What charges will my Dad have to pay for with the $50 per month that the nursing home leaves him from his Social Security check?

That $50 is his PNA - personal needs allowance. He or you as his dpoa can spend it anyway he Or you want to as long as the $ is spent on him or his needs. Most use it to have a set barber shop weekly visit so that cost is automatically paid out of the PNA held at the NH.

That being said, IF you all have opted for the NH to become his payee for his SS or other monthly income so that the PNA goes into a personal trust fund account at the NH it may not be easy to get to if not used for an in-house service (like barber shop). Often you have to physically go to the billing office or SW office to sign out $ via a ledger to get cash OR present cash receipts for things bought for him and be reimbursed to the penny.

Just as an aside on this, you DO NOT, DO NOT have to have the NH become his payee.

Dad can continue to keep a bank account with his check(s) continuing to be direct deposited and you write a ck to the NH for the copay amount required as a exact $ amount as per the states Medicaid eligiblility letter sent to your dad / you. I did this with my mom for 2 different NH and the first one wasn’t happy but 2nd one was its your decision. In my experience the NHs will press heavily that it’s required or must be dealt with this way. Hogwash. It’s not, doesn’t have to be. Medicaid does not require this. BUT you have to send the copay check like clockwork. Any late fees are on you and if it’s late NH can contact Medicaid for noncompliance. But by going this route it allows you to build up his PNA to do a bigger shopping trip or buy him a more costly item. Even pay on his preneed funeral policy. You just need to make sure that every month his bank statement is below 2k as his assets must be under 2k for Medicaid.

And should you find you’d like to move him to a different NH - as it’s closer to you or better staffed or whatever - it will be eons easier to do so as you control the copay needed to be paid to each the month of the move. I moved my mom from 1 NH to another within her first year, it can be done but is a bit of a ballet to do. Trying to get old NH to deactivate a direct payee / Representative payee situation is not at all easy as the old NH can be totally foot dragging with you.

I’ve found some NH are totally predatory with the PNA $. Like they charge for cable & phone and the monthly fee is Viola! magically the exact amount of the PNA! And you have to send a written opt out request to get it cancelled. Yeah sure and I have some waterfront land in Plaquemines Parish in Louisiana or at Discovery Bay in MS to sell to you... The whole charging the resident for inflated toiletries cost is predatory behavior. You know at both NHs my mom was at, for those residents who had family who were themselves limited financially, the Salvation Army came in regularly to provide for free personal care packs of lotion, shampoo, etc. that SA gets from big co like Proctor & Gambel and repack. There should be no need to take funds out of their PNA for this much less price gouge for toiletries imo.

Usually the bathing room will have liquid soap dispensers for bathing to begin with, so no real need for body wash or bath soap and has stacks of towels to be used as well for residents who don’t bring in linens. These costs are within thier overall room & board fee. Take a peek into the bathing room. At my mom’s 2nd NH had a labeled bin / shelf for each resident with their stuff in them.

I have never heard of this. And if it was done, it was illegal and should be reported to SS. The NH has to have authorization to deduct from that money.

When Mom went to a NH $50 of her SS was put in a Personal Needs Account that the NH oversaw. This money can be used to buy clothing, snacks, cigarettes, haircuts, etc. The NH had Chinese night and they had me sign it was OK to deduct the cost of the dinner from her PNA. Being a Medicaid patient has nothing to do with it. My Moms NH provided all her diapers and toiletries. In my area, I know of no NH that doesn't provide these things.

Now, was this person really talking about an AL? That would be a different thing since they don't provide personal needs. But then again, without written permission they should not be deducting from the PNA acct.

This is a good question to ask the NH. The only way I would think the NH would get away with this is if the State had guardianship. Even then, they shouldn't be allowed to deduct for toiletries that they should provide.

I know that all nursing homes are different....I regretted sending my mother's social security to the nursing home. It took me a long time to reverse that. We were always private pay, so in my opinion there was no reason for the nursing home to receive her social security payment.

Secondly, the trust account that I set up with the nursing home was used only to pay for my mother's weekly beauty shop visits. I provided everything else.

Also, I found that if I brought, extra supplies, like facial tissues, lotions, adult diapers and even snacks, they seemed to disappear very quickly. Since I visited almost every day, I decided it would be better to keep the "extra supplies" stored in my car.

In addition, I did my mother's laundry myself as I found that the nursing home laundry absolutely destroyed her clothing. You still have to label clothing but if your parent has nice clothes/outfits to wear, you will be happier if you take the time to do the laundering yourself. (By the way, we did the same for my father.) Yes, it is a pain in the neck but I always liked my parents to look nice in the nursing home.

Another suggestion, if you have spécial outfits for your parent to wear, take them home. Sometimes nicer clothing seems to "disappear".

I believe that Medicaid pays for incontience supplies. I wonder if the person you were speaking to knows the difference between Medicare and Medicaid. Many, many people do not.

In any event, if your loved one is going into a Nursing Home and will be on Medicaid, read your contract carefully and ask specifically about this issue, i.e., what are legitimate expenses for the personal needs allowance?

Of course you have to supply receipts; this is your loved one's money and it cannot be disbursed to someone else without proof that the money is being spent for their care.

My mom’s nursing home provided all that was needed. Her personal money allowed by Medicaid paid for the hairdresser and clothing. We never did anything with getting other items or getting reimbursed.

Thank you for all your answers. I finally made it back to Ohio. The 50$ per month in Dad’s personal account at the SNF is his to spend as he wishes.
He will start having his Social Security check deposited into the nursing home and that 50$ per month will build up if he doesn’t use it. He likes to shop in their little store as he can get Pepsi for 50 cents a can. And there are some vending machines he can get snacks from.
Everything is covered including cable. Only thing not covered is phone. Medicaid provides a free cell phone with so many minutes per month on it.
All is well.
We can breathe again.
He is safe and settling in. Today staff kept saying everyone loves him. He goes out into the courtyard and sunbathes everyday, with his cap, shorts, and sunglasses on.

I have never heard that a NH can change a resident separately for personal care items like depends, TP, and such! What a PITA that would be to deal with receipts and reimbursements. Ugh. We only pay for Moms cableTV and hairdresser with hers. Hopefully someone more familiar with Medicaid law will chime in. Maybe this is how smaller NH handle it?

No, no! She doesn’t pay for incontinece supplies! Hubby is on Medicare and Medigap and when he was in the NH and rehab, everything was provided and we took the unused stuff home when he was discharged.

Also, watch the balance of his personal account. When it gets too high, withdraw funds to get it back down to below Medicaid allowance level. Buy him a pair of shoes or something. Save the receipts.

My mother was in a skilled nursing facility, on Medicaid, for 2+ years. My sister is now in skilled nursing facility pending approval for Medicaid. The $50.00 is for personal use, haircuts, movie, whatever. Anything the resident needs for daily living is covered by Medicaid. For instance, my sister needs adult diapers, the facility provides them, however, my sister prefers another brand, so, I provide them. We never deposited the SS check to the nursing home. The checks were deposited in their own bank accounts, and I pay the nursing home from that account. I have POA for my sister, as I did for my mother.
I hope this helps.
Stay strong!

Health, the facility should send you a list of all the expenses at least every month. I always got a rundown of my mom’s personal needs account, including the withdrawals she made and what she spent at the beauty salon. You should also get a rundown of all the meds given. Pay attention to both these forms. Not because the facility is bound to try to scam you, but because you need to keep track.

This is not a reason to dump the facility. The kind of care your dad gets is far more important than the nickels and dimes of his personal needs account. Just be aware.