Episode 70: Nursing Home Abuse & Neglect Investigations with Nic Decker, PI

Nursing home abuse and neglect is a real problem - especially for several states. In this episode of The Investigation Game Podcast, Nic Decker, PI explains the evidence and investigation steps he takes while investigating cases involving nursing home abuse and neglect. Based on his investigative experience with such matters, Nic shares with listeners the red flags and warning signs to look for, and ways to research a nursing home, when having to make long-term care decisions for a loved one.

In 2005, Nic began his career as a Private Investigator. It became evident soon after, that there was a lack of overall quality of service and innovation in the Oklahoma market. Nic sought out veterans in the fields of personal injury, nursing home abuse & neglect, and criminal defense who exemplified these long lost qualities and studied the foundational principles and practices that built their stellar reputation among their clients and colleagues. One year later, in 2006, Paradigm Investigations was born out of Nic’s drive for excellence to restore honor to his field. It is this same passion and drive that continues to accelerate each of Paradigm Investigation’s cases to success today.

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Transcript

Leah Wietholter:

Hi, I'm Leah Wietholter. And this is the Investigation Game Podcast.

            Welcome to the investigation game podcast. I'm Leah Wietholter, CEO of Workman Forensics in Tulsa, Oklahoma. Joining me today is Nic Decker. In 2005, Nic began his career as a private investigator. It became evident soon after that there was a lack of overall quality of service and innovation in the Oklahoma market. So, Nic sought out veterans in the fields of personal injury, nursing home abuse and neglect, and criminal defense investigations who exemplified these long lost qualities and studied the foundational principles and practices that built their stellar reputation among their clients and colleagues. One year later in 2006, Paradigm Investigations was born out of Nic's drive for excellence to restore honor to this field. It is the same passion and drive that continues to accelerate each of Paradigm's Investigations cases to success today.

            Nic has agreed to share stories about his investigations. So, I just wanted to mention that this might be an intense or heavy topic for our listeners. Thank you so much for joining me today, Nic.

Nic Decker:

Thank you for having me, Leah.

Leah Wietholter:

I know we're here to talk about what could be a really heavy topic today, but before we get into that, I have to start this episode like I do just about every other episode with a private investigator. How did you end up in this field?

Nic Decker:

I was actually encouraged by, I have several colleagues in federal law enforcement, local law enforcement down in Oklahoma City, Oklahoma area. Federal law enforcement was... There's the National Custom Aviation Center down there for what used to be known as US Customs. Now it's known as ICE, Immigration Custom Enforcement. A lot of those guys that were there at the time, they encouraged me to get into the private sector of investigations, as I was able to see a lot of detail, a lot of data analytics, which is, you well know, that's a big chunk of what we do, is having the ability to see things that most other people don't see. And so they kind of guided me in that direction as a good fit for them because they were kind of my mentors at that time.

Leah Wietholter:

Yeah. Awesome. So, what is one of your favorite things about being a PI?

Nic Decker:

Honestly, I say this to a lot of the people that I interview and a lot of people that I actually work with, even my clients, the attorneys and individuals, one of my favorite things as a PI is to be a third party. Whoever pays my check, it does not matter to me. I am an unbiased individual. I come in, I look at all the facts, and then I just present them. So, it doesn't matter who writes the check, who is the one that issued the case. I'm the person that gets all the details. I can take the case and pursue it as how I see fit to make it the most complete and comprehensive court ready report for the client.

Leah Wietholter:

Yeah. So, I think having worked with law and then also as a private investigator, I do like the private side of things a lot, for a lot of reasons. But I do like just being able to go in and have that third party approach to an investigation. That's really great.

Nic Decker:

Absolutely.

Leah Wietholter:

Really great. So, what was one of the most surprising things you discovered after entering this industry?

Nic Decker:

Yeah, that's an easy one for me. And of course other PIs may say something different, but you could have the best skills, the best training, and the best results but if you don't have marketing in the PI industry, you're never going to get noticed, which means no cases then and as I always liked Gary Glanz adage that we're only as good as our last case. That's true. But if you don't have marketing, no one's going to see you. And you can't perpetuate that lack of a better word of stigma about your reputation.

Leah Wietholter:

Yeah. So, you know the phrase, "If you build it, they'll come?" I don't feel like that's true in our world.

