Hello, l would like to know where l can find a list of allowed subjects for reimbursement from my mother's PNA. Does anyone know?

I’d ask to see the accounts for mother’s PNA, which should be being held in a trust a/c. If it’s held in a joint a/c for all residents, separate details should be being kept.

It is not unknown for some facilities to use this money as their own piggy bank, and in addition for any balance that should be there to disappear mysteriously when the resident dies. If they refuse, or say there are no records, it’s not a good sign, and I’d consider a complaint to the Ombudsman or some other appropriate outsider.

I’d do this first, to see what is happening to the money, before trying for the rules.

PNA = Personal needs allowance
Social Security and SSI payments made directly from SS to the NH leave a small monthly allowance for Mom's personal needs.

Is that what we are talking about?

A life insurance policy that your mother is not the beneficiary of is not usually eligible for PNA. If the benefit is paid to a person other than mother or funeral home, it’s not benefit for parent. It’s a gift. Medicaid doesn’t allow gifts. if it’s a funeral policy naming a funeral home, then Medicaid is ok with that. Cost to cut hair, cable, phone service, the cost of a meal for parent only, all should be Medicaid eligible. We just went thru this with my mother-in-law. NH went thru list of what they covered in detail. The biggest drawback for facility and PNA was making sure they didn’t facilitate gifting and run risk of Medicaid disqualification

Call your Social Service Dept. They oversee PNAs. Ask them ur questions. I do think you need authorization to get reimbursed. My Mom had Dementia and I never needed to use it.

If Mom was paying on that policy and it has cash in value, it should have been cashed in and the money used towards her care or to pay for a prepaid funeral. If it doesn't have cash in value and ur paying it, then thats by choice. I don't think u can take the cost out of her PNA but be careful asking the question. You may just want to ask what is it I cannot be reimbursed for.

I am sure you must show receipts. Just showing that you charged it or came out of your bank account is not enough. They have to see what was bought. It has to be something personal for Mom.

It sounds as though the PNA (personal needs allowance) is being held at the nursing home. I also assume that the nursing home must be the rep payee for your mom's social security income which goes toward paying her cost of care, with an amount withheld to go into her PNA. I believe the list of things that the PNA may be used for may vary based on the state's Medicaid regulations. One way around the situation would be to have your mom's social security and any other monthly income deposited into her own bank account, and she then is billed by the nursing home and they are paid from that account. That works if someone has POA for your mom or if your mom is still capable of signing checks. The amount she'd have to pay for her cost of care is the same whether her social security is deposited in her bank account or the NH is the rep payee. In the scenario I describe, your mom has control over how she spends her PNA. My husband has POA for his brother and pays the NH monthly from his bother's checking acocunt where his social security and small pension is deposited. He's nwver been told that there is a list of allowable things his brother's PNA may be used for, but nursing homes are bound by more stringent regulations when they hold the PNA for the resdient.

I'd have to ask why your mother is still paying into life insurance. (In actuality, you have paid it for her at this point.) If it's whole life with a cash value, that's supposed to be cashed in to cover her care. If it's term life, is she paying it to cover funeral expenses? If so, you might want to consider having your mom use her funds for a prepaid funeral contract. I would doubt she's accumulated enough in her PNA account for a usual funeral contract, but it's worth checking out. A pre-paid funeral contract or trust is allowed by Medicaid and isn't counted as an asset. (The amount allowed varies by state I believe.)

Besides life insurance, are other other things you've paid for that you want reimbursed out of your mom's PNA? Check with your state's Medicaid office to get the list of allowable expenditures before you spend any more of your own money!