My mother has dementia and is not able to manage her personal & business affairs. I feel that my mother's rights are being violated when the facility frustrates my ability to have access to her Trust Fund as her legal POA, in order to use her funds as she would use them for purchasing items to meet her needs. If my mother was able to access her funds, she would not be required to purchase the item and then give them a receipt to be reimbursed. The LTC facilities process is in conflict with the Medicare regulations. The relevant POA language and Medicare rule are listed below. I feel the process they have in place is the cover whatever issues they have audits vs. meeting mom’s needs.
POA Language: Bank Accounts. “My agent is authorized to establish accounts of all kinds for me with financial institutions of any kind, including but not limited to, banks and brokerage firms; to make deposits to and to make withdrawals from all accounts in my name or with respect to which I am an authorized signatory; to execute and deliver any instruments or checks with respect to such accounts; and to contract for any services rendered by any bank or financial institution.“
42 CFR § 483.10 Resident rights. DEFINITIONS §483.10(b)(3)-(7)
Medicare Rule: (4) “The facility must treat the decisions of a resident’s representative as the decisions of the resident to the extent required by the court or delegated by the resident, in accordance with applicable law”
I also had to deal with unfathomable inconveniences as her POA; it didn't ever seem to stop. On one hand, I can really sympathize and empathize with you on the headaches!! My Mom had a pension from the University of Guam (15 hours time difference), which is a Trust Territory of the United States, but they are stuck in like 1970 when it comes to modern technology. I had to have so much paperwork notarized and faxed and copied and faxed, then one page went missing and so the whole circus would start over. I thought I was going to lose my Freaking Mind so many times!! I was Mom's sole medical and financial POA . She wasn't married; I don't have any brothers or sisters. It was all on me.
I really hope your headaches are out of the way for the moment, but make sure to keep that P.O.A. paperwork handy at all times!! Just try to keep a folder with expenses for her all in one place (in your car if that's convenient for you). Sorry to forewarn you, but this stuff comes up about every few months, as a rough estimate from my experience. I kept a folder in my car with an original of my POA and Trust paperwork in my trunk...because that's how often I needed it. Almost weekly, sometimes more often.
I could not pay her 1st Phone bill & get reimbursed because her cell provider does not have paper bills. They bill via an app. The bill screen does not have her name on it. I had to go to several cell phone Co. franchises and someone was finally able to figure out how to even print a paper bill so the LTC facility could pay her bill.
I am 72 years old and cannot run around like this every month in the middle of this pandemic. Mom has sufficient money in her LTC Acct to take care of her needs. As her POA she has legally given me the right to make withdrawals from all accounts in her name.
Medicare has nothing to do with PNA. The PNA is taken from her Social Security check. When she passes, any money left goes to her estate.
Put "Personal Needs Account in (your state) into your search engine. You will see the rules for your state.
If your mother is paying her own way, then indeed she would have no reason for a resident trust account.
But if Medicaid is involved, the facility is tasked with preventing the resident's funds from being gifted or used improperly.
If mom is private pay, she has need of a resident trust fund.
If this is only about status, and the only problem is an additional layer of security and accountability, then irritating though it might be I should find something else to worry about. Goodness knows we all have plenty of worries to choose from at the moment!