Nic Decker:

No.

Leah Wietholter:

Like, I mean, it's fine. You have to build it so that someone will come. But most importantly you have to tell people that's what you built.

Nic Decker:

Yes, yes. And you have to continually market yourself. It can't just be like it's up here, but you have to keep generating and keep putting money in to make sure those cases and people know that you're still there and that your name is still out there in the PI industry. Because we're always in the background. It's not like one of those things where you see a QT or a Blue Cross Blue Shields, there's signs everywhere. You don't see PIs, you don't hear about us. So we're always in the background and it's easy to forget about us.

Leah Wietholter:

Yeah. And I remember I had a PR consultant for several years who was really, really helpful, but the number one thing I think that she found so frustrating working with me, or at least from my perspective, I don't know, she could have had other things she didn't like about working with me. But the number one thing was that she was always saying, "Can you get your clients to leave recommendations, reviews, referrals, things like that, testimonials on your website?"

            And I would say, "So and so, no, I can't, because these are very sensitive, private matters." I mean, how many businesses really want to say, "Oh yeah, Leah was so great at investigating an embezzlement for us."

Nic Decker:

Right, yeah. And it's just publicizing that, and then not only that is on pretty much every case I have, I have an NDA, so-

Leah Wietholter:

Yes.

Nic Decker:

I can't. These people are not going to come forward and make a Google review about what I did for them.

Leah Wietholter:

Right.

Nic Decker:

So, yes. I completely understand on that level as well.

Leah Wietholter:

Unless there's like, I don't know, I've had a couple. Or attorneys will leave reviews.

Nic Decker:

Yeah.

Leah Wietholter:

Sure.

Nic Decker:

[crosstalk 00:05:32] Reviews, yeah.

Leah Wietholter:

Right. Because you don't know who the end client was, but yeah, that's true. Yeah. I was talking to somebody just today about how we can have all these credentials and licenses and all of those things. And we can say, "This is what we want to get paid." But if we don't actually know how to do business development, networking, marketing, like you said, it's all well and good, but we got to be able to-

Nic Decker:

Right. And you can be the best of the best. But if you are not out there marketing, it's not going to matter.

Leah Wietholter:

Letting people know what you do. Yeah.

Nic Decker:

Yeah. Letting people know what we do. And then even that, 90% of the time, even if you explain it to them, they still don't understand.

Leah Wietholter:

Right.

Nic Decker:

So, you still have to tell them, "Hey, this is our specific niche. This is what we do." And really hone it in and then just keep putting your name out in front of them. So, that's really what I've found to be the most surprising thing after I got into the industry.

Leah Wietholter:

Yeah.

Nic Decker:

Was kind of getting into the industry.

Leah Wietholter:

Yeah. I would agree. I would agree. But even those niche areas, like whenever you've explained it, it's incredible. I remember whenever we started specifically trying to get outside of Oklahoma, so we needed to use more digital marketing efforts. And I remember thinking, "I don't have anything to say to anybody. Who wants to listen to me?" But just like what you said, explaining what you do, it's amazing how much content can come from explaining this little niche or this one service, like what we're here to talk about today. Just this one thing that you do.

Nic Decker:

Right.

Leah Wietholter:

There's a lot of content and education that can come out of that.

Nic Decker:

Yeah. And the amount of training that we have to go through just to stay on that curve with laws and working with software and everything we have to put continuing, when they say continuing education, I mean, it's really something that we have to hone in on-

Leah Wietholter:

Yeah.

Nic Decker:

... On our skillset. So, it's not just once you learn it's there. You have to keep at it almost every week, every month, and just keep going with new laws, and new strategies, new methods.

Leah Wietholter:

Yeah.

Nic Decker:

So it's very interesting.

Leah Wietholter:

Speaking of training, what has been the most valuable form of training that has helped shape your career?

Nic Decker:

I'm a member of NALI, the National Association of Legal Investigators, and several other associations. Those are all great and networking is really good. But what has helped me the most during my career so far to date is actually mentorship. As you know, I worked with Gary Glanz and there's also another individual, another PI. It's female, but reminded me of a female Gary Glanz. Very, oh, how would you put it? That gum shoe, older, very smart, very intelligent. You would never, if you saw her out in a crowd, never know that she was a PI, that sharp as a tack. She was the one that taught me how to write my reports and she was the one that always said that, oh, she goes, "Nic, if you ever have a bad case," which you will, as you know Leah, there's those cases that no matter what you do, it could just be a bad case.

