Who repays SS check - patient's estate, spouse, family or the state?

You did an amazing job with their PNA funds! I was more of a slacker in PNA funding and did a big Target spend every 2 - 3 months or so.

We resisted the PNA. If non-emergency transport was needed @ 50.00 we paid provider directly. SNF booked the transport and family took a check directly to the snf a couple days ahead. The check was always payable to the transport company. We always got a receipt. When time for a haircut we paid the on-site vendor. If it was personal and could be bought at Walgreens or CVS, it was. If able, we went out for a meal or coffee using funds that would otherwise be held in a PNA. I've kept the receipts in case this becomes an issue. I don't know if Medicaid can tack on a penalty fee to the final bill. We wanted quality-of-life expenditures than using it for "extras" that meant nothing. Quality of life and a bottle of lotion, cup of coffee, candy and colas can be purchased on the economy. Respite on the economy translates to quality of life. When able, we spent at Taco Bell, Dunkin' Donuts - both stores close to the snf and doable on a "good" appointment day. Family does a much better job of allocating PNA funds for constructive causes than the snf. PNA funds are for the patient. We tried to transfer all monies outside the QIT asap in order to keep control of how monies are spent. Sometimes we brought in a cup of coffee to go from Dunkin' Donuts. (The senior French-vanilla coffee with 2 creams and a Sweet-n-Low was the attraction rather than the donuts). It was a tremendous struggle to get through the entrances at each store front and to remain upright. Someone in the shop helped steady or keep the door open. It was a challenge to get back in time to use the restroom. Adult briefs were worn on these trip days. It was painful but not harmful - not reinjuring anything. By the next appointment the pain was gone. Combining the appointments/outings just seemed to be a good way to utilize the allowance.

JessieBelle is right...SS will do a clawback IF they did not live long enough into the month of the last SS check issued to be paid.

For my mom, who died EOM & got paid on 3rd of following month, the clawback was within a week. But for her other retirement, that took almost 6 weeks. So you kinda have to just leave the bank account alone for at least a few weeks for this to clear.

So your elder had a Miller Trust /QIT done? Glad you were able to do one!
Where did your elders PNA (personal needs allowance) go to? Was it in the QIT? Or was it in a personal trust account at the SNF? If its the latter, the SNF will hold it for a while (my moms was just a couple of months while MILs almost 2 years) and send a check in the name of whomever was indicated on the trust acct. it is an asset of the estate but should be outside of QIT so can be used for probate or other death related costs.

Well, really, Medicaid won't keep it. It will go toward paying the expenses of the nursing home. I should have worded that differently.

If I understand correctly, SS gets first pick. If there is money to refund, they will claw it back out of the account it was deposited to. Medicaid gets the rest. Normally a person gets to keep the SS for the month in which they died. For example, if they die on Aug 5, they get to keep the check they receive in the first of Aug. In Sept they will receive a check for $255. Sometimes mistakes are made by either SSA or the bank. If things work right, the family or Medicaid will be able to keep the check for the month.