| 6500.121(a) | Individual #1's annual Physical dated 10/7/13 was done more than 12 months from the previous physical dated 7/10/12. | An individual shall have a physical examination within 12 months prior to living in the home and annually thereafter. | Individual lost their eligibility on 11/9/2012. When they lost their eligibility, they no longer had health insurance. JEVS is not their rep-payee, their niece is. JEVS repeatedly worked with the niece to get Individual #1 reinstated. When it came time for their annual physical, JEVS notified the niece. The niece was unresponsive and would not submit the cash so JEVS could take Individual #1. JEVS was finally able to get the niece's cooperation and on 10/7/2013 the physical was completed. At the time of the audit, the inspector was given a packet of correspondence showing JEVS diligence to complete appointments, including the physical, mandated by the 6500 regulations. At this point in time, JEVS is still waiting for Individual #1 to be reinstated. The issue causing Individual #1 to lose their eligibility was resolved and we do not see this occurring again in the future. JEVS has counseled the niece on the regulations and responsibilities of being a rep-payee. JEVS has also offered to become the rep-payee which the niece had declined. Going forward, JEVS will be proactive in starting to collect necessary paperwork before their redetermination is due, so individual #1 will not lose their eligibility again. JEVS has also decided that if the individual needs something or is due for an appointment and the niece is not being responsive, JEVS will follow through with fulfilling individuals needs and follow up with the niece, which may include filing for rep-payeeship. |
10/07/2013
| Implemented |