In a Georgia nursing facility, Medicaid lets a resident keep just $70 a month for personal expenses, the Personal Needs Allowance (PNA), while nearly all their other income goes to the facility. That $70 sits above the federal floor of $30 set at 42 USC 1396a(q) in 1987 and never raised by Congress since, and it covers everything the facility does not provide.

The PNA is not "extra" money. It is the only money a nursing facility resident on Medicaid has to spend on anything beyond what the facility provides: clothing beyond institutional supplies, preferred toiletries, snacks, telephone, hair care, magazines, transportation for outings, small gifts, and similar personal-dignity expenses. Without the PNA, a resident's entire monthly income would flow to the facility, leaving them with nothing for autonomy or quality of life.

This guide explains how the $70 PNA fits into the broader post-eligibility income calculation that converts gross income into patient liability, how it differs from the much larger maintenance allowance for HCBS waiver participants who live in the community ($2,982 per month in 2026), how the federal $90 VA pension cap for veterans on Medicaid stacks with the Georgia PNA, the rules for the resident trust account at the facility, what the PNA can and cannot be used for, the $2,000 asset limit interaction, and what happens to the balance at death or transfer.

In This Guide

What the Personal Needs Allowance Is and Where the Authority Comes From

When an individual receives Medicaid-funded nursing facility care, the facility is paid through a combination of three streams: the federal Medical Assistance Percentage, the state share (paid by Georgia DCH from the General Fund and assessments), and the resident's own income contribution (called patient liability or share of cost). The resident does not pay rent or board separately; Medicaid pays the facility a contracted per-diem rate that covers room, board, nursing, food, basic personal care supplies, and most therapies.

Federal law requires that the resident retain a small portion of their monthly income for personal expenses before patient liability is calculated. This is the Personal Needs Allowance. It is deducted from the resident's gross income alongside other protective deductions (health insurance premiums, spousal maintenance allowance, dependent family allowance, certain medical expenses) before the remaining amount is owed to the facility.

Federal authority:

  • 42 USC 1396a(q) establishes the mandatory PNA and sets the federal floor at $30 per month for nursing facility residents. The floor was created by the Omnibus Budget Reconciliation Act of 1987 (Public Law 100-203, Section 4211), effective July 1, 1988, and has never been indexed for inflation or raised by Congress since.
  • 42 CFR 435.725 governs the post-eligibility treatment of income for institutionalized individuals, specifying the order of deductions: health insurance premiums, PNA, spousal MMMNA and CSMIA, dependent family allowance, incurred medical expenses, then patient liability.
  • 42 CFR 435.726 governs the post-eligibility income calculation for HCBS waiver participants, which uses a larger maintenance allowance to allow community living.
  • 42 CFR 483.10(f)(10) governs how nursing facilities must hold and account for resident funds.

State authority:

  • O.C.G.A. Title 49 Chapter 4 establishes the Georgia Medicaid program
  • The Georgia DCH Aged, Blind, and Disabled (ABD) Medicaid Policy Manual contains the operational PNA and post-eligibility rules
  • Rules of Georgia Department of Community Health 111-3-8 (NF licensure) incorporate the federal resident funds requirements with state-specific reporting

States may set their PNA above the federal floor, and most do. Georgia's $70 is approximately 2.3 times the federal minimum, but lower than several states that have raised their PNAs significantly in recent years.

The $70 Georgia NF PNA in Context

A $70 per month PNA places Georgia in the middle of the national distribution. As of 2026, the range of state NF PNAs runs from the federal floor of $30 per month (in a small number of states) to $200 per month in Alaska. Florida is at $160. Texas, Massachusetts, and several others are between $60 and $90. Georgia at $70 is roughly typical for southeastern states.

The PNA has historically lagged inflation badly. Adjusted for inflation since 1988, $30 in 1988 dollars is approximately $80 in 2026 dollars. The federal floor has remained at $30, meaning that the floor's real purchasing power has eroded by approximately 65 percent over 38 years. Even the Georgia $70 PNA represents less purchasing power in 2026 than $30 did in 1988.

