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Resident Trust Fund Policy Notification and Authorization
Residents of this facility have the right to manage their own financial affairs and handle their own spending money. Residents also have the right to have the facility keep their money in a trust account to safeguard and manage personal spending money. This facility has a resident trust fund available, upon the written authorization of the resident or authorized representative, to any resident that wishes to deposit funds for safekeeping. The facility will maintain a separate accounting of funds available to the resident or authorized representative. Upon discharge, all funds and a final accounting will be provided to the resident, the administrator of the resident’s estate, or agent legally entitled to such funds.
Accessible Cash and Savings Accounts: Resident funds under $50 are kept in a non-interest bearing accessible cash account for use by residents. Any funds in excess of $50 are deposited in an interest bearing savings account. Residents may have an individual savings account in his or her name. Any interest on the account is accrued to the resident. According to Medicaid regulations, residents receiving Medicaid may not have more than $2,000 in this account. Any resident funds in excess of $2,000 will be taken by Medicaid and used toward the cost of care. The facility will inform the resident or authorized representative whenever the trust fund balance approaches $2,000.
Purchases and Withdrawals: Purchases and withdrawals may be paid out of either the accessible cash account or the savings account, as long as funds are available. No funds will be distributed or purchases made without appropriate written authorization of the resident or authorized representative.
In accordance with state and federal laws, individuals making purchases and withdrawals on behalf of a resident out of the resident’s trust fund must sign an affidavit assuring that funds will be used for the resident’s benefit. The facility will pay any charges presented to it by contract services such as the barber and beauty shop and clothing suppliers. Statements from trust fund accounts will only be made if the resident has appropriately authorized the purchase. Quarterly statements are issued to all residents detailing account activity.
Residents and/or their authorized representatives are asked to observe the trust fund banking hours that are posted in the facility. Those residents wishing to withdraw or deposit money may do so at these times. Residents will be asked to sign their name or make their mark acknowledging receipt of money.
I have received a copy of the facility’s Trust Fund Policy and wish to have my personal funds handled as follows:
I DO authorize this facility to hold my personal funds for safekeeping in accordance with their written policy and to disburse them as authorized below.
I DO NOT wish to participate in the Resident Trust Fund.
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Print Name of ResidentSignature of Resident/Guardian
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Signature of Witness who has no financial or employment relationship with the facility