            She's like, "A good report will fix a bad case." And that's something that you often see with PIs now is they don't know how to write a report. It's just part of the analytics or something that they don't want to put the time into the report, or they don't know how to properly explain what they're saying or how to decipher it for the client so that not only the client wants to read it and they can read it quickly. Because as attorneys don't have all this time in the world to read a really condensed or comprehensive report to make it to where they can consume all that or digest all that information you're giving them in a real simple manner. But at the same time, that the reports that they were able to consume that condensed information down into what is the most beneficial for their timeframe.

            And a lot of PIs just don't know how to do that. And mentorship, so by far, has been the best thing for me. And I always seek out, no matter how far along I am in my PI career, I always seek out additional mentors. If I notice that, "Hey, this person knows something that I don't know," I will always kind of have that, "Okay, I need to be more around them because I can improve my skills around them." I think that's the best... I know other PIs would say other things, but mentorship by far and surrounding yourself in a good network of people are the best things in our industry.

Leah Wietholter:

We often have people who reach out and ask us if they can do internships or volunteer or whatever to kind of get experience. And that, just from a forensic accounting standpoint, that is really difficult. I'm just being real transparent in these episodes, but it's really difficult. How do you drop somebody in on a case that it might take three weeks to get complete information, and then the learning curve and all of that? And I know that's frustrating as an investigator. So, this is how I handled mentorship. And then I'm curious how you've gone about it. Because maybe you have been around mentors that didn't mind doing those things. But when people reach out to me, it is complicated to try to bring somebody into a case and confidentiality and all of that at the same time.

            So how I handled mentorship, because I would agree having mentors to help you navigate some of the pitfalls of a case, I mean that's invaluable. I mean, you can't even put a price on that. So, what I would do is whenever I got a case, going back to that marketing networking business development, I would go get the case. And then I would ask someone with more experience, "Would you like to work on this case with me?" So then both of us are being compensated for our time. I'm the newbie, but I'm bringing the work in, right? And then I'm gaining experience and also valuing that person's time. Now, there's stuff in those conversations and everything that sure they don't get paid for. And that I remember to this day that like, "Oh, that was such good advice on that case that I've taken." But I feel like that has worked really well. What about in your experience? Is that how you brought in, built those mentor relationships, or have you found people who were willing to kind of take you under their wing?

Nic Decker:

And the thing with mentors that I was able to, I went through associations first and in actuality I think I actually, Gary, I had actually met through somehow through you. There was some kind of, I think we had discussed him at one time or you had maybe given me an introduction, which would've been a form of networking. And I can't quite... It's been so long ago. I'm trying to remember how I had that exact introduction to Gary. But I was able to get those introductions to mentors because of they knew my work ethic and they knew that I was willing to put in something and they could get something back from me. It wasn't a one sided deal, like what you're saying.

            You can't just go in and just expect, "Hey, this person's going to teach me everything and then they're going to leave." It doesn't work like that with mentorship. [inaudible 00:12:19] Each party, it has to be a partnership in there. And that's what a mentorship is about. You will always, when there's a partnership on it, you'll always walk out of it knowing something more than you did when you went in. And that's how you grow in our industry. You will always be the best in your field when you have more knowledge and more wisdom, that you can charge all you want, but you can still be the stupidest person in our industry.

Leah Wietholter:

I mean, it may not last very long, but-

Nic Decker:

You may not last very long. That's exactly right. But as long as we're partnering with individuals that are like-minded and our ethics are high, our standards are high. So, we're not willing to bring it down below a certain bar and we're partnering with each other to where we're continually learning, I feel like that's the appropriate manner that I've got in the past about mentorship.

Leah Wietholter:

Well, very cool. Well, I want to get into our topic for the day, but first let's take a quick break.

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            Welcome back to my conversation with Nic. So, Nic, today we're talking about nursing home abuse and neglect investigations. So, first, how do you define this topic? What's involved typically in these investigations?

