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casiphia Asked October 2021

How do I keep my dad in the hospital while I gather all of my parents' information? Mom can't take care of him.

I have read the forum on applying for Medicaid for elderly parent. My dad broke his femur over a month ago. He was placed in rehab, then released because he refused treatment and sent home. Dad is no longer in his mind. We sent him back to the hospital for we could get him up and moved out of the chair and though he is no longer there in his mind he is a very difficult man.
I have started the process of collecting all their information. My mother has complained at how dad keeps statements and what not so good thing he did that. Have to make sure she doesn't throw the out.
Their elder lawyer is not open due to the pandemic and have not set a date to reopen. Yes, I am the POA and have those documents. I have called their lawyer and she never called back. She has the message on her answering machine that they aren't open.
My dad can't come home. How do I keep someplace safe while I do the leg work with my mother to gather this? Note: my mother has some form of dementia too and it's not easy to get information from her, especially when dad paid all the bills and took care of everything important and left her out of the loop.
I'm about ready to scream for help for all this is giving me a headache. Siblings live out of state.
Lots of advice would be greatly appreciated to get through this.
Financial Advisor has been contacted so he's working on it. Now I have to go rummaging through their home to find any and all paperwork.
Thank you for anything and much needed support.

JoAnn29 Oct 2021
The hospital will not keep him if Medicare tells them he needs to be discharged. If he has been there over 3 days or more, Rehab maybe suggested. Send him. If he didn't use up the 100 days he was in the last time he can use them now. (Be aware though, if the last stay he used the first 20 days, Dad may have to pay 50% of his care unless he has a really good supplimental). While there, have him evaluated for 24/7 care. If found he needs it, have him transferred to LTC once rehab is done. In the meantime, start the Medicaid process.

JoAnn29 Oct 2021
Do not throw out those Bank Statements. Five years of them will be needed for Medicaid. I found Moms in a file drawer.

Where I live rehab is in the same building as the Longterm care. So easy transition from rehab to LTC. Let him go to rehab again. You do not need a lawyer to get the ball rolling. Call Medicaid and ask if they are allowing appts. If so, talk to a caseworker. You will need to know how your parents stand financially. Social Security and any pensions are monthly incomes. Your problem will be if that income goes over the cap Medicaid allows. So have that proof with you. The house is an exempt asset and so is a car. But questions maybe made concerning their value. Take everything you can to the appt. Statements for savings too. Any CDs and retirement accts. There are somethings that may be exempt like retirement accts. I would not be confident in using a Social worker (unless knows Medicaid law) to answer questions concerning Medicaid especially when a spouse is involved. If they do help with an application, then I would be very involved. In my State you are only allowed 90 days to spend down, get info needed to the caseworker and get the person placed.

I am surprised a Law Office is still closed. Since yours seems to be, you may need to find another elder lawyer. Because you will need one if Dad goes over the income cap allowed by Medicaid. Some States allow Miller trusts. The extra money Dad gets will be deposited into the Miller trust and when he passes, it reverts back to Medicaid. If your parents have assets that exceed the asset level set by the state (normally 2k but each state is different) these assets need to be split between your parents. Dads split going towards his care and when spent down, you apply for Medicaid. Mom becomes the Community Spouse. She remains in the home and gets enough or all of the monthly income to live on.

With my Mom, she had 20k in assets and was under the income cap. I started the Medicaid application in April, she was placed May 1st and privately paid for May and June. I confirmed in June that Moms assets were spent down and the caseworker had all the paperwork needed and Medicaid started July 1st.

This all seems overwhelming but take it a step at a time. It will all fall into place. As POA I was able to go to the bank and have them print out every acct Mom had with that bank. I found besides her checking account she had 4 CDs that totaled 48k. She was living off $1700 a month 5 yrs ago.

I hope I have helped and not confused u more.

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Beatty Oct 2021
The hospital won't keep a patient past the 'acute' stage, but they will often transfer to rehab (or respite/nursing home temporarily until rehab is possible).

Speak up to the hospital social worker. Point out Mom cannot be the discharge plan. That another discharge location is needed.

If you are the primary contact - good. If it is Mom, be alert.

It only takes one call from a pushy hospital staffer to advise that Dad will be sent home & unless Mom is VERY firm with her refusal he may be delivered home.

Geaton777 Oct 2021
Check the PoA document to see if it is "Durable" or "Springing". Durable means you won't need an actual diagnosis of dementia to activate your authority. You can then start managing his affairs. If it is springing then you will need a diagnosis of "incapacity" (a legal term) for your authority to be activated. At any rate your next step is to have a doctor give both your parents a cognitive and memory test so that it is in their medical records. Having this in your dad's record will prevent him from being able to check himself out. You must also make sure that IF the discharge office starts harrassing you about coming to get him, to stand firm and inform them that as of right now, he is an "unsafe discharge" since is wife also has dementia and you are working to set up a care arrangement. The hospitals can be very aggressive in trying to get you to take him back but DO NOT until you have a place for him to land (like a facility).

As his PoA you will need to take the paperwork to his bank and set up your authority there. Banks have their own process and may require you to bring in your dad. You may need to negotiate with them on why this can't happen (he has a broken femur). They will then probably want 2 forms of his ID (driver's license and major credit card) instead of his physical presence. That's what I had to do. Once this is established you can set up online banking and put their bills on autopay.

You should definitely inform your siblings that you are over your head and ask them for hands-on help for about 1 or 2 weeks to get your parents into a facility. They may not be able/willing to help and if this is the case you can't force them but you can inform them that you may need to resign your PoA and allow the county to become their guardians. This may motivate your siblings to help, but maybe not.

There is much to do so eat the elephant one bite at a time. Many on this forum have been in your shoes (including me). Having group calls with siblings where you have a prepared an agenda and identified short and long-term goals will help keep things moving forward and out of the "emotional train wreck" area. Transparency of what you are doing and why will help them understand the challenging nature of your efforts. Send out group emails on a daily basis so that everyone is informed of the same thing at the same time. I did this and it helped tremendously. Don't let them complain about anything without also providing a workable solution. I wish you all the best as you work to help your parents.

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