Deficiency in Access to Resident Personal Funds
Summary
The facility failed to ensure that residents had ready and reasonable access to their personal funds during evenings and weekends. This deficiency was identified through interviews with residents and staff, as well as a review of the facility's policy on managing residents' personal funds. A resident reported that he could not access his money on weekends, which was corroborated by interviews with nursing staff who confirmed that funds were not available during these times. The Business Office Manager stated that funds were available at a specific location on weekends, but this was contradicted by the nursing staff's statements. The facility's policy on the management of residents' personal funds, last revised in March 2021, did not address the availability of funds to residents during evenings or weekends. The Administrator confirmed that the policy lacked guidance on this issue and that there was a discrepancy in the reported location of available funds. The Business Office Manager mentioned that funds were placed in a locked box at the receptionist desk, but this could not be confirmed at the time of the survey. This lack of access to personal funds could potentially affect all 50 residents whose funds were managed by the facility.
Penalty
Resources
Below are regulatory guidelines relevant to this citation:
Residents were unable to access their personal funds outside of regular business office hours, as confirmed by staff and resident interviews. Personal funds were not available after 4:00 P.M. on weekdays, nor on weekends or holidays, and there was no alternative method for residents to obtain money when the business office was closed.
A resident's right to manage their own financial affairs was not honored, resulting in a violation of federal regulations regarding resident autonomy.
A resident with depression and quadriplegia did not receive a required $50 social security allowance for one month after a delay in the deposit of their check. The facility's system failed to recognize the need for a retroactive payment, resulting in the resident not receiving the allowance for that period, as confirmed by business office staff and record review.
The facility did not ensure residents could access their personal funds after business hours or on weekends. Only one staff member was responsible for distributing funds, and no process was in place for other staff to provide access outside of regular hours. Multiple staff and residents confirmed that this led to frustration and delays in accessing personal money, with some residents waiting days or being unable to obtain funds when needed.
A resident was unable to access personal funds outside of standard business hours and on weekends, as confirmed by staff interviews and facility policy review. The facility's process limited fund access to weekdays, and the policy lacked guidance for after-hours or weekend withdrawals, resulting in delayed access for the resident.
The facility did not obtain properly witnessed written authorization forms before managing the personal funds of two residents, as required by policy. Although representatives signed the consent forms, the witness signature sections were left blank, resulting in incomplete authorization documentation.
Failure to Provide Resident Access to Personal Funds After Business Hours
Penalty
Summary
The facility failed to make residents' personal funds available outside of regular business office hours, affecting three residents reviewed for access to their funds. Residents reported being unable to obtain money from their personal accounts after 4:00 P.M. on weekdays, as well as on weekends and holidays, due to the business office being closed. Staff interviews confirmed that personal funds are not kept in the medication cart or otherwise accessible when the business office is closed. One resident was unaware of how much money was available or how to access it, only knowing that someone would assist with purchases when needed. Observations confirmed that posted banking hours were limited to Monday through Friday, 8:00 A.M. to 4:00 P.M., and that the business office was inconsistently open during the survey period.
Failure to Honor Resident's Right to Manage Financial Affairs
Penalty
Summary
A deficiency was identified regarding the facility's failure to honor a resident's right to manage his or her own financial affairs. The report notes that the resident's autonomy in handling personal finances was not respected, which is a violation of resident rights as outlined in federal regulations. No additional details about the specific actions or inactions, the resident's medical history, or their condition at the time of the deficiency are provided in the report.
Failure to Provide Resident Social Security Allowance Due to Missed Retroactive Payment
Penalty
Summary
The facility failed to ensure that a resident had access to his social security allowance as required. The resident, who was cognitively intact and had diagnoses including depression and quadriplegia, had his social security check for February recalled by Social Security and not deposited until April. As a result, the system did not recognize that the resident should have received his $50.00 allowance retroactively for February. The resident did not receive this allowance, even though subsequent months' allowances were properly allotted and withdrawn by the resident as documented by signed receipts. Interview with the Regional Business Office Manager confirmed that the oversight occurred because the system did not account for the late deposit of the February check, and the resident was not given his $50.00 allowance for that month. This deficiency was identified during a review of the resident's personal fund statements and was verified through interviews and record review.
Failure to Provide Resident Access to Personal Funds After Hours
Penalty
Summary
The facility failed to ensure that residents had access to their personal funds after business hours and on weekends. Four residents with personal funds accounts managed by the facility were affected. Observations and interviews revealed that only one staff member, HR #153, was responsible for dispensing resident funds, and she did not leave the money box accessible to other staff after her shift ended at 5:00 P.M. on weekdays or on weekends. Multiple staff members, including RNs, LPNs, and CNAs, confirmed they did not have access to the funds box outside of business hours, and residents were required to withdraw money before HR #153 left for the day. Residents reported being unable to access their funds after hours and on weekends, with some stating they had to wait days to receive money or that the facility had run out of money in the personal funds box. Staff interviews corroborated that residents voiced frustration and concerns about not having timely access to their funds. Review of the facility's policy indicated a requirement to comply with federal and state regulations regarding resident funds, but the observed practices did not align with this policy.
Failure to Provide Resident Access to Personal Funds Outside Business Hours
Penalty
Summary
The facility failed to ensure that residents had access to their personal funds outside of normal business hours and on weekends. Interviews with staff revealed that residents could only access their personal funds Monday through Friday, from 8:00 A.M. to 5:00 P.M., and were unable to obtain money on weekends. The Business Office Manager and receptionists confirmed these restricted hours, and the facility policy did not specify procedures for accessing funds after hours or on weekends. A resident with intact cognition reported previous difficulties in obtaining money, stating it typically took at least three days to receive requested funds and that they did not attempt to access funds outside business hours because they knew it was not possible. The Administrator stated an expectation that residents should have access to their funds seven days a week, but this was not reflected in practice or policy. This deficiency was identified during a complaint investigation and affected at least one resident reviewed for personal funds.
Failure to Obtain Proper Written Authorization for Management of Resident Funds
Penalty
Summary
The facility failed to obtain appropriate written authorization to manage the personal funds of two residents. For both residents, the authorization forms allowing the facility to manage their funds were signed by their representatives, but the required witness signatures were missing. The forms included designated spaces for two witnesses, but these were left blank. This was confirmed during an interview with the Administrator, who acknowledged that the proper written authorization had not been obtained for these residents. The residents involved had significant medical histories, including diagnoses such as cerebral infarction, hypotension, anxiety disorder, cerebral vascular accident, transient ischemic attack, and dementia. Despite the facility's policy requiring written designation when accepting responsibility for a resident's financial affairs, the lack of witnessed signatures on the authorization forms constituted a failure to follow this policy.
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