Frequently Asked Questions

Nursing Home Care - Recipient/Resident Trust Account Funds

Below are some questions people often ask about Recipient/Resident Trust Account funds for recipients who are on Medicaid in the Nursing Home. Click here to email additional questions.  Click on the questions to see the answers:

Where can we locate the Administrator of Estate Designation Form?

This form is found on the Medicaid website at medicaid.alabama.gov at Resources > Forms Library > Long Term Care Forms.

Who can be listed as the beneficiary on the Administrator of Estate Designation Form?

The primary and secondary beneficiaries listed must the the Medicaid recipient's adult next of kin. Adult next of kin means any blood relative of the Medicaid recipient. An adult next of kin includes, but is not limited to, surviving spouse, recipient's children, parents, brother/sister, grandparents or children of Medicaid recipient's grandparents (aunts/uncles).

Who can sign the Administrator of Estate Designation Form?

The form should be signed by the Medicaid recipient. If the recipient is unable to sign the form, a person who has legal authority (e.g. Power of Attorney, Conservator or Guardian) can sign this form on the recipient's behalf. The form cannot be signed by any person who does not have the legal authority to do so. If the recipient cannot sign, and there is no one with legal authority, nursing home providers should handle patient/resident trust funds as instructed in Medicaid Administrative Code 560-X-22-.25(5)(e). Funds would need to be sent to the state's Unclaimed Property Division. Remember, that a Medicaid sponsor does not have any authority to sign this form unless they have legal authority to sign on the Medicaid recipient's behalf.

What does the facility do when there are funds available in the patient/resident trust account at their death, but a balance is owed to the facility? Can the facility retrieve the funds in the account as payment on the debt owed the facility?

The facility will be able to be reimbursed for the month of death only. This could be for the month of death's liability amount or any service that is not covered by Medicaid. These services include, but are not limited to, haircuts, cable or telephone. The facility's records must have this documented.

The form has a place for two witnesses. Is it mandatory that two people sign after the resident or authorized individual has signed?

Yes. Medicaid requires that the form have two witnesses over the age of 18 to sign after the recipient/authorized person to ensure consistency and accuracy.

Can employees of the facility sign as witnesses to the signature of the Medicaid recipient?

Employees of the facility are allowed to serve and sign as witnesses on the form.

Can the funds in the patient/resident trust account be used for funeral expenses?

The funds may only be released to the following: The estate of the Medicaid recipient when an Administrator has been appointed by the probate court; the beneficiary designated on the Administrator of Estate Designation form; or the state's Unclaimed Property Division. At no time should funds be disbursed directly to a funeral home for expenses after the resident's death. Medicaid recommends that funeral expenses be paid in advance, ideally, prior to applying for Medicaid benefits or shortly thereafter.

Can an Administrator of Estate Designation Form be signed after a resident's death?

No. This form is only for living residents. The purpose of the form is to provide an alternative in case no estate is opened when the resident dies.

What happens if the recipient pays the entire month's liability but dies before the month ends? How should this credit be handled?

If the patient's liability (patient responsibility) amount was paid out of the patient/resident trust fund, any overpayment should be moved back into the recipient's account and handle disbursement as instructed. If the patient's liability account was paid in any amount from a Qualified Income Trust (QIT) account, any overpaid amount is due to the Alabama Medicaid Agency. If an individual (other than the resident) pays for items which Medicaid does not cover (e.g. private room, cable, etc.) any refund amount after the prorated amount has been determined should be returned to the person who paid for the service. Information on the payment and refund must be documented in the facility's records. The source of each payment should be identified to maintain the most accurate information.

Can the facility pay all funds in the patient/resident trust fund to the surviving spouse when there is no Administrator of Estate Designation Form?

No. Medicaid requires that funds in the patient/resident trust fund only be released to the adult next of kin (beneficiary) stated on the Administrator of Estate Designation Form. The surviving spouse would only be entitled if they are one designated on the form. If an estate has been opened in probate court, letters of administration should be available and would overrule the Administrator of Estate Designation Form.

Where can I get information about sending funds to the state's Unclaimed Property Division?

Information about sending funds to the state's Unclaimed Property Division is located online at https://alabama.findyourunclaimedproperty.com/.

Unclaimed Property Division requires that information be submitted electronically. What does Medicaid require?

For each Medicaid recipient, Medicaid requires the recipient's name, Social Security Number, amount of funds submitted to the Unclaimed Property Division for that particular recipient, and the date submitted to the Unclaimed Property Division.

Learn More:

Link to:

  
Medicaid Home
News
Alerts
Calendar
Directions
My Medicaid
A-Z index
Site Map
Email Sign-In
Contact List
Sign Up for News Updates
Press Inquiry
State Employee Directory
Forms Library
Administrative Code
Educational Materials for Recipients
HIPAA/Privacy
HIPAA Notice of Privacy Practice (NPP)
Alabama Online Privacy Standards
Report Fraud and Abuse