The question nobody asks in time
Your mother is admitted. For two weeks everyone talks about the room, the assessment, the paperwork. Nobody addresses the plainest practical question: what about her money? Where does her Social Security check go, who signs, and how much is left for the beauty shop, a magazine, a birthday card for a great-grandchild.
Six months later the question arrives on its own, usually badly: a withdrawal nobody can explain, a cash envelope with no receipts, one sibling who has handled everything and now cannot show the others what happened.
The rules here are unusually specific
This is one of the few areas where federal requirements give you exact things to ask for. A nursing home may not require a resident to deposit personal funds with the facility. If she asks it to hold her money, she gives written authorization, and then the facility must follow rules that exist precisely because this money used to disappear:
- Funds over $100 go into an interest-bearing account, separate from the facility's own accounts, with the interest credited to her.
- Amounts at or under $100 may be held in a non-interest-bearing account or petty cash, but still separately.
- The facility must keep a full, complete and separate accounting of her funds, available to her or her representative on request and quarterly.
- The facility must be bonded or otherwise assure the security of those funds.
- When her balance approaches the level that would cost her Medicaid eligibility — the requirement is written as within $200 of the resource limit — the facility must notify her.
That last one matters more than it looks. A resident who quietly accumulates funds can be pushed over the Medicaid resource limit and lose coverage for a month, which is a far bigger problem than the money involved. The notice exists so somebody can spend it down on her behalf, legitimately, before that happens.
So do not ask "are you looking after her money?" Ask: may I see the last four quarterly statements for her personal funds account? They exist. Asking for them is the whole move.
Who is lawfully allowed to sign
If your mother can still manage her affairs, her money is hers. Being her child gives you no authority over her bank account, and the facility cannot require you to pay her bills out of your own money as a condition of admission.
If she cannot, the mechanism depends on what exists. A durable power of attorney for finances, signed while she had capacity, is the clean and cheap route. Failing that, families often become a Social Security representative payee — quick and free, but narrow: it covers her Social Security or SSI benefits and nothing else. It does not reach her bank savings, a pension, or a house. For those, you are looking at a court-appointed guardianship or conservatorship, which is slow and expensive, and which comes with an accounting to the court — an outside check that is genuinely worth having when siblings disagree.
The commonest expensive mistake in this area is assuming that being a representative payee covers the savings account. It does not.
What the facility may spend, and what it may not
Beauty shop, newspapers, a trip out — fine, and useful, provided it is handled the way you handle somebody else's money. Ask who authorizes spending and above what amount they need to reach you. The haircut every other week is one thing; a $200 purchase decided by a staff member is another.
Note also what the facility may not charge to her personal funds: services already included in her rate under Medicare or Medicaid cannot be billed to her account. Families sometimes find items on the ledger that should never have been there. Compare the ledger against what her coverage includes.
And one practical rule that solves most problems: no meaningful cash in her room, and no debit card. Not because staff are dishonest — the overwhelming majority are not — but because in a room ten people enter a day, cash creates accusations nobody can disprove, and honest aides are the ones who get hurt.
Warning signs
Repeated withdrawals nobody can explain. A signature from a period when she could not have understood the document. A new and very attentive friend who drives her to the bank. A relative who handles everything and bristles when asked to show the accounts. A sudden change to a will or a beneficiary designation.
Financial exploitation of an older adult is reportable. Adult Protective Services takes reports from anyone, the long-term care ombudsman will help you think it through, and banks have their own escalation processes for suspected exploitation of vulnerable customers. But the effective first move is the dull one: request two years of statements and read them. Most of what gets found is found there.
Six questions to ask
- Is her money held in a personal funds account, and may I see the last four quarterly statements?
- Is the balance anywhere near the Medicaid resource limit, and have you sent the required notice?
- Who has legal authority — power of attorney, representative payee, guardian — and does it cover her savings?
- What can the facility charge to her account, and above what amount do you contact me first?
- Where is her debit card, and who has the PIN? If the answer is uncomfortable, that is the answer.
- What happens to the balance if she dies or transfers? There is a deadline on conveying it, and knowing it now saves a bad month later.
If the numbers do not add up
Put it in writing to the administrator, naming the period and asking for an itemized accounting. If that does not resolve it, three routes exist and all are free: the long-term care ombudsman, independent of the facility; the state survey agency, which investigates complaints and for which personal funds handling is a specific requirement it checks; and Adult Protective Services where exploitation is suspected. Because there is a hard regulation behind this, a complaint about personal funds lands on solid ground rather than on an opinion.
Where to start
If your mother is about to be admitted, settle this before you sign: where her income goes, who has lawful authority, whether she wants the facility to hold funds at all, and how statements will reach you. If she has been there for years and nobody has raised it, start by requesting the quarterly statements. It is an ordinary request and a well-run facility will hand them over.
If you would rather not run it alone, we can. For $89 we take down your mother's situation, look for the facilities near you that answer these questions properly, and report back what they told us, with names and dates. Start here
This article is for information and does not replace legal or financial advice on your own situation. Federal requirements set a floor and states add their own rules on guardianship and reporting; dollar thresholds are set in regulation and can change. Check what applies where your mother lives. Curalune does not allocate beds and does not guarantee availability.