Sentinel Project

Designed to Protect Vulnerable Adults

The Sentinel Project lives within the Health Care Fraud Division (HCFD). The project follows the division’s mission of combatting abuse and neglect of vulnerable adults in long-term care settings.

Long-term care settings include:

Skilled nursing facilities;

Assisted living facilities; and

Adult foster care homes.

Specially trained investigators look for evidence of abuse or neglect. They develop a case and follow it through to trial.

The team collaborates with:

Licensing and Regulatory Affairs (LARA);

Long Term Care Ombudsman;

Elder Abuse Task Force; and

Local law enforcement.

Nursing Facility Abuse or Neglect Complaint Form

View Related Press Releases

The Process

1

Complaints Received

Complaints are received through internal sources, such as hotline, online form, and traditional mail. They are also received through external sources such as local law enforcement, Long Term Care Ombudsman, LARA, and medical professionals.

2

Evaluate

The intake team evaluates which complaints may warrant a Sentinel Project visit or require the collection of additional information relative to the complaint prior to assigning to Sentinel Project for review.

3

Visits Occur

Once the Sentinel Project visit has concluded the team decides whether to move forward with an investigation, refer to LARA, or close out.

4

Outcome

It should be noted that criminal investigations can take months or well over a year to complete, resulting in charges or closing of the case.

What Factors We Consider
Each visit is customized based on the complaint received. Items considered include:
- LARA survey citations;
  
  Federal Survey and Certification Search;
  
  Statewide Search for Adult Foster Care / Homes for the Aged Facilities;
- Facility incident reports;
- Past complaints against the facility; and
- Input from partnering agencies.
The investigative team also considers:
- Adequacy of staffing levels;
- Overall general wellbeing of residents;
- Maintenance and staff education of medical equipment used;
- Safety of medication storage and administration;
- Appropriateness of nutrition and feeding;
- Fall prevention measures; and
- Wound care management.
Visits Since 2021

Sentinel Project Visits Across the State of Michigan Since 2021 (PDF)

Positive Practices
- HCFD providing education to staff on vulnerable adult financial exploitation, abuse, and neglect;
- Actively work to increase staff satisfaction and morale;
  
  Staff are honored for their good work through an Employee of the Month program which may be done by hanging their picture near the facility entrance, choosing a gift or receiving a gift card.
  
  Daycare is available within the facility for staff making it easier for parents to create a healthy work/life balance as they can interact with their children while on breaks.
- Provide stimulating activities for the residents to allow them to stay engaged with family and friends;
  
  Various themed festivals are held throughout the year where special activities are scheduled that may include costume parties, family water balloon fights on the patio, cookouts, or movie nights with special treats.
  
  If daycare is provided within the facility residents are able to interact with the children by reading them books or participating in games or activities.
- Residents are allowed the opportunity to have an active role in solutions to an identified concern.
  
  Audits are completed by residents when extended call light wait times are identified, residents report feeling as though they have a little control over their care.
Concerns
- Wound treatments not being completed as prescribed;
- Medication not being available;
- Medication being administered incorrectly;
- Briefs not being changed for a long time;
- Hygiene care not occurring on a regular basis;
- Extended call light wait times;
- Inadequate staffing, especially during evening, night, and weekend hours;
- Facility maintenance issues that could lead to injuries;
- Staff not completing jobs assigned to them;
- Lapsed nursing licenses or certified nursing assistant certifications;
- Improper documentation of controlled substances being administered;
- Resident to resident verbal, physical, and sexual assaults;
- Staff to resident verbal and physical assaults; and
- Lack of ongoing education on resident care procedures for nursing staff.
Impact
The Sentinel Project is alerting the nursing home industry of the Attorney General’s focus and of the legal penalties that may come for failing to care for our elderly and other vulnerable adults.

Most staff are doing their best to provide the greatest care. However, some facilities may still have challenges that could lead to regulatory and/or criminal violations.

Our goal is four-fold:
1. Ensure facilities improve their operations and quality of care.
2. Bring awareness and educate facilities about gaps in care.
3. Prevent adverse events from happening.
4. Improve the physical and mental well-being of residents.
This ensures our loved ones receive the best care possible now and in the future!