For families, the practical implication is that the PNA is sufficient for very modest personal expenses (telephone, small clothing and toiletry items beyond what the facility provides, hair care, occasional outings) but not for substantial discretionary spending. Families often supplement the PNA from outside funds, which is permitted as long as the supplementary funds are not pooled into the resident trust account in ways that affect Medicaid asset accounting.

Practical PNA categories in dollar terms:

Expense Typical monthly cost PNA can cover?
Telephone (basic landline or low-cost mobile) $15-$25 Yes
Hair care (cut and basic styling) $15-$25 Partial monthly
Personal toiletries beyond facility supply $10-$20 Yes
Clothing replacement $20-$40 Partial monthly
Magazines, books, music $5-$15 Yes
Snacks beyond facility menu $10-$20 Yes
Holiday or birthday gifts $10-$30 Limited monthly
Transportation for outings $20-$50 Partial
Cable TV or streaming subscriptions $10-$30 Partial

In practice, $70 per month requires careful budgeting. Many residents prioritize telephone, hair care, and snacks; clothing and other items are often supplemented by family.

The Post-Eligibility Income Calculation Step by Step

This is the most operationally important part of the PNA framework. The post-eligibility calculation at 42 CFR 435.725 converts a Medicaid nursing facility resident's gross monthly income into the patient liability owed to the facility, with the PNA and other protective deductions taken first.

Order of deductions (mandatory federal sequence):

Step 1: Start with gross monthly income. This includes Social Security retirement or disability, SSI (note: SSI is reduced to $30 for institutionalized individuals after the first month, but this is a separate federal mechanism), private pensions, military pensions, federal civilian pensions, VA pension (subject to $90 cap discussed below), interest and dividends, annuity payments, IRA/401(k) distributions in pay status, and rental income.

Step 2: Subtract Medicare Part B premium. For 2026, the standard premium is $202.90 per month. Most NF residents have premium-free Part A but pay the Part B premium, which is deducted from Social Security in most cases. The Medicaid post-eligibility calculation treats this as a protective deduction so the resident is not double-charged. Some residents qualify for QMB (which would have Georgia pay this premium directly), in which case the premium does not appear as a deduction.

Step 3: Subtract other health insurance premiums. Medigap, Medicare Advantage, retiree health insurance from a former employer, TRICARE supplemental, vision and dental supplemental plans (limited). All legitimate health insurance premiums are deductible.

Step 4: Subtract the Personal Needs Allowance. $70 in Georgia.

Step 5: Subtract spousal Monthly Maintenance Needs Allowance (MMMNA) and Community Spouse Monthly Income Allowance (CSMIA). If the resident has a spouse living in the community, federal spousal impoverishment rules at 42 USC 1396r-5 require that the community spouse have at least the MMMNA available each month. The MMMNA in 2026 has a floor of $2,643.75 and a ceiling of $4,066.50, with the actual figure based on the community spouse's shelter costs (excess shelter allowance available if shelter exceeds $793.13). If the community spouse's own income is below the MMMNA, the difference (the CSMIA) is shifted from the institutionalized spouse's income before patient liability is calculated.

Step 6: Subtract dependent family allowance. For dependent minor children, disabled dependent adult children, or other dependent family members (siblings under certain conditions), a federally-defined allowance is deducted.

Step 7: Subtract Incurred Medical Expenses (IMEs). Out-of-pocket medical expenses for services not covered by Medicare or Medicaid (including past medical debt, some over-the-counter items, certain dental or vision expenses) can be deducted within state-specified standards. Georgia DCH has specific IME policies that determine which expenses qualify.

Step 8: The remainder is Patient Liability. This amount is paid by the resident to the facility each month. The facility receives Medicaid payment for the gap between patient liability and the contracted Medicaid rate.

Worked illustration. A single, widowed Georgia NF resident with $1,500 per month in Social Security and no other income:

  • Gross income: $1,500
  • Minus Part B premium ($202.90): $1,297.10
  • Minus PNA ($70): $1,227.10
  • No spouse: no MMMNA/CSMIA deduction
  • No dependents: no family allowance
  • No IMEs: no medical deduction
  • Patient liability: $1,227.10

The resident pays the facility $1,227.10 per month. Medicaid pays the facility the remainder of the contracted Medicaid rate.

