Commonwealth of Massachusetts 
Executive Office of Health and Human Services 
Division of Medical Assistance 

600 Washington Street
Boston, MA 02111


MassHealth 
Long Term Care Facility Bulletin 72 
March 2000 

TO: Nursing Facilities, Chronic Disease and Rehabilitation Inpatient Hospitals, 
and Psychiatric Inpatient Hospitals Participating in MassHealth


FROM: Mark E. Reynolds, Acting Commissioner 

RE: ANNUAL ACCOUNTING FOR PERSONAL NEEDS ALLOWANCE FUNDS 

Accounting Requirement

The Division's regulations at 130 CMR 456.615 require that long-term-care 
facilities make an accounting to the Division of the balances of the Personal 
Needs Allowance (PNA) funds for each MassHealth member for whom the facility 
handles funds. This accounting must be made as of April 30 of each year, and is 
due to the Division by June 1 of each year. 

June 1 Deadline for PNA-1 Submissions

To comply with these regulations, long-term-care facilities must use the 
PNA-1. This form must be dated and signed by the facility administrator 
and sent to the following address by June 1, 2000. 

Division of Medical Assistance 
ATTN: Cynthia Ramey 
Office of Financial Compliance 
600 Washington Street 
Boston, MA 02111 

On the PNA-1, state the PNA balance for each MassHealth member as of April 
30, 2000. Attach to the form a copy of the bank statement and reconciliation for 
the aggregate trustee bank account as of April 30, 2000, and submit the 
documents to the Division at the above address. 

If a facility does not handle PNA funds for any members, the facility must state 
this on the PNA-1. The form must then be dated and signed by the facility 
administrator, and sent to the above address. The PNA-1 form must be used. 
Substitute forms will not be accepted. 

If a facility does not submit the PNA-1 by June 1, 2000, or if the form is 
incomplete, the facility may be subject to administrative sanction by the 
Division. 

A copy of the PNA-1 is enclosed with this bulletin. This form may be photocopied 
as needed. 

Questions

If you have any questions about this bulletin, contact Cynthia Ramey at 
(617) 210-5182.