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she was put on a 72 hour hold at the hospital, she has no money, lives alone in a rural area. What will happen after the hold if she is found to need more help but refuses.

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First, how old is your mom? I don't know how old one has to be to be eligible for services through the area agency on aging, but they were a godsend to me with taking care of my mom. They're also an official outside care source that can provide an objective assessment of her situation. Worse case scenario is seeking guardianship of your mother. If she's not able to take proper care of herself and is unwilling to take steps to make sure she's getting proper care, that may be your only recourse.
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I would think the control would be taken out of her hands, and she'd be forced into a nursing home or whatever. But I could be wrong. You'd better be calling the hospital administration and find out what they will do with her.
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