<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".19" citation="COMAR 10.07.09.19" title_num="10" subtitle_num="07" chapter_num="09" heading="Records of Resident Personal Funds.">
  <paragraph num="A.">
    <text>Records. For all resident funds entrusted to a nursing facility, the facility shall:</text>
    <paragraph num="(1)">
      <text>Maintain an individual record for the funds of each resident, which includes the following information regarding each fund transaction:</text>
      <paragraph num="(a)">
        <text>The date of the transaction;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The type of transaction, whether it is a deposit, withdrawal, or any other transaction;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>When the transaction is a withdrawal or deposit, reference to a numbered receipt; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>The balance of funds after the completion of the transaction;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>At least weekly, post to the record of the funds all deposits, withdrawals, and other transactions;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Furnish each resident or, when applicable, the resident's agent or interested family member, with a quarterly statement of the resident's individual account not later than 30 days after the end of each quarter;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Make available for inspection by the resident or, when applicable, the resident's agent or interested family member, a monthly statement of the resident's account; and</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Make available at the nursing facility, for audit by the Department and the Office, records pertaining to each resident's funds.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Receipts of Transactions.</text>
    <paragraph num="(1)">
      <text>If a transaction involves a transfer of funds between a resident and a second party, or between the nursing facility and the institution in which the resident's account is located, the nursing facility or financial institution shall:</text>
      <paragraph num="(a)">
        <text>Provide a receipt or copy of a receipt to the resident, or retain the resident's copy of the receipt as part of the resident's individual financial record; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Maintain the original receipt and make it available for audit.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Except as provided in §B(3) of this regulation, a nursing facility shall require that each receipt for withdrawal of funds from a resident's account be signed by the resident or, when applicable, the resident's agent.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>A nursing facility may allow a resident to withdraw money from the resident's account without signing a receipt only if the nursing facility documents that the resident is not disabled but is incapable of signing due to a physical disability.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Except as set forth in Regulation .18H(2) of this chapter, a nursing facility may withdraw money from a resident's account without written authorization of the resident or, when applicable, the resident's agent, if the:</text>
      <paragraph num="(a)">
        <text>Nursing facility documents that the resident is incapable of understanding the resident's rights and responsibilities regarding finances;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Resident's agent is unavailable; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Withdrawal of funds is for an item or service needed for the resident's direct and immediate benefit and the facility maintains documentation that the withdrawal was used for that purpose.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(5)">
      <text>A withdrawal under §B(4) of this regulation requires witness signatures of two facility employees authorized by the facility administrator.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Availability of Funds.</text>
    <paragraph num="(1)">
      <text>A resident has the right to access funds entrusted to the nursing facility:</text>
      <paragraph num="(a)">
        <text>During normal business hours, if the funds are held within the facility; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Within 3 banking days, if a bank, the State treasurer, or a county or municipal treasurer holds the money.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>When a nursing facility transfers or discharges a resident, the nursing facility shall either:</text>
      <paragraph num="(a)">
        <text>Request and follow the resident's written instructions for transferring the money;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Return, upon the resident's or, when applicable, the resident's agent's demand, the resident's money that the nursing facility has in its possession and have the resident or agent sign a receipt for the money; or</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Make available to the resident or the resident's agent, within 3 banking days, the resident's money which is in an account with a bank, the State treasurer, or county or municipal treasurer.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Notice of Balances. A nursing facility shall provide written notification to a resident who receives Medicaid benefits:</text>
    <paragraph num="(1)">
      <text>As specified in §1611(a)(3)(B) of the Social Security Act when the amount in the resident's account reaches $200 less than the Supplemental Security Income (SSI) resource limit for one individual; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>That, when the amount in the account, in addition to the value of the resident's other nonexempt resources, reaches the SSI resource limit for one individual, the resident may lose eligibility for Medicaid or SSI.</text>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>Death of a Resident. Upon the death of a resident for whom a nursing facility is holding funds, the nursing facility shall notify the resident's agent or interested family member and:</text>
    <paragraph num="(1)">
      <text>Convey within 30 days a final accounting of the resident's personal funds which are deposited with the nursing facility;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Transfer, pursuant to the resident's preexisting burial contract, an amount not to exceed the outstanding unpaid balance of the contract, or the total of the resident's funds entrusted to the nursing facility, whichever is less;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Release the resident's funds only to an individual who presents certified letters of administration that designate the person as “Representative of the Estate of _______________________________________”; and</text>
    </paragraph>
    <paragraph num="(4)">
      <text>When the nursing facility is still in possession of a resident's funds 1 year after the resident's death, the facility shall report all money it holds for the former resident to the Unclaimed Property Section, Comptroller of the Treasury.</text>
    </paragraph>
  </paragraph>
</regulation>