Spend down ideas??? Any other children with POAs been in this situation and have any guidance to offer?

Yes, twice now.

Buy a headstone or cemetery plot if needed. Favorite non-perishable (long-life) favorite foods. All haircuts for a few months, manicures, pedicures, massages. There are professionals that will do this !(more likely as COVID subsides)or go to them if she can travel and get out. Restaurant gift cards for dine in or carry out. Cell phone ( that may be a tough one)
Best wishes for you and your Mother 💕
Postage stamps by the (100 )roll for thank you notes you send now or after her passage. Magazine subscriptions., Games, jigsaw puzzles, puzzle books(buy the best---easier for her to handle)
Holiday decorations for her room, little gifts she may want to give visitors. A guest book for visitors to sign and write notes to her.

Adult diapers, medications, walker or other assist device, clothing, shoes, eyeglasses, dental care. And please, don’t say "claw back." Why should the government pay for your mom's care? Use her funds to pay for her fees until you spend down, then apply for Medicare.

It is difficult to tell a person what to do or expect when care turns from mom to child.

My mom had a stroke. She gave me POA, so I could pay her Bill's, use her money not mine.

I took the POA, went to my bank and spoke with my financial advisor. Mom had several accounts. Money she was not aware she had. It was an automatic deposit. The financial advisor helped put all moneys into one account with auto bill pay from the bank. This way I received a statement each month.

My state requires that each POA I sent out to do business for mom, also had to be notified after her death.

POA does not stand for peddle over adults. Mom loved to talk at 2AM. So I began making her favorite desserts or snacks and we talk. Mostly she talk and I listened.

Her mom died when she was three. She did not have a mom to share her experiences. Having a child, getting married.

She wants your help, but also wants your respect. You did not say how old your mom is. My mom was 94 when she past away. She always wanted to go home, but what others did not know was that mom wanted to go home to Heaven.

I pray this helps. May God Bless You.

PatsyN I.hope those home caregivers were through an agency or mom became their employer and NOT paid under the table. If paid under the table you had best chat with that attorney again, it be is an elder law attorney, on how to fix this. Paying cash under the table could easily disqualify her for medicaid.

Private pay at that facility. What would she do with a car, no it cannot be for you. It has to benefit mom.

I'm with DeckApe on the recommendation on getting an iPad. You didn't say where your Mom is physically or mentally, but having a tablet to play games, read, communicate via email or facetime would be super useful. My Mom had her Kindle Fire tablet that she used all the time, including her daily emails to me just checking in. Obviously not close to the 20K, but getting the more expensive Cadillac version will put a few hundred dollar dent into it.
(And yes on hearing aids too if she needs them - my Mom's were like 6K, so that will help.)

ThruTraffic: Imho, she could spend down some of the funds on her prepaid funeral.

too late to establish a trust. her money should be used to pay for her care. Or pay for items that she needs for the home.

Depending on state, she can have a medical needs trust. Money can be spent on things Medicare and Medicaid will not cover.

Better ed, alternating pressure mattress, power wheelchair, lift chair, handicapped equipped van - many things trust can buy.

Best to consult an elder care attornet.

Pre-paying for her funeral is a biggie.  That will eat up half of that twenty grand and that is if you have a very conservative funeral.  Then make sure she has plenty of sleepwear and comfortable clothing.  The rest can be used to pay her first months care where she is going,

Talk to a senior advisor about a trust. Then if expenses come up such as dental care etc you have a cushion of funds that can be used for unexpected item. The trust can be used to buy clothing, phone, transportation for her etc. Yes state might take it back but we had unexpected dental come up that is a couple thousand dollars.

Please do not depend on the information the Home is providing you. Talk to someone at your state's medicaid department to ensure you are doing it correctly.

Definitely pre-pay funeral expenses. We did this, as it’s a heavy expense and will be needed sooner or later, and it’s legitimate. Don’t waste the spend-down on non-sense or you’ll later regret it.

TV, phone etc to use at the home. If you take her out for trips a vehicle she can access is fine. My mom could never get in or out of my Jetta. She got a van for me to drive her around in. The costs of any outings or trips you take with her. Care until she goes to a home. The costs of prepping the home for sale. My brother was a ward of the state. $35 a month was withheld for his use( hair cuts mostly). My father had managed his care until my father died. My brother died a few months later. The balance in the fund went toward his cremation. The state of NJ paid for the rest. All medical equipment was paid for by Medicare.

If she needs a wheelchair a top of the line ROHO seat cushion with extra waterproof covers!

Pre pay funeral, casket, and any "extras" there might be.
Dental work?
Hearing aids?
glasses. .and get more than 1 pair they seem to go missing a lot.
Does she use a walker? A new walker
Is she using a wheelchair? A better one.