HCBS Waiver Community Maintenance Allowance (300% SSI)

For Medicaid recipients in CCSP, SOURCE, ICWP, NOW, or COMP HCBS waivers who continue to live in the community (their own home, a family member's home, an assisted living facility under contract with the waiver, a small group home, or similar setting), the calculation is fundamentally different. The maintenance allowance is set much higher because the participant must pay for housing, food, utilities, transportation, and all the other costs of community living.

Georgia's HCBS waiver maintenance allowance in 2026: Up to $2,982 per month, which equals 300 percent of the SSI Federal Benefit Rate (the same figure as the LTC Special Income Limit that gates waiver financial eligibility).

How it works in practice. Most CCSP, SOURCE, ICWP, NOW, and COMP participants have income at or below the SIL of $2,982 (either by direct income or through a Miller Trust that funnels income through to the SIL). The full $2,982 (or the participant's actual income, whichever is lower) is then the maintenance allowance, meaning the participant typically owes zero or minimal cost share to the waiver.

For participants whose income exceeds the SIL and who use a Miller Trust to qualify financially, the Miller Trust mechanics distribute income each month with the PNA-equivalent amount flowing to the participant for community living expenses, and the remainder either flowing to the state (typically zero for HCBS waiver participants) or accumulating in the trust subject to state-payback at death.

Comparison to NF PNA:

Setting Maintenance allowance Why the difference
Nursing Facility $70/month PNA Medicaid pays the facility for room, board, food, care
CCSP / SOURCE community living Up to $2,982/month Participant pays own rent, food, utilities, transportation
ICWP community living Up to $2,982/month Same
NOW / COMP community living Up to $2,982/month Same

For more on the HCBS waivers, see our guides to CCSP, SOURCE, and the broader Georgia long-term care framework.

The Resident Trust Account at Georgia Nursing Facilities

Federal regulation at 42 CFR 483.10(f)(10) requires every Medicare- and Medicaid-certified nursing facility to manage resident funds in a specific way if the resident requests it. Most NF residents on Medicaid have their PNA deposited into a facility-managed resident trust account from which the resident or their representative can draw for personal expenses.

Federal requirements that apply to Georgia facilities:

  • Separate accounting for each resident. Funds may be pooled for banking efficiency, but separate accounting must be maintained per resident.
  • Interest-bearing account for balances over $50. Resident funds in excess of $50 must be held in an interest-bearing account, with interest credited to the resident's account.
  • Quarterly written statements. The facility must provide each resident or their representative with a quarterly written statement of the account showing deposits, withdrawals, and current balance.
  • Reasonable access. The resident or authorized representative must have reasonable access to withdraw funds during business hours, and after-hours access for emergency needs.
  • Notice of approaching asset limit. If the resident's trust account balance is approaching the $2,000 categorical Medicaid asset limit, the facility must notify the resident and provide an opportunity to spend down before Medicaid eligibility is jeopardized.
  • Surety bond or equivalent protection. The facility must protect resident funds through a surety bond or equivalent so that funds are recoverable in case of facility insolvency.
  • Return of funds at death or discharge. At the resident's death, the balance must be conveyed to the personal representative of the estate (typically requires letters of administration from probate court) within 30 days. At discharge, the balance must be returned to the resident.

Georgia-specific NF licensure rules at Rules of Georgia DCH 111-3-8 layer on additional state requirements, including state-specific reporting to DCH on resident funds management, audit requirements, and complaint procedures through the Department of Community Health Office of Healthcare Facility Regulation.

Practical points for families:

  • Request and review the quarterly statement; verify that deposits match expected PNA inflows and that charges match expected expenses.
  • Question any charges you do not recognize. Facilities sometimes charge for items the resident did not request or that should be covered by Medicaid.
  • Keep records of the resident's preferences and the family member responsible for trust account decisions.
  • File complaints with the Long-Term Care Ombudsman (Georgia LTC Ombudsman through the Division of Aging Services at 1-866-552-4464) if the facility mishandles funds.

