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I recently found out, quite by accident, that my mother's nursing home used her personal health benefits to purchase supplies for the building.


Last month I purchased some health supplies for my mother through her personal health benefits that are a part of her insurance benefits. The products never arrived. I called daily to try and track down the supplies but no one I spoke to was knowledgeable.


Several weeks later I went to order more supplies and discovered that my mother's account was depleted of points. Further conversation revealed that her account had been used by the faciltiy to order a very large quantity of a particular toiletry. Several other patient accounts were used to purchase the same in large quantites.


I called the facility to ask why my mother's account had been used without my knowledge and consent. An administrator called me to apologetically say that it was an oversight not to discuss the order with me first, but I could have the supplies if I wanted them, their goal was to make me happy, I declined as it was too large a quantity and my mother doesn't use the item. I was told the missing supplies I had ordered would be replaced. It came to light that the original missing supplies were picked up by another unit and the invoice revealed my mother's account number allowing an order to be placed in her name. However, the supplies were never redirected back to my mother.


Is this a common practice? Should I be alarmed? Do I take any further action? Thank you for answering!

Found this:

The Personal Needs Allowance is the monthly sum of money that 
residents who receive Medicaid may retain from their personal income. Any income above the allowance is applied toward the cost of their care. This allowance is intended for residents to spend at their discretion on items such as telephone expenses, cigarettes, a meal out with friends, cards to send to family, reading materials, or hobbies. Federal regulations prohibit long-term care facilities from charging residents’ PNA for services that are included in Medicaid payments such as toothpaste, tissues, shampoo, and incontinence products, among other things.
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Reply to JoAnn29
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mommycare Jan 5, 2020
Thank you for your reply!! The health product benefits are actually a part of her insurance plan, it provides members with quarterly monetary credits, which allows the insured person to shop for over 400 personal care items, over-the-counter (OTC) medications and home medical items! Most insurance plans offer this, a lot of people don't know about it or just don't use it. It is for the insured's personal benefit!
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I think it shouldn't happen. Can you get a statement of the items purchased for your loved one after they are purchased?
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Reply to Anonymous1256
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mommycare Jan 5, 2020
Thank you! I will ask the company to send me info about the order.
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NO! Read up on Personal Needs Acct on the Medicare org site. That money is taken from Mom's SS. Its her money. When she passes, you can request it to be paid to you (with a short certificate from Probate) to be part of her estate.

This is fraud. That money is to be used for her needs only. They need signed permission from Mom or her representative to use it. REPORT THEM. She should be getting diapers and toiletries thru the home. If there is certain things she likes that is what the PNA acct is for. You buy them, show a receipt and get reimbursed. You should be getting a statement. I agree, call the Ombudsman to investigate. Or go to the State who inspects them. They know what they r doing is wrong.
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Reply to JoAnn29
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mommycare Jan 5, 2020
Thank you!
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WTH. Ombudsman. Now.
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Reply to rocketjcat
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They have stolen from your Mother. Would you stand for it if they stole her personal possessions, jewelry or anything else?
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Reply to Sawdust
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mommycare Jan 5, 2020
Thank you!!
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H3LL no you shouldn't just let this go, this is no different than using the money to pay salaries or for cleaning supplies or maintenance, it is theft plain and simple. If this facility is so strapped for cash that they routinely steal from their residents I wonder what else is going on behind the scenes, I would be looking for an alternative placement if possible. And do report this to your state regulatory body and to the ombudsman, IMO a little heads up to the press might be reasonable as well.
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Reply to cwillie
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Wow -- that is fraud on the NH's part. It wasn't a mistake; they used her personal health benefits deliberately to purchase supplies for the facility.

As far as the missing supplies you ordered, they should replace them for your mother.
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Reply to CTTN55
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mommycare Jan 4, 2020
Thank you for taking the time to reply. Do I take the issue further or just let it go? I have found out that this is a regular occurence at this particular NH. Should I anticipate possible retaliation?
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