Follow
Share

My mother is combative with dementia and ended up in the hospital. She is unable to walk and can barely transfer. The hospital wanted to send her back home. She does not own a home and does not live with us. The hospital downgraded her status to observation within 12 hours of her stay. They finally found a facility to take her . My concern is the admission paperwork they sent wants us to sign as a representative. Red flags everywhere and even though they say it’s only because she has dementia I’m afraid I will be hit with all her medical bills not covered by Medicare A. She will qualify for Medicaid after admission. Should I sign and admit her?

This question has been closed for answers. Ask a New Question.
Please read each line carefully and do not sign your own name next to any statement that says you will personally pay any debt incurred by your mom or be responsible personally for that debt. Do not sign your name as responsible party. Instead, sign "(mother's name) by family member, her agent". Of course its always best to consult an attorney, but if you can't, please follow that advice.
Helpful Answer (6)
Report

What I was told to do was on every signature line do it as “Jane Smith in her limited capacity as DPOA for Anne Jones Smith”.
AND
get a copy of each and every page of all admissions paperwork!
It will be quite the Stack of paper. Get every page.

You can strike out items and initial by those lines or paragraphs. Admissions will not be happy if you do this. So you have to be able to hold your ground on this. I assume you have a valid DPOA.

also please please realize if she applies for LTC Medicaid, she will be required to have basically all her monthly income to be paid to the NH as her copay as of day of her Medicaid application. She will have a small needs allowance- maybe $50 or $60 each mo - and it will kinda be just enough for on site beauty shoppe. So if she has any debts, she will default on them. If she has a home or car, she can continue to own those as exempt assets but she will have no $ to pay a penny on either..... & imho if there’s home or car, you as Dpoa / family / heirs need to make a clear decision to either keep her owing them to beyond her death or sell them before Medicaid LTC gets applied for. LTC Medicaid in almost all states have a maximum of 2k in non exempt assets. So if she has over $2,000 in the bank, she will have to do a legit for Medicaid spend down before Medicaid will have her eligible. Medicaid can require 5 years of her finances to review to see if there r any $ impropriety. Good luck.
Helpful Answer (7)
Report
Jennifercrane Dec 2020
If a person applying for Medicaid has assets such as a home, there will be a spend down period. The house will have to be sold (some extenuating circumstances will affect this, such as dues a spouse still reside in it) and assets used until her income and assets are below certain limits. In our state tge income does go to the NH with a $45 allowance to the person applying.
(1)
Report
Are you POA. If so you sign as her name by your name under POA. If not, tell the home that you cannot sign as you have no legal right to sign. That you are not her POA or guardian. You also have no right to file for Medicaid for her. In that case they need to get State Guardianship (which would mean an appointed fiduciary in charge of her assets, her placement).
Currently your Mom is on her own, I am assuming, with no legal representative to file for medicaid, and no one to sign for a Nursing Home.
A social worker can get legal temporary guardianship for you with a phone call to a judge, so it is on them. If I was not her POA I would not sign. They have no choice then but to get a temporary guardian. Do know if that person is not YOU , that you have no rights to advocate for her.
Helpful Answer (5)
Report
Jennifercrane Dec 2020
Not in all states. I could not just call a judge to get someone temporary guardianship. Someone must file for guardianship and request an expedited hearing. A temp guardian ;usually an attorney) will be appointed until a hearing and permanent guardian is appointed. And this is IF the person in question is really incapacitated. Courts take this question seriously. Dementia alone doesn’t always mean incapacity because progression can be rather slow sometimes.
(2)
Report
According to profile, NO DPOA.

If possible, have it reviewed by an atty - do NOT let them rush you!
If possible, have your mother sign it.

SEE THIS:

https://www.elderlawanswers.com/am-i-financially-liable-if-i-sign-a-nursing-home-agreement-for-someone-else-15051

Follow the links they have in it - there are examples and more detail!
There are warnings in this article about "signing as representative" and that some NHs will sneak in questionable wording. Since you don't have POA, I would be VERY hesitant to sign ANYTHING they are asking you to sign. Them saying Oh it's just standard stuff doesn't cut it.
Helpful Answer (8)
Report

For peace of mind, spend one hour ($300-400) with a CERTIFIED eldercare attorney about this matter. Make sure you understand the pros and cons of your responsibilities to avoid headaches later.
Helpful Answer (5)
Report

When you sign anything for your mom, make sure that you are signing as POA....Jane Smith, POA for Mary Jones.  That way you are signing on her behalf.
Helpful Answer (7)
Report
babsjvd Dec 2020
Such a good point ! I have just been signing the care plan with my name , I have to sign one this week, timely comment for me..thanks
(2)
Report
See 2 more replies
Tell them you will only help your mom sign her own name or Sign your mom's name as per your name under and just to make sure, before signing my name, I would have the home write on a piece of their letter head that you are just signing your mom's name with yours underneath but you are no way responsible for any payments whatsoever.

Then have the Home Admissions Person Sign it.

Do this before you sign your mom's name by your name.

