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?

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One person told me the nursing home was taking money out of that 50 stipend for adult diapers, toilet paper, Kleenex, toothpaste, etc. And way overcharging. She had to go and buy all those items, present the receipts, and get reimbursed for them. That was so her mother would have some money left over for haircuts, etc.


She was on Medicaid.


My Dad’s SS check starts getting deposited next month in the nursing home. We are curious about this.

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Spore1941, yes it's Medicaid. We didn't have the nursing home make the Medicaid application. We had an Elder Law attorney. My FILs SS goes into his bank account just like it always did. We pay the NH the amount Medicaid says is his monthly liability, and don't let his account balance go over $1500.
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Reply to Agingmyself
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This rule about the $50 stipend is being made by Medicaid. It is my understanding that the nursing home cannot grab this money for anything. This money is for clothing, haircuts and stuff like that. If your dad is on medicaid, I would check with medicaid about the rules for the stipend. Some nursing homes will try to grab this money in defiance of the rules.
If your dad is not on medicaid and is self paying things are different. I had one loved one in this situation (self pay). We were visiting her once a week and taking a box of tissues every week. We put her name on the box in sharpie. There were several boxes piled up. The first month there was a bill item for tissues. There was also a bill item for gloves unspecified number of gloves. I took a camera and made a photo of the tissues we had brought. I wrote a letter telling them to remove the tissues charge because we had photo evidence of our supplying tissues. Here's a tip: use you cell phone to take photos of everything. I asked them in the letter to tell me how many gloves were in a box and how much each box costs. I did the math. They were claiming to have used 26 pairs of gloves everyday for each day for the whole month. No they didn't! I called them on this. They said Oh that's a typo. Notice everything I did was in WRITING. Very important, document everything. These people never again tried this nonsense with us. You should have yourself as payee for the SS check. Go to the SS office to set this up. Under no circumstances should the nursing home be the payee for that check. They will take severe advantage of your dad.

I have had loved ones in assisted living and memory care. They routinely try to bill for wipes, toothbrushes etc. Their charges for these items are so very high. I don't know what a $6 toothbrush looks like but it better be gold plated. I supply all of these items for them. I document the supply with photos and a written record. Once I complain and include some cell phone photos, they realize they can't put one over on me. The charges stop. Please pay attention to what these people are doing, don't just trust them.
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Cinderella5001 Sep 5, 2018
I very much agree with what you have written. Although we were private pay, one nursing home coerced me into having the social security payment go directly to the nursing home. It was NOT required. And it took me a long time to unravel that with social security. I have very few good things to say about nursing homes. You were smart to keep the records you kept. I also used my cell phone to document what I saw in the nursing home. I even took pictures of my mother, her food tray, the condition of her room, her wound dressings, bruises on her arms, etc. so that I had solid évidence of things that happened. It is good advice to be alert. Sometimes, an elderly parent can't really tell you about the things that happen there.
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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.
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Reply to Ahmijoy
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We also pay my FILs nursing home from his own bank account. I wouldn't entrust the NH with it, especially because my MIL, the Community Spouse, is entitled to some of his SS, which we transfer monthly to her personal account.
I've noticed that their billing is sometimes erroneous, and we pay them exactly what Medicaid says we owe, plus incidentals they provide, like haircuts, etc. Then, they just have to figure out how they billed wrong and correct it--we don't mistakenly overpay their incorrect billing.
Also, I know of a case where a NHs bookkeeper stole about $40,000; and I suspect it was from the residents' personal needs accounts. If no one is watching, bad people can take advantage.
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Spore1941 Sep 4, 2018
Is this Medicaid?
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I am glad your dad is enjoying his new place. Please keep an eye on him to insure that he continues to be treated correctly.
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Toadhall Sep 2, 2018
Absolutely! I have had the care of several relatives. I would make regular visits and also random visits to see what's going on. When they see you popping in at all hours, I believe your loved one gets better care. The staff may be doing this unconsciously but I believe having someone visit keeps them on their toes.
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The $50 is used for incidentals, e.g. personal effects.
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Reply to Llamalover47
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Thank you for all your answers. I finally made it back to Ohio. The 50$ 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.
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igloo572 Aug 30, 2018
Prairie- take a picture of him “sunbathing” and keep a copy with you so that whenever you feel angst on the move Or somebody gives your grief on your not caregiving personally for him in your home, you have the photo to have a moment of zen.
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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!
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Reply to KathyB1125
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To answer this question I would need to know if dad is in a skilled nursing home (private pay or Medicaid) or an assisted living facility.

If he is in a skilled nursing home then usually the cost of toilet paper, Kleenex and toothpaste should be covered in the daily rate. The cost of diapers would be covered under the per diem rate if the individual was on Medicaid, if they are not on Medicaid then it would be an additional charge. You have a right to have all the charges explained to you. I would also ask for am itemized statement that shows all charges, the home must provide this upon request.

If your loved one is in an assisted living facility they may charge for those items. Again the facility should tell you upfront what they will cover and what you are responsible for. Ask for a list of covered items.

You do have a right to shop around and find the lowest cost for personal items for your loved one. Many homes will require you to purchase the items and then present a receipt to get reimbursed.

As far as the Personal Needs Allowance (PNA) the nursing home or assisted living facility can NOT use those funds without permission from the resident or their legal representative. Most residents use their PNA for beauty shop appointments, for personal supplies or snacks.
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Toadhall Sep 2, 2018
I know for a fact that Medicaid covers adult diapers in my state. This would be for a person of any age living anywhere.
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The family can ask for a list of what is included, but, I've never heard of a facility charging a Medicaid patient to pay for toilet paper or soap. That sounds like something that would be included with the facility cost. And, adult diapers should be covered by someone, if the person is incontinent and there is a doctor's order for it. Check with facility or the Medicaid case worker. I have always purchased the toiletries, clothes and miscellaneous items for my LO from her personal needs allowance fund. It covers her haircuts too.
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