TN 25 (07-06)

GN 00605.524 Outline of Onsite Review Functions

A. Introduction

The following information is provided to assist the members of the review team in understanding the various areas covered during an onsite review. Where training is conducted for the onsite review, the RO should prepare its own training package or outline. The information in GN 00605.541—Collecting Data for the Onsite Review may also be used as a guideline.

B. Procedure — Conducting the Review

1. Notify Servicing FO

When an onsite review is scheduled, the RO will notify the servicing FO. The RO will explain the review process and any other pertinent information will be shared with the FO. For example, the RO will provide the FO with a copy of the SSA-9584-BK completed by the institution. The review team and FO will also examine the findings of the prior onsite review. Generally, this can be confined to information contained in the prior report, plus information outlined in the wrap-up meeting report.

2. Meeting with Institution’s Staff

The review team will meet with the director and other appropriate staff members to discuss the facility’s policies and procedures, particularly as they relate to the use of benefits and the reporting of significant events. The SSA-9584-BK recently completed by the institution is used as the basis for this discussion.

3. Examination of Beneficiary Accounts

The review team will examine the sample of the beneficiary accounts and compare them with the beneficiary’s MBR/SSR/PHUS in order to verify the monthly benefit amount received and posted. It is important that the institutions have the fiscal records for the most recent 12-month period available for review.

The financial review provides information on the effectiveness of the accounting system, the amount of funds available for personal use, the level of spending, and the amount of conserved funds. While examining vouchers, make note of significant personal expenditures, large purchases, etc., to be used later when touring the living quarters and meeting the beneficiaries. The lack of purchases or minimal purchases should also be noted.

If the facility maintains a collective account for its beneficiaries, determine whether it is set up and maintained in accordance with SSA’s policies and procedures. Follow the instructions in GN 00603.020—Collective Savings and Checking Accounts.

For terminated beneficiaries included in the sample, verify that any remaining conserved funds were returned to SSA to reissue. (See GN 00603.055—Transfer of Conserved Funds.) If the beneficiary died during the review period, verify that conserved funds were turned over to the deceased beneficiary’s estate. (See GN 00603.100B.3—Deceased Beneficiary.)

4. Beneficiary Visits

The review team should meet with as many of the sample beneficiaries as time permits. Verify the identity of the beneficiaries by asking to see institutional or other personal identification cards or other records maintained by the facility.

The purpose of these meetings is to obtain some general impressions about the beneficiary's environment, and his/her ability and the opportunities available to spend money. This phase of the review gives the team an opportunity to relate the information obtained from the fiscal records to their surroundings.

For example, if the records show purchases of large items such as a television, stereo, or a bicycle and the item is not present in the living quarters, the reviewers should find out what became of the item. This information may be obtained from speaking to facility staff. Whenever possible, the beneficiary's personal items should be labeled with the beneficiary's name.

NOTE: For beneficiaries included in the sample who are no longer in the physical custody of the institution, the review team should determine whether the beneficiary’s current and foreseeable needs are being met. Depending on the review team’s findings, it may be necessary to consider a change of payee. (See GN 00605.562 B.9.—Development Where Institution Does Not Have Custody.)

5. Wrap-Up Meeting

At the conclusion of each institutional visit, the review team will again meet with the appropriate staff members to present and discuss the team's preliminary findings and recommendations.

6. Summary Report

The review team members will prepare a written summary report focusing on the findings and recommendations relating to the use of benefits and reporting practices. See GN 00605.544—Summary Report of Onsite Review

NOTE: Changes in review team composition, travel arrangements, and length of stay at an institution may be made as necessary, depending on the needs of the review team. Any changes involving the institution should be discussed with the institution immediately. For example, if the beneficiary visits are scheduled for the afternoon but a beneficiary included in the sample is scheduled to be off campus at that time, you may be able to arrange to visit him or her in the morning instead.

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GN 00605.524 - Outline of Onsite Review Functions - 07/14/2006
Batch run: 04/25/2016