A facility failed to notify residents or their representatives about excessive resident trust account balances for 7 sampled residents whose funds exceeded the $2,000 Medicaid asset limit. Records showed balances ranging from $2,547.70 to $18,955.25 for residents with diagnoses including DM, COPD, dementia, CVA, depression, anxiety, respiratory failure, and HTN. The BOM and Administrator both acknowledged the $2,000 limit and confirmed that notification had not been provided.
A resident with COPD, depression, and adult failure to thrive died, and the facility did not refund the remaining resident trust fund balance within the required 30-day timeframe. Review showed a returned check for $1,285.81 was issued 33 days after the deadline. The BOM stated the timeframe was overlooked, and the Administrator confirmed the funds should have been sent within 30 days.
The facility did not follow its admission agreement requirement to refund any resident credit balance within 30 days, resulting in a significant delay in returning funds owed to a responsible party after a resident with a history of stroke, CHF, and metabolic encephalopathy died of natural causes. Although the responsible party was clearly documented as authorized for healthcare and financial decisions and was listed on the resident’s private bank accounts, the facility withheld a $1,995.00 refund until a notarized Heirship Affidavit was obtained and then delayed issuing the check for an additional 41 days, leading to the refund being paid more than five months after the resident’s death.
Failure to refund resident trust fund balances within 30 days of death for three residents. Facility policy and the admission/financial agreement stated that funds held in trust would be paid to the resident’s estate within 30 days of death or discharge, but account reviews showed remaining balances of $4,012.18, $1,948.00, and $573.91 after the residents expired. The BOM stated the facility held the funds until insurance balances were paid and that the checks were written later, while the Administrator confirmed the 30-day requirement.
A facility failed to refund resident trust account balances to estates within 30 days after death for 4 sampled residents. The residents had diagnoses including respiratory failure, diabetes, lupus, dementia, COPD, and hemiplegia/hemiparesis, with BIMS scores ranging from cognitively intact to severely impaired. Records showed each account had a closing balance, but the checks were issued and cleared after the required timeframe; the Interim BOM stated the facility had 60 days to settle accounts, while the Administrator stated the timeframe was 30 days.
A facility failed to notify resident representatives when resident trust account balances were within $200 of the Medicaid eligibility limit for four residents. Records showed balances above the limit or near it, and the affected residents had cognitive impairment ranging from moderate to severe. Staff said notice letters were mailed, but they were not sent certified and there was no process to confirm receipt by the representatives.
A resident with severe cognitive impairment and multiple diagnoses died, but the facility did not issue a refund of the resident's personal funds until more than two months after death, exceeding the required 30-day timeframe as confirmed by the Business Office Manager.
The facility did not refund the trust fund account balances of two residents, both with multiple medical conditions including hemiplegia and dementia, within the required 30-day period following their deaths. The accounting bookkeeper confirmed that the funds remained unrefunded, contrary to facility policy.
A resident with a history of psychotic disorder, dementia, and hypertension was discharged, but the facility did not refund the resident's personal funds within the required 30-day period. The responsible party confirmed the refund was received late, and facility staff acknowledged the delay.
A resident with Cerebral Infarction, Malnutrition, Dysphagia, and Anxiety died with a trust fund balance of $70.08, but the facility did not refund the funds within 30 days or provide documentation that the estate had been reimbursed. The BOM confirmed the balance had not been returned to the resident’s estate.
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