After Medicaid was approved they back paid her nursing home. She now has money over the amt allowed in her checking account each month?

Are you saying that she will use up that excess money in a few months for a known expense? If that is the case I hope you can simply leave it there. Yes, there is a periodic check by the state on the money she has on hand. See if you can find out when that will next occur.

But if it isn't going to be needed shortly, then do as Pam suggests and use up the excess each month.

My mother ran into that while she was still home, once in a while. That was when we insisted she buy new sheets, or get a decent bathrobe, etc. Now that she is in a nursing home she hasn't had excess checking account money, but I think we'd buy a really nice plant for her room, or improve her wardrobe, etc.

Pam's idea about checking with the nursing home financial person about what is allowed is a good one. Also check with her usual caregivers and the floor nurse about what might be pleasant for her.

Get the amount below what the limit is. Check the list of allowable expenses and get it down. The financial person at the NH can give you some advice on how to do that.