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I know nursing homes use social security checks if necessary to help pay for patient's nursing home costs---can they also take a patient's retirement income checks?

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Of course.

The notion that nursing homes 'take money' is a hot button for me. Like all businesses, nursing homes are paid for their services. If a resident has the income or savings to pay the monthly rent, they do. If they do not have the money, they apply for public assistance through Medicaid. Once on Medicaid, whatever savings or income they do have goes towards their monthly rent and then Medicaid pays the rest. Medicaid will take into account the needs of a resident's spouse, so if your loved one is married, you should see an elder law attorney to get advice.

The strange thinking around nursing homes 'taking money' may come from the fact that Medicaid will wait until someone is dead to recover the cost of their nursing home care. Imagine if you didn't have enough money to pay your rent and your landlord said, "That's OK, I'll lend you the money for your rent every month and wait for your estate to reimburse me after you've died." That would be pretty darn charitable of your landlord, right? But somehow, when Medicaid does that it's considered a heartless money grab.
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If your loved one is on Medicaid, then all of your LO's income goes to pay for nursing home.

If your lo is not on medicaid, then the are paying 12-15,000$ per month for care.
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They take all income and then Medicad makes up the difference.
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Yes
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Is the retirement income the resident's? Or does it belong to the spouse? Medicaid has waivers and policy in place so if one partner needs hospitalization the other is able to continue to pay for their own needs. You or your friend need an elder law attorney that specializes in Medicaid Planning. Ask specifically about spousal impoverishment procedure. Medicaid will not impoverish one spouse to pay for the other.
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If the person is on Medicaid, then yes, their income checks are considered well.....income, of course.
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Medicaid requires an "SOC" aka "share-of-cost" for participation. The SOC is basically a co-pay similar to what a co pay is for insurance.

For individuals (widow /widower) who qualify for NH Medicaid, the copay is straightforward: all monthly income (SS, pensions, retirement, etc) less a small personal needs allowance (this varies by state from $ 35 -$105 a mo) MUST be paid to the facility as your SOC for you to be in compliance for Medicaid. Most states have the PNA at $ 60 a month which basically pays for beauty / barber shoppe weekly & maybe some toiletries or clothing replacement. Often a NH will press upon family/DPOA to make the NH the payee for the residents income but the resident or thier DPOA can write a check to the NH for the copay and let the PNA build each month in their bank account. Sometimes NH have cable & phone charges which are magically the exact amount of the PNA.

For individuals on NH Medicaid, they will have only the PNA for spending. So if they have a home, car,CC debt, life insurance or funeral policy payments, they will really have no-none-nada of $$ anymore to pay on those accounts. Family will have to pay on all their debts or property IF they want to keep the house, insurance, etc. Now whether or not that makes sense to do and pay from day 1 of NH medicaid till debts paid or till they die & through probate totally depends on your situation.

For couples it's IMHO way WAY more complex, as the community spouse can apply for CSRA or MMNA (community spouse resource allowance / monthly maintenance needs allowance) which diverts the NH spouse income to the still living in the community spouse. I think of it as old-school style alimony for the CS. Some states have CSRA quite high -like TX has it at $ 2900 so in theory if your living in TX NH spouse gets 3k a mo, thier CS could get 2900 of that leaving only $ 100.00 a mo as the required Medicaid co-pay.

Personally I think that anyone facing their parents or their own NH Medicaid admission with a CS situation should see an elder law atty asap and before ever doing the medicaid application as its not simple and if you need to shift assets (like doing a SPIA or downsizing to a smaller home), you need to do the whatever's before the Medicaid application is filed & most of this is not a DIY project.
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