what happens when an oig nursing investigation goes to the attorney general illinois

by Elaina Nicolas 10 min read

Once the investigation is concluded, and if a violation is found, a report of the investigation is completed and provided to the Attorney General. In that report, the Inspector General may include recommendations for personnel actions or recommendations for addressing any violations uncovered during the investigation.

Full Answer

What is the Office of Inspector General (OIG)?

Jan 25, 2018 · The Department of Health and Human Services' Office of the Inspector General (OIG) is charged with identifying and investigating health care fraud and abuse. If you are a health care provider—or you work for one—you may find yourself the target of an OIG investigation. When that happens, you should not panic.

Can an OIG investigation result in a criminal proceeding?

Sending a completed complaint form to the Office of Executive Inspector General for the Agencies of the Illinois Governor, Attention Complaint Division, 69 West Washington Street, Suite 3400, Chicago, Illinois 60602; Contacting the Office by telecommunications device for the disabled (TTY) at (888) 261-2734; or.

Do nursing facilities report abuse and neglect to OIG?

Dec 22, 2021 · If the Executive Inspector General determines, after an investigation is completed, that reasonable cause exists to believe that a violation occurred, a summary report of the investigation will be issued.

Who is the Inspector General of the Ohio Department of Nursing?

The Inspector General investigates allegations of fraud, waste, abuse, mismanagement, misconduct, and related violations of the law involving individuals employed by or doing business with the Attorney General's Office. The Inspector General's Office is authorized by the State Officials and Employees Ethics Act (5 ILCS 430). The Office of the Inspector General is …

What is the Office of the Inspector General OIG responsible for?

On April 14, 1989, the Office of the Inspector General (OIG) was created in the Department of Justice (Department) by amendment to the Inspector General Act of 1978. OIG's mission is to detect and deter fraud, waste, and abuse in Department programs and misconduct by Department personnel.Oct 27, 2021

Who investigates the OIG?

Q: Who conducts OIG investigations? A: OIG is staffed with trained, credentialed, and sworn special agents (criminal investigators who are federal law enforcement officers), investigative attorneys, and administrative investigators.

What does the Illinois Inspector General do?

The Inspector General investigates allegations of fraud, waste, abuse, mismanagement, misconduct, and related violations of the law involving individuals employed by or doing business with the Attorney General's Office.

Are OIG reports public?

OIG reports and documents are made available internally and publicly, subject to the restrictions imposed by the Privacy Act and the Freedom of Information Act.

What happens in an OIG investigation?

Most investigations concern alleged fraudulent activity involving travel, time and attendance, workers' compensation, or ethics violations. OIG also investigates non-NLRB employees in matters involving fraud against the Government, primarily cases of contract fraud.

How long do DOJ investigations last?

So if you have still not been charged after the time set by the statute of limitations, the investigation is effectively over. For most federal crimes, the statute of limitations is five years. Bank fraud has a statute of limitations of ten years. Immigration violations and arson are also subject to a ten year limit.

How do I file a complaint against DCFS in Illinois?

Filing A ComplaintMAIL OR IN PERSON DELIVERY: INTAKE DEPARTMENT, Office of the Inspector General, Department of Children and Family Services, 2240 West Ogden Avenue, Chicago, Illinois 60612; OR: 4 West Old State Capital Plaza, 8th Floor, Springfield, Illinois, 62701.FAX: ATTN: INTAKE DEPARTMENT at (312) 433-3032.More items...

How do I report a judge for misconduct in Illinois?

How do I file a Complaint against a judge? Request a Complaint form by contacting the Board at 555 West Monroe Street, Suite 800-N, Chicago, Illinois 60661, (312) 814-5554, (800) 227-9429, TDD (312) 814 -1881 or Fax (312) 814-5719. You may also download a Complaint form from the Board's website – www.illinois.gov/jib.

How do I contact the Illinois Attorney General?

You can contact our office by e-mailing [email protected] or sending mail via U.S. Postal Service to: I'm sorry but your internet browser has JavaScript disabled.

What is OIG LEIE check?

