Is this how the Attorney General investigates reported fraud? If so, we are in trouble.

Is this how our Attorney General’s Office typically investigates concerns of fraud?

If so, I’m rather concerned about the competency level of the investigators.  This information was retrieved from Public Records.  I have left out the names of the agency, reporter and Attorney General Investigator’s name.  If you are interested in learning more, please contact me.

Reported to Attorney General Fraud Unit:

A provider in a supported living home listed herself for two positions:

Licensed nurse = – worked 53,505 hours in 2010 (most likely a typo) – Washington State paid her $123,063 or this position

Aid – worked 1,195 hours in 2010 – Washington State paid her $15,705 for this position

This person was paid a total of $138,768 in 2010 for her combined positions

(8760 hours in one year)

ATG Response:

Thanks for this referral. Do you know what the financial impact of reporting the overlap hours? If she didn’t report the aid hours, how would that affected the group home rate?

Reporter response:

I’m not quite sure what you are asking and why – what I can tell you is that I’m concerned about the number our hours that his one person stated she worked and was paid for.  It’s not the rate that I’m concerned about.

This one person stated that she worked 53,505 (obviously a typo, I think that she meant 5,350) as a licensed nurse and 1195 as an aide – that makes 6545 hours that this one person worked in a year.  Given that there is 8760 hours in a year, that means that she only had 6 hours a day every day of the year to sleep and attend to the other aspects of her life.  Is this doaable?  Does the state allow people to legally work that much?

That’s what I’m concerned about.  To me this seems obvious what the issue is but maybe I’m missing something – please let me know.

ATG Response:

In order for my office to prove fraud charges, specifically, theft we need to determine amount of loss to the State of Washington relating to Person’s inaccurate reporting of hours.  If she inflated hours worked on a cost report, I’m assuming that could possible impact the rate she is paid in subsequent years?  I’m trying to determine financial impact.

Reporter Response:

Wouldn’t it be fairly easy to determine the financial impact?  How many hours can one person work – subtract that from what was reported and the difference is the number of hours that was overreported.    A normal 40 hour a week job is 2160 hours a year.  This person claimed to work 6545 hours.  That means that she worked 4385 hours of overtime?  Is that even legal.

I’m sorry that this appears so difficult to figure out.  From my perspective it’s very easy.  I don’t understand what your difficulty is.

 

Why is the ATG Investigator asking these odd questions of the reporter?  What am I missing in this scenario?

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