What the PNA Can and Cannot Be Spent On

The PNA is intended for the resident's personal use and dignity. The federal and state rules do not provide a precise itemized list, but general categories apply.

Allowable categories:

  • Clothing, including replacements, alterations, and special-occasion items beyond what the facility provides
  • Personal toiletries beyond what the facility supplies (specialty soap, preferred deodorant, makeup, etc.)
  • Hair care (cuts, styling, color)
  • Snacks, food preferences, beverages outside the facility menu
  • Telephone (landline or mobile)
  • Magazines, newspapers, books, music
  • Cable TV, streaming services, internet for personal devices (some facilities include in room rate; others require resident pay)
  • Transportation for outside appointments, family visits, religious services, outings
  • Religious or spiritual materials
  • Hobbies, crafts, art supplies
  • Personal furnishings (lamps, photos, small decorations) for the resident's room
  • Greeting cards, postage, small gifts to family members (limited amounts to avoid transfer-penalty concerns)
  • Personal grooming items, including over-the-counter health and beauty items
  • Eyeglasses, hearing aids, dental work, and other health items not covered by Medicare or Medicaid (these may also qualify as Incurred Medical Expenses with deeper protection in the post-eligibility calculation)

Generally prohibited or restricted:

  • Room and board. The facility cannot bill the resident's trust account for room and board; that is what Medicaid pays for.
  • Services the facility is contractually obligated to provide. This includes basic nursing, basic personal care, basic food service, basic linens, basic transportation to medical appointments. If the facility tries to bill the trust account for these, file a complaint.
  • Large gifts to family members. Substantial gifts (typically more than $50 to $100 per occurrence, or accumulating to substantial annual amounts) can be treated as transfers for less than fair market value under 42 USC 1396p(c), triggering a Medicaid transfer penalty.
  • Loans to family. Same transfer-penalty concern.
  • Investments, securities, or other accumulating assets. The PNA should be spent for personal needs, not accumulated for non-allowable purposes.
  • Services to non-residents. The trust account is the resident's, not the family's.

The $2,000 Asset Limit Interaction

Georgia categorical Medicaid for institutionalized individuals has a $2,000 asset limit ($3,000 for couples). The PNA balance counts toward this limit. If the trust account accumulates beyond approximately $1,800 (giving a safety margin), the resident is approaching the asset limit and must spend down before the next Medicaid redetermination.

Allowable spend-down items in addition to ordinary PNA categories:

  • New clothing, especially larger purchases (winter coats, suits for special occasions)
  • Replacement personal effects (luggage, jewelry replacing lost items, furniture for the resident's room)
  • Dental work not covered by Georgia Medicaid (Georgia adult dental is limited)
  • Hearing aids and audiology services beyond Medicare coverage
  • Eyeglasses and vision services beyond Medicare coverage
  • Customized wheelchair, scooter, or DME upgrades beyond Medicaid-covered standard equipment
  • Prepaid funeral and burial contracts (these convert countable cash into an exempt prepaid funeral asset, often the single largest legitimate spend-down)
  • Burial reserves (limited dollar amount of cash earmarked for funeral, exempt from countable assets)
  • Personal computer or tablet (modest amount, depending on documentation as personal-use)

The prepaid funeral spend-down is often the most useful tool. Georgia allows a Medicaid recipient to purchase an irrevocable prepaid funeral contract with no dollar cap (subject to reasonable funeral industry pricing) without triggering a transfer penalty, and the contract is treated as an exempt asset. For residents whose trust account balance accumulates over time, prepaying a funeral converts $5,000 to $15,000 (or more) of cash into an exempt asset that the family does not have to pay out-of-pocket at death.

Failure to spend down. If the resident's trust account exceeds $2,000 at redetermination, Medicaid eligibility can be terminated. The resident becomes responsible for the full cost of facility care at private-pay rates until the balance is reduced back below $2,000. This can be devastating financially. The facility's social services and the family member or representative responsible for the trust account should monitor the balance monthly.

