Health inspection·August 24, 2023

F 0567 Honor the resident's right to manage his or her financial affairs. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview, and record review, the facility failed to ensure resident trust funds were accurate, monies due to residents were credited in a timely manner, and safeguards were in place for managing resident funds for two residents (R3 and R4) of six residents reviewed for resident trust funds in a sample of six. Residents Affected - Few Findings include: The facility's Resident Funds policy, revised 4-29-19, documents Guidelines: This facility manages the personal funds of residents when such request is made by the resident. Resident funds may be managed by any of the following: d. The resident may choose to have the facility hold, safeguard, and manage his/her personal funds. This policy also states 4. Resident funds are deposited into an interest-bearing resident trust fund account which is different from the facility's banking account. And 6. Inquiries concerning the facilities management of resident funds should be referred to the administrator or the business office. 1. R3's Minimum Data Set/MDS assessment, dated 6-4-23, documents R3 is cognitively intact. On 8-23-23, at 11:15am R3 is lying in bed watching television. R3 confirmed that the facility manages R3's funds and R3's stay here is paid out of R3's Social Security money. R3 continued to state the following: Sometime last year $600 was taken from R3's account and never replaced. R3 stated that R3 spoke to the finance person many times about it. R3 was told it was for rent, but rent was already paid. R3 received letters from R3's bank saying R3 was overdrawn. R3 stated I never got any answers or the money back. R3's resident trust fund statements, dated 8-23-23, document that R3's room and board was paid for twice in September 2022. On 9-2-22 there was a Care cost automatic withdrawal for $609.64. On 9-8-22 there was a bank debit of $609.64 into R3's trust fund followed by a payment in the same amount made for R3's room and board. This same statement documents that $609.64 was refunded to R3's trust fund on 10-25-22. R3's resident trust fund statements, dated 8-23-23, document that R3's room and board was paid for twice in May 2023. On 5-3-23 there was a Care cost automatic withdrawal for $682.64. On 5-15-23 there was a bank debit of $682.64 into R3's trust fund followed by a payment in the same amount made for R3's room and board. On 5-19-23 R3 incurred a $53.00 fee for lack of funds. These same statements do not document any refund of $682.64 or $53 for the fee. On 8-23-23, at 1:15pm, V2 Regional Financial Coordinator stated the following: On 9-8-22 there was an auto withdrawal of $609.64 for R3's room and board. On 9-8-22 an auto payment of $609.64 was Page 1 of 2 145437 145437 08/24/2023 Goldwater Care Princeton 515 Bureau Valley Parkway Princeton, IL 61356

F 0567 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few debited from R3's bank to R3's trust account by V5 the previous Business Office Manager/BOM. R3's $609.64 was refunded back on 10-25-22 to R3's trust account. (V4 Business Office Manager/BOM) should not have put in a debit. It happened again on 5-15-23 with V4 BOM for $682.64. R3's bank returned the money because R3 didn't have enough to cover that one. On 7-17-23 a refund was put into R3's trust fund account for $682.64, but then it was debited back out on 8-11-23 and shouldn't have been. It looks like V7 Corporate Bookkeeper had put it in as PL 5/2023 which means patient liability. We need to refund that amount ($682.64) plus the $53.00 fee that R3 incurred and should not have to pay. On 8-24-23, at 1:20pm, V2 stated As soon as we find out it should be refunded. V2 also stated that per an email V2 received today, check #16 for R3 in the amount of $682.64 was dated 7-26-23, but never deposited into R3's account. It was re-issued and deposited today. 2. R4's Minimum Data Set/MDS assessment, dated 7-7-23, documents R4 is cognitively intact. On 8-23-23, at 11:19am, R4 sat in R4's room. R4 confirmed that the facility manages R4's money. R4 denied any concerns or issues with R4's trust fund account. R4's resident trust fund statements, dated 8-23-23, document that R4's room and board was paid for twice in September 2022. On 9-2-22 there was a Care cost automatic withdrawal of $968.64 for R4's room and board. On 9-8-22 there was a bank debit of $968.64 into R4's trust fund followed by another payment, in the same amount, made for R3's room and board. On 9-15-22 there was a fee of $53.00 for lack of funds. This same statement documents that $968.64 was refunded to R3's trust fund on 10-25-22; there is no documentation of R4's $53.00 fee being refunded. On 8-23-23, at 2:56pm, V2 Regional Financial Coordinator stated the following: We started R4's Social Security money as direct deposit on 5-3-22. On the same date (9-22-22) as what occurred with (R3), V5 previous Business Office Manager/BOM did a direct debit. On 10-25-22 it was refunded back to R4. We owe R4 the $53.00 from the fee R4 incurred on 9-15-22. On 8-23-23, at 2:15pm, V2 stated there are no safeguards in place for what happened here. The debits should not have been done. V2 didn't get notified and doesn't know why. On 8-24-23, at 2:05pm, V1 Administrator stated that it is concerning to V1 that there is no system in place to check for double or over payments. If no one is checking, then it can't be paid back timely. 145437 Page 2 of 2