Commonwealth of Massachusetts
Executive Office of Health and Human Services
Division of Medical Assistance
600 Washington Street
Boston, MA  02111
www.mass.gov/dma	
	MassHealth
	Long Term Care Facility Bulletin 84
	April 2003

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

	FROM:	Douglas S. Brown, Acting Commissioner

	RE:	Annual Accounting for Personal Needs Allowance Funds

Accounting	The Division’s regulations at 130 CMR 456.615 require that long-term-
Requirement	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 is due to the Division by June 1 of each year.

June 1 Deadline 	To comply with these regulations, long-term-care facilities must use the
for PNA-1	PNA-1.  This form must be dated and signed by the facility administrator
Submissions	and sent to the following address by June 1, 2003.
	
Division of Medical Assistance
ATTN:  David Telegen
Office of Financial Compliance
600 Washington Street
Boston, MA  02111

	On the PNA-1, state the PNA balance for each MassHealth member as of February 28, 2003.  Attach to the form a copy of the bank statement(s) and reconciliation(s) of the aggregate trustee bank account(s) as of February 28, 2003, and submit the documents to the Division at the above address.  

	Providers may use their own reconciliation form or may use the reconciliation form attached to this bulletin (PNA-2).  This form is available on-line as an Excel file on the MassHealth Provider Services Web site at www.mahealthweb.com/publications_and_forms.htm, where it can be completed on-line, then printed and mailed to the above address.  
	Please Note:  The amount on Line 7 of the attached bank reconciliation form must agree with the Total PNA Balance-All Pages on the PNA-1 form.
										
continued on back

June 1 Deadline 	Providers using Microsoft Excel or Access to maintain listings of patient 
for PNA –1	balances may submit these on a 3½” floppy disk or CD.  It is suggested
Submissions 	that these disks be enclosed in a disk mailer envelope.  Attach the disk or
(cont.)	CD to the PNA-1 form and indicate the list as an attachment on the PNA-1.  The PNA-1 form can be downloaded from the MassHealth Provider Services Web site at ww.mahealthweb.com/publications_and_forms.htm.

If a facility does not handle PNA funds for any members, the facility muststate this on the PNA-1.  The form must then be dated and signed by the facility administrator, and sent to the address listed on the front of this bulletin.

	If a facility does not submit the PNA-1 by June 1, 2003, 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 David Telegen at 617-241-6106.