If this is the money that every month your mom is allowed to keep as their personal needs allowance (PNA) as all the rest of their income goes as a copay to the NH, the NH might have mom on a preset charge for items NOT covered by LTC Medicaid. So those charges use up her PNA & so she really does not have any allowance $ left.
When looking at NHs for my mom, a couple of places did an automatic fee for cable and phone (these are not paid by Medicaid) and it magically was almost all the PNA $. These same NH were heavily insistent on their becoming the representative payee for my moms monthly income. Some flat out stated that this was required, which is NOT at all accurate.
When a NH has PNAs, it is a in-house Trust at the facility and the facility is required under federal rules on Medicaid to pay interest on it and is supposed to send a statement every 90 days to the resident or their POA. ((My moms first NH did not do statements & always an excuse as to why but her 2nd NH did and had a ledger at the ready at the billing office to do withdrawals & mailed a check to me for the balance abt 8 weeks after moms death.)) Subpar NH will do whatever to reduce work, so having fees use up all the PNA each month by billing for cable accomplishes this. To me if a NH does this or implies / insistent that they have to become the rep payee, is a NH I would never ever place a family member in.
"extra funds left from the patient"... does this mean your mom has passed and you are referring to her Resident Trust account? Your profile says you are her PoA.
You are going to need to do what you did previously. Charge it or pay cash and bring receipts back to get a refund. If Mom was of sound mind, yes they would give her the money but your not Mom.
When looking at NHs for my mom, a couple of places did an automatic fee for cable and phone (these are not paid by Medicaid) and it magically was almost all the PNA $. These same NH were heavily insistent on their becoming the representative payee for my moms monthly income. Some flat out stated that this was required, which is NOT at all accurate.
When a NH has PNAs, it is a in-house Trust at the facility and the facility is required under federal rules on Medicaid to pay interest on it and is supposed to send a statement every 90 days to the resident or their POA. ((My moms first NH did not do statements & always an excuse as to why but her 2nd NH did and had a ledger at the ready at the billing office to do withdrawals & mailed a check to me for the balance abt 8 weeks after moms death.)) Subpar NH will do whatever to reduce work, so having fees use up all the PNA each month by billing for cable accomplishes this.
To me if a NH does this or implies / insistent that they have to become the rep payee, is a NH I would never ever place a family member in.