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Concerned daughter. My mother has dementia, she has SS and Medicaid. The care facility is getting both, they say they want her pension too. Do they have a right to it now, even after Medicad never said I had to sign it over to them before they started paying for her care?

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In facility Medicaid requires the resident to do a copay of SOC (share of cost) of all their monthly income to the facility. It’s her $$ not yours even if your her dpoa. Their monthly income would be SS plus and other income sources like pensions, retirements, annuities in payment mode. Your mom must do the SOC with her income in order to be considered in compliance for Medicaid. If she doesn’t, the facility can report or could be required to report that to the state and her eligibility can be suspended or revoked. Really you don’t want to go down that path.......

Once on Medicaid, the only income $ they will be allowed to keep will be whatever your state has as the personal needs allowance. PNA varies from $35 to $115 a mo. That’s it. If mom has debts, or has continued to keep her home, or still has a car, mom will have no-nada-none of her income anymore. So either she defaults on her debts OR family pays them. Choices stark once on Medicaid as you are expected to be impoverished. 

For some states, if they have a home with a mortgage, they can file a request to Medicaid to have some income diverted to pay mortgage IF property is up for sale with a MLS type of Realtor Listing Agreement (so no FSBO nonsense). These seem to be time limited. Like 6 mo, so must be a motivated seller. And then all the proceeds from the sale as it’s her $$ must become a spend down for her care. No $ to family.

Her income sources as their tied to her SS# will be known to Medicaid. By applying for Medicaid she granted basically an All-Access Pass to Medicaid which means Medicaid can get info from IRS as well. She must do copay unless there’s a very extraordinary situation - like community spouse or legally dependent child.
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Your mother's pension is your mother's money and should be used to pay for her care.

Her pension income should have been part of Medicaid's financial assessment. How did it come not to be included?

You say Medicaid never said you had to sign it over to them. Did you declare it to them?
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Igloo is correct. Yes, the NH is entitled to Moms pension. Like said, she gets an allowance (PNA) for her personal needs. This can be used for hair appt, clothing, etc. You just need to show receipts to get reimbursed.
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My mother was a private pay resident in a Nursing Home until her cash dipped down to $2500. She was then temporarily on Medicaid for seven months, until her house sold—then she was again a private pay resident until her death. While on Medicaid her SS and retirement pension paid only $2500 a month toward a $7000 a month bill. I paid Medicaid back (out of her funds) $30,000. Medicaid was like a no-interest loan, in my mom’s case, that allowed her to continue to receive very wonderful care.
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Are you thinking that the care facility is getting double payment, pension and medicaid? In fact, the amount that they get from medicaid is REDUCED by the amount of the pension that your Mom is receiving and owes the care facility for her care. Medicaid only pays for the gap amount.
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Possibly anonymous was the recipient of gifts/house/assets during the 5 year lookback period and Medicaid came after them for the assets? That’s the only way I can think of that the family would be responsible for more money....
To answer the original post, I pay all of Moms SS and her pension to the NH. Medicaid pays the balance. She gets $50 a month which i put in her personal account for her cable and hairdresser. If you didn’t disclose the pension, they will figure it out and take it. (And maybe even a slap on the wrist for not disclosing it?). I hope you haven’t spent it!
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They want it because they are entitled to it. All of the previous responses are correct.
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The only thing our Mom is allowed to keep is $60 for incidentals. The rest of her Social Security and Retirement go to the Nursing Home. Medicaid pays the rest.
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That may be so in some states, Anonymous 44, but not so in mine (NC.) My wife is in an Alzheimer's and Dementia care facility which Medicaid pays for. The house is in both her and my name. If I should die first Medicaid gets the house, but if she dies first the house becomes mine. The only thing Medicaid will come for is whatever happens to be in her name alone. My advice for misfits would be to see an elder care attorney.
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Would you have not signed mom up for Medicaid had you known her pension would be included?
 Is the pension enough to pay for your mothers full-time care without Medicaid?
What would you have been saving moms pension for has Medicaid paid the full fare - her in a nursing home and all?
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