My Mom has recently been approved for Medicaid. According to her case worker, part of her spend down for Medicaid includes the cost of home health services that are provided through the Illinois Department of Aging. We are transferring her to a skilled nursing facility that will accept her medicaid eligibility and she will no longer be receiving those services. How will this affect her spend down?

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So your mom has applied for and been approved eligible for NH Medicaid, right? If so, then mom will have a monthly co-pay or her "SOC" (share of cost in Medicaid speak) to the NH from her monthly income. There won't be a spend-down but instead a SOC. The SOC will be all the $ she is paid each month less whatever your state has as its "personal needs allowance". PNA varies by state from $ 35 - $ 105. Like for TX $ 60. That PNA is the only $ mom will have as spending $ from here on out - you do need to spend it over time as it cannot build up and go over 2K (Medicaid maximum for non-exempt assets). PNA is meant to pay for hair salon / barber costs and perhaps their phone & cable fees @ the NH.

Speak with admissions & the billing office @ the NH as to how her income and the PNA can be done. Most NH will imply that residents monthly $ be sent to the NH directly and the PNA builds at the NH trust fund each month. But whomever is the DPOA does NOT have to do it this way. I kept my mom's checking account with her income direct deposited and the NH got her SOC by check each month and mom had a PNA of about $ 100 - 150 which got additional $ as needed.

If mom has any debts, a home, a car or CC's, there will be no - none - nada of her $ anymore to pay on anything once in a NH on Medicaid.
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