Resident Trust Fund Monitoring for Medicaid Certified Nursing Facilities
This is a draft cheat sheet. It is a work in progress and is not finished yet.
GENERAL COMPLIANCE ITEMS TO BE REVIEWED
A. The facility must maintain resident trust fund accounts separate from the facility’s operating accounts.
B. The facility must not commingle the trust funds of Medicaid residents and private-pay individuals in a collective trust fund account unless it has signed release forms from the private-pay individuals.
C. The facility must make the resident trust fund records available for review by DADS staff during working hours without prior notification.
D. The facility records have been reviewed and assessed for fraudulent activity. (Indicate if a fraud referral will be made.)
E. The facility must purchase a surety bond or otherwise provide assurance to the Secretary of Health and Human Services to assure the security of all personal funds of residents deposited with the facilit
COMPREHENSIVE REVIEW OF SAMPLE CASES
1. The facility must have written authorization to manage the resident’s trust fund.
2. The facility cannot charge the resident for services or items which the facility is expected to provide for the resident’s total care needs.
3. The facility may not charge the resident for banking service costs if the resident’s trust fund is in a pooled account.
4. The facility must obtain authorization for payments from the trust fund.
5. The facility must maintain receipts for payments from the trust fund.
6. The facility must maintain trust fund accounts so that month ending balances are accurate according to the deposits and withdrawals recorded on the resident’s trust fund ledger.
7. The facility must refund the resident trust fund money of a discharged or deceased resident according to the time frames and procedures in the Requirements.
8. The facility must credit all interest earned on individual accounts to the resident’s account. If the trust fund is maintained in an interest-bearing pooled account, the facility must distribute interest received among the co-holders on an equitable basis.
9. The facility must deposit a resident’s personal funds in excess of $50 in an interest-bearing account separate from any of the facility’s operating accounts.
10. The facility must provide a written statement quarterly AND upon request to the resident or their representative giving the balance of the account at the beginning of the reporting period, total deposits and withdrawals, interest earned, identification number and location of any account the residents’ funds are deposited in, and ending balance