OIG maintains a list of all currently excluded individuals and entities called the List of Excluded Individuals/Entities (LEIE). ... To avoid CMP liability, health care entities should routinely check the list to ensure that new hires and current employees are not on it.

What does OIG mean in medical terms?

Office of Inspector General, U.S. Department of Health and Human ServicesInspector General of the United States Department of Health and Human ServicesUnited States Department of Health and Human ServicesAppointerThe President with Senate advice and consentTerm lengthNo fixed termWebsiteoig.hhs.gov2 more rows

What is OIG exclusion list?

According to the OIG, the List of Excluded Individuals/Entities (LEIE) “provides information to the health care industry, patients and the public regarding individuals and entities currently excluded from participation in Medicare, Medicaid, and all other Federal health care programs.” Individuals and entities are ...Feb 10, 2020

Who investigates an allegation?

If so, the allegation is investigated by a member of the Inspector General's Office. Once the investigation is concluded, and if a violation is found, a report of the investigation is completed and provided to the Attorney General. In that report, the Inspector General may include recommendations for personnel actions or recommendations ...

What is the Inspector General's Office?

The Inspector General's Office is authorized by the State Officials and Employees Ethics Act (5 ILCS 430).

When was the Inspector General appointed?

The Attorney General's Office appointed the first Inspector General in September 2004. The role of the Inspector General is to ensure that all the employees and vendors under the jurisdiction of the Attorney General maintain the highest standards of integrity and accountability.

What is the role of the Inspector General?

The Inspector General serves a valuable role in ensuring that the Office of the Attorney General operates efficiently and without fraud or abuse, thus ensuring that the public maintains the highest degree of trust and confidence in the Office of the Attorney General.

Can a complaint be anonymous?

Although a complaint may be made anonymously under the law, it is the practice of the Inspector General's Office to keep the name of complainants confidential, unless otherwise required by law. Further, under the law the name of the individual providing information can only be disclosed with that person's consent or if disclosure of the identity ...

What is the OIG report?

A: Generally, when an investigation is complete, OIG will produce a report based upon relevant witness interviews, records, and other evidence. The report will be reviewed within OIG to ensure that it is fact-based , objective, and clear.

What is the OIG?

A: OIG investigates a variety of matters, including allegations of fraud involving Commerce Department grants and contracts; improprieties in the administration of Department programs and operations; allegations of employee misconduct; and other issues concerning ethics and compliance received through OIG’s hotline. OIG also investigates alleged reprisals against whistleblowers within the Department, as well as its contractors and certain grant recipients.

What is the purpose of the Inspector General Act of 1978?

Under the Inspector General Act of 1978, as amended, OIG is authorized to carry out both investigations and audits to "promote economy, efficiency, and effectiveness in the administration of, and … prevent and detect fraud and abuse in … [the Department's] programs and operations.". Through its investigative and audit findings and recommendations, ...

Why is recording important?

Recording is to the benefit of all parties, because it ensures that a definitive record exists of both what was asked and the information provided in response. Pursuant to the above-referenced directives, employee cooperation extends to participating in audio/video-recorded interviews.

What is an OIG audit?

In contrast, an OIG audit or evaluation is conducted to examine organizational program performance or financial management matters, typically of a systemic nature.

Can an employee be interviewed by OIG?

DAO 207-10 provides that employees “shall furnish sworn oral or subscribed statements upon request.” OIG cannot compel anyone to be interviewed; however, management can direct an employee to be interviewed as requested by OIG, and take disciplinary action if the employee declines.

Can an employee retain a private attorney?

An employee may retain a private attorney at personal expense for representation during an OIG investigation or interview. Consistent with current prevailing law, employees who are bargaining unit members may be permitted to have union representation present during interviews.

What is the Office of Inspector General?

The Office of Inspector General investigations deal with various instances of fraud, waste, abuses situations and misconduct in regards to federal employees, contracted workers and entities that have business with the Federal Trade Commission. When the OIG investigates an issue, it usually deals with the administrative, ...

What is the investigation based on?

The investigation is usually based on information garnered through various sources which may include numerous hotlines, referrals, requests by administration and persons that have provided data about potential crimes in progress or known violations.

