Failure to Uphold Resident Self-Determination and Financial Rights
Penalty
Summary
The facility failed to ensure a resident's right to self-determination and choice regarding personal finances and significant life decisions. A male resident with dementia, anxiety, heart failure, hypertension, and impaired coordination, who had a moderate cognitive impairment (BIMS score of 8), was not provided access to a working debit card attached to his personal funds for daily use. The resident's care plan indicated a goal of maintaining dignity and meeting his needs in a timely manner, but the facility did not uphold these standards. The resident was unable to use his debit card for purchases, as observed when a transaction was denied at a vending machine. Additionally, the facility failed to prevent the administrator from purchasing a pre-need funeral plan for the resident, despite the resident having previously expressed to his family that he did not want such a plan. The administrator withdrew over $13,000 from the resident's account to purchase the funeral plan and start a trust fund, without the resident's informed consent. Interviews revealed that the administrator acted on the suggestion of a family member who was not the resident's POA or guardian, and that the resident had not authorized these financial decisions. There were also concerns raised by staff about other residents and staff accessing the resident's debit card without proper authorization, resulting in unexplained withdrawals from his account. The facility's inaction in addressing repeated staff concerns about unauthorized use of the resident's funds, as well as the administrator's decision to proceed with significant financial transactions against the resident's wishes, led to the identification of Immediate Jeopardy. The facility did not ensure the resident's right to make choices about aspects of his life that were significant to him, particularly regarding his finances and end-of-life arrangements.