Veterans: The $90 VA Pension Cap Stacks With the $70 PNA

Federal law at 38 USC 5503(d) caps the VA pension at $90 per month for veterans (or surviving spouses) who are receiving Medicaid-paid nursing facility care. The remaining VA pension that the veteran would have received is forfeited to the federal Treasury; it does not go to the state, to the Medicaid program, or to the facility.

This creates an unusual situation where the veteran's effective monthly spending money is the $90 VA + $70 Georgia PNA = $160 per month, more than non-veteran residents who receive only the $70 PNA.

Mechanics:

  • Veteran enters Medicaid-paid NF care
  • VA receives notification of Medicaid coverage through data exchange
  • VA reduces the monthly pension to $90 effective the month after Medicaid begins
  • The reduced pension is deposited directly into the veteran's account (typically the resident trust account at the facility)
  • The $70 Georgia PNA is also deposited into the same account
  • Combined $160 is available for personal expenses

Aid and Attendance (A&A). Veterans receiving the A&A supplement to VA pension (additional monthly amount for veterans needing the aid and attendance of another person) have more complex post-eligibility treatment. A&A is generally counted as income for Medicaid purposes, and Georgia applies specific rules. Veterans receiving A&A should consult a Georgia elder law attorney or the Veterans Service Officer for their county before entering a Medicaid-paid nursing facility.

Georgia State Veterans Homes. Georgia operates state veterans homes through the Georgia Department of Veterans Service. These homes vary in their Medicaid contract status. Veterans considering admission should verify whether the home is Medicaid-certified, how the VA per-diem grant interacts with Medicaid, and whether the standard $90 VA cap applies. Locations include Augusta (Georgia War Veterans Home) and Milledgeville (Georgia War Veterans Nursing Home). Contact the Georgia Department of Veterans Service for specifics.

What Happens to the PNA When a Resident Dies or Transfers

At death. The balance in the resident trust account becomes part of the deceased's estate. The facility must convey the balance to the personal representative of the estate within 30 days under 42 CFR 483.10(f)(10). For most Georgia residents, this requires the family to open a probate estate and obtain letters of administration, then present the letters to the facility's business office. For small balances under approximately $10,000 (Georgia's small-estate threshold under O.C.G.A. 53-2-40), simplified affidavit procedures may apply.

The PNA balance is subject to Georgia probate creditor priority. If the deceased was an LTSS Medicaid recipient at age 55 or older, Georgia estate recovery may apply against the probate estate, including the PNA balance, after administrative costs and funeral expenses. See our Georgia estate recovery guide for the full framework.

Pre-arranged funeral. If the resident pre-arranged a funeral while alive and the trust account funded the pre-arrangement, those funds were already converted to an exempt asset and are not part of the probate estate.

At transfer to another facility. If the resident transfers to a different NF (whether Medicaid or private-pay) or to a community setting (HCBS waiver, assisted living, home), the original facility must return the balance to the resident or representative within 30 days. The funds can then be deposited in a new resident trust account or in a personal account for the resident.

At hospital admission. Short-term hospital admissions do not require trust account transfer. The facility holds the funds during the absence.

Three Worked Examples

Example 1: Widowed single resident with Social Security only

Mrs. Henderson is 82, widowed, with no children dependent on her. Her only income is $1,400 per month in Social Security retirement benefits. She is admitted to a Medicaid-paid nursing facility in DeKalb County.

Post-eligibility calculation:

  • Gross income: $1,400
  • Minus Medicare Part B premium ($202.90): $1,197.10
  • Minus PNA ($70): $1,127.10
  • No spouse: no MMMNA/CSMIA
  • No dependents: no family allowance
  • No IMEs: no medical deduction
  • Patient liability to facility: $1,127.10 per month

Mrs. Henderson keeps $70 per month in her resident trust account for personal expenses.

Example 2: Married resident with community spouse below MMMNA

Mr. King is 78. He has been admitted to a Medicaid-paid nursing facility in Fulton County. His wife Carol, 76, continues to live in their home in the community. Mr. King's gross income is $2,500 per month from Social Security and a small pension. Carol's gross income is $1,800 per month from her own Social Security.

