Who Can Be the Trustee of a Qualified Income Trust in Nevada?
In Nevada, the trustee of a Miller Trust (Qualified Income Trust) is whoever manages the trust account — depositing the applicant's income each month and paying out only what DSS allows. Nevada's MAM F-500 defines "trustee" generically -- "any individual(s) or entity... that manages a trust... and has fiduciary responsibilities" -- and never states who may or may not serve, nor whether the individual may serve as their own trustee. No Nevada QIT-specific FAQ or guidance addressing self-trusteeship was found. This is a confirmed policy silence, not an oversight in this kit's research -- consistent with general trust law's caution against a sole beneficiary also serving as sole trustee (the "merger" doctrine, which can collapse a trust back into an ordinary countable asset). Confirm the trustee question directly with your drafting attorney; this kit does not treat self-trusteeship as either permitted or barred by Nevada's own rule text. The trustee does not have to be a lawyer or a professional; for the core setup this is a role most families fill themselves. For a complex situation, consult a Nevada-licensed elder-law attorney. This guide is informational only and is not legal advice.
What usually happens
Nevada doesn't publish a fill-in form, so the trust has to be drafted to DSS's requirements, and an elder-law attorney quotes $1,000–$2,500 to research and draft it. Once it's signed, you take it to the bank, where the branch has never opened one of these and says no.
Meanwhile the month is running out. In Nevada, coverage can't start before the month the trust is funded, so a month that slips is another month of private-pay nursing care at $11,208–$12,790.
This applies when the person who needs care has gross monthly income over Nevada's income cap of $2,982, whether you're their child, their spouse, or a professional helping them.
Free: the questions to ask a Nevada bank before your first visit
7 questions for a five-minute phone call, so you find out whether a branch knows how to open this account before you make the drive. Emailed now, then 4 short follow-ups over the next 10 days — then we stop.
The trustee does not have to be an attorney or a professional fiduciary. Managing a Qualified Income Trust is an operational job, not a legal one: open the account, move the applicant's income through it each month, and pay out only what DSS allows — the same short list of tasks every month.
What the trustee does each month
- Deposits the applicant's income — Social Security, pension, and any other named sources — into the dedicated trust account.
- Pays out only the amounts DSS permits: typically the applicant's personal-needs allowance of $154/month, any spousal allowance, and the applicant's share of medical and care costs.
- Keeps simple records of what went in and what came out, so the trust stays compliant and Medicaid has no reason to question it.
For the full list of payments DSS allows, with the source for each, see what the trust can pay for in Nevada.
Name a backup trustee
Many families name a successor trustee when they set the trust up, so that if the first trustee cannot continue, the trust keeps running without interruption. Either way the Nevada setup is the same — see the step-by-step setup and what to say at the bank.
Whoever you name will need this
The trustee is the one who opens the account — and most banks have never seen this type of trust before. Free one-pager: the questions to ask before that first visit, emailed now. Then 4 more short emails over the next 10 days — then we stop.