Recently, I have been handling a Medicaid application for a senior who, sadly, must remain in a nursing home. His family includes his wife and an adult developmentally disabled child (both physically and intellectually) since birth.
The clients’ disabled son receives services under OPWDD under Self-Direction. An individualized ‘budget’ was created for their son based upon his plan of care and services. Their son’s budget is a combination of direct payments by OPWDD/Medicaid (to vendors, care agencies, day programs) and reimbursement to the parents for clothing, transportation, utilities, and family respite. Reimbursement isn’t on a schedule and can be small amounts based upon the budget. In my client’s case, deposits over the 5-year nursing home look back period ranged from below $100 to $730 or more.
Most families are not prepared for nursing home care nor its application process nor the scrutiny many counties place on documenting financial transactions of deposits and withdrawals. Here, the family deposited the OPWDD checks but didn’t keep a copy of the checks, or deposited some checks as cash without recording the source or purpose, or cashed the check because their own finances were stretched and the reimbursed monies had to be used for their son’s clothing or transportation or utility payments upon receipt.
And so, my hints for you to prepare for a possible nursing home application, including if you, too, have a developmentally disabled adult receiving payments through Self-Direction under OPWDD:
1. Take a photograph of the check you receive and save it to an email account. Or, make an old fashion copy of the check and save it in a folder.
2. Deposit slips should have details – it’s okay to write on the deposit slip who the check is from and what it’s for. This serves as legal proof in the future.
3. If you are cashing a check, or making a partial deposit and partial cash withdrawal, then follow the same steps in 1 and 2.
4. Not able to take a photograph, make a copy, or don’t use email, then use your check register. Write down what you deposit, where it came from and why. And if you are cashing the check, write down the same information. A check register is considered a legal “contemporaneous record” and lawful evidence of a transaction.
5. If you have a child who receives OPWDD payments, speak with the Self Direction broker about setting up an account into which you deposit each and every check or payment so that funds are segregated from your own until used by you and separate from any future Medicaid documentation if nursing home care is needed.

My office handles elder law and special needs planning, Medicaid applications, guardianship and estates. For a legal consultation, please contact the office.