Nic Decker:

Okay. So one first, and this is my opinion as an investigator who's worked on these cases for several years and just to kind give you some background. I was trained by literally some of the best attorneys in this field in both Oklahoma and Texas. They sent out all their attorneys, they put me hands on. This is how we do these types of cases. There's not courses you can take for nursing home abuse and neglect investigations. You just have to have that hands on in the moment. And there was a firm out of, I believe it's Houston, was where that law firm was. And they sent up their investigator and said, "Hey Nic, we're going to have our investigator work with you. And he's going to show you how to write reports, how to take statements, do everything, what specifically to look for in these cases." And also I worked with their nurse case manager, which is basically an RN, or a registered nurse.

            And they're like, "Okay. So when you look at the medical documents, the medical charts, here's what you're looking for, A, B, and C, and so forth. And this is how you, when you're talking to your witnesses, this is how you lay out your questions." So, you kind of have to understand that when you read or when you hear the word nursing home abuse and neglect, abuse and neglect is not one word, it's two. Abuse shows an intention, basically it's an intentional act. And so there could be several things in this, but just to give you some examples, there is staff, and to give you an idea of this, it's a medical professional at a nursing home or a staff member that's verbally degrading a patient or threatening a patient. So, it could be verbal, it could be emotional. Elderly are typically very... At that stage in their life, when at a long term care facility, assisted living, or otherwise, they can be a little bit more malleable in their frame of mind.

            And a lot of people, they have, unfortunately to say, there are those people that they will use that to their advantage. That's considered abuse. Then there's also where they physically manipulate a patient. That's where they forcibly try to make them do actions that they are not used to, or they're not able to do that. And then also where another physical aspect of that would be injuring a patient where you hear about this often. A medical professional will just, they get frustrated or they get upset, they take their anger out of them, a elderly patient, and either beat them in the face or they break their bones, push them down. One of those things. And then also, what I've also seen is sexually abusing a patient. That is, you wouldn't think that's a topic that comes up with elderly care, but it is very much so. And that's something that we will be discussing here later as an example.

            That's what I would say on the abuse side, the neglect can be intentional or unintentional. And so, whenever I say neglect, that's often where they... Think of it this way, neglect is where a nursing home, they didn't do their background checks because they're trying to have a profit margin up there. A lot of these nursing homes have shareholders. So, they have to keep their profit margins up here. So they've got to bring their costs down. So they will hire less skilled nursing staff to pay the minimum wage. It's not so much as a willful intent as it is, "Hey, we've got to meet a profit margin. And so, we're going to place profit over people." Other times, smaller nursing homes just don't have the money to replace equipment like lifts and things where then because they're not responsible in that manner, their patients or their residents, they get injured, they get hurt, which at that age, a broken bone can eventually lead to death. It's sad, but you see that as some of the most common themes of in the differentiation between abuse and neglect.

Leah Wietholter:

So who hires you in this type of investigation and what role do you play?

Nic Decker:

So, I am hired by and I strictly work for attorneys. And when I say that, it's because it's not that I don't want to work for individuals. I'm certainly more than happy to, but I will refer them to an attorney for attorney client privilege, and then to go through that process too so we can obtain all the information and we're not just spinning our wheels, wasting client money, because I'm not about that. I'm about, "Hey, let's get in there, let's get this case done," because once we start on a case, that means that, and I'm just going to be blunt about this, cases have to move as quick as possible so that you can find all the witnesses possible on a witness list before, and we've seen this time and again, and when I say we, I'm not just referring to my private investigation firm, but others in other states, other colleagues that I work with that are specialists in the nursing home field who have written books and we've all seen this.

            It's not a one time thing where a nursing home will go out and scare one of their employees or threaten them not to say something, even though there's whistleblower laws or the whistleblower's law, people still get scared and they still are threatened and they don't want to talk to us. So, once we get all our information, we come up with the case plan and we move like lightning. We talk to all our witnesses, we get everything down and there's a certain way that we are able to make sure that we get all our information at once.

Leah Wietholter:

Yeah. Speaking of that, what access do you have to obtain evidence? And in specifically, I guess, what types of evidence do you try to obtain, and then what access do you have to obtain that evidence?

