Nuts and bolts question - How does this actually work? We know the Share of Cost amount from the case worker’s notice of change in status. They are allowing her to retain $35/month. Her social security goes into her checking account where I am a joint holder and I can pay her bills monthly (all funds and bills are mom’s). She does not own a home or have other assets or liabilities. Kaiser has been paying for the SNF monthly.
We are in California.
I was under the impression the social security payment will now be diverted directly to the SNF and Kaiser will reduce their payment. But the SNF told me today they will send me a monthly bill and I will be responsible to make the payment from mom’s funds. If payment were to be made directly they would be her Representative Payee which does not seem necessary or desirable. I could use any insight as to how we will actually want to set this up. Also wondering if we should expect to be billed (20th of each month) in advance for the following month or for the current month?
thank you all!
I'm in MN and when my MIL was on LTC on Medicaid here, her SSI was directly deposited into her account and then the facility autowithdrew her payment portion. My husband was her PoA but not her RP.
I would set up auto withdrawals with the facility if at all possible as it was very convenient. The facility did still send out monthly itemized paper invoices and statements for her Resident Trust account.
Your Mom will most likely need to reapply for Medicaid again at the 1-yr anniversary of her qualifying, as did my MIL. But eventually she no longer had to prove need every year.
If mom continues to have her monthly income (her SSA any other pensions) be direct deposited to her bank account, then you as her POA that has signature on her account, would write a check to the NH for all of moms income less $35. That $35 is her CA PNA (personal needs allowance). The $35 is technically income for the month paid AND becomes an asset the months afterwards. It is supposed to be restricted spending so only used for things not covered by LTC Medicaid (beauty shoppe, clothing).
The State will send out a letter that states the exact amount her required to be paid to the NH will be. NH will be cc’d.
Most States have 2K as maximum allowed for nonexempt assets for those on LTC Medicaid living in a facility. So ya have to pay attention to not letting her bank acct and her at the NH in house trust account ever added together each end the month go above the 2K max.
You mentioned it’s a joint account. If it’s actually this, personally I’d be beyond cautious in doing this because if you have any any - ANY - $ that is yours in it, Medicaid will consider it all ALL to be hers and count towards her resources (income and assets). When she does her renewal, most States will once again want to see 2-3 latest months of bank statements. So if you put your own $ in there it takes her over the 2K max, there will likely be a suspension of her LTC Medicaid till this is worked out. You do not - DO NOT - want this to happen. Your own $ really should go into your own bank in only your SS# so never ever any commingling. Comprende?
For a lot of POAs, it is flat easier to let the NH become the elders representative payee for their SSA income. NH will place the $35 PNA income an at the NH in house trust account that you can go and sign a ledger to do a withdrawal from to buy things for your mom that her LTC Medicaid does not pay for. Again you as her PoA have to mindful that the PNA $ doesn’t go over 2K. The facilities prefer that they become the rep pay as it’s easier, runs less risk that the POA will be late in paying, etc.
But you as POA do not necessarily have to do his. Mom can continued having her direct deposits done and then you as her POA who is a signatory on her bank account then pays the NH your mom’s exact SOC. I did it this way. For all the NHs both my mom and MIL were in, bill was due by the 5th of the month with late fees if not paid. Please realize her NH may want you to sign off on a personal responsibility agreement if your mom does not switch & allow this Nh to become her representative payee. Also her NH may have items that LTC Medicaid does not pay for….. like in her room cable, or an in room phone. So charges like that are extra and either she pays these items from that $35 PNA or you as her POA pay for it from your own $ or she does without.
Fwiw if mom moved in mid month, she will have her Share of Cost prorated for the month of entry. Then due in full at the start of the next month.