She receives $1830 a mth in SSI. Her monthly Medicaid cost for the Dementia unit is $1616.60 per month. Because of the hospital bills, I am able to pay the first month cost but I am concerned that Medicaid would see this as a gift and affect her eligibility!
It's kinda important that family keep track of and spend the trust account because if it builds up over time and exceed 2K, it will make them ineligible for Medicaid.
Some NH provide a statement or tell family the balance at the every 3 month care plan meeting. If the facility charges for phone & cable, then there essentially is no PNTA funds. If the resident is put on a hair salon schedule, then too there is essentially no funds as well.
What is amazing is that often family sign over the SS check to direct deposit and do not even realize that funds are going into a trust account with sums being withdrawn from it to pay for phone, cable. etc and don't ask the NH for an accounting.
If this is the situation, here's my suggestion: get moms last 3 mos bank statements & a slip from the bank mañana that shows her balance. Go to the admissions office with these and pay all you can on moms required co pay ( like all but leaving enough for service charge). Then @ NH get a separate agreement done for the $700 balance due to come out of her trust acct (TX personal needs $60 a mo) so maybe agreement for $ 50 a mo which you sign off on as DPOA. Hopefully the NH will do this. Otherwise you kinda have to just personally pay the $700 direct to the NH. If you personally pay to NH, then not an asset or income of moms.
You know Medicaid could have approved mom to the month before her entry to the NH. If so, Medicaid could be billed for any services from the date of eligibility till now. So if the provider accepts Medicare & Medicaid, there should be no copay. As DPOA you can send certified letters requesting rebilling to medicaid and return of copay$ to mom. If a provider accepts the M & M's, then they kinda have to do this. It is a lot of paperwork though, so think if worthwhile for you to do. If you have continuing relationships with the providers, well personally I wouldn't do it.
As an aside, are you having it such that moms SSI is deposited to her bank account and you write a ck to the facility for her copay? Or has the facility asked for deposits to go to them? facilities will press on family to do this but legally they cannot force a resident to give them their SS, retirement or whatever eise they get for income. Most often family is in panic mode when placing their elder in a facility so take whatever the facility says as gospel but often it's not in your best interest.