Failure to Timely Provide Resident Financial Records Requested by Ombudsman
Penalty
Summary
The facility failed to provide copies of financial records within the required timeframe after a request was made on behalf of a resident by the Long-Term Care Ombudsman (LTCO). The resident involved was admitted with a history of transient ischemic attack and vascular dementia and was documented as self-responsible, with a Minimum Data Set indicating capacity to understand and make decisions. The LTCO emailed the Business Office Manager (BOM) requesting the resident’s trust account report, any representative payee documents from the last 12 months, and a financial summary of coverage and share of cost, and included a consent form signed by the resident authorizing release of this information. During an interview, the BOM stated that she typically provides requested financial information to residents or responsible parties within 10–15 minutes and that, for non-responsible parties, she obtains resident consent via a signed form. She acknowledged receiving the LTCO’s email request and consent form and stated that she is expected to respond to financial record requests within 24 hours and fulfill them by the next business day. The BOM further acknowledged that she should have responded and fulfilled this request by the next business day but had not done so, and that 12 days had elapsed since the request was made. The facility’s policy allowed up to 30 days for providing copies of personal or medical records but also recognized the right of the LTCO to examine resident records in accordance with state law. The failure to provide the requested financial records within two business days constituted a violation of the resident’s and the resident’s representative’s rights.
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