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My mother is in the State of NJ nursing home. Originally, she was in a AL paying self pay with VA and SS. The PNA was $109 per month. She ran out of money so I got her on Medicaid. It took the state of NJ 8 months to get their paperwork together because of staff changes and backlog so in the end it was retro back 9 months. I informed the VA immediately providing them with State documents, medical info, nursing home forms, the VA support forms requested, etc. They responded that there was not change to amount of VA benefit. Knowing this was wrong I called, faxed and mailed the forms again. Another letter from the VA stated no change. I called today and they put in a report to another department to look into the situation. Hopefully it will be resolved. I don't want a situation where I pay the NH the VA money then the VA demands it back. Any feedback on situation?


My mother only gets $35.00 personal needs allowance being in a NJ nursing home. Why would she not get the $109.00 PNA?


Final question... If and when VA reduces to $90.00 and mom is straight Medicaid and SS does she get to keep the $90.00 for PNA? I know about keeping under $2K. Since they have not been doing $109 and have been doing $35. I am majorly confused.

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Actually, effective July 1, 2017, the PNA with regards to Medicaid in nursing home in NJ was increased to $50 per month from $35. So that may be part of the confusion, I don't know about the rest of the question since it's VA benefits. If the nursing home is only allowing her $35, you need to bring this up with the billing office.
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VA Aid and Attendance and Medicaid are both funded by federal funds, at least partially in the case of Medicaid. From the date Medicaid starts, A&A will stop. It may take the VA some time to close the case, but they will expect a return of any money they deposit from that date. It took a year for the VA to close my mom's case, and we were given conflicting advice from them, including "go ahead and spend it on what she needs. It's her money". We saved the money instead, knowing it would all have to be returned .

A&A is awarded to help defray the cost of care, which is being paid by the resident. But once the resident is on Medicaid, she is not self paying so there's no need for the VA to help with the cost. My mom gets the state level of PNA only.
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Mom will have 2 pna’s... the $50 - thanks GuestShoppe! - from her SS that she gets to keep and the VA has its own pna that is $ 90. So $140 a mo pna total. Eventually & perhaps a glacial eventually, the VA and the states Medicaid will get the overage figured out and VA will claw it back from the bank account it’s getting direct deposit into. So just let the va $ stack up. But I’d try to spend the $140 each month so it makes the math easier. I imagine mom or you as dpoa has gottten the Medicaid eligibility letter that states to the penny what her copay or SOC (share of cost) is to be and it’s leaving out the VA $$. If so, pay that exact amount to the NH each month. Just make sure that’s done. If NH billing office carps that it should be more......well it’s the states eligibility letter that determines what the figure is; not the NH. 

If mom starred out with the 2k in nonexempt assets allowed by Medicaid, you might want to spend down to get it to 1k, just to make the math easier as well.
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We found out afterward that there is a form you can submit to the VA, requesting that the amount be dropped to $90. The idea is that instead of them putting $1000+ into the account for the many months it takes to close the case, it's only $90 a month that'll get pulled back.
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