My mother went to a rehab facility after hospital stay. During her stay she had chest pains and went to the ER. They found 3 blockages and fixed them. She then went back into the rehab facility/SNF. She was supposed to be discharged Wednesday. My father went to the facility and agreed to private-pay for a month. However, he did not return with payment and is not returning their phone calls.
I spoke with him yesterday and this was what he said
His attorney advised him to not pay and not to have contact with them.
The facility would have no choice but to keep her. He also asked me not to have any contact with the nursing home and if I did not to tell them anything.
My father has been her caretaker for the last year-and-a-half due to a leg amputation. He wants to put her in a nursing home permanently so he does not have to care for her any longer.
He has been working with an attorney to separate the assets and whatever else needs to be done legally so that Medicaid will pay for her to be in the nursing facility.
All legalities should be finalized next week.
My mother was okay with staying another month so she could get physical therapy with her leg.
As of yesterday, she is extremely frightened and scared of what's going to happen to her because they have not heard from my father. Because of the unknown, and his lack of response, now she wants to go home.
Basically he is not going to pay and just left her there.
I also have a power of attorney for my Mother's medical and financial.
My question is:
What are the options for the SNF if he doesn't make the payment today and he refused to tell them anything? Which I already know, he will not. From an SNF standpoint what happens to my mother?
Are they legally obligated to keep her? Do they contact legal officials such as social services etc?
If pick her up and take her to her home, well that make me legally responsible for her care?
Once all the legalities are finalized early next week, and if she is home and does not want to go back once Medicaid is setup to psy. Can he force her to return to the SNF against her will?
If not, what happens if he simply leaves the house and refuses to care for her?
I realize I have lots of questions, but if you could give me the legal answers to the above I would appreciate it.
Should I inform the SNF that he has been advised by his attorney not to make this payment and all legal paperwork will be done early next week so Medicaid will pay? Are they legally responsible to keep her if I tell them what's going on?
What options does the SNF have if no one picks her up today?
Is there an organization or person that I can speak with that can advise me on what to do?
Thank you
Do not pick mom up.
I sure hope that this is an elder are attorney who knows what he's doing.
There are some states in which "spousal refusal" is an accepted legal technique. I hope yours is one of them. You might want to Google that term.
https://ohioseniorlaw.com/medicaid-101-part-8-spousal-refusal-or-just-say-no/#:~:text=Under%20Ohio%20law%2C%20spouses%20have,the%20spouse%20seeking%20Medicaid%20eligibility).
The other sticky wicket is that YOU, as POA for your mom, have an obligation to do what SHE wants done financially.
Does your mother have access to her accounts that she can share with you? Do you trust your father? Does your mother? Or does mom need her own lawyer?
OP needs a consult with an elder law attorney. Hopefully she can get one when she tells them it is an emergency.
There is the site AVVO.com that she could ask her questions as well and maybe get a quick response.
Putting that aside, your father has the right to step away as a caregiver when it becomes too much, you need to figure out what kind of care your mother needs and how you can best provide it.
Please consult an elder attorney ASAP.
Keep us updated.
Tell the facility that it is an unsafe discharge and you need guidance.
If you take her home, I assume you mean to your house, you just accepted the situation as your very own. Think long and hard before you go there.
Your dad can no longer care for her by himself, don't try to force him to do it. The stress of caregiving is more than you can imagine, he has reached his limit and he can become a statistic if he is forced into being her hands on caregiver.
Tell your mom that she just has to trust her husband and do her best with physical therapy and give it some time. Don't tell her that she is never going back to her house, let it play out with her while you deal with the financial situation as her legal representative. You can't really tell them anything because you don't know what is going on, but starting the Medicaid application will help calm the facility down.
Here is what will happen with the SNF. They will threaten. They will ask for medicare or medicaid extension through Social Services, which they may get or may not get. Moot point because the cost will likely not be a lot more than private placement care.
Your father is doing the correct thing with the assets. This is what must be done now and it needs professional help. Your Mom is beyond what he can do in care and beyond what YOU can do in care. The SNF will say and do anything to THREATEN you and to get SOMEONE/ANYONE to get your mother. You simply say no one can now physically of mentally take on her care and she will require placement and they should get their Social Workers busy with that immediately. They will say "Impossible because of Covid". That is end of conversation. Your father is correct. Do not speak with them. And of course you CAN speak with your mother. They have no right to block your calls.
