Rochester Nursing Home Worker Accused of Stealing $154,000
State investigators say a business office employee diverted money residents had deposited to pay for their long-term care.
A Rochester nursing home theft investigation has led to the arrest of a former employee accused of stealing more than $154,000 that residents had deposited to cover their care expenses.
New York Attorney General Letitia James announced Monday, July 20, that Tammy Echols, 56, of Rochester, had been arrested and arraigned on felony charges. Echols worked in the business office at St. John’s Home, a long-term care facility in Rochester.
Prosecutors allege that she used her access to the nursing home’s financial system to send fraudulent checks to friends, associates and businesses where she owed money.
The accusations have not been proven in court. Echols is presumed innocent unless and until she is convicted.
Employee Accused of Diverting Resident Funds
According to the attorney general’s office, Echols worked as a senior account specialist at St. John’s Home. Her responsibilities included billing residents and their families for costs that Medicaid did not cover.
She was also authorized to issue refund checks when residents or their representatives overpaid the facility.
Investigators allege that Echols exploited that authority between January 2023 and August 2025.
Instead of issuing certain checks to residents or their authorized representatives, Echols allegedly arranged for checks to be sent to:
- Friends and associates
- A local florist
- A bakery
- A construction contractor
- Other businesses where she reportedly had personal debts
Friends and associates who received checks allegedly kept a small fee and transferred most of the money back to Echols, according to the criminal complaint and the attorney general’s office.
Investigators calculated the total allegedly stolen at $154,525.99.
The money had been deposited with St. John’s Home by residents to help cover their expenses, state officials said.
Charges Include Grand Larceny and Scheme to Defraud
Echols was charged with:
- Grand larceny in the second degree
- Scheme to defraud in the first degree
The felony complaint alleges that she stole property valued above $50,000 and carried out a continuing scheme involving St. John’s Home, its residents or their authorized representatives.
She was arraigned before Rochester City Court Judge Latoya Lee.
If convicted of the most serious charge, Echols could face a maximum prison sentence of five to 15 years, according to the attorney general’s office.
That possible sentence is not a prediction of the case’s outcome. The prosecution must prove every charge beyond a reasonable doubt.
Attorney General: Residents Deserved Better
Attorney General James said nursing home residents and their families should be able to trust employees who manage money connected to their care.
“New Yorkers save up for their entire lives to afford dignified care in a nursing home, and they expect the staff treating them to have their best interests at heart,” James said.
She accused Echols of taking advantage of the trust residents placed in the facility.
“My office will continue to go after fraudsters who corrupt our health care system and make sure they are held accountable,” James said.
The Rochester Police Department assisted the attorney general’s Medicaid Fraud Control Unit with the investigation.
What Are Resident Funds in a Nursing Home?
Nursing home resident funds are personal funds placed with a facility to pay for expenses, services or personal needs not fully covered by Medicaid or another insurance program.
In this case, state officials said the affected money included funds residents had deposited to meet their care-related financial obligations.
The federal Justice Department’s summary of the case described the money as Medicaid Net Available Monthly Income funds, sometimes known as NAMI funds. These payments generally represent income that a Medicaid nursing home resident must contribute toward the cost of care after permitted deductions.
Employees who handle these accounts may occupy positions of considerable trust. They can have access to payment records, refund systems, resident information and financial paperwork.
That access makes strong oversight essential.
The Broader Risk of Elder Financial Exploitation
The allegations highlight a concern that reaches beyond one Rochester facility.
Older adults and nursing home residents may be especially vulnerable to financial exploitation because they often rely on other people to:
- Manage bills and insurance paperwork
- Deposit or withdraw funds
- Review bank statements
- Communicate with care facilities
- Understand complicated Medicaid rules
- Detect unexplained financial changes
A questionable transaction can go unnoticed when a resident has serious health challenges, limited mobility or no nearby family members.
Facilities can reduce that risk by separating financial duties, reviewing refund payments, requiring more than one approval for large checks and conducting regular audits.
Families can also help by reviewing account statements and asking for written explanations of charges and refunds.
Warning Signs Families Should Watch For
One unexplained charge does not necessarily prove wrongdoing. However, several warning signs may justify closer review.
Families and authorized representatives should pay attention to:
- Refund checks sent to unfamiliar people or companies
- Missing resident account statements
- Unexpected changes in available balances
- Bills for services the resident did not receive
- Delays when requesting financial records
- Signatures that appear unfamiliar
- Staff members who discourage family involvement
- Repeated accounting corrections without a clear explanation
Anyone who notices an irregularity should document it. Save statements, receipts, emails and the names of employees involved in discussions.
Concerns should first be reported to the facility’s administrator or compliance office unless doing so could create an immediate risk to the resident.
How to Report Suspected Nursing Home Fraud
The New York Attorney General’s Medicaid Fraud Control Unit investigates Medicaid provider fraud as well as allegations of abuse or neglect involving nursing home residents.
New Yorkers with information about possible fraud, abuse or neglect may file a confidential complaint with the attorney general’s office or call the Medicaid Fraud Control Unit hotline at 800-771-7755.
Emergency situations should be reported to 911.
The unit’s work is financed through federal and state funding. For the 2026 federal fiscal year, its total funding is approximately $70.8 million. The federal government provides 75 percent, while New York supplies the remaining 25 percent, according to the attorney general’s office.
Oversight Must Protect Residents Without Prejudging the Case
The allegations are serious, but the legal process must be allowed to move forward fairly.
Echols has the right to challenge the evidence, question witnesses and present a defense. An arrest and arraignment are not the same as a conviction.
At the same time, nursing homes have a duty to protect the money entrusted to them. Residents and families deserve clear financial records, prompt answers and strong controls against unauthorized transactions.
This case should encourage long-term care facilities across New York to examine how employees request, approve and distribute resident refunds.
Conclusion
The Rochester nursing home theft case centers on more than a dollar amount. It raises questions about trust, accountability and the systems meant to safeguard people who may be unable to protect themselves.
State prosecutors allege that Echols diverted $154,525.99 from funds connected to St. John’s Home residents over more than two years. She now faces felony charges, though she remains legally innocent unless convicted.
Families with loved ones in long-term care should review financial statements regularly, question unfamiliar transactions and report suspected exploitation. Nursing homes should also ensure that no single employee can control a resident refund from beginning to end without independent review.
Protecting residents requires vigilance from facilities, regulators and families alike.