Nic Decker:

Yeah, that's a good question. So, typically that goes through the attorney and through the discovery process and the bare minimum that I like to have for my investigative standpoint are the... One, it's going to be the medical records because you can pull surveys. There's what's called a nursing home survey. And it's on the state website. The state has keeps surveys of each of the nursing homes and long term facilities, assisted living facilities where nursing home inspectors have gone in and done periodic checks because all these facilities are licensed by the state. So, they have to be inspected by basically state investigators. If for some reason they go in on their scheduled time, which just so you know, most nursing home facilities know that they're already coming.

            If they're short staffed, which nursing homes typically are, because that's one of the ways they keep their profit margins high up, and the expenses down, we see it time and time again, whenever there was on the time sheets, all of a sudden, week after week after week after week, there's low people. There's low staff. Then on the day of the inspection, there's a lot of people there. And then, I always work with an attorney and I always refer my clients to attorneys. I work with exceptional attorneys that specialize, you always want to find an attorney that specializes in nursing home abuse and neglect cases, because it's not one that a general attorney knows how to handle or ins and outs. Like with everything, you want to find a specialist. And so the evidence that they obtain obtained during discovery, we're talking about the medical charting of the resident or the patient, and keep in mind most of the time that I receive the case is maybe a year, year and a half after the incident.

            And I mean, it's just by the time it goes to, they filed and you get discovery and most of the time the individuals are deceased just because of the severity of the type of case. And it is sad. But we also look at time charts that we get to see who was at the facility at that time. And then as well as, and that's the thing you have to understand about these nursing home cases that we receive. Whenever we get it from a facility, and I don't want people to think that nursing homes overall are just inherently bad. There's not. There's great people out there, people that want to do great things to help the elderly, but there's also, like I said, those nursing homes that you just see over and over and over again, they just put profits over people.

            So they will, whenever we receive the records, instead of putting names on charts like medical charting, they'll put initials, or they'll put initials on time sheets. So you don't know who was where and who was at which time or they'll use numbers. So what you have to do is you have to use the surveys, the state surveys, to coincide everything, and the state surveys are anonymous. So they're redacted, or they'll say, "Investigator, I think it's like, surveyor one went into residence room." And so there's a methodology that I was taught on how to read these charts and correlate like we were talking about earlier, all the analytics and connecting the dots. And then you go find your witnesses. We use that as a starting point.

            So it's medical records, time sheets, surveys. I mean, it is when you're talking records, they send me boxes of records to go through. It's like most of the cases that we've seen together, it's those banker boxes that you just have loads of them and you're going through and highlighting them, every single thing you need. And then you make notes of who you need to go find, who you need to go talk to, and just deciphering that information.

Leah Wietholter:

So you use the information in the medical charts or records, time sheets, state surveys to identify then the people that you're going to go interview about the incident. Is that correct?

Nic Decker:

That is correct. And it's not like, I think you and I had a conversation not too long ago. Our work is not clear cut. It doesn't just say, "Hey, you need to go here." There was a two initials on a chart out of how many people that were employed at that facility, and sometimes you don't know who was employed at that facility because they don't send you those records or those records magically disappeared. And so you have to find another person. You have to find that connection. It's pretty much every case that you could become involved in from a missing person's case, to a locate, to witness statements, to interpreting medical data along with a nurse case manager, and to have optimal case results for the client.

Leah Wietholter:

So then with these findings, like after you've interviewed these individuals, what do you do with your information? Do you end up testifying to it? Do you just turn it over to the attorneys so that they can work their side of the case? What do you do with this evidence?

Nic Decker:

The way I work it, and one of my colleagues, and it's different in different states. So, in Oklahoma, this works, and it works quite well. Is the, I go out and I find the witnesses we create, what is an affidavit. It's a statement of fact. "I was here on this date. I saw this happen and I was employed from this date to this date." It's what you truly have to find in these cases are the medical staff or the staff at a nursing home that actually care about the residents. And that's what this is all about. It's about the residents or it's about someone's loved one that got hurt. It's not about a lawsuit. It's not about what some people think as revenge or just being angry, being frustrated. It's about that the statistic came out a short while ago, and I'm trying to remember when it came out that one in 14 cases of abuse and neglect in the US get reported in nursing homes.