Step one: determine Carol's MMMNA. Suppose Carol's verified shelter costs (mortgage, taxes, insurance, utilities, food allowance) total $4,000 per month. The MMMNA is the greater of the floor ($2,643.75) or the MMMNA + Excess Shelter Allowance, capped at the ceiling ($4,066.50). For Carol, the calculation runs to the ceiling of $4,066.50 because her shelter costs exceed the floor by more than the available shelter allowance gives.

Step two: determine CSMIA. Carol's own income of $1,800 is below her MMMNA of $4,066.50. The shortfall is $2,266.50, which must be shifted from Mr. King's income to Carol.

Step three: Mr. King's post-eligibility calculation:

  • Gross income: $2,500
  • Minus Part B premium ($202.90): $2,297.10
  • Minus PNA ($70): $2,227.10
  • Minus CSMIA shift to Carol ($2,266.50): $0 (cannot go negative; CSMIA limited to remaining income after PNA)

Actually, the CSMIA cannot exceed available income. In this case, Mr. King has $2,227.10 left after Part B and PNA. The full CSMIA shift would be $2,266.50 but only $2,227.10 is available. So CSMIA = $2,227.10.

  • Patient liability to facility: $0

Mr. King keeps $70 per month for personal expenses. Carol receives $1,800 (her own income) + $2,227.10 (CSMIA from Mr. King) = $4,027.10 per month, just short of her MMMNA but the maximum possible from Mr. King's available income.

Note: In real practice, this scenario shows how the spousal protections can leave very little or no patient liability for the facility. Medicaid covers the entire facility cost. This is exactly the situation the federal spousal impoverishment rules at 42 USC 1396r-5 were designed to prevent (the community spouse being pauperized to pay for the institutionalized spouse's care).

Example 3: Veteran with VA pension cap

Mr. Robinson is 76, a Korean War veteran, widowed. Before NF admission he received $1,200 per month in Social Security and a $1,500 per month VA pension (with Aid and Attendance supplement for which he had qualified due to need for ADL assistance). He is admitted to a Medicaid-paid nursing facility in Chatham County.

Effect of NF admission on VA pension. Under 38 USC 5503(d), once Medicaid begins paying for NF care, VA pension is reduced to $90 per month. The Aid and Attendance supplement also continues at reduced level subject to specific VA rules.

Effective monthly income after VA reduction:

  • Social Security: $1,200
  • VA pension (capped): $90
  • Total: $1,290

Post-eligibility calculation:

  • Gross income: $1,290
  • Minus Part B premium ($202.90): $1,087.10
  • Minus PNA ($70): $1,017.10
  • No spouse: no MMMNA/CSMIA
  • No dependents: no family allowance
  • No IMEs: no medical deduction
  • Patient liability to facility: $1,017.10

Mr. Robinson keeps $70 PNA + $90 VA pension = $160 per month in his resident trust account. This is more than non-veteran residents because the VA $90 cap creates a residual cash flow above the standard PNA.

Practical point. Mr. Robinson's family should verify the VA pension reduction with the VA Regional Office to ensure the change was processed correctly. Some veterans have had VA pension continue at the pre-Medicaid level for several months after Medicaid begins, creating an overpayment situation that VA later recovers.

