F0568

E

Untimely Resident Trust Account Updates Result in Inaccurate Negative Balances

Cleveland, Ohio Survey Completed on 02-27-2026

Penalty

No penalty information released

Summary

The facility failed to properly hold, secure, and manage residents' personal funds by not keeping resident trust account financial records timely updated, resulting in multiple accounts showing negative balances. Fourteen residents' financial records were reviewed, and each showed a negative balance as of 02/27/26, despite facility leadership stating that most of these residents did not actually have negative balances. The residents involved had a range of medical diagnoses, including hypertension, dementia, schizophrenia, major depressive disorder, COPD, diabetes, and other chronic conditions, and several had documented cognitive impairments ranging from mild to severe, while others were cognitively intact.

Specific review of each resident's trust account information dated 02/27/26 revealed negative balances varying in amount. One resident had a negative balance of -$970.99, another had -$31.45, and others had negative balances such as -$59.09, -$77.14, -$110.97, -$31.57, -$56.96, -$44.47, -$4.73, -$18.97, -$64.57, -$39.72, and -$36.71. One resident's account showed a significantly larger negative balance of -$1,819.10. These negative balances were documented for residents with differing cognitive statuses, including residents whose MDS assessments showed severe cognitive impairment, mild cognitive impairment, intact cognition, and some whose cognitive status had not yet been evaluated.

Interviews with facility staff confirmed that the negative balances were largely due to delays and backlogs in bookkeeping and updating of financial records, rather than actual overspending by residents. The Business Office Manager stated that many resident financial records were not up to date and that she depended on the Executive Director to provide information about cashed checks and cost-of-care payments before she could update the accounts. The Administrator acknowledged that the facility was behind in paperwork and bookkeeping, resulting in resident financial records reflecting negative balances that did not correspond to the residents' true financial status. The Executive Director confirmed he could fall behind on documenting resident financial expenses and revenues and that most residents with negative balances did not truly have negative balances because the records had not yet been updated. Facility policies stated that residents are permitted to manage their personal funds or, if managed by the facility, to receive quarterly statements and to obtain their account balances and written breakdowns of fund activity upon request, underscoring the requirement for accurate and timely financial recordkeeping that was not being met.