What is OIG in nursing home?

In 2006, the Office of Inspector General (OIG) conducted an evaluation entitled Nursing Home Complaint Investigations (OEI-01-04-00340), which found that State agencies did not investigate some of the most serious nursing home complaints within required timeframes; States did not take full advantage of the available complaint reporting system; and, in a targeted review of five States, State agencies followed protocol for intake and triage but followup letters to complainants often lacked meaningful information.26

What is the Office of Counsel to the Inspector General?

The Office of Counsel to the Inspector General (OCIG) provides general legal services to OIG, rendering advice and opinions on HHS programs and operations and providing all legal support for OIG’s internal operations. OCIG represents OIG in all civil and administrative fraud and abuse cases involving HHS programs, including False Claims Act, program exclusion, and civil monetary penalty cases. In connection with these cases, OCIG also negotiates and monitors corporate integrity agreements. OCIG renders advisory opinions, issues compliance program guidance, publishes fraud alerts, and provides other guidance to the health care industry concerning the anti-kickback statute and other OIG enforcement authorities.

What are nursing policies?

To protect the well-being of residents, nursing facilities must develop and implement written policies related to reporting allegations of abuse, neglect, mistreatment, injuries of unknown source, and misappropriation of resident property (allegations of abuse or neglect). Further, allegations of abuse or neglect must be reported to ...

How many elderly people will be abused in 2050?

It is estimated that approximately 5 million, or 10 percent, of elderly adults are abused, neglected, or exploited annually.1 Between now and 2050, the United States is projected to experience significant growth in its elderly population. In 2050, the number of Americans aged 65 and older is projected to be 88.5 million, more than double the population of 40.2 million in 2010.2 Nursing facilities are likely to experience increases in their resident population; therefore, it is important to ensure that residents are protected from abuse and neglect.

What is a 6703b(3)?

Section 6703(b)(3) of the Elder Justice Act of 2009 amends the SSA by adding section 1150B.19 Section 1150B requires owners, operators, employees, managers, agents, or contractors of nursing facilities (covered individuals) in applicable nursing facilities to report any reasonable suspicion of crimes committed against a resident of that facility to the appropriate entities (e.g., law enforcement entities).20 The nursing facility’s responsibility to report all allegations of abuse or neglect is separate from a covered individual’s responsibility outlined in Section 1150B.

How many allegations of abuse or neglect were reported in 2012?

In 2012, 53 percent of allegations of abuse or neglect and the subsequent investigation results (1,338 allegations) were reported, as Federally required. Sixty-three percent of allegations of abuse or neglect were immediately reported to the nursing facility administrator or designee and the State survey agency, as required. Further, the subsequent investigation results for 63 percent of allegations of abuse or neglect were reported to the appropriate individuals within 5 working days, as required. See Table 7 for the number and percentage of allegations of abuse or neglect that were reported in compliance with Federal regulations.

What are nursing facilities policies?

Nursing facilities must have policies that prohibit abuse or neglect, which must include policies for reporting alle gations of abuse or neglect and the subsequent investigation results to the appropriate individuals within the required timeframes. In 2012, 76 percent of nursing facilities (11,744 facilities) maintained policies that address Federal regulations for reporting both allegations of abuse or neglect and subsequent investigation results. Ninety-five percent of nursing facilities had policies that reflected Federal regulations for reporting allegations of abuse or neglect. Seventy-six percent of nursing facilities had policies that reflected Federal regulations for reporting subsequent investigation results of allegations of abuse or neglect. See Table 5 for the number and percentage of nursing facilities that had policies that address Federal regulations for reporting allegations of abuse or neglect. 31

How IDPH Investigates Reported Cases of Abuse or Neglect

Illinois law gives the IDPH the authority to license nursing homes in our state. As a result, IDPH can investigate complaints involving its licensed facilities and take action if its finds a violation of nursing home regulations.

How Pursuing a Nursing Home Abuse or Neglect Claim Would Work

Much of the information from the IDPH’s investigation, finding of a violation and hearing can be used in a personal injury or wrongful death claim against a nursing home. An attorney may also conduct an independent investigation into the case.