Kentucky and Tennessee recently passed legislation increasing how much money residents in nursing homes can keep of their income to use for personal items. The Personal Needs Allowance is the monthly sum of money that residents who receive Medicaid may retain from their personal income that remains exempt from nursing home care costs. Signature HealthCARE and its “legislative lady”, Kathy Gallin, VP of Legislative Affairs and Health Policy led the charge to bring much needed awareness to this quality-of-life issue that effects so many nursing home residents across the country.

When Medicaid was passed into law in 1965, the cost of living was undeniably a lot less than it is now.  First-class stamps and candy bars both went for a nickel. You could buy a full-sized new car for around $3,000. You could fill up your tank with gas that cost $.30 a gallon, and, when Congress and the President decided on how much a nursing home resident should be able to keep from his or her income toward meeting “personal needs”, they decided that $30 per month would be a fair allowance.

Most Medicaid recipients who reside in nursing homes do have some personal income, some in the form of a retirement fund, a pension or even Social Security.  These funds are typically used for their cost of room and board and medical expenses, however, Medicaid rules designate that there are exclusions, such as personal articles which are covered by the Personal Needs Allowance (PNA) and these amounts vary in dollar amount state to state.

The Personal Needs Allowance is important to residents to enable them to maintain a higher standard for quality of life in long-term care facilities. It provides residents the opportunity to participate in activities beyond those provided by the facility, to remain connected with family and friends and to obtain basic items that have a significant positive impact on the residents’ quality of life and are a valuable compliment to the services provided by the facility.  And while Medicaid rules specify that a resident’s PNA can be used to cover certain expenses that are NOT covered by the monthly rate for their room and board, this allowance is intended for residents to spend at their discretion on items such as cell phones, toiletries, clothes, shoes and personal care services like haircuts, a meal out with friends, cards to send to family members, reading materials, or hobbies.

In 2014, Signature HealthCARE’s “legislative lady,” Kathy Gallin, had a facility visit with the Florida President of the Senate and he heard the message from our then resident council president, “Ms. Lucy”, that she hardly had enough money in her PNA account at the end of the month.  That message transcended and by a bipartisan vote the legislature increased the PNA from $70 per month to $105 per month.  The following year they raised it to $130 per month and during the 2023 legislative session, without any “ask,” raised the PNA to $160 per month.

After several years of researching the overall 50 state PNA’s, we realized this was really a crucial issue and once again, Kathy Gallin took the initiative to our legislators in Georgia, and they followed suit, with bipartisan support, and ultimately raised their PNA from $50 to $70 per month.

It is now 2024 and the cost of living has dramatically increased, but the personal needs allowance across so many states has not kept up accordingly, as had been the case in Kentucky and Tennessee.  And, while individual states do have the ability to change this, many just don’t.  The PNA in Kentucky had not been updated for decades and had remained stagnant at $40 per month with no inflation or other factors having been made as costs of living rise.  The last PNA increase in Tennessee was 2009, where it remained at $50 per month. 

The goal was to encourage policy makers to raise the Personal Needs Allowance in Kentucky from $40 per month to $60 per month and in Tennessee from $50 per month to $70 per month for our beloved nursing home residents and again, through the efforts of our “legislative lady,” Kathy Gallin, who began the discussions with Kentucky legislators back in 2019, before COVID, and with the support of Ashli Watts and the Kentucky Chamber of Commerce, the KAHCF, and the heartfelt support from Rep. Amy Neighbors, a licensed nursing home administrator herself, the Kentucky legislature approved a PNA increase for long term care residents in the Commonwealth.

At the same time, Gallin, who is a board member of the Tennessee Health Care Association, brought this to the legislative committee and the THCA Board and they approved it to take to the legislature.  Representative Patsy Hazelwood and Senator Ferrell Haile sponsored bills in both chambers, and ultimately the Tennessee General Assembly passed an increase in the Personal Needs Allowance from $50 per month to $70 per month.

And so, we applaud both the Kentucky General Assembly and the Tennessee General Assembly as the Personal Needs Allowance will be raised in both states and we are so grateful that our elected officials listened and ultimately understood that this will enhance the lives of so many long term care residents and their families­ it was right thing to do!

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About Signature HealthCARE

Signature HealthCARE is a family-based healthcare company offering Skilled Nursing & Assisted Living. The company’s organizational culture inspires nearly 8,500 employees with our foundational three pillars: Learning, Spirituality, and Innovation, plus our Sacred 7 Principles: Be Heroic, Embrace Teamwork, Show Compassion, Give Respect, Have Integrity, Encourage Positivity, and Be Accountable. A growing number of Signature HealthCARE centers are earning five-star quality ratings, the highest classification from the Centers for Medicare & Medicaid Services and earning QAPI accreditation. Signature HealthCARE has also been awarded a Best Places to Work in Kentucky honor by the Kentucky Chamber of Commerce, for six years.     

Kathy Gallin 
Signature HealthCARE
(502) 259-0239
kgallin@signaturehealthcarellc.com