Failure to Follow Policy for Resident Trust Fund Disbursements
Penalty
Summary
The facility failed to properly safeguard and manage the personal funds of a resident by not following its own policy requiring two staff signatures when cash was disbursed from the resident trust fund. Multiple withdrawals were made for one resident, each signed only by the resident and lacking the required witness signature. The facility's policy specifically mandates that when a resident cannot sign to approve a withdrawal, a witness signature is required, and the witness must not be the person responsible for accounting for the funds, their supervisor, or the individual accepting the withdrawn funds. However, review of the trust fund petty cash logs revealed several instances where cash was withdrawn and only the business office manager's (BOM) signature was present, with no witness signature documented. The resident involved had a history of schizoaffective disorder, bipolar disorder, cataracts, choroidal atrophy, transient visual loss, and major depressive disorder. The resident was assessed as having impaired vision and a BIMS score indicating moderate cognitive impairment. Interviews with the resident confirmed that she regularly requested and received varying amounts of cash, which she kept in her possession and used for personal purchases. The resident was able to account for her money and provided receipts for some purchases, but discrepancies in the amounts withdrawn and the amounts reportedly received were noted during the investigation. Interviews with facility and corporate staff confirmed that the BOM did not consistently follow the required procedure for cash disbursement, as some transactions had witnesses while others did not. The issue was identified during a corporate audit, which led to further review of the records. Although the facility and corporate staff did not find evidence of missing funds, the lack of adherence to the required process for safeguarding resident funds constituted a deficiency in the facility's management of resident trust funds.