Being private pay for a time might not be a bad idea as well.
Is there anything that she will need for her room? A better bed? Alternating pressure mattress? Her own shower wheelchair?

ThruTraffic
Igloo lives in Louisiana.
She was POA. Her mom was in NH on Medicaid but In Texas. She knows the rules for La and Texas.
Cwillies mom was in NH. So was JoAnns.
The thing is after your moms money is gone, it is gone. Anything that she might need in the future will be whatever you can provide for her or her personal need allowance will cover or what you purchased with her money before she needed it and it was spent down.

P.S.
I have an aunt and uncle who are donating their bodies to science. uncle is donating his to the university he “always wanted to go to”. 🤔

Don't forget hearing aids, dental, DME like walkers and wheelchairs. If she needs to supply her own incontinence products you can stock up on that too.

Based on my experiences:

Certain services like cremation may be pre-paid.

A bidet toilet seat to wash her rear after using the bathroom. A lot easier than self wiping if she has or may have mobility issues. (Besides, it’s kind of fun.)

A Sara lift may be useful. It’s used to transfer a person with limited mobility between a bed and chair. (Hoyer lifts are usually paid via insurance so it may not be worth it.) Even if she doesn’t need it now she may later.

A large iPad. Computers may become too complicated and phones may be too small.

Clothes. I’m not talking about nice clothes. I mean stuff for around the home. Sweat pants, t-shirts, no-laces shoes. That kind of thing.

Both options exist. Using the 20K for the first few months of care is my throw up my hands option.

I'd still like to hear responses from folks in the same situation that I'm in as a PoA and if they did "spend down", what strategies and tactics they used.

Here is one of Igloos post from a few years ago that has some good suggestions.

“Your best served by using the money to pay for things that will not be covered by Medicaid. Remember she will have only $ 30 - $ 60 a month in personal money to use once on Medicaid there will be no other money for her to access.

here's my suggestions:
A. if she has a home & you want to keep it - prepay utilities, property taxes,insurance, even do prepaid maintenance contracts for the yard, AC, etc. Poof $$$ all gone.

B. if she doesn't have a funeral & burial policy done - this will easily be more that $4K so another good spend down. The critical thing is to have the policy as
non-transferable and no cash value. NCV is a key when dealing with Medicaid.

C. if she doesn't have life insurance and is still young enough to buy it - a $ 1K or
$ 1,500 TERM life policy. This must be POD (paid on death) only with NCV and no ability to be transferred, the beneficiary ideally should be whomever is the executor of her estate. This would then be $$ the executor/family could use for her final/burial expenses. Again NCV is critical for anything you get for her. 

Life insurance is sticky in that whole policies have a cash value (you don't want that). The CV amount of the policy MUST be under whatever is the Medicaid ceiling for insurance policies - for Texas it is $ 1,500. If not, you have to cash out the whole life policy before Medicaid will pay. For term policies, it's also important if mom is still kinda young enough to outlive her term policy to the point that it produces a dividend. That dividend is "income" for Medicaid so you need for the
dividend to either be: 1) required to be put back into the policy with no cash distribution OR 2) of such a low amount that it is under the state's ceiling. My experience is that insurance agents hate writing these as they make no real $$ on these type of policies. AARP seem to have the best & easy to set in place ones.

D. legal stuff - If she doesn't have a will, DPOA, MPOA and "guardianship in case of incapacity" done, then go see an elder care attorney to have this drawn up.
This maybe will cost $ 500 - 750 and well worth it.

E. if you have all of the above already done - dental work for mom. Get whatever done ASAP. 1 crown, cleaning and xrays & gum work and poof! 4k gone.

F. New glasses, hearing aid and a good premium walker (like a Hugo) are also good items to buy as Medicaid reinburseable's on those items are cheap and ugly.

G. New easy to put on and hot water washable clothing.

Remember to keep all the receipts and business cards, in case there is a glitch when her application is reviewed. Good luck!”

Take the 20k and pay privately for two months. (Hoping that care is 10k a month). While in care you can start the Medicaid application and do not rely on the facility to do this. If Mom has no assets the application will be easy. Her SS and any pension will need to be below the income cap for her State, mine is 2300+.

My Mom also had about 20K. I started her application in April, placed her May 1st. She paid May and June privately. June I confirmed with the caseworker that Mom was spent down and they had all info needed. Her Medicaid started July 1st.

Mom had an insurance policy with cash value that I had to cash in. Medicaid allows for a prepaid funeral up to a certain amt. If no insurance than part of the 20k can be used as for a prepaid funeral.
I would not buy a car. It will become an albatross around ur neck. Because if sold, it has to be at market value.

You cannot set up a trust now. Thats hiding money in Medicaids eyes. Use the 20k for caregivers. But I found that by placing Mom for those 2 months on private pay, things went so much easier.