Current through Register Vol. 42, No. 11, August 30, 2024
(1) Personal Fund Management. In accordance
with Federal Regulations for Medicare and Medicaid Facilities, a Medical
Assistance resident may manage his personal affairs unless a facility accepts
the resident's delegation of this responsibility. A resident managing his
personal affairs may voluntarily have a facility hold custody of his
funds.
(2) Voluntary Resident
Delegation of Responsibility to the Facility. There are at least three (3)
specific categories of Medical Assistance residents who may voluntarily
delegate to the facility the management of personal financial affairs.
(a) Persons receiving Social Security checks
or other income which is applicable under Medical Assistance to the cost of
services less a thirty dollar ($30.00) per month personal care
allowance.
(b) Persons receiving a
check from the Department of Human Resources for a twenty-three dollar ($23.00)
per month personal care allowance.
(c) Persons receiving donated funds from
their family or friends which are not applicable to the cost of services. In
the event these persons voluntarily delegate the management or custody of such
funds to the facility, proper management and accountability for the funds must
be provided by the facility.
(3) Establishment of a General Resident Fund
Account.
(a) All resident funds for which the
facility has accepted delegation or legal responsibility will be maintained in
a separate General Resident Fund Account, which may also include the funds of
persons who are not under the Medical Assistance Program.
(b) Receipts, disbursements, and earned
interest will be debited and credited to this account. The separate account is
required to assure that personal funds of residents are not commingled with
other facility accounts and records. Maintenance of the personal fund account
is considered to be a normal function of the administrative staff, and no
additional personnel will be authorized for reimbursement purposes.
(4) Endorsements, Receipts, and
Deposits. The facility shall present checks or other receipts for monies to the
resident for his personal endorsement prior to depositing them in the
facility's General Resident Fund Account. If funds received by the facility do
not require endorsement, the facility will ensure that all such funds are
properly posted in the individual Resident Subsidiary Ledger. Unless prior
written authorization is given by the resident or his/her guardian, a voucher
or other form of documentation showing the date, amount, and proper authorizing
signature for each transaction shall be retained by the facility.
(5) Expenditure of Funds from the General
Resident Fund Account.
(a) A facility may not
use a Medicaid resident's personal funds to supplement a payment for nursing
care. A facility that fails to comply with this regulation will be subject to
prosecution under Federal and State laws.
(b) Also, a facility may not bill a resident
for undelivered personal services such as manicures, haircuts, hair styling,
laundry, and dry cleaning.
(c) The
resident or his/her sponsor must have freedom of choice in determining the
purpose for which the resident's personal funds will be spent.
(d) Within thirty (30) days after discharge
or transfer of the resident to another facility, all remaining funds for the
resident shall be returned by check to the resident or the resident's legally
responsible relative or legal guardian.
(e) In case of death, all remaining funds shall be returned by
check to the resident's estate.
(6) Accounting Records to be Maintained. A
facility shall maintain the following records relative to the receipt and
expenditure of a Medicaid resident's funds.
(a) General Resident Fund Account.
1. The facility shall maintain a separate
accounting record for the General Resident Fund Account. This accounting record
may be maintained in the General Ledger. The total of all resident's funds
shall be reflected in this account, except funds transferred to a savings
account.
2. The total resident's
funds record shall be reconciled to the bank statement each month.
(b) Individual Resident Subsidiary
Ledger.
1. An Individual Resident Ledger,
which may be a card or computer record, shall be maintained for each Medicaid
resident for whom the facility has accepted the responsibility for personal
funds. If a computer record is maintained, a quarterly printout is required and
should include the same information as is required on the card.
2. The Medicaid resident's full name and
Medicaid number are to be entered on the form. All deposits and disbursements
are to be recorded in chronological order.
(c) General Ledger Savings Account of Total
Resident Funds.
1. The facility must deposit
in a Federally insured savings account all funds in excess of $50.00 per
resident.
2. An account of the
total amount of resident's funds deposited in a savings account is to be
maintained by the facility.
3. The
facility may not use interest earned on resident funds to meet the costs of
maintaining the resident funds.
4.
Interest earned must be appropriately apportioned to each member's account
balance during the period involved.
(d) Petty Cash Fund Records.
1. Facilities that maintain a petty cash fund
to disburse small amounts of money to residents shall credit the total
withdrawal of such funds to the General Resident Fund Account described
previously.
2. When the Petty Cash
Fund is replenished, the amounts of the disbursements shall be posted to the
Individual Resident Subsidiary Ledger.
(e) Inadequate Records. When individual
resident subsidiary ledgers or records do not reconcile with the resident
Personal Fund Bank Accounts and/or control account, the resident's funds are
commingled with facility funds, or when any other situation exists in which
auditors are unable to determine correct balances and/or separation of the
resident personal funds, an income offset adjustment for any difference shall
be made against other allowable reported costs of the provider. The adjustment
(if any) will be determined during the course of an audit in accordance with
generally accepted accounting principles and auditing standards.
(7) Reporting of Resident's Funds
Quarterly Report to Resident. In accordance with Federal regulations, at least
once every three (3) months, the facility will give the resident, or the
resident's legally responsible relative or legal guardian, a copy of the
Individual Subsidiary Resident Ledger Card or computer printout listing all
deposits, disbursements, and the current balance.
(8) Assurance of Financial Security. The
facility must purchase a surety bond to assure the security of all personal
funds of residents deposited with the facility.
Author: Susan mims
Statutory Authority: State Plan; Title XIX,
Social Security Act;
42 C.F.R.
§§447.250 - .255.