            So for what you hear for the majority, multiply that by 14 and you'll have a solid average. Oklahoma is up there right around the 46th. I think that's what it was last. I think Texas is the worst still in the United States, Oklahoma's around 46th, 47th, I believe. And depending if Puerto Rico's sometimes in that statistic, you have to understand, some states are great at really looking at it from a, "Hey, these are our loved ones. These are our parents. These are our grandparents." Other states, especially Oklahoma, we do not have a agency that really polices nursing homes. It's there, but it's that same statement that you always hear. There's not enough funding it's they just don't police it.

            And like I said earlier, nursing homes always know when these are coming up, when these surveys are coming up, these inspections. And so, they're always properly staffed at those times. They're always have every hot meal out, everything. So the elderly are not in any way, shape or form whenever they see it in need. But on the evidence that we see, it's different. So, that's what people do have to understand. This is about their loved one. It's not about any type of other figure.

Leah Wietholter:

So before we wrap up, do you have a case story that you can share with us?

Nic Decker:

So there are two types of cases that I typically see is one is the going to be the, like we said, the neglect, which is going to be where someone is they don't turn the elderly or the patient or the resident. And so, which becomes, there's all the pressure on, let's say a hip. In one specific case, there was an individual where they just, she was overweight by standards. So they just didn't turn her. And eventually because of the thinned out skin which occurs with most elderly people, that the skin, just for lack of a better word, in layman's terms broke. They didn't treat it where they cleaned it off.

            And so, and this gets graphic is where then the flesh starts to rot and they'll pack it. But once it's there, it just kind of gets... you start to smell the rotting flesh. And eventually they do die from that. And that's the neglect part that you see a lot of times is they won't turn the individuals. They won't pay attention to them. And with neglect, that was a difficult case to see.

Leah Wietholter:

And in that case, did you end up interviewing different people to find out kind of what happened? And then can you say what the result of that case was?

Nic Decker:

I believe what that, on that particular case, I went around and spoke to the RN. There were two RNs on that file. And they provided an affidavit and a recorded... So basically it's a recorded statement with an affidavit, a written affidavit where they signed off on it stating that, "Hey, this interview was accurate and these are the actual statements." And then I notarize it, because to authorize it and everything. And then I believe there were three or four, I'm trying to remember right off the top of mind, LPNs that worked. And then that rotated that some knew of her, some had direct contact with her. You'll always find that they're not directly affiliated, but they know of what's the staff to patient ratio and how full is the facility compared to what their occupancy rating is, what the facility was initially designed for. A lot of these facilities, they were all designed to hold 150 people, and now they're holding 300.

            And so, which means they're bathroom facilities, their food facilities, their nursing stations, they weren't designed to contain that capacity. So it means they're just, again, pumping that up. So, that's what you see a lot of. And then you really get into the CNAs and the CMAs. And those are the people that have the hands on care. They will keep the residents clean. That's, at least, that's their job. And the CMAs can also help them with medication, whether they get that medication or not, that's a different story. So you have to follow through on everything. There's a certain type or a certain list that you ask of each CMA to make sure that, "Hey, is that prescription being stolen, or are they receiving what they're supposed to? Are they being over-medicated?" Because you will see that with a lot of nursing homes and over-medication does lead to quite a bit in our industry, especially in Oklahoma.

            I believe the last statistic I saw was we were number one for over-medicating our elderly in nursing homes and long-term care facilities.

Leah Wietholter:

Well, wonderful. You are really helping people want to move to Oklahoma through this podcast episode.

Nic Decker:

Yes. And I do apologize- [crosstalk 00:31:00].

            The positive aspect that-

Leah Wietholter:

Oh my gosh.

Nic Decker:

So, but, and I can provide references for that at the very end. Then also what you also see on the other side of it is going to be the abuse. And this one is a little bit more... If we have a few minutes. I don't want to over.. There's, you do have cases like this where nursing homes don't always know who they've hired. And of course that's common with any company.

            There was a case that I investigated the individual, I'll put it that way, had raped multiple residents and had also assaulted some of the RNs. And this one actually turned out good because this person turned out to be... The information was turned over to the authorities. And this was also used in, after that was finished, it was turned into a civil case. But what was difficult was talking to the nurses, the LPNs and the CNAs about this individual.

            There's kind of an emotional trauma as you can imagine and how they wanted to talk about it, but they didn't really want to talk about it. Because a lot of people are in fear for their jobs. When you approach people who really want to make a difference, they will talk to you. It's just, they need to understand the context of what's going on. And this particular individual did receive prison time and the family or families just kind of leaving it ambiguous, did receive compensation for what could have been prevented.

