Failure to Notify When Resident Trust Fund Balances Exceeded Limits
Penalty
Summary
The facility failed to notify the family and/or resident when the amount in the residents' trust fund accounts exceeded the eligibility limit, as required by both facility policy and federal regulations. Specifically, for two residents, account balances were found to be significantly above the $2,000 limit for Medicaid eligibility, with one account showing balances of $4,180.09 and $4,375.49 over two quarters, and another showing $6,085.51 and $6,283.72 over the same periods. The facility's policy mandates that when a resident's account is within $200 of the permitted limit, a notification letter must be sent to the resident or their legal representative, and documentation of this notification must be maintained in the financial folder. Review of the records revealed that while the Business Office Manager stated that the families had been sent the required $200 notification letters, there was no documentation provided to confirm that the families of the two residents had actually received these letters. Both residents had cognitive impairments, with one having severe cognitive impairment and the other moderate impairment, further emphasizing the importance of proper notification to their representatives. The lack of documentation and failure to ensure notification constitutes a deficiency in the facility's management of resident trust funds.