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Most places require inspection of items brought it..Its policy # 1 and in your case your are asking for reimbursement( dont blame you). I dont understand why they have the trust in the first place? I have never heard of that. Please inform.
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In discussion with the snf, the Trust is supposed to insure the patient/resident will not be forced to go without very personal items - like toothpaste and clothes. These are basics that Medicaid does not pay for. Non-emergency medical transport from snf to a doctor's appointment is a legitimate use of the money. If the resident wants cupcakes and coffee (for him/her self only) it's supposed to be made available for that purpose.
Barber/beauty shop, books & magazines, houseplants, Christmas decorations, are some other examples. I think non-Medicaid covered co-pays for any drug or medical service can also be paid for out of a trust fund.
If the resident wants cupcakes, is he/she allowed to buy a dozen to share with others or only one (a la cart) for him/herself? I wonder if Medicaid or snf decide if the resident can share a box of 24 cards w/friends or family.
Maybe this is a gray area.
My second point of understanding is when it comes down to brass tacks, the government i.e. Medicaid/Estate Recovery hopes to have some funds in this trust account as it will be paid to the state upon death of the patient. If more than the $2,000.00 accumulates in the trust that can be an issue with Medicaid.
My objective would be to coordinate money-in/money-out so the fund never accumulates over $50 - $100. A lady at the snf said when Medicaid recertification begins, the snf must report to Medicaid how much money is in the Trust fund. I'm still trying to learn the ins/outs so I will know how to conduct business. It's not fair that families are left to their own devises to try and figure it out.
The OP really has legitimate requests as far as I'm concerned - unless the contract states items purchased must be inspected. If services are obtained on the economy - like out-of-pocket co-pays that aren't covered by Medicaid, or a sandwich and cola at Subway, the only proof that can be submitted is the receipt/invoice for those services and goods. The doctor and the patient can't demonstrate to the snf what is listed on the receipt/invoice. It would be a cold day underground if a doctor and Subway manager had to be present to verify a receipt. So, again I'm sensing there are grey areas when it comes to snf trust funds. Maybe the snf arbitrarily sets it's own standards for what is appropriate if it thinks too much money is being spent or if it is concerned about the amount that is actually in the trust fund at a given point.
If anyone else knows more about this or why the OP really had problems getting the money back, I'd like to have a firm grasp on this issue.
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I worked in LTC for over 25 years and most of the residents were medicaid. To my knowledge any of the $ ( under 2 grand) was in the relatives hands not the facility. If the families came and visited ( wasnt always the case) they may have brought them some needed items. All SS checks went straight to the finance office from what I was told. I am an RN so I really wasnt involved in this but my SW friends filled me in on the facts......
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