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West Virginia Income Maintenance Manual Chapter 24

West Virginia Income Maintenance Manual Page 90 Chapter 24 Long Term Care

24.14 MANAGEMENT OF THE PERSONAL NEEDS ALLOWANCE (PNA) This section is not applicable to clients who are in a Modified Adjusted Gross Income (MAGI) or Qualified Medicare Beneficiary (QMB) eligibility category. Each nursing care patient is entitled to an allowance to meet his personal expenses. Any amount accumulated in the patient's personal expense account is an available asset. Responsibilities for the management of this allowance are outlined in this section. 24.14.1 NURSING FACILITY RESPONSIBILITIES Funds in the personal expense account must not be used by the nursing facility to meet costs of services covered by the Medicaid nursing care payment. Examples of services and items covered by the nursing care payment are listed below. In addition, the facility must: • Not charge a resident for any item or service not requested by the resident, or his authorized representative; • Not require a resident to request any item or service as a condition of admission or continued stay; and, • Inform the resident or his authorized representative requesting an item or service for which a charge will be made that there will be a charge for the item, and the amount. When a facility has responsibility for a patient's Personal Needs Allowance (PNA), individual records must be kept with documentation of all disbursements made. Patient funds must be held in a separate account and not co-mingled with facility funds. Misuse of the personal funds by the facility is considered a fraudulent practice and any misappropriated funds must be repaid. Because funds accumulated in the personal expense account are an asset, the facility is required to notify residents when they are within $200 of the asset limit. When the patient is discharged, any unused amount remaining in his personal expense account is refunded to him by the facility.