Common Mistakes Families Make

  1. Confusing the $70 NF PNA with the $2,982 HCBS waiver community maintenance allowance. The two are very different and apply to different settings.
  2. Not subtracting Medicare Part B premium first in the post-eligibility calculation. Premiums come before PNA in the deduction order.
  3. Not establishing CSMIA when the community spouse's income is below MMMNA. This is the single most expensive mistake families make. Without CSMIA, the institutionalized spouse's income flows to the facility rather than supporting the community spouse.
  4. Letting the trust account balance exceed the $2,000 asset limit. Active monthly monitoring and spend-down on allowable items is necessary.
  5. Believing the PNA can be gifted to family without consequence. Large gifts can trigger transfer-penalty review.
  6. Not knowing the VA $90 cap stacks with the Georgia $70 PNA for $160 effective spending money. Veterans should ensure both flows are arriving in the trust account.
  7. Not reviewing the resident trust quarterly statements for unauthorized charges. Facilities sometimes charge for items the resident did not request or that should be Medicaid-covered.
  8. Trying to use the PNA to pay for room and board. Medicaid covers these; the facility cannot bill the trust account.
  9. Forgetting that the resident representative cannot use the trust account funds for their own expenses. The funds belong to the resident.
  10. Not knowing the facility must return the trust account balance at death or transfer. Within 30 days under federal rule.
  11. Confusing the Georgia $70 PNA with other states. PA is $60, AK is $200, FL is $160, TX is $75. State PNAs vary.
  12. Not factoring Incurred Medical Expenses (IMEs). Out-of-pocket medical costs for services not covered by Medicare or Medicaid can reduce patient liability and free up more of the resident's income.

FAQ

The Personal Needs Allowance is a federally-mandated amount of monthly income that a Medicaid nursing facility resident keeps for personal expenses before patient liability is calculated. In Georgia, the PNA is $70 per month for nursing facility residents, above the federal floor of $30 per month set by the Omnibus Budget Reconciliation Act of 1987 (42 USC 1396a(q)). The PNA covers personal expenses like clothing, toiletries, telephone, hair care, snacks, and similar dignity expenses that the facility does not supply.

$70 per month for Medicaid-paid nursing facility residents. This applies to each resident individually, so a married couple both living in nursing facilities would each have a $70 PNA for a combined $140 per month. The amount is set by the Department of Community Health and is above the federal floor of $30. For HCBS waiver participants (CCSP, SOURCE, ICWP, NOW, COMP) living in the community, the maintenance allowance is much higher (up to $2,982 per month, equal to 300 percent of the SSI Federal Benefit Rate).

Clothing beyond what the facility provides, personal toiletries beyond institutional supply, hair care, telephone, magazines, books, music, snacks, transportation for outings, modest gifts, religious or spiritual materials, hobbies and crafts, personal furnishings for the resident's room, and similar personal expenses. The PNA cannot be used for room and board (Medicaid pays for that) or for services the facility is contractually obligated to provide.

Patient liability is the amount of a Medicaid nursing facility resident's monthly income that flows to the facility after protective deductions are taken. It is calculated by starting with the resident's gross income and subtracting (in order): health insurance premiums (Medicare Part B first), the $70 PNA, spousal Monthly Maintenance Needs Allowance and Community Spouse Monthly Income Allowance, dependent family allowance, and Incurred Medical Expenses. The remainder is patient liability, paid to the facility each month. Medicaid pays the facility the gap between patient liability and the contracted Medicaid rate.

The $70 NF PNA does not apply to participants in CCSP, SOURCE, ICWP, NOW, or COMP HCBS waivers who live in the community. They instead receive a much larger "maintenance allowance" of up to $2,982 per month (300 percent of the SSI Federal Benefit Rate) to cover housing, food, utilities, and other community-living expenses. Most HCBS waiver participants owe zero or minimal cost share because their income is needed for community-living expenses up to the SIL.

The balance in the resident trust account becomes part of the deceased's estate. Under 42 CFR 483.10(f)(10), the facility must convey the balance to the personal representative of the estate within 30 days, typically requiring letters of administration from a Georgia probate court. The balance is subject to Georgia probate creditor priority, including any Medicaid estate recovery claim if the deceased received LTSS Medicaid at age 55 or older. Pre-arranged funeral contracts funded from the PNA during life are exempt and are not part of the probate estate.

Georgia categorical Medicaid for individuals has a $2,000 asset limit ($3,000 for couples). The resident trust account balance counts toward this limit. If the balance accumulates and approaches $2,000, the resident must spend down on allowable items to maintain Medicaid eligibility. Allowable spend-down items beyond ordinary PNA expenses include new clothing, prepaid funeral and burial contracts, hearing aids and dental work not covered by Medicaid, customized DME, and personal effects. The facility's social services or the family member responsible for the trust account should monitor the balance monthly to prevent accumulation beyond the limit.

