state-specific information should not be designed in a manner 

that gives the impression that the guide is a CFPB product or has been 

officially endorsed by the Bureau. The CFPB logo should not be used, nor 

should the guide include any language to the effect that CFPB produced the 

material, endorses the final product, or has approved of it. States may indicate 

that their guide was based on a separate guide produced and distributed by 

CFPB. 

2 This guide uses the terms “financial exploitation” and “financial abuse” 

interchangeably. Your state’s laws that protect older adults may use these or 

other terms. 

3 A few states have two separate agencies, one for people over age 60 or 65 

and another for people from age 18 to age 60 or 65. 

4 In addition to adult protective services laws, there may be other state or 

federal laws that require you and your staff to report suspected abuse or 

suspected crimes. 

5 42 U.S.C. 1320b–25 

6 The term “long-term care facility” means a residential care provider that 

arranges for, or directly provides, long-term care. The term “long-term 

care” means supportive and health services specified by the Secretary of 

the Department of Health and Human Services for individuals who need 

assistance because the individuals have a loss of capacity for self-care due to 

illness, disability, or vulnerability. 42 U.S.C. 1397j.

7 www.cms.gov/Medicare/Provider-Enrollment-and-Certification/

SurveyCertificationGenInfo/downloads/SCLetter11_30.pdf 

8 For example, see www.fms.treas.gov/godirect/partners/nursing-facilities/.

This link includes a federal government webinar that was developed in 

conjunction with the American Health Care Association. 

May 2014

consumerfinance.gov

Consumer Financial Protection Bureau

1700 G Street NW

Washington DC 20552

855-411-CFPB (2372)

TTY/TDD 855-729-CFPB (2372)

info@consumerfinance.gov