If they won't do it then you don't do it.

They have already agreed to the Hospital to take your mom and they will have to keep her
Helpful Answer (6)
Report

Take the paperwork to a lawyer that specializes in elder law. She/He can advise you about your responsibilities and how to negotiate this. It is worth the expense.
Helpful Answer (6)
Report

Sometimes the person asking you to sign does not understand the paperwork themselves! So, them possibly telling you it's "standard" or "everybody signs this" means even less. They could have had only 5 mins of training because the regular person wasn't going to be in that day that you were coming to sign. I'm not even saying it would be deliberate deception - just someone who has no idea what the papers truly mean and was asked to have you sign them. Period. Person will be wanting to get that done and it's really nothing to them. Please have paperwork reviewed by someone who truly gets it. I'm certain it will not be the first time nursing home has had someone do that.
Helpful Answer (3)
Report

Jennifer, Ime whether or not the now in a NH elders old home or car HAS TO be sold is dependent on your states Medicaid program, state administrative code and state laws for property rights. Most states cannot force the widow or widower elder to sell their homestead in order to be eligible for LTC in facility Medicaid. Elder can continue to keep their home & 1 car. Home has to be under a set assessor value (most 500/550k some upper east coast higher 750/850k). But they can continue to own it. Now Medicaid is required to attempt a recovery of the costs paid after the elder dies via MERP. But there are exclusions and exemptions to MERP as well as required federal cost benefit analysis and probate law issues (“lady Bird deeds” for a few states, Testamentary Trusts, Level of Claim) that come into play & can make a difference as to what MERP can or cannot do. Like for TX administrative code, some property costs paid can be filed as an deduction to the LTC Medicaid tally.... but you have to keep meticulous documentation and file after death documentation to MERP or it’s outside contractor or into the docket if probate get opened.

If NH elder flat wants to keep the old homestead, they can, but family will need to do whatever’s to make this work..... and not for just the time elder is in a NH but beyond their death.

The rub inevitably is that due to the Medicaid required copay of basically all the elders income, all property costs fall to the DPOA or family to pay for and do whatever needed on the now vacant home.
If there is still a mortgage (horrors!) this alone could be quite a tidy sum required to be paid each & every month till whenever and paying mortgage & items required by mortgage, like insurances, on a home they do not own. If no mortgage, there are still property costs. The elder can file annual “right of return” so keeps homestead exemptions and if DPOA / family gets the place fixed up & sealed so minimal utilities & maintenance, family keeps yard tidy or happily pays for lawn service, pays taxes and insurance..... the house costs may be quite minimal. Home can just stay existing in thier name. So the place is basically safe & shuttered. But family /heirs have to be all in on this and do & pay for whatever needed to keep the place safe & secure till forever. It involves risk that what you were hoping to happen may not. It may be worth the risk and outlay.

I’ve been on this site quite a long time and inevitably what happens is:
1. either it’s 1 person (DPOA usually) who has the wallet, time and some degree of a sense of humor to deal with a old house that they may be total or partial heir or not an heir to & is OK on doing & spending on this till undetermined end point. & OK on risk.
OR
2. What usually happens is that within 6, maybe 9 months, all those family / heirs promises to do the whatever's for maws place are totally forgotten (like Sissy does not pay property taxes, grandkid does not cut yard as agreed, Bro uses house as a hookup address). Family then squabbles.... house starts to get all sorts of issues and it ends up going up for sale; any $ spent by fam to make it “market ready” is too bad so sad as all $ from the sale is memaws as she’s still technically owner of the home; the Mom due to house sale $ ends up having to get off Medicaid and do a spend down to become eligible again. The responsible DPOA sibling who paid for & did stuff & dealt with Medicaid application ends up dealing with all this. And inevitably the deadbeat siblings or thier spouses will second guess responsible ones decisions. Devolves into a ugly mess.

But for most states, House can be kept.
Now whether or not it makes sense to do depends on a lot of other factors. In many ways, it’s like having a 2nd home but without definite ownership. Most of us realistically cannot afford a 2nd home, so it’s best to sell it, if feasible, and sell it before ever applying for LTC Medicaid as gives ekder more flexibility in spend down.
Helpful Answer (2)
Report
1heretohelp Dec 2020
But that's how it is whether or not her offspring sign on as her Representative or not. That's just how the system works and it's worked out via Medicaid and the facility. The kids would have to provide information as requested by Medicaid and the facility whether they are her Representatives or not. Being her Representative (not the same as Power of Attorney) gives the kids rights to represent her medically without taking on her medical debt. So, while that's all good information, that doesn't quite answer the question about whether they should sign on as her Representative. There is a difference between being the POW and being the Representative.
(0)
Report
See 2 more replies
I'm sorry if this will sound critical of previous answers to this question. It's standard procedure at intake to ask for someone to sign as a "Responsible Party", not to be confused with Power of Attorney (POA), and one does not need to consult an attorney before making this decision, one only needs to understand the difference between the two.

