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We've been caring for our LO who is in a nursing home. We are on the cusp of having our LO on Medicaid, and our attorney has advised us to not spend more than $35 of her monthly income on personal care items and services. Because this amount is so little and much of what we purchase for her routinely is done in cash, we've chosen instead of just absorb the costs ourselves on our limited income. For instance, we take our LO's laundry to a laundry mat rather than let the home do it (and lose it), and the laundry mat takes cash only. Clothes, shoes, and the small amount of toiletries we've also absorbed as either way too expensive for the monthly stipend amount or just mixed in with our own purchase. We are leery of writing checks to ourselves as co-guardians and managers of her social security. Are we being overly cautious? Is it acceptable to have her pay us $35 a month for various care steps in light of how difficult it would be to provide an accounting for the money? One of the reasons we're asking is that we'd like to ensure we have a stable amount going to the nursing home monthly, and feel that if she doesn't spend her $35, it should go to the home to cover her bill and large balance.

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Thanks, Igloo! The NH never established this kind of account, perhaps because there was a big question about her Medicaid status as well as the wide spread knowledge that we're not happy with care and will be moving our LO soonest to a different and hopefully better home. It's almost laughable regarding the hair solon...they can't even keep our LO in dry pants, much less address hair. But that's a different story and issue that's been addressed with various state agencies.

Certainly agree about control of those funds.

This is new territory for us, and we really appreciate everyone's support and experience!
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Run - all states Meducaid program have it so the resident must do a copay or their SOC (share of cost) of their monthly income to the NH less the PNA. PNA varies by state from $35 - $105. My moms for TX was $60. Really it's just enough to cover hair salon at the NH and some toiletries or their phone /cable fees.

The NH will press upon family to have their income sent to the facility with a personal needs trust set up to capture the $ 35 which builds by $35each month. You do NOT have to do it this way! My mom kept her SS and retirement direct deposited to her checking account which I as a signature on then wrote a check to NH for her required by Medicaid copay each month. Moms bank account would grow by $60 each month; which worked better as I could do a bigger spend every 2-3 months when I came in to visit and get her " inventory" refilled or new. Plus I'm very much a control personality. I did establish a trust acct at mom second NH as well with about $150/200 in it so mom could pay hairdresser or spend at the canteen they had at her NH. Nh sent me a statement every 90 days as to the trust acct too.

One issue with NH getting their income is that IF you want to move them to another facility, it will be somewhat very very difficult to do. My mom moved from NH#1 to NH#2 at about mo 10 and really by having control over her income made the move go pretty seamless financially.

The NH can hold the PNA after death till their account settles. For my mom, they sent a check within 2 mos; but for my MIL that NH held it for almost 2 years.

The NH should provide laundry services as its a basic need. If $ is tight, you may want to let NH do her clothes and spend the $ 35 & your time rather shopping for clothing & toiletries instead. I bet the NH beauty shop has ladies on a weekly or bimonthly schedule & you may want to establish this for mom as it is quite the social center. Also if family or friends ask what they can do for mom, they can send a check in her name to her PNA at the NH.
Yes Goodwill is an amazing resource & not just for those with limited resources.
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No one has asked to establish a PNA yet, but considering the home, nothing woud be too big a surprise.
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As Pam says, the personal needs allowance is kept by the nursing home. In this state it is $90/month -- $35 would be very limiting! In any case Mom has her hair done onsite each week and that comes out of the allowance. Occasionally she goes on the outing to Walmart and she went to the NH's rummage sale this year. If she needs something special (fingerless gloves, for example) one of us buys it and gets money from her account.

We do not keep track of what the allowance is used for. It is for personal needs and that is how it is used.

We let the NH laundry do Mom's clothes. Everything is required to be labeled, no matter who does the laundry. (In case of an accident they don't let the dirty items sit around until family picks them up.) Yes, sometimes we have to track items down. We manage. Mom does not have any special-care clothing -- no fancy wool sweaters, etc.
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You do realize the entire check goes to the Nursing Home and they maintain the $35 PNA (personal needs allowance) in an account there. Label all her personal clothing with her room number including undergarments and shoes. Avery has "Kids No-Iron Fabric Labels" that you press on for 5 seconds and they are totally washable. Use a Sharpie laundry pen and problem is solved.
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You're right about dollar stores; and oftentimes the merchandise is from an emerging market and of low quality.
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Great point. We've shopped some at Goodwill. We're cautious about dollar stores due to the questionable quality of some of their products. Not everything with the same brand label is the same quality run.
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I can't speak to your specific question as I really don't have any experience with Medicaid issues, but I was thinking that some of the things you purchase for your LO might be cheaper at dollar stores and thrift stores. I was surprised to learn that at least one retailer donates to a thrift store merchandise which hasn't sold. I don't know if it's seasonal merchandise or just overstock.

Next time I donated to Salvation Army, I did some checking and found a LOT of clothing as well as some mattresses that were brand new.
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