Death of a Member

(A) Upon the death of a MassHealth member, the nursing facility must (1) render an accounting of the member’s PNA funds. The funds must remain at the facility for 30 days after the death of a member to allow for the appointment of an administrator or executor of the estate and for the payment of burial expenses; and (2) notify the next of kin or the member’s authorized or legal representative of any remaining funds, determine whether an executor or administrator has been or will be appointed, and explain to the next of kin or the member’s authorized or legal representative how to obtain the funds from the facility. (a) If there is an outstanding balance due on a funeral bill, the funeral home may submit an itemized funeral bill to the nursing facility and the nursing facility may pay the bill from the PNA funds. (b) If an executor or administrator is appointed within 30 days after the death of a member, the facility must send the balance of the PNA account and a final accounting of the member’s account to the administrator or executor of the member's estate. If any payment has been made to the funeral home under 130 CMR 456.614(A)(2)(a), the final accounting must reflect that payment. (B) If any funds remain in the PNA account after 30 days after the death of the member, the facility must (1) send a check for the balance and a final accounting of the member’s account to MassHealth or its designee; (2) notify the next of kin or the member’s authorized or legal representative of the amount of the funds, and the address to which they are being sent; and (3) notify the next of kin or the member’s authorized or legal representative that they may apply for the funds if they are appointed executor or administrator of the member’s estate. (C) A final accounting of the PNA funds must include any transactions that occurred during the three months prior to and the 30 days following the member’s death. If there are no PNA funds, the nursing facility is not required to submit the final accounting; however, the facility must maintain all member records according to 130 CMR 456.604 and 130 CMR 450.205: Recordkeeping and Disclosure. (D) The facility must include with the returned PNA balance and the accounting the following information: (1) the member's name and MassHealth ID number; (2) the member’s date of birth and date of death; (3) the name, address, and relationship of the next of kin or the member’s authorized or legal representative; (4) the name, address, and MassHealth provider number of the facility; and (5) the name and address of the funeral director.