Leah Wietholter:

Do you think it could have been prevented by like a background check? Was this person a repeat offender?

Nic Decker:

In this case, yes. It could have been prevented entirely. And it was one of those cases where, as you and I both know, if you just a cursory background check on Google or something, doesn't do anything. But if you hire a professional to do the background checks, then yes, you can normally mitigate a large portion of your liability.

Leah Wietholter:

Yeah, for sure.

Nic Decker:

In this instance, let's put it that way.

Leah Wietholter:

Yeah. So kind of to wrap up here, since we've had a couple of stories that are definitely sobering and I don't... I always want to discuss the realities, right? Of what's happening in the world. And as an investigator, I mean, we just see things that maybe others don't necessarily see, or even think about. Having worked these investigations, what are some of the things that you recommend people, and I know you have a white paper on your website that will link to in the show notes, but what are just a couple of the things that you recommend when people are trying to make a decision on a nursing home?

Nic Decker:

I would go obviously visit the location. I mean, some people just say, "Hey, this one fits my Medicare or my budget," which I understand that is, especially nowadays, that is a priority is because long term care, assisted living, it's expensive. That's certainly something to consider, but go visit the location, go talk to the individuals, go talk to the staff. Whenever you're walking in the halls, see if food is sitting out in the hallways. Is the food cold? Because there's a certain staff to patient ratio. If the CNAs aren't able to keep up with all of their individuals that they're assigned to, then your loved one's going to get cold food or they're not going to get fed. Because eventually that food's going to go back and thrown away.

            So, which also means that your loved one, if they need to go to the restroom and they need help getting up, they're going to be sitting in their own urine, their own fecal matter. And they can't make it, which means they're going to try to get out of their bed, possibly fall, break their hip, and then that could lead to additional issues. And something like that would be great. Do an interview, like I said, with the staff. And when you're looking at the staff, make sure you note their names, ask for the names of the staff. That's your right to know who's taking care of your loved one when you're doing this.

            And then on my white paper, which will be linked to the notes is nursinghomeinvestigator.com, I'll show you links on what to pull up. You can pull all of Oklahoma's RNs, which is a registered nurse and the LPNs. And then you can put in their names and then I'll show you, "Hey, do they have a disciplinary action?" If so, what's that action for? A lot of them have been there previously, have a disciplinary action for stealing drugs, being high on drugs while they're UA or their urinalysis failed whenever they were administering medical treatment. These are things that everyone needs to know and you do have a right to know. And also you can go to what I provide too, is the link to look at surveys for nursing home facilities or long term care facilities.

            And you can see in there, "Well, Hey, the survey found last time." They won't provide, like I said, detailed information, like a person's name or the investigator's name. They won't provide any of that, but it will say, "Hey, what we found here was they call them F tags," and there are different types of tags in there. And you can read the actual case notes where it says, "Hey, this person who was found, this person fell due to negligence," or not negligence, but they called something else in there. But it will tell you that there was what type of issues were involved, whether it was a slip and fall because no one was watching them when they were supposed to.

Leah Wietholter:

Right.

Nic Decker:

And whether medication, yes, they didn't receive their medication on time, which caused additional issues. There are a lot of different things people can take to be proactive in preventing these types of issues. But if anyone ever has any questions, they can feel free to call me. I mean, this is a passion of mine. It's not something... I've seen it time and time again. And it's something you carry, but you understand what I'm saying.

Leah Wietholter:

Yeah. Well, thank you so much for taking time to talk with me today, Nic. And if any of our listeners want to connect with you, we'll make sure to list all of your contact information if they have any questions. And we'll make sure to mention those in the show notes.

Nic Decker:

I appreciate it. Thank you, Leah.

Leah Wietholter:

Thank you for listening to the Investigation Game Podcast. For more information on any of the topics brought up on this show, visit workmanforensics.com. If you enjoyed our show, please be sure to subscribe and leave a review. You can also connect with us on any social media platform by searching Workman Forensics. If you want to learn more about using data and forensic accounting engagements and fraud investigations, make sure to check out my book, Data Sleuth, available on Amazon or anywhere else you like to buy your books.

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