Ala. Admin. Code r. 560-X-42-.22
Current through Register Vol. 43, No. 1, October 31, 2024
Section 560-X-42-.22 - Resident Personal Fund Accounts(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
Ala. Admin. Code r. 560-X-42-.22
Rule effective October 13, 1988. Amended: Filed: June 8, 1993; effective July 13, 1993.Statutory Authority: State Plan; Title XIX, Social Security Act; 42 C.F.R. §§447.250 - .255.