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If I were to buy this, should I pay cash or debit card with receipts?

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I would think Medicaid might question buying a computer for a patient who is living in a continuing care facility. Then it depends on why your Mom is in a nursing home, if it is only mobility issues but her brain is still very sharp and she always had used a computer at home, then maybe. I would check with Medicaid first.

Some rehab nursing facilities have a community computer that the patients can use to get their emails. The long-term-care facility my Mom was in, did not.
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I am looking at this from a slightly different angle...not related to the spend down. In nursing homes items "disappear". They are hidden, taken by other residents, dropped and broken. I would think a laptop would be the prime example of something not to take to a care community because of these issues. Sort of like throwing money down the toilet.

Angel
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They steal or walk off with stuffed animals, boxes of candy, clothes. Magazines, potted plants, SHOES. What do you think is going to happen to a laptop? If it doesn't disappear within a day, it will get lost, broken, 'borrowed'. You will never see that laptop again once you bring it into the nursing home. I guarantee it.
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I've seen residents in nursing homes interested in their family's iPhones, iPads, etc. and I've seen family's buy their loved one in a NH an iPad or whatever it is they think their loved one is interested in. Once the loved one in the nursing home is faced with a new laptop or iPad they don't know what to do with it and they quickly lose interest because it's too overwhelming for them. To us it's easy to navigate and we think we can teach our loved ones to enjoy it but they don't.

The last time I saw this happen a family bought their elderly loved one an iPad.The elderly loved one was interested in her family tree and the family thought she'd love an iPad. I cautioned the family to not leave it at the facility but they thought it would be OK. Within 2 weeks it's was gone never to be seen again.

Medicaid aside investing money in an electronic like this is a waste of money.
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dtrinfl2. No you cannot. Big Red Flag item= financial abuse citation.
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I think it is OK for spenddown purposes. It is for her use and that is the key.

But whether it is a practical thing to take into a nursing home is a separate issue. Other posters raise good points.
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