I have been paying SOC separately. What recourse do I have to get money back? We live in California. My mom has early onset and severe Alzeimers. Nursing Home has taken control of my Mom's SS checks without my knowledge claiming they weren't being paid. I have been paying Share-of-Cost seperately not realizing they were getting the SS checks too. What recourse do I have to get overpayments back? What recourse do I have to gain control of SS checks again? Plan on going to SS office tomorrow to try and straighten that side of it out, and then have conference call with NH afterwards to deal with overpayments. Any advice whould greatly be appreciated. Thanks.

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Awesome answers from CMagnum (crowemagnum!! rocks!).

My mom gets both SS and federal retirement direct deposit into an account of which I am the signature and it's a POD account (to me). I write a check for her SOC to the NH based on the exact amount TXDADS indicates is required in her bi yearly eligibility letter. The $ 60 a mo PNA (mom's in TX) stays in the account, so her account builds by $ 60 each month. I do have a separate personal needs trust account @ the NH and did that with about $ 200 when she moved into this NH (her second NH).

If you have been paying the SOC, then I'd suggest you go on-line to your bank and download all those payments and copies of the checks. Then do a cover letter as to all this and fax the letter and the payment documentation to the NH. Fax from a FedEx/Kinko's type of place where you get a transmission report. Fax is important as faxes are legal (so that transmission report is mucho importante) while your speaking to them is not. You can also mail this to NH, if you do I'd suggest to send it certified with the RRM - return registered mailing (green post card) from USPO. The RRM is important as you get the card back with date & signature of receipt. Runs maybe $ 8.00 at the post office. Again the RRM provides you a way to show that the NH definitely received the documents.

Now perhaps mom's NH made an honest mistake, so either you'll get reimbursed or they credit mom's account. If you have any input in this, you want to be directly reimbursed, the check written to you. Having mom's account credited may be a problem for Medicaid renewal (if your state does this) as her bank account will increase and be over the required Medicaid limit and if you write a check to yourself from it, it could trigger a gifting/transfer penalty inquiry. My mom's in TX and for her annual renewal, I have to submit her current month bank statements and 3 months prior, so any excess money would show up and be an issue. If MediCal does this, you want to do whatever not to have to deal with that issue.

But I'd like to go back to just WTF why & how did the NH go & get themselves to be the SS payee? If you already are on file as representative payee & the account was current, then someone at the NH submitted a fraudulent request to a federal agency. SSA will have all this paperwork within their system and will have to do an investigation. If you are representative payee already then no worries. If you know you are the representative payee, I would not speak with the intake person at SSA but request to speak to a higher level person as they will be the one to have to initiate a fraud research action.

But if you are not, this is going to be much more difficult. SSA doesn't recognize POA and seems to go into defense mode with family trying to deal with their elderly parents accounts. Take all the payment details, and any legal you have for your mom and your ID (if you have a passport take that too) and be very calm but firm when dealing with SSA. It could be a very frustrating experience.

What is this NH like? Are there other issues? Is it likely mom is going to stay there till forever? Are you going to keep mom there OR do you foresee finding another NH. My mom has been in 2 NH. The first one, well the facility mom & I saw before she moved in changed dramatically within her first couple of months there; had 4 different administrators within a year; the social worker left about month 6 & not replaced when mom moved out @ month 11; business office was beyond incompetent with a stream of new employees; lots of overturn in nursing staff. Her statements were never correct & always higher. Now I paid mom's SOC from mom's bank account for the exact amount on her TXDad's confirmation of eligibity form. Took NH 10 months to correct errors only after I sent certified letters to their home office & CC'd to AOA ombudsman. NH kept on pressing to be payee for both SS and retirement … way. Then sent letters with the forms to have her income direct deposited, again no way. There were also all sorts of billing irregularities at the beginning when mom still was on BCBS as BCBS sends you a copy of all billing or items of dispute, so I could see charges and charge backs. Also mom had a personal needs account for beauty shop, etc. and we never got a statement on that account ever. Every month there was another issue so it seemed.

I moved mom from NH #1 to NH #2 at about month 11. It was pretty easy too & no issue for Medicaid as they reimburse by day rate. The only drama was in getting all of mom's medications from NH #1 but I took zip locks and sharpie markers for her meds that weren't in those 90 day vacumn packs. For NH #2 residents family can pay the co-pay, the only requirement was that payments had to be received by the 12th of the month otherwise there would be a $ 100 late fee assessed to the family representative on file which you signed off agreeing to in admissions documents. Huge difference in billing: I get every 90 days a statement on activity in mom's personal needs allowance that shows the signature of whomever took funds out; twice a year they send a copy of the Medicaid renewal form they get from the state with that month's invoice so there is no ? as to what mom is being billed & why. Nursing care and staff at NH # 2 also is much better; they seem a happier lot and lots of the staff have worked there over 5 years.

