What do I do with the check?

Hmmm, interesting.

Lataza - should you decide to want something to keep the ashes in or some of the ashes in, St Josephs Abbey on the north shore in Covington, LA sells handmade caskets in pine & cremation boxes of cypress. They are some kinda beautiful & legal for remains in all states.

Their Benedictine monks & also do the Pennies for Bread program, AB-Bee honey & artists retreats on the grounds in addition to the woodworking shop.

Thank you. I did not know that. The money is from her trust account at the NH. I am in Louisiana. She had no assets except her burial insurance and the money in the NH personal funds. My brother and I want to take her ashes and spread them in the forest near her hometown in Washington State. That's a long way from Louisiana so any money would be helpful.

Lataza - If the $ that the NH is referring to is that $ built up in the NH residents personal needs allowance (PNA) placed in a trust account at the NH, then that $ is an asset of the Elder when alive or an asset of their estate when dead. As such it does not get returned to Medicaid. It's not Medicaid's $.

The PNA would have been the $ ($35-$105 a mo) that was NOT require to be paid to the NH as her copay or SOC (share of cost) under Medicaid rules.

The NH will be under whatever your state has as financial rules on these accounts. For my mom & my mil - both on medicaid is TX - they died with $ in their PNA. For my mom, who was current on medicaid approval & reinbursement paid to the facility, $ was paid within a couple of months & made out to me as I was on file as financially responsible and as a signature on moms PNA account. I've kept moms bank account opened as it was POD to me & this $ went there to have banking $ as needed through the probate process. But for my mil, she was still in the Medicaid pending stage at the time of death, so that NH held the funds for way over a year till Medicaid approval & retro payments were finally cleared. Check when finally done was written out to BIL.

Medicaid can't ask for this $ back per se. They will have to go through the MERP or MERS process to get any assets of the estate of the medicaid receipient. If you do probate, then the recovery runs however your state does probate ( or small estates affidavit or muniments).

Whatever the case, most states have it such that the costs of funeral & burial are payable first & foremost from estate $. Like for TX, funeral is a class 1 claim, executor & estate admisintration are class 2 & 3 claims, while MERP is class 7, and assets are paid by order of class.

You may get a letter either from the state or from your states outside contractor for MERP or MERS, which will ask about the estate and it's assets to determine the recovery process that they will need to do. This is called a Letter of Intent (to file a claim or lien for medicaid estate recovery). Seem to be done within 4 - 5 mos of death if your state has HMS as the outside contractor for MERP. If your state still has its HHS or Dept of Aging is doing it, could be a year or more before letter of intent goes out. Sometimes no letter is sent, if mom had no exempt assets obvious in the medicaid application or renewal process. Be on the look out for this letter as you should respond to it to tie up any loose ends on moms Medicaid situation.

And Lataza, I am sorry for your loss.

Thank you, Lataza. The is something I did not know, and may have use for it in the future.

Problem solved. I called the nursing home and she said that under law she can only make it out to the estate or a funeral home. So I called the funeral home. He said he was glad to help. Since he hasn't been paid yet he's going to fax the bill to the nursing home and then when he gets that money and the money from her funeral insurance he will send me what's left. Now when Medicaid asks for their money I'll be able to send a check. Thanks for kick starting my brain. It's been a rough couple of weeks.

Also call the nursing home, they should be more responsive.

You might be surprised how quick Medicaid gets back to you. They always live to get money back.

I left a voice mail message at the Medicaid office. There is not telling how long it will take for them to call me back.

Contact Medicaid and ask them. Or ask the nursing home to send it to where they received the payments from instead of to you. I am surprised that nursing home doesn't do this by policy.