Iowa Administrative Code › Agency 441 - Human Services Department › Title VIII - Medical Assistance › Chapter 81 - Nursing Facilities › Rule 441-81.4 - Arrangements With Residents

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Resident care agreement.
Rescinded lAB 12/6/95, effective
				2/1/96.
(2)
Financial
				participation by resident. A
resident's payment for care may include
				any voluntary payments made by family members toward cost of care of the
				resident. The resident's client participation and medical payments from a third
				party shall be paid toward the total cost of care for the month before any
				state payment is made. The state will pay the balance of the cost of care for
				the remainder of the month. The facility shall make arrangements directly with
				the resident for payment of client participation.
(3)
Personal needs account.
When a facility manages the personal needs funds of a resident, it shall
				establish and maintain a system of accounting for expenditures from the
				resident's personal needs funds. (See subrule 81.13(5) "c.") The funds shall be
				deposited in a bank within the state of Iowa insured by FDIC. Expense for bank
				service charges for this account is an allowable expense under rule
				441-81.6
				(249A) if the service cannot be obtained free of charge. The department shall
				charge back to the facility any maintenance item included in the computation of
				the audit cost that is charged to the resident's personal needs when the charge
				constitutes double payment. Unverifiable expenditures charged to personal needs
				accounts may be charged back to the facility. The accounting system is subject
				to audit by representatives of the department and shall meet the following
				criteria:
a. Upon admittance, a ledger sheet
				shall be credited with the resident's total incidental money on hand.
				Thereafter, the ledger shall be kept current on a monthly basis. The facility
				may combine the accounting with the disbursement section showing the date,
				amount given the resident, and the resident's signature. A separate ledger
				shall be maintained for each resident.
b. When something is purchased for the
				resident and is not a direct cash disbursement, each expenditure item in the
				ledger shall be supported by a signed, dated receipt. The receipt shall
				indicate the article furnished for the resident's benefit.
c. Personal funds shall only be turned over
				to the resident, the resident's guardian, or other persons selected by the
				resident. With the consent of the resident, when the resident is able and
				willing to give consent the administrator may turn over personal funds to a
				close relative or friend of the resident to purchase a particular item. A
				signed, dated receipt shall be required to be deposited in the resident's
				files.
d. The ledger and receipts
				for each resident shall be made available for periodic audits by an accredited
				department representative. Audit certification shall be made by the
				department's representative at the bottom of the ledger sheet. Supporting
				receipts may then be destroyed.
e.
				Upon a patient's death, a receipt shall be obtained from the next of kin, the
				resident's guardian, or the representative handling the funeral before
				releasing the balance of the personal needs funds. In the event there is no
				next of kin or guardian available and there are no outstanding funeral
				expenses, any funds shall revert to the department. In the event that an estate
				is opened, the department shall turn the funds over to the estate.