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I posted this question yesterday under Financial Matters. I received a kind answer from an expert who suggested that I post it here.....

I found out that my almost 65 year old sister had a massive stroke last November. We have been estranged for many years and she has no other living relatives, never married, no children. She has been on some sort of medicaid for many years and has had a case worker for several years. That case worker was the one who contacted me, but now I, nor the long term care facility where my sister is now, have been able to contact her.

The problem is that in order for the care facility to qualify my sister for medicaid assistance, they need to know her financial status. I have no idea what that might be or where to inquire. She is unable to communicate and apparently time is running short for that facility to keep her. If anyone can help or suggest anything that I can do, I would appreciate it and pass on the information to the care facility. I live outside the country and am unable to visit my sister and all of the information that I have from that facility is sketchy at best, no one knows if she might have given someone her health care POA at some time.

Thank you.

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What ultimately will happen is that your sister will need to become a "ward of the state" and from that point on the state via a court appointed guardian will determine her placement and care. I would think that the facility has some sort of system for doing this and letting the state know that a resident is at need.

The religious organization, sounds like it's a volunteer outreach program, and if that is the case and unless your sister gave them a DPOA, MPOA, has no standing in all this.

Now alot of this will depend on how involved you choose to be. If you want to make sure the state is doing it's part and you don't mind spending some $$, you can try this: Guardianship and Conservatorship are heard in probate court. The documents are public. Most counties in the US have these court records on-line and can be purchased for nominal fees. Usually in Chancery Court records. You can go to last years filings and just start searching for guardianships. What will happen is that there will be a group of the same attorney names or law firms names that come up over & over again for guardianship hearings. These are the guys with experience and know how to find out stuff and make things happen efficiently. Pick one or two and send them a letter that you are a relative of Anne Smith, live outside the US and that you are estranged and make it clear that you do NOT want to become Anne Smith guardian or conservator but want to make sure that she becomes a ward of the state and that her residence & care in a facility continues to be. Basically you are asking someone to be a legal consultant for you.
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If the case worker works for the state, can't you contact them. They should know how to contact her/him. You might also seek the advice of an attorney especially if the case worker can't be contacted. It sounds like the state will need to step in as her DPOA. Ask the facility if you can speak to a social worker. I am sure this is something that has happened to others so they must have a way to handle it.
In the mid 1990's my mother was contacted by the state of PA because her brother's wife had passed away and her brother had Alzheimer's. My mom was his next living relative who could make decisions since my uncle had no children and my aunt (older than my mother) was in a nh due to Alzheimer's. My mom gave the State of PA authority to act for him. Mom went back to PA to get things in order with the state and they kept her informed on his condition since we live in California. Good luck, I hope this helps you.
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If you had died abroad and your sister had no other living relatives, the NH would know how to handle it. They should handle it the same way, because you have no authority to handle your sisters affairs nor are you going to seek such authority. They need to do whatever they do in these situations.

I did not take my husband's last name when I married, years ago. The clinic we both went to could not figure out how to handle us as a family unit with different last names. "Our computer can't do that." Grrrr .... so I called them up and asked if they could handle stepchildren with different last names than the household name. Yes, they had a lot of those situations. Well, I told them, pretend I am my husband's stepchild or that he is mine. Your computer knows how to handle that. End of problem. (No computer systems have this limitation today!)

Sometimes institutions really do know how to handle a situation but because the circumstances aren't identical to what they are used to they get in a tizzy. On a practical level, your sister has no living relatives they can call upon to sort out her finances. They should just proceed as they would when a resident has no living relatives.
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Thank you Sharynmarie.

Apparently the caseworker is with some Presbyterian organization which is not being helpful to the care facility. I'll pass on your suggestions and hopefully a resolution will be successful.

Sister 522
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Thank you so much, Jeanne and Igloo.
I feel more comfortable now knowing that there is not much I can do and that the "system," as antiquated and unwieldy as it is will probably be able to do something!

I just find it odd that since my sister was on some form of Medicaid before and during her stroke that there are no pathways to her financial status that could be investigated to make sure that the Care Facility can collect their fair share.....I guess all just points to the almighty dollar.
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