Failure to Timely Refund Resident Payment After Discharge
Penalty
Summary
The facility failed to provide a refund to a resident's representative within 30 days of the resident's discharge, as required by federal regulations. The resident was admitted on 5/9/25 and passed away in the facility on 5/28/25. Documentation showed that the resident had privately paid for care. The Business Office Manager (BOM) confirmed that a refund request was submitted to the financial office on 6/11/25, and a follow-up request for an update was made on 8/5/25. The refund was ultimately processed and provided to the resident's representative on 8/6/25, which exceeded the 30-day requirement. During interviews, the BOM and the Director of Nursing both confirmed that the facility did not issue the refund within the required timeframe. The deficiency was identified for one of three residents reviewed, and the failure to comply with the 30-day refund policy was substantiated by both documentation and staff interviews.
Plan Of Correction
1. Resident R1's representative was issued a refund on 08-06-2025. 2. BOM performed an audit on 08-06-2025 of any potential refunds that are due to current and discharged residents. Rose City is working on one refund currently that is within the allotted time frame for re-imbursement. 3. NHA will educate the BOM to ensure all refunds are addressed timely. NHA will reach out to Accounts Payable if there are delays in reimbursements to ensure timely distribution. 4. BOM will perform weekly audits to ensure that any potential refunds are addressed per regulations. Audits will be weekly for two weeks, then every two weeks for two weeks, then monthly for one month. Results of audits will be submitted to monthly QAPI for review and recommendations.