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Will I have to show proof on what he spends it on? It will mostly be for snacks and haircut.

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Nursing homes ordinarily have resident accounts. The money can be deposited there and he can draw it out for whatever he wants, and there will then be a paper trail. My husband is POA for his brother, and the NH sends a monthly accounting of the resident account, which shows amount and what it was used for, e.g., haircut, outing, Walmart, ordering in food, etc. The NH doesn't have any kind of canteen or snack bar, but if they did I presume it would say "cash for snacks" or something like that.
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So hubs is on Medicaid and is able to do this as he’s got a Miller Trust set up, right? His Miller QIT is $60, right?
(Btw big round of applause 4 y’all on getting a Miller done!!!)

Does he also have a PNA (personal needs allowance) that he gets to keep from the income Medicaid requires to be used as his copay?

so he’s getting both $60 QIT and $ PNA? If so I’d let whichever is the smaller amount stay at the NH and get deposited into & become his Personal Needs Trust account at the NH. This will be used to auto draw for his weekly or twice a mo barber shop visits. If there is something else he regularly pays for at the NH that is not covered by Medicaid, they too can get paid from the in house trust account. Like some NH charge for in-room phone or cable & that gets paid from in house trust acct.

The other mo $ (if there’s 2 sources of $ ea mo), I’d let go into his checking acct that you use to do bigger spends on…. Like he needs whole new set of winter clothes as he’s lost / gained weight. You buy all writing a ck from this acct.

if he gets only a single $60, to me, it’s whatever is easier for you to deal with (have all go into In house acct or into his checking account)l

Whatever the case you MUST to pay attention to the $, whether it’s in the in-house trust at the NH or in his solo bank account or both, you MUST watch that all in they stay under $2,000.00.$ 2K is the asset limit for most states Medicaid and if he goes over, his Medicaid could be suspended till it goes below $2k.

my mom did not have a QIT but she was on LTC Medicaid and had a $60 mo PNA. She did not make the NH her representative payee but instead I as her dpoa wrote a ck to the NH for her required copay ea mo. $ 60 built up ea mo in her checking account. I did have a in-house trust account at the NH for her for beauty shoppe and the canteen but kinda kept it at $200-300. NH sent a balance statement on it every 90 days with a tiny interest payment. So I knew if it needed to get topped up w $. Whomever the resident signs off to be their POD to that in house account is will get by check whatever funds left in it after they die. It technically is POD type of account (named beneficiary) so passes outside of probate and should not be part of any estate recovery (MERP).

I was out of state & it was easier to let the $ build then do a bigger spend every couple of months and write a ck from her acct I was signatory on. Otherwise I’d have to get to the biz office at the NH when they were open and sign out the $ & hope they had $300 in cash if that what in anticipated spending.

I kept all the receipts but was never asked to produce them from Medicaid. You’ve got a Miller going on, I bet that will need an annual accounting as Miller is a way more involved legal structure. If had to guess it will be like what’s done for representative payee stuff from SSA. If so, it’s a straightforward document that you attest to that all spend was done within the rules & regulations and you sign it and list your authority. My hubs was FRA SSA (& still working) when son was in high school so son got the old rooster SSA minor benefit jr & sr year of HS (they get abt 50% of benefit till 18 or still in HS). Hubs got an annual request to self attest $ spent on kid and filed to SSA along with document from HS registrar that he was full time enrolled. If after 18 any $ was left (lol), it needed to returned to SSA. We got a final letter from SSA to do a self affidavit as to this.

I’d suggest that you clearly find out if there is any $ left after death whether it reverts to the Miller (so goes back to the state) or can be POD to you or whomever your hubs names as the beneficiary of the account so bypass probate & MERP. If it reverts to the state, I’d be sure to spend $ regularly and just have $200 - $300 or so as a “cushion” in case he needs new eyeglasses type of spend.
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JoAnn29 Sep 2021
The PNA amount is included in the spend down amount. So, if his PNA acct takes him over the (let's say) 2k he is allowed, that money has to be spent. So, how does this QIT fit in with the assets he is allowed?
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