Let your father alone. This is hard enough for him to take care of this. Offer him your support and love. Unless you suspect there is some nefarious thing afoot here, this is exactly how it should work.
The SNF cannot do an unsafe discharge. The worst they can do is bill your dad and her, and if they don't pay ruin their credit. It is unlikely they NEED credit at this point. That is the ultimate worst. They can place her if they can find placement. That won't be easy.
As a nurse all my life that is my opinion. Wishing you luck. Sorry for all the pain and confusion. Leave this to Dad and the Lawyer. Covid will make it all worse.Sorry; can't be helped.
I get that the dad is totally stressed; per the OP's profile, the mom has dementia (in addition to the physical issues that were presented). I totally get why and how the dad may need to step away from caregiving. But the OP has an obligation to make sure that her mom's best interersts are being looked after.
In the end, it depends upon how much the OP trusts her dad.
This is certainly a tangled web. It very much hinges upon what "dad's" intentions are .
I so hope this turns out well for the Mom.
My eldest daughter has MY POA; my husband who is also her stepfather has POA for him as well, and I think for my ex and my ex's wife as well; it's because she is level-headed and has ALL of our best interests at heart. And in an situation like the one described, she would be ahead of the game, if you know what I mean.
Our OP does NOT appear to be ahead of the game.
In the situation described, it sounds as though the mom knows that her daugther has Mom's best interest's at heart and that there is some suspicion about dad. Which is why I suggest that the daughter get a lawyer for her mom, separarate for her mom.
Again, whether this is second marriage, or whatever the reason, there must be a reason you and not the Dad is appointed POA. Protect your mom but do NOT bring her home. That will make more a mess to comb through. See a lawyer, and again I apologize for not reading more carefully and for having missed that you are the POA for your Mom.
Their is nothing said to indicate that dad is up to no good and even if he is, he won't get away with it. There is nothing financial that the government doesn't know about.
He is doing the right thing based on his legal counsels instruction. He isn't saying he is not going to pay, he is saying next week when he is protected then he will deal with it.
We are forever telling people to protect themselves from financial ruin by seeking legal advice BEFORE doing anything.
That is what he is doing, she will be getting her legal share, no attorney wants to risk their license for Medicaid fraud. They obviously don't have enough money to pay an attorney to lose his/her livelihood because if they did they would just pay for the care.
you say you have power of attorney over your mother, well does she have money because someone is going to have to pay. If they own a house, it will have to be sold. You can’t sell anything up to 3 years before placing someone in a nursing home if you want Medicaid to pay for the nursing home. You need to talk to the nursing home since you have power of attorney. What your dad is doing isn’t right. It sounds like he wants to get rid of her. Is she of sound mind so you can talk to her.
I'm not in the legal field, but this statement isn't necessarily true.
IF the person needing SNF, is single and will never be returning home, at some point the place will need to be sold and the assets used to pay/pay back what Medicaid covers. Often it results in a lien on the home, which would require sale/payback on the death of the patient. Sometimes if another family member were providing care for a given amount of time, they are also protected from being evicted so the place can be sold.
However, when there is a spouse, they are generally protected. We went through all that with mom and dad. The EC attorney was able to secure the home and enough assets so that mom was taken care of. Medicaid aims to get reasonably reimbursed, without impoverishing the spouse.
If Medicaid was able to take all assets, both liquid and real estate, we would have a HUGE homeless impoverished problem with the spouses who don't need NH. The best advice is to have this all set up BEFORE the need happens!
What's the relationship like between the OP & Father?
Sound alike he's reached his line in the sand. Could they join forces to get Mom the care she needs?
It's heartbreaking to realise your Dad feels he has no other choice but abandonment.
This started happened to a friend. The Father just couldn't go on. When he admitted that to the family, councelling & more help was found & the Mother was able to stay home. I would hope I can find the right accommodation for my folks if care at home is no longer working for one of them.
What a stressful time. I hope it works out.
Not sure what you meant with this statement. To clarify for others:
POA doesn't *really* make anyone "legally responsible."
