Failure to Provide Personal Needs Allowance and Financial Assistance
Penalty
Summary
The facility failed to provide medically-related social services and financial assistance to ensure that residents received their entitled state-funded payments and personal needs allowances (PNA). One resident, who had been in the facility for nearly a year, was not receiving her monthly PNA despite being on Medicaid. Her trust account showed a balance of only $0.01 for several months, with no deposits or transactions, and she reported having no money for personal expenses such as haircuts or shoes. The Business Office Manager confirmed that the resident's Social Security payments were not being received by the facility due to the payee not being updated, resulting in the resident not receiving her monthly allowance. Additionally, three other residents, all under the age of 65 and with Medicaid as their payer source, were not receiving a monthly PNA because they had no income. Staff interviews revealed that neither the Business Office Manager nor Social Services had assisted these residents in applying for Supplemental Security Income (SSI) or disability benefits, which would have enabled them to receive a PNA. The staff were unclear about the process and responsibilities for initiating SSI or disability applications, and there was no documentation to show that these residents had been assessed or assisted in obtaining financial benefits. Job descriptions for the Social Services Assistant, Admissions Coordinator, and Business Office Coordinator outlined responsibilities for ensuring residents' financial arrangements and facilitating access to benefits. However, the facility did not follow through with these duties for the affected residents. The lack of action resulted in multiple residents not receiving funds for personal needs, and there was no evidence that the facility had made appropriate referrals or provided necessary assistance to secure these benefits.