| 72 |
THE PILLARS OF BILOXI |
255093 |
2279 ATKINSON ROAD |
BILOXI |
MS |
39531 |
2017-03-10 |
159 |
D |
0 |
1 |
U1S311 |
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review of the Residents Trust Fund, Resident Council meeting interview, and staff interview, the facility failed to make resident funds readily accessible at all times for 73 of 73 residents participating in the trust fund account, and the facility failed to ensure the resident's account balances did not reach or exceed the applicable resource limit for three (3) of 73 resident accounts reviewed. This affected Unsampled Residents B, C, and D. Findings include: Review of the facility's policy titled, Resident Trust Fund Policy & Agreement, dated (MONTH) 17, 2007, revealed there was nothing addressed to make funds available at all times to residents who choose to participate in the trust fund. Further review of the policy revealed: The facility must notify each resident receiving medical treatment assistance under Title XIX (Medicaid) when the amount in the resident's account reaches $200.00 less than the SSI (Supplemental Security Income) limit of $2,000.00, and $500.00 less than the Medicaid resource limit of $4,000.00 to remain eligible for Medicaid long term care benefits. The notice must include the fact that if the amount in the account, in addition to the value of the resident's other nonexempt resources, reaches the applicable resource limits, the resident may lose eligibility for Medicaid or SSI. The facility must notify the Medicaid regional office of any resident receiving medical assistance under Title XIX when the resident's account balance reaches or exceeds the applicable resource limit to remain eligible for the Medicaid program. During the Resident Group meeting held on [DATE] at 2 PM, six (6) residents voiced a complaint that they usually got their money by the 3rd of each month, and they had not received it as of today. One resident spoke up and said the business office lady said it would be there tomorrow. She was new and didn't know she was supposed to request the money. Review of the residents', who attended the Group Interview, most recent Basic Interview for Mental Status (BIMS) revealed scores of 11 to 15, which indicated mild cognitive impairment, to no cognitive impairment. An interview conducted with the Business Office Manager on [DATE] at 10:10 AM, revealed when she was asked about the residents' money being available, she stated she's only been working here since (MONTH) 24, (YEAR). She revealed she didn't know she had to request the money ahead of time. The Business Office Manager further stated she didn't know money had to be available for the residents at all times. Review of the facility's Trial Balance sheet for [DATE] revealed the facility managed 78 resident trust funds. Of the 78, five (5) were expired residents. Unsampled Resident B had a balance of $4346.09 which put him $346.09 above his resource amount. Unsampled Resident C had a current balance of $5555.55, which put him $ 1555.55 over the resource amount of $4000.00. Unsampled Resident D had a current balance of $4425.40, which was $425.40 over the resource amount of $4000.00. The Social Worker was interviewed on [DATE] at 11:05 AM. She revealed she had been working with the family of Unsampled Resident B. and a burial policy was being purchased. The Social Worker revealed she had done nothing with Unsampled Resident C, and she thought Unsampled Resident D had expired. Further investigation with the Business Office Manager on [DATE] at 4:30 PM, revealed Unsampled Resident D left the facility against medical advice (AMA), and did not receive his money at the time of discharge. Facility staff revealed the resident was a veteran who was homeless, and preferred living homeless. The Business Office Manager stated she was unaware as to why they didn't return his money. |
2020-09-01 |