What POAs are for is to allow the person appointed to help make decisions, sign paperwork, and manage health and financials for a person, in the manner they would want, when they are no longer capable. It doesn't make you responsible for their care, just oversight for them.
As an example, some people either don't have family/friends to appoint, don't trust any family/friends, or just prefer not to burden family/friends, so they appoint another party to be their POA. Often this is the attorney who set it up. Do you think any attorney would agree to this if it meant they have to take in and care for their client?
One more point about POAs: these are not all encompassing powers. You can manage finances for the person. You can sign documents for the person. You can coordinate their medical care. You CANNOT force them to do anything THEY don't want to do. Our mother developed dementia. In the early stages, she denied having any problem and REFUSED to consider moving anywhere. We tried bringing in aides, to keep her in her condo as long as we could, but after a short time she refused to let them in. They were only there for 1 hour (min) and mainly to check on her and ensure she took her meds. After refusing to let them in, we had to find a MC facility and move her. The EC attorney told me we could NOT force her to move. He suggested guardianship, but the facility we chose would not accept committals. As a result, we had to get creative to make the move happen. Facility said to just get her there, they would do the rest.
So, POAs need to be fully understood. Too many people think this is the answer to everything and it isn't. It is something that should be in place, and it does help greatly when the situation demands it, but it does NOT give you superman or wonderwoman powers.
Medicaid issues aside, they will get straightened out. It would be abuse and unlawful if rehab kicked her out without a plan for care that all have agreed to. Rehab would be getting the attorney to defend their actions, abandonment of a vulnerable person.
Mom has dementia she does not knw what is going on. Though i am sure this is hurtful to daughter.
Huge assumption. The dad may just be heeding advice from the attorney and is doing what should have been done long ago. He needs to protect himself and assets, so that he is not impoverished or rendered homeless. My mother had to do something similar, also on an emergency basis, to ensure dad was cared for AND she wasn't left with nothing.
Later, after dad had passed and she was in early stages of dementia, we had to revisit everything and ensure she would be cared for. There was no relationship problem. Paying for long term care is expensive, and can ruin finances for both parties. Thankfully our parents had saved money and by protecting those assets at the time, we are now able to fully cover mom's care in a private pay facility.
As your mother's POA, you do have responsibility to oversee her affairs. That does NOT mean you have to take her in. Your dad also doesn't have to accept her return to him. He may feel that he is no longer capable of providing her care and wishes her to remain in a long term care facility. Care-giving is difficult, and given mom's cognitive and physical disabilities, it may be well beyond his capability.
Without knowing all the details, it is hard to say what is going on or what will happen, but given what information you have provided, it sounds very similar to what my mother had to do when dad required extra care. In their case, it was in process, but had to be hurried up (should have been done already!) when she wanted him to stay in NH. The EC atty handled everything, so I am not privy to all the details, but he did ensure the condo was transferred to her and "split" the assets. He was left with the minimum and his pension and SS were used to cover part of the cost, with Medicaid picking up the rest (unclear if she was able to keep some of his income - we were not part of the whole process other than taking her to this attorney and getting the ball rolling.)
If you can, discuss with your father what is going on. If he won't talk to you, contact his attorney and ask what you are allowed to do/know as your mother's POA. If they won't discuss anything with you, then you need to find an EC atty to represent your mother. She should be allowed some assets, her income and hopefully be Medicaid accepted. The current facility may not be a Medicaid facility, so she may need to find another long term care facility that does accept Medicaid.
"...the OP's mom appointed HER POA and not her husband..." That is a false assumption, in my opinion. My husband had POA both medical and financial for both of his parents while they were still both alive and had all of their mental faculties intact so that, in the event they needed his help, he could act swiftly on their behalf ***if they asked him for help***. Your father has asked you for your help in that he asked you to NOT tell the SNF anything.
Do not open a can of worms for your father. You will regret going behind his back and, perhaps, making things harder for him and causing unnecessary friction between you.
If your father were the poster on this forum instead of you, the same folks who are accusing him of neglect, abandonment and money grubbing would be the same ones telling him to hire an attorney (done), get Medicaid (almost done) and place her where she will get the professional care he cannot provide anymore!