I mention all this because IF you feel that mom may need to move NH, you want to make sure that her account is all cleared up, credited properly and no issues with Medicaid before you do. Good luck & please post what happened @ SSA, we all learn from each other
Helpful Answer (1)

Great info on the tax savings. My mom doesn't have much in so far as assets though. Share of Cost is for Medicaid. You only pay as much as you have available.
Helpful Answer (2)

MDandy, you are welcome.

I have one unrelated question. You pay the nursing home directly from your account and you reimburse your account from your mother's Direct Express account. I assume the Direct Express account at one time received her social security check and possibly has other funds of her's in it. How does that work out tax wise? Are you able to take a medical deduction for the amount your mother pays for her part of the nursing home cost or does she lose that because in reimburses your account because you directly pay the nursing home their Share of Cost? I'm not a CPA tax person, but I was just wondering.

I bet you stay on top of that Direct Express account more closely after this. I hope that you will get the money back. They may chose to spend down the overpayment and not have you pay anymore for a while. I would think that there is legal recourse if the NH tries to mess this up further.

When I was my mother's POA, I paid her nursing home bill directly from a joint account which I was joint owner with right of survivorship but she was the primary owner. Then I sent the NH bill to her long term care insurance policy company who would write her a check for the amount they would cover. It usually took about a month to get the check from the insurance company which I would deposit back into the joint account. Her SS check and her pension was automatically deposited each month into the account. Any other medical expense like for meds, etc. were paid for out of that account. She had wisely set up her long term care insurance premiums to be paid automatically from that account. The premiums stopped being charged once she was in the nursing home. At the end of the year, I would give my CPA the information of how much had been paid to the nursing home from that joint account and the amount the long term insurance company paid. The amount paid above what was covered by the LTC policy plus other medical expenses became her medical deduction for the year which helped reduce her taxes from other income like her investments. Over the four years she was in the nursing home, this averaged about $30,000-$32,000 or so for each year that she paid from that joint account. She was blessed to get far more back in benefits than she ever paid in. She died of a stroke after being in the nursing home for 4 years.

Let us know how things work out.

You are welcome. I'm glad that I could help and I wish you well.
Helpful Answer (2)


Thank you for your thoughtful response and for the helpful link. I will be sure to spend some time reading through the information. I believe I am the representative payee for my mom for Social Security. The social worker at the Nursing Home said that my mom’s account wasn’t being paid and therefore they made the request and were granted by the SSA. However, I was never contacted by anyone about it, and didn’t realize what was going on. Furthermore, I have been automatically paying the nursing home for quite a long time now and was completely paying for everything. My mom’s money was supposed to be deposited into a Direct Express account from which I withdrew periodically to reimburse my account from which I paid the nursing home their Share of Cost. I hadn’t checked the Direct Express account for several months before I discovered what was going on..

The nursing home is in the process of reviewing their records, and so am I, however, at least initially, it looks like they have received more money than they were due, and now I’m afraid I won’t be seeing that money returned. I’m interested if there is any legal recourse for me to get the money back if the nursing home tries to stiff me.

Thanks again for your interest and help.

Very best regards and sincerely!
Helpful Answer (1)

How was the NH able to legally take control of your mom's SS checks? That does not sound right at all.

Where have her SS check been going earlier? Were they electronically deposited into her bank account?

Are you your mother's social security representative payee? Just having durable POA will not be enough to straighten this out. For more information about his see the article below @

I don't live in California and am not familiar with Share of Cost.. I googled it and think I understand what it is.

As far as getting over payments back, you will need to talk with the business office of the nursing home and have them search through the billing and payment records and send you a copy of what information that they have on file. You need to look into your mom's bank statements and see when the social security checks stopped being electronically filed if that is how she was receiving them. You also need to contact Share of Cost and find out what has been going on there.

The nursing home really should have contacted you first about them not being paid before just taking over your mom's SS checks which I don't know how they managed to do that legally.

I hope this helps some. Let us know how it all works out.
Helpful Answer (4)

I realize I spelled Alzheimers wrong. Never was much good at spelling...
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