I have been the Responsible Party for two people within the past few years, neither of which I am related to. One has passed the other is still living. The Responsible Party is NOT liable for medical bills. If the person qualifies for Medicaid that covers everything and whether or not one qualifies depends on that person's assets. She's already qualified so there is no question about that.

The term Responsible Party simply means that you are responsible for making certain decisions about the patient, in this case, a parent. It's especially essential for a dementia patient because they can't make good decisions for themselves. Because of a law that was designed to protect the privacy of patients, otherwise known as the Health Insurance Portability and Accountability Act, or HIPAA , being the Responsible Party actually gives you rights to access to your mother's medical records, and the authority to make decisions on your mother's behalf, that could otherwise be denied you, even if you are a relative.

As the Responsible Party, I receive notifications anytime the patient I am responsible for develops any concerning symptoms. The facility also consults me anytime the patient's condition changes. If you are not listed as a Responsible Party the facility is under no obligation to share medical information with you, in fact, just the opposite.

Again, the Patient Representative is not the same as Legal Power of Attorney. Legal POA gives you control over the patients estate and finances in addition to making other medical decisions. You don't get control over finances and/or the estate as the PR though you will be given the right to obtain patient records and to make decisions regarding your mother's care. Without those rights you pretty much give up most control over what happens to your mother, and can be denied access to medical records. You will not be responsible for her medical bills since she qualifies for Medicaid. If you want to be included in decisions about your mother's care and the quality of that care, you will need to be her PR, which despite the name, gives you more rights without taking anything from you. Consult with a local Ombudsman if you still need further clarification. Each nursing facility contracts with the local Ombudsman program and should be able to provide you with the contact information for that.
Helpful Answer (5)
Report
Pasa18 Dec 2020
1heretohelp, if a medicaid application is made while at SNF, who signs? the dementia patient, the personal representative, or responsible party? I discovered that my aunt's signature was on the medicaid application, while I was denied access to medical records although my aunt verbally requested that I be allowed access.
(0)
Report
See 3 more replies
I agree with others who have said, *get an attorney, *sign nothing in your own name, only as a poa for your mother. Don't let the hospital bully you. You neither have to let her come back to your home nor sign for her care. You are right in refusing to sign anything you do not understand fully. If you are like most of us, anything that comes out of your pocket for your mother's care comes directly out of your own retirement funding and you cannot afford to litigate misunderstandings after the fact.
Helpful Answer (2)
Report

do you have POA?  they need someone' signature to place her in the AL.  And unless your name is on her bank accounts, you are NOT responsible for HER bills.  plain and simple.  contact an elder attorney.  You can sign but I would also put behind your name that you are NOT responsible for any bills that are not covered by her insurance, etc.  I had POA for my father and when he was admitted to NH, I had to sign him in.  This way they can let me know of any changes in administration stuff, etc.  Wishing you luck.
Helpful Answer (0)
Report

Sign and make a note that you are representative only and not responsible for financials. If you can meet w/an atty rather quickly - send it to him, ask the question, and pay him for his time to review the document.
Helpful Answer (0)
Report

Several people in this forum mentioned the cost of legal services, and I want to clear something up. I am not an attorney, but someone who wanted an attorney to review my trust in case I had to do it over when my DH passed. Some attorneys will review POA's, Trusts, and other legal documents complimentary the first time. I found this out at a caregiver's meeting. So, try to find out which attorney does complimentary one time look-see for elderly people's documents. Helps a lot. In my case I didn't have to re-do the trust, contrary to what some people had told me upon my husband's death.
Helpful Answer (0)
Report

Imho, sign nothing in your name. Consult an attorney if need be.
Helpful Answer (2)
Report

Read it. Some say that signing the document you agree to be financially responsible. I didn't have to sign anything for my dad but, he could sign his name and I had him do that on everything, even if he couldn't understand it I made sure I did.

If you are POA always put POA for your mom.
Helpful Answer (2)
Report

I always sign my Mothers name for her, and places never say anything about it.
Helpful Answer (0)
Report

No, you can not be liable in signing admissions paperwork.

You are not expected to know all the laws of a nursing facility admission but the facility is.

If the facility has you to sign the paperwork and you don't have any "legal responsibility," that's their problem.

Let them take you to court and see what happens to you. NOTHING
Helpful Answer (0)
Report

I don't know but in this case I think you have no choice but to get advice from an elder care attorney - be safe and check. Also, perhaps if you call Medicare you might find out some things. You can also check with the local state senator and representative. They can get answers for you.
Helpful Answer (2)
Report

I worked for an Attorney 2 years ago. He told me Never to sign admissions paper because he was currently struggling with a case where the signees were being billed thousands of dollars. If possible, tell the Home to have the patient sign, although not sure if a dementia patient would qualify to do so. If in doubt, see a lawyer - the piece of mind is worth it. And while you're there, make a list of other questions he can answer for you so you don't have to pay a 2nd lawyer to answer them in the future. Think ahead.
Helpful Answer (0)
Report

This question has been closed for answers. Ask a New Question.
Ask a Question
Subscribe to
Our Newsletter