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savanah Asked June 2018

Rehab facility coerced my father into signing long term care agreement. Should we hire an attorney?

Hi,
Let me give you some background information first regarding my father: my brother and I live in Pennsylvania and my father has been living in Florida with his girlfriend for the past 15 years.
My father has a history of falling and is suffering from some mild dementia. He was recently hospitalized after falling and fracturing his hip. Hip replacement surgery was performed and after two weeks he was transferred to a rehab facility for short term. The rehab facility is about a 30 minute drive from my father's house and his girlfriend doesn't drive. So she made a request to have him transferred to a closer rehab facility that she can get to. She then contacted my older brother seeking his approval of the transfer request. A week passed and his girlfriend asked his case worker if any progress has been made regarding his transfer request and she responding by saying,"I'm sorry, I forgot to put it in." His girlfriend informed me one day that the physical therapist came into his room and asked him if he "wanted" physical therapy.
Now, if you know my father is instinctive answer to any medical question regarding treatment is,"No". So his girlfriend caught wind of this and informed the PT and staff he isn't in full possession of his facilities and that he would always want PT and in the future to make sure she was present or contacted concerning any significant changes to his stay. Unfortunately, his girlfriend is very timid and not persistent as to getting her questions answered. So , the other day I was informed by her that the rehab facility put a legal document in front of him and asked(without his girlfriend present or contacting any of his family members) do you want to stay here? He responded in the affirmative and signed this document. Then she related to me that one of the documents he signed was to cancel his health care with Aetna and that his medicare will run out on August 2, 2018. His room in the facility was moved at this time. She did contact Aetna and they told her his insurance could not be canceled at this time. One of my questions is how can they request consent from my older brother regarding a rehab transfer request but not request his consent(or informing any of his family members) to what is perhaps the most live changing event in one's life? This seems not only unethical, but illegal and would not hold up in a court of law. I never filed for power of attorney and am wondering how this would impact the current situation. Do you think hiring an attorney is warranted or try and work this out with the rehab facility?

GardenArtist Jun 2018
Savanah, I guess my first impression is that it's difficult to really determine what happened, especially the "coercion". That's a particularly strong accusation to make.

And I'm not really sure whether or not the GF understood the situation, or whether or not the facility recognized her as someone who could speak on behalf of your father.

I guess I would ask what the facility would have been trying to accomplish by coercing your father into signing something, especially if there was any indication that "informed consent" was existent.

Let us know when you get a copy of the document and hopefully that will shed some light on the situation.



But as a first impression, doesn't it sound like some impropriety has been committed by coercing a patient that's not in full possession of his faculties into signing a document and not informing his caregiver or contacting his family members to get approval first?

savanah Jun 2018
I'm currently in the process of obtaining a copy of the document he signed and will let you know of the contents when I can. But as a first impression, doesn't it sound like some impropriety has been committed by coercing a patient that's not in full possession of his faculties into signing a document and not informing his caregiver or contacting his family members to get approval first? Especially, after his caregiver made it very clear to the social worker that she was to be present before any decisions regarding his future care were to be made.

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GardenArtist Jun 2018
You need to get some facts identified before drawing any conclusions, including why the nursing home staff is allegedly relying on statements by the GF. Has your father executed any POAs authorizing her or anyone else to make decisions for him, such as moving to another facility, wanting or not wanting to participate in therapy?

And you need to get a copy of the alleged document. From what you describe of the GF, and not having seen it, it's too early to make conclusive judgments on what it might or might not have been and whether or not you need an attorney.

shad250 Jun 2018
Pepsee

You're welcome. Some NH's can do this when the person is not up to going over a written contract, which can take a while to go over (explaining, signing, etc). There are generally many pages to an NH or AL contract.

Pepsee Jun 2018
Thank you Shad.

JoAnn29 Jun 2018
I think someone needs to take the time to fly down there and find out what is going on. Who has POA. This can get very confusing and I like a one on one conversation.

Medicare never stops. Insurance only takes cancellation of insurance from the owner of the policy unless a POA sends in proof they can now do it. Medicare pays up to 20days of rehab 100%. 21 to 100 days 50%. Atena is not good at paying so Dad probably owes the other half. They may have had him sign for Medicaid. Also, GF may have told one person about his confusion but that person didn't pass on the message. It needs to be put in his chart. I think the GF has confused things because she doesn't understand how things work. Dad refusing therapy is a no no. After 3 X Medicare will ask for discharge. A therapist asking if he wants therapy is a pet peeve of mine. Of course a Dementia patient is likely to say no. It all has to do with forcing him to do something the patient does not want to do. I told rehab don't ask her just say its time for rehab. If she refuses then than don't take her. My daughter says there is a way to get them to do what they need to without force but some people don't go out of their way.

shad250 Jun 2018
Pepsee
It's a contract that is created when 2 or more parties have no written contract (NOLO defined) It is created by conduct or circumstances. If you get a chance, Google search it. It may make it more understandable then trying to explain it here,

Pepsee Jun 2018
What is that Shad?

Veronica91 Jun 2018
I don't think anyone other than the owner or POA can cancel health insurance. Now the ins co can cancel the policy if the premiums are not paid or the insured moves out of the service area. You can't change insurance policies except at open enrolement in the Fall or under a couple of other circumstances.
I don't think Medicare runs out. What runs out is the number of days Medicare pays for in a rehab facility.
I think there has been some misunderstanding here both by your Dad and the GF. Dad was probably asked if he wanted to stay after the Medicare days ran out. He may have been moved into a Medicaid room if he does not have the money to self pay and they are applying for Medicaid.
You need to call the facility and find out for yourself what is going on and see for yourself what your father's condition is really like It may be that he really does need long term car the home is not suitable for his return and/or the girlfriend could not manage the care.

shad250 Jun 2018
Have you personally seen the signed document? The reason I asked, this facility may have initiated an Implied in Fact Contract that would require no signature.

savanah Jun 2018
no I have not.

shad250 Jun 2018
Have you personally seen the signed document?

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