Failure to Timely Refund Resident Credit Balance After Death
Penalty
Summary
The facility failed to timely disburse a resident refund in accordance with its admission agreement, which required that any credit balance be refunded within a reasonable time not to exceed 30 days after discharge or transfer, minus any outstanding private insurance balance. The admission and financial records showed that the responsible party was clearly identified on the admission documents, face sheet, and financial records, and was authorized for healthcare decision making, care plan participation, emergency contact status, healthcare representative status, and management of the resident’s financial liabilities. The responsible party was also an authorized party on the resident’s private bank accounts used to pay the resident’s monthly private pay liability to the facility. The resident, who had diagnoses including unspecified cerebral infarction (stroke), chronic CHF, and metabolic encephalopathy, was admitted on the specified date and later died of natural causes at the facility. At the time of death, the business office and resident account records showed that $1,995.00 was owed to the responsible party to settle the account. The facility did not disburse these funds until after it received a notarized Heirship Affidavit from the local court and then further delayed issuing the refund check for 41 days after receipt of that document, resulting in the refund being paid more than five months after the resident’s death. During interview, the Administrator confirmed that, under the admission agreement, the refund should have been issued within 30 days of the resident’s death and that the agreement had not been followed by the former administration.
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