My uncle is currently Mediciad pending and already in long term care facility. Every month his income is paid to the facility with two checks. One for NAMI and one for personal expenses for $50.
Am I allowed to decrease that amount occasionally if he need personal expenses paid that is outside the LTC facility? For example, new clothing for $30 and then the remainder of the $50 personal allowance will be paid to his personal allowance account at LTC.
The $ amount of the PNA Personal Needs Allowance varies by State. Most States do $50-$75 range. But some do $35 up to $130. It technically is supposed to be “restricted spending” so used for things not provided by the NH &/or paid for by Medicare or Medicaid for him. The usual is that a resident places $ into an “at the Nh Trust account” that is used to pay for regular beauty shoppe or barber shop fees. A mom in a State that has a $40 PNA would basically use all her $ to cover twice a month beauty shoppe visits at the NH. But it is totally up to the POA to determine just how that PNA $ is to be spent that is best for their elder.
One issue - and for what it’s worth I’m still very salty about this - is that a NH can provide for a service that is NOT covered by LtC Medicaid and the NH uses the PNA to pay for said service automatically from the PNA. Like when I was looking for NHs for my mom, more than 1 NH touted “all expenses covered if on LTC Medicaid” and they had in room cable & phone and magically Voila!!! the monthly costs were exactly the same amount as moms PNA. And these NH also implied that mom’s monthly incomes had to - HAD TO - both have the NH become her representative payee. Which would mean the NH got her $ paid to them directly & all the PNA $ paid to cable. So for these NH all her $ totally taken by the NHs. This is not a requirement by LTC Medicaid at all. Now some POAs like having the NH become their elders rep payee as it’s easier. But it’s not a requirement & if something should go amiss and you want to move your elder out of this NH to another, getting the rep payee switched back will be quite challenging as SSA will want the elder to do this on their own as SSA does not recognize POA.
But I digress….. Zebb you as his POA can go to the business office of the Nh to withdraw $ from his at the NH trust account to use to buy your Uncle’s wardrobe replacement. There should be a ledger for this. But there could be issues….. like the Nh doesn’t have much of a on hand cash drawer or the billing office is only open set day & time. But the bigger issue imo will be if somehow his Nh is using up his $50 a month PNA for something else. Like the aforementioned in room cable bs. If this is happening then ya gotta cancel that billed every month service so Uncle has more flexibility as to what his PNA is available for you to get from the NH to use.
fwiw for my mom she never had either of her NH ever become her rep payee. Her income continued to go int her long existing checking account that I was a signature on. I mailed the NH a check each month for her Share of Cost based on the amount indicated in the eligibility letter sent by State Mediciaid. Later on switched to an ACH at her 2nd NH. The $ at the NH trust account I added $ to periodically to cover beauty shoppe and smallish charges for the canteen or outings. It had my name, a cousin and mom’s old neighbor as her allowed signatures on the account. With it to be POD to me. Got a statement n it every 90 days from her eons better Nh too. When mom died, I got a check for the balance maybe 6 weeks later. For us p, it worked as it allowed me to let the PNA $ build up so that when I went in (live in another State) I could do a bigger spend for clothing, toiletries, books, etc. and I did not have to be at the business office on the days it was opened and before noon.
Another item of contention is the OTC expenses that is charged to his advantage plan. I don't see anywhere in his room the items they charged. Plus, they are trying to have me change his Medicare Advantage to a Senior Choice plan that is cheaper less services but the difference of cost will go to the nursing home.
Such a game and I am fully aware of the game because I work in Hospital Finance department.
I do have POA and have been submitting a check for $50 to his personal allowance account at the nursing home.
However, it is unclear to me, if my uncle needs items that are not available to purchase at the nursing home like clothing; do I purchase the items (keeping meticulous record of receipts) and submit the remainder of the personal allowance to the nursing home?
Are you his POA for finances? If so, you should be able to access his account to pay for whatever he needs.