(USA TODAY) -- The administrator at the Vicksburg Convalescent Center knew something was wrong when she saw the receipt: a $90 debit from a resident's trust fund account for a pair of designer jeans.
Of all the elderly residents at the 100-bed nursing home, Amy Brown figured, this one was especially unlikely to spend his savings on pricey pants.
Both of his legs had been amputated.
Brown pored over the trust fund books. There were receipts to back up every charge, so audits had found nothing amiss. But she spotted "receipts for things I knew the residents wouldn't buy" - North Face jackets and Ugg boots, hair dryers and makeup, even a baseball bat. "I felt sick," Brown recalls.
Suspicions fell on Lee Martin, an office staffer at the Mississippi facility and an affiliated nursing home across town. Martin was charged in 2012 with billing $101,000 in personal expenses to the trust accounts of 83 residents at the two facilities. She pleaded guilty in August to multiple counts of exploitation of vulnerable adults.
"These (residents) are vulnerable; the nursing home is supposed to take care of them," says Phyllis Foster, 67, whose 89-year-old mother-in-law had funds embezzled by Martin. "I was surprised there wasn't more oversight."
Thousands of residents in U.S. nursing homes and other long-term care institutions for the aged and disabled have had their personal savings raided or mismanaged after relying on the facilities to safeguard the money in special trust fund accounts, a USA TODAY investigation shows.
These trust funds, which most long-term care providers are required to maintain for residents who request that the facility handle their money, are supposed to work like conventional bank accounts, with accrued interest, regular statements and reliable oversight. But USA TODAY found more than 1,500 recent cases in which nursing homes have been cited by state and federal regulators for mishandling the funds.
In scores of cases, employees or administrators siphoned huge sums of money from trust accounts - hundreds of thousands of dollars in some instances - for everything from shopping and gambling sprees to routine household expenses. In hundreds more cases, facilities failed to pay interest on the funds, could not account for their holdings, or did not carry adequate insurance to protect the money from loss or theft.
NURSING HOME WORKERS WHO STOLE TRUST FUNDS: List of trust fund raiders
The investigation spotlights a growing problem that has caught the attention of state attorneys general, several of whom have beefed up units that investigate financial exploitation in long-term care. Yet the problems continue, and there could be far more thieves who never get caught.
WHAT YOU CAN DO: Tips to protect family members' funds
Trust fund cases "can be hard to detect," says Lori Smetanka, head of the National Long-Term Care Ombudsman Resource Center. "It can take a long time before anyone figures out that someone is stealing the money ... I think a lot of cases don't even get picked up."
When a case does come to light, the victimized residents usually get reimbursed because nursing homes are supposed to keep the trust funds insured. But the worry, confusion and emotional damage often linger on.
Officials at the Centers for Medicare and Medicaid Services, the federal agency that regulates almost all of the nation's nearly 16,000 nursing homes, were unavailable to comment due to the federal government shutdown. But many state officials acknowledge that trust fund thefts and mismanagement are a growing problem that gets insufficient attention from both nursing home operators and the agencies that oversee them.
"I do think there's an oversight issue ... There aren't a lot of safeguards in the system," says Ken Moore, a senior assistant attorney general in South Carolina's Medicaid Fraud Control Unit, which has prosecuted at least a dozen trust fund theft cases in recent years.
"A lot of these cases involve an office manager or a business or finance manager, and they're the only ones at the facility who really know how much money is coming in and going out of these accounts, Moore adds. "So these cases can be very difficult to detect - a lot of these people get caught just by happenstance."
In 2010, Moore's office convicted a nursing home business manager who was caught forging checks from the trust fund after she dropped one of the checks in the parking lot. A co-worker found it, triggering an investigation into the theft of $50,000 in residents' funds. Says Moore: "If she hadn't dropped that envelope, I'm not sure she ever would have been caught."