Improper Deduction of Medicaid Resident's Personal Needs Allowance for Facility Debt
Penalty
Summary
The facility failed to protect a resident's personal funds by charging her personal needs allowance (PNA) for services that are covered under Medicaid. The resident, who was cognitively intact and had a diagnosis of chronic obstructive pulmonary disease (COPD), was admitted with a monthly income from which the PNA was deducted, as required by Medicaid regulations. Despite this, the facility deducted an additional $20.00 each month from the resident's PNA to pay off a debt owed to the facility, as agreed upon in a payment agreement signed by the resident. The deductions were made over a period of nearly two years, totaling $460.00, with additional unclear debits also noted in the resident's account. Interviews with the resident and facility staff confirmed that the resident was not informed that she was not obligated to pay her outstanding balance from her PNA funds. The business office manager acknowledged the arrangement and the facility's role as the resident's representative payee, while the nursing home administrator confirmed the ongoing deductions and the lack of documentation showing the resident was properly informed of her rights regarding the use of her PNA. The facility's actions were found to be in violation of state regulations regarding the management of resident funds and resident rights.