It's more of a shock to me than a dilemma. That's why I am posting my comments to the Discussion section and not the Questions section. I wonder if nursing homes can abruptly discharge elderly individuals like this and if others have experienced this same situation.
My sister is POA and sent us all an email with the news. Apparently a conference call was set up without notice - it included the charge nurse, social worker and what my sister called "the administration" (figure she means the Director). They stated that it was time for my Dad to "move on" --- that he was not suited for nursing care and that he was far too demanding.
Fortunately we had looked at a personal care home last week as alternative living arrangements for him. Dad wants to move back home and has repeatedly asked my sister to make it happen. However, after touring the place, he told us that he was either going home or staying at the nursing home. Then, he said he was perfectly happy at the nursing home (?!). Yes, he has become more forgetful the last couple of months but certainly not a personality change.
Anyway, we had no idea that he was being difficult with the staff. I guess we assumed if the nursing home had a problem with Dad, they'd talk it over with us first --- give us the opportunity to make it right one way or the other. According to my sister, there was no room for discussion and it was an iron-clad decision without family input. From what I've read, we can contact an ombudsman (?) but I don't understand what he or she would be able to do.
Fortunately the personal care home will have an opening next week so we'll move him then. Frankly I am happy about the move considering the personal care home has a much more comfy atmosphere and it's nothing like an instituion-like setting. It's just something we didn't see coming and it doesn't feel right that a nursing home can kick someone to the curb --- at such short notice.
NH routinely have "care conferences" in which the residents care plan is reviewed with NH staff (usually social worker & activities director, the floor RN for them and their primary CNA) and the patient's family representative gets a letter on the date. If they are on Medicaid, it is required to do one within the first 30 days and thereafter about every 90 days. If they are private pay, the DPOA / MPOA can request these done even more frequently. Family need to go to these or do it via a conference call. If the NH determines they do not meet the criteria for needing "skilled nursing care" or they require care that the NH does not provide - like a locked unit or psych unit care - they can be discharged with a 30 day notice. Now if they are being an imminent danger to staff, the NH seem to have them sent to the ER and then it's the hospital's & family's problem to solve as the NH won't readmit them.
I would suggest that you try to be more involved with your DPOA sister on a frank discussion with the board & care home he is moving to. If it is a board & care type of personal care home, they are not designed or have the staff to deal with residents with significant medical issues or emotional problems. The one's I;ve seen are more about group housing - kinda like a dorm for the elderly who can do a lot for themselves but need medication management & meals done.
I bet you are beyond peeved with the old NH, but maybe you can contact the social worker @ the old NH to ask her what some of the issues were with dad. That you want to find a situation in which he can be himself and it can work for everybody. The social worker's I've found are often lots more upfront in their comments than nursing staff will be. Due to dementia, aging and medications, the parent you knew is not at all the 88 year old they now are & it would be good to get the insight from a non-family member. You don't want to face dad getting evicted from his new "home" as word does get around and placement will be very limited.