MLTSs Medicaid funeral expenses. What should we do?

Check with Medicaid to see if they contribute to funeral expenses.
Buying a prepaid funeral will not work now. That is usually done to spenddown Moms money for Medicaid. You do not gain anything doing it now.

The money in Moms Personal Needs Acct with the NH goes to Moms estate, as does the money left after spend down. These can be used for her funeral. You may only be able to cremate her. But check with Medicaid first.

I would think a funeral home would wait for payment. Your not the only person that needs to get the money. Insurance companies don't pay out overnight.

If you are listed as a withdrawal signature on your mom’s Personal Needs Acct at the NH, you can go an take $ from it. The paperwork for this is usually done as part of the admissions paperwork. If you are not already a signature, then either mom needs to do the withdrawal of $ OR whomever is her POA needs to add you on. I as POA was a signature for my moms but added name and address for a local cousin and one of my moms neighbors as signatures.

NH may have their own rules as to withdrawals. Like my moms first NH had it only weekdays and limited hours and limit on maximum withdrawn as it was cash. But my moms 2nd Nh had it available during all business office hours but too limited if it was in cash . I don’t remember the exact amount but it was modest. It’s a good idea as they don’t want residents w dementia coming and getting a roll of $$$$. If you wanted to do a big withdrawal- like they were at the 2k maximum for LTC Medicaid & you want to empty it - you put a request in and they would do a check to you in a couple of days. Both NH had a ledger for $ moves for the in-house Trust account and you put your signature and reason for withdrawals. Similar to the old school system used for going into a safe deposit box.

I’d suggest that you call the business office to see if your a signature or if it needs to be mom that obstensibly takes $ out of it. To make this easier, you could ask the preneed Fah guys to give you an estimate and you have the NH do the trust account $ as a check made out to the FH.
This way no “gifting” issues.
If she’s current on her billing, the folks in the office I’ve found to be quite helpful. Plus if she has a preneed, it makes things smoother for the NH when she dies as they know who to contact. Actually I’m surprised that the Nh didn’t require info on who would be handling your moms passing.

The POA may withdraw to pay a check for prepaid funeral, yes. Medicaid may indeed come after money in the account at her death. And I doubt medicaid will object to a simple prepaid cremation. You can also call medicaid for your state and ask them this question. That might be the safest way to proceed. You can also ask the LTC facility she is in as they may know the answer. The account will be frozen upon her death and no POA can access it. I am sorry you are facing this loss.