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Elizabeth M. Whitehorn, Director

Provider Notice issued 09/15/15

Resident Accounts – Death Claims  

 

To:​ Supportive Living Providers​
Date:​ September 15, 2015​
Re:​ Resident Accounts – Death Claims  ​

This Notice informs providers that Healthcare and Family Services (HFS) Bureau of Collections (BOC) has replaced the Small Estates Affidavit form previously used to collect the resident account/room and board account when a resident dies and the facility manages their funds.

A new form titled, “Notice of Claim for Funds in Personal, Trust and Room and Board Accounts on Death of Resident”, has been developed for this purpose. This form will be sent to a facility when a resident’s death is reported to the Department of Human Services by the facility.  This form will be directed to “Bookkeeper” as the facility contact. 

 

Facilities that receive this form should follow the instructions on the Death Claim and submit the decedent’s account balance to the identified BOC contact.  If a facility has not yet received a Death Claim and wishes to remit the funds in a decedent’s account they may contact the BOC directly by faxing requests to 1-217-785-6121.

  

A separate form titled, “Affidavit in Support of Funds Transfer” may be submitted by BOC to a facility in the event a client no longer resides at the facility, account funds were not transferred when the client left and, despite best efforts, the client is unable to be located.

 

Any additional claims on these accounts received by the facility should be directed to the BOC for disposition.

  

Questions regarding this Notice may be directed to the Bureau of Long Term Care at 217-782-0545.

                                                

Felicia F. Norwood
Director