Failure to Obtain Consent for Representative Payee Application
Penalty
Summary
The facility failed to obtain consent before applying to become the representative payee for a resident who was cognitively intact, as evidenced by a BIMS score of 15 on multiple MDS assessments. The resident, who had diagnoses including paraplegia, chronic pain syndrome, opioid dependence, osteoarthritis, insomnia, and urine retention, was admitted to the facility and had an outstanding balance for care. Despite being alert and oriented, the facility applied to manage the resident's Social Security benefits without documented consent from the resident. The facility's policy defines misappropriation of resident property as the use of a resident's money without consent, and the application for representative payee was completed based on a physician's assessment that the resident could not manage finances, though the resident had previously signed a payment agreement. Interviews with facility staff confirmed that the resident was alert and oriented, and that consent was obtained for other residents in similar situations but not for this particular resident. The facility received one Social Security payment as representative payee before the resident was discharged, and the subsequent payment was rejected. The administrator and business office manager both acknowledged the lack of consent and the resident's cognitive intactness at the time the application was made.