I always have to look it up but I think a grantor trust has to file a Form 1041 if the trustee is not the grantor (as in, the grantor new resides in the dementia ward).  But I don't think a Schedule K-1 is filed, there is just an attachment that tells the grantor what to show on his/her Form 1040.  Paying bills for the grantor's care, is the same as making distributions directly to the grantor.