Small, occasional gifts (greeting cards, birthday or holiday gifts of modest value) are generally permitted. Large or recurring gifts can be treated as transfers for less than fair market value under 42 USC 1396p(c), which can trigger a Medicaid transfer penalty (a period of ineligibility based on the gift amount divided by the state penalty divisor). Families should not use the PNA as a way to transfer money to themselves or to other relatives in substantial amounts.

Under 38 USC 5503(d), veterans receiving VA pension whose nursing facility care is paid by Medicaid have their VA pension reduced to $90 per month. The remaining pension is forfeited to the federal Treasury. The $90 is deposited into the veteran's resident trust account and stacks with the Georgia $70 PNA, giving the veteran $160 per month in personal funds. Veterans receiving the Aid and Attendance supplement have more complex post-eligibility treatment and should consult a Georgia elder law attorney or their county Veterans Service Officer.

Several free resources are available in Georgia. The Long-Term Care Ombudsman through the Division of Aging Services at 1-866-552-4464 investigates resident rights and trust account issues. The Department of Community Health Office of Healthcare Facility Regulation at 1-404-657-5700 handles facility licensure complaints. Georgia Legal Services Program at 1-833-457-7529 (outside metro Atlanta) and Atlanta Legal Aid at 1-404-524-5811 (metro Atlanta) provide free legal representation for qualifying clients. The Senior Legal Hotline at 1-888-257-9519 provides free legal advice for Georgians 60 and older.

Bottom Line for Georgia Families

The Personal Needs Allowance is the only money a Medicaid nursing facility resident has each month for any expense beyond what the facility provides. In Georgia, that amount is $70 per month, above the federal floor of $30 but well below what the average resident would need for full personal autonomy. Families typically supplement the PNA with outside funds, which is permitted as long as the supplementary funds are not pooled into the trust account in ways that affect Medicaid asset accounting.

The PNA is part of a broader post-eligibility income calculation that protects the resident's basic dignity, the community spouse's standard of living, and dependent family members before patient liability is calculated. Understanding the order of deductions (health insurance premiums, PNA, spousal MMMNA/CSMIA, dependent allowance, Incurred Medical Expenses, then patient liability) is essential for families navigating long-term care Medicaid in Georgia. The Miller Trust and spousal impoverishment guides cover the financial mechanics in more depth.

For HCBS waiver participants who continue to live in the community, the maintenance allowance is much higher ($2,982 per month in 2026) because the participant pays for their own housing, food, utilities, and other costs. The waiver maintenance allowance is one of the strongest financial reasons families pursue HCBS waivers when clinical eligibility allows.

Get Help With Georgia Medicaid Personal Needs Allowance

If a Georgia nursing facility resident's PNA is being mishandled, or if you need help understanding the post-eligibility income calculation, free assistance is available.

  • Long-Term Care Ombudsman (Division of Aging Services): 1-866-552-4464 (resident rights, trust account, facility complaints)
  • DCH Office of Healthcare Facility Regulation: 1-404-657-5700 (facility licensure complaints)
  • DCH Member Services: 1-866-211-0950 (Medicaid eligibility and post-eligibility questions)
  • DFCS: 1-877-423-4746 (Medicaid applications, redetermination, change reporting)
  • GeorgiaCares (Georgia SHIP): 1-866-552-4464 (Medicare and dual-eligibility questions)
  • Georgia Legal Services Program: 1-833-457-7529 (free legal help, outside metro Atlanta)
  • Atlanta Legal Aid Society: 1-404-524-5811 (free legal help, metro Atlanta counties)
  • Senior Legal Hotline: 1-888-257-9519 (free legal advice for Georgians 60+)
  • Georgia Department of Veterans Service: 1-404-656-2300 (VA pension cap, state veterans homes)

For broader help understanding Medicaid eligibility, long-term care planning, or finding the right nursing facility or HCBS waiver in Georgia, Brevy can connect families with vetted care advisors.

Learn More

Find personalized help navigating Georgia Medicaid nursing facility rules at brevy.com.


The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.