§483.10(f)(10) The resident has a right to manage his or her financial affairs. This includes the right to know, in advance, what charges a facility may impose against a resident's personal funds.
(i) The facility must not require residents to deposit their personal funds with the facility. If a resident chooses to deposit personal funds with the facility, upon written authorization of a resident, the facility must act as a fiduciary of the resident's funds and hold, safeguard, manage, and account for the personal funds of the resident deposited with the facility, as specified in this section.
(ii) Deposit of Funds.
(A) In general: Except as set out in paragraph (f)( l0)(ii)(B) of this section, the facility must deposit any residents' personal funds in excess of $100 in an interest bearing account (or accounts) that is separate from any of the facility's operating accounts, and that credits all interest earned on resident's funds to that account. (In pooled accounts, there must be a separate accounting for each resident's share.) The facility must maintain a resident's personal funds that do not exceed $100 in a non-interest bearing account, interest-bearing account, or petty cash fund.
(B) Residents whose care is funded by Medicaid: The facility must deposit the residents' personal funds in excess of $50 in an interest bearing account (or accounts) that is separate from any of the facility's operating accounts, and that credits all interest earned on resident's funds to that account. (In pooled accounts, there must be a separate accounting for each resident's share.) The facility must maintain personal funds that do not exceed $50 in a noninterest bearing account, interest-bearing account, or petty cash fund.
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Observations:
Based on review of facility policy, observations, resident and staff interviews, it was determined that the facility failed to make certain resident funds were accessible on holidays and weekends for two of four residents reviewed (Residents R1 and R2).
Findings include:
Review of the facility "Resident Trust Account Withdrawals when the Business Office is Closed" indicated residents must be able to access their funds, even when the business office is closed. If a resident needs to withdraw money from their trust account outside of regular business hours, the following procedures must be followed that include but not inclusive to:
A bank bag containing cash is kept locked in the Registered Nurse (RN) office.
RNs may only issue the amount of cash available in the bag. If additional funds are requested, contact the Administrator immediately
During an interview completed on 9/29/25, at 10:04 a.m. upon asking Resident R1 concerning access to her funds stated "I asked one time during the weekend, and I could not get any it was on a Saturday a few weeks ago, they were going to set something up moving forward for availability on the weekends. I have not asked again on the weekend, I just ask during the week".
During an interview completed on 9/25/25, at 12:00 p.m. upon asking Resident R2 concerning access to her funds stated, "I have asked the other day for two twenty-dollar bills and one ten-dollar bill, I still have not gotten it".
During an interview completed on 9/25/25, at 10:25 a.m. upon asking RN Employee E3 concerning resident request for funds on the weekends replied, "I would tell them they would have to wait until Monday, I don't believe they have any money on the cart".
During an interview completed on 9/25/25, at 10:28 a.m. upon asking Nurse Aid (NA) Employee E4 concerning resident request for funds replied "I tell them they have to go to the business office or have the business office come see them. If it was on the weekend would let them know no one was in the office. I don't think anyone has access to the funds on the weekends as far as I know".
During an interview completed on 9/29/25, at 10:50 a.m. upon asking RN Employee E6 concerning resident request for funds replied," Usually they go to the business office, I know they have been talking about having petty cash available, nothing has been put into place yet".
During an interview completed on 9/29/25, at 11:04 a.m. upon asking Licensed Practical Nurse (LPN) Employee E5 concerning resident request for funds replied "The process is the business office, the nurses do not have any way to get money. I don't know what would happen on a weekend, there is nothing kept in the cart for the residents".
During an interview completed on 9/29/25, at 11:20 a.m. the Maintenance Director Employee E2 stated "I am temporarily taking care of the business office. We have a new business office manager starting soon and a regional office person is also helping". Upon asking Employee E6 concerning the process if the business office is not available replied "On the weekends we have a withdraw book where the RN supervisor would have access to it. The process is the same, there is a log with carbon copies. This has recently been put into place around early spring. Because someone wanted funds on the weekend. The supervisors will get it". The Business office keeps $500.00 on hand.
During an interview and observation completed on 9/29/25, at 1:05 p.m. upon asking RN Employee E1 concerning residents request for funds when the business office is not available replied "it's supposed to be in the cart, I think". RN Employee E1 went to obtain the nurse who was responsible for the cart. Upon RN Employee E1 returning to the back hall nursing station it was revealed that cash is not kept in the cart, it is in a locked box outside of restroom area at back hall nursing station.
During an interview on 9/29/25, at 3:30 p.m. the Nursing Home Administrator confirmed that the facility failed to provide residents with access to their funds on weekends and holidays as required.
28 Pa. Code 201.18(b)(2) Management.
28 Pa. Code 201.29(a) Resident rights.
| | Plan of Correction - To be completed: 01/06/2026
Facility resident 1 and resident 2 are now able to request and receive funds on the weekends.
Facility residents are able to request and receive money from their resident trust fund account on the weekends, even when the business office is closed. A bank bag containing cash is kept in a lock box which is installed on the wall at the back nurses' station next to the restroom. A list with resident names and resident trust fund account balance is also kept with this cash in the lock box. RN's may only issue the amount of cash available in the bag. If additional funds are requested, contact the Nursing Home Administrator immediately.
Facility nursing staff have been in serviced on the facility policy for when a resident requests money from their resident trust fund account on the weekends when the business office is closed. The Business Office Manager or designee will instruct the RN supervisor on Fridays as to the amount of cash and the list of residents' trust fund account balances to be placed in the bank bag and locked in the lock box for the weekend.
These actions will be reviewed Monday following the weekend by the Business Office Manager or designee with the Administrator or designee. These reviews will occur each Monday for 3 months, and then once on the first Monday of each month for 3 months. All reviews will be reviewed at the monthly Quality Assurance Meeting.
This corrective action will be completed by January 6th, 2026
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