I think it would be helpful to enter some type of $0 adjustment in the Guarantors ledger titled "(name)moved from/to family" in order to keep track (find) any historical adjustments that may have been done between family members. i.e., moving credit from "Dad" to "child" to clear a balance owed. The child has now moved out and has his own family. An opposite transaction will no longer appear in either of the patient's ledgers, if audited this does not appear as correct and instead as an administrative error.