My mom has late stage dementia. If Medicaid denies her because of checks for haircuts and rides to Dr. appt., do I have any recourse?

Medicaid is not going to deny her because there were rides to the doctor paid for and she got haircuts. Medicaid will deny her if she has assets that need to be spent-down or if she has a long-term care policy.

The new home you're going to place her in on the other hand will scutinize every cent. They want to make sure there's not a dime hidden somewhere that isn't being turned over. If she cash paid or eight years, there's money.

The new facility wants to make sure every cent is handed over before they accept a Medicaid resident. It's not Medicaid that gives people a hard time. It's the care facilities they're trying to get placed in.

I bet issue is it looks like duplicate payment for services within the timeframe she was under another contract (the adult family home).
Could it be this…. that the checks or payments in question were paying for something or to someone during the same period of time that obstensibly she should have been provided a service to her as per a State contract? It’s the adult family home situation that is causing the glitch is my guess.

We went thru something like this for my MIL…. hang with me on this…. Mil was a handful, She managed to get herself out of a NH and into a low income State paid congregate living apt plus an aide who came in and the complex had a van with driver who took them shopping. As an aside she hated it. Anyways she would write checks to the aide & van driver which they would cash to go a buy liquor for her and not in small amounts either. Flash forward she moves to another city and she files for LTC Medicaid as she’s back into an NH and there was a stack of these checks and looked like gifting or questionable withdrawals. As her living costs were taken care of - as it was congregate housing with everything pretty much included except clothing & toiletries - no need to writing out checks in the name of an aide or a driver. Trying to get any help from the aide or driver, well neither wanted anything to do with this as totally against their rules of employment so that was a dead end. Luckily found a couple of liquor store receipts that matched amounts and hubs basically told the caseworker abt having to deal with alcoholic parent. It actually was ok once realization that MIL not paying the aide or driver for services (that would be a problem) but she could be letting them buy liquor.

If it’s this, You have to establish that the money was for something not included under the terms of contract of the adult family home. The hairdresser should have a state license via State board. So that’s a match for all those checks. The transportation say her physician was outside of the radius the programs driver could go, so you had to hire an outside driver. And do a receipt. There are federal standards for mileage set every year; easy to figure out a reasonable cost that comes close to what you paid. Just sayin’.

yeah I bet it’s the adult home that’s the glitch. It’s making her application be different. It’ll work out.

OK, something is wrong here
This isn't normal.
People are allowed to get themselves haircuts, groceries, clothing, toiletry products, transportation, cabs, even vacations, furniture, etc.
These aren't unusual/abnormal expenditures in a life, and aren't gifting.
It isn't normal to have these things questioned. So something is "off here".
This is not making any sense and it isn't how Medicaid works.

If Medicaid is denying your Mom you MUST find a way to be clear on WHY; and it won't be these things you told us about.

If this is simple questions such as "What was this amount spent on" then simply answer that. Hairdresser. Toiletries. Transportation to the MD. Vacation. Saturday dinner and gambling at the casino. Chest of drawers. Massage. Whatever.
Even her moving expenses are legitimate expenses for a life. Things shouldn't be questioned unless the amounts are well into the 1,000s.

If denial of Medicaid has happened, then you are going to need expert help to negotiate these facts/applications for Medicaid.
By that I mean you have to take your Medicaid documentation to an elder law attorney to find out EXACTLY why she is denied.
Your POA documents should allow you payment for this expert advice.
(While there you should get together a legal contract for shared living expenses; your Mom's SS should help you with utility bills, food costs for her and so on.
While there also check on how to keep your records so as not to arouse questioning. Make sure all her documents are done. Ask how to get yourself correctly put on her accounts as POA. A general "check up" at the attorney office.)

So sorry, but I have never in my LIFE heard such a story.
So I do hope others can tell us whether or not they have EVER seen or heard anything like questioning from Medicaid about these minimal daily living expenditures.
I can't know what's up here.
Don't know if she isn't qualifying physically for placement costs or if it has something to do with residency, or just exactly WHAT the problem is, but it isn't haircuts and cab fare to doctor's office, believe me.

This will be worked through. Just keep following up. There has to be more to this story because it isn't making sense right now.

Please return to tell us what you have learned because I am truly perplexed by your situation.

You just tell them the checks were for haircuts and transportation to apts. I so hope you have receipts. But if not, you can get check copies from her bank showing who the checks were written to. Or show them her bank registry. Since it seems to be a regular expenditure on her bank statement, they may be happy with just an explanation or one check showing the name of the hairdresser or person who took her to the appts. All they want to make sure is that the money went towards Moms care. Which it did.

Are you utilizing an elder lawyer for help? I utilized an elder lawyer and it was so beneficial.

I ran into the same problem but explained, in a formal document, the situation. My mom had surgery twice for skin cancer, (of which I paid for) and I also paid for all of her utilities bills, when she still lived in her home. She reimbursed me for all. I simply wrote a document explaining the situation and offered to provide receipts. After that, they approved.

I think Countrymouse comments are spot on. This is the normal process. It helps if you have receipts from the things you did for her.

Take deep breaths. At this stage, from what you describe, Medicaid are looking at the spending history and asking you to show what your mother's money was spent on. That's just normal. Are you having any difficulty finding the information they want?