How do we determine if the one sister (POA) is making the right decision?

What was the recommendation from her doctors? And if the doctors say she needs rehab longer, why is the sister taking her out? Is your mom incoherent, and does your sister have a durable power of attorney or a regular POA? If your mom isn't deemed incompetent, what does she want to do? And if your mom isn't able to make the decision, if your sister doesn't have a durable POA then she cannot make the decision either. Durable POA is the only POA that allows her to make decisions even if your mom is incapable of making decisions for herself.

Does this sister have both medical and financial power of attorney? (Medical POA is sometimes called healthcare proxy and is often established in a healthcare directive document.) If so, I think your best bet is to persuade the POA to follow the doctor's recommendation. Your mother made her POA so she has the authority to make decisions, assuming that Mother cannot. If the other 12 children feel that Mother should have more rehab, why is POA sister taking a different view? Is mother complaining and not wanting to do the rehab work? That would not be unusual. Doesn't mean it wouldn't be best for her -- just that we don't always like what is best for us. You say she is now transferred into a decent center -- was she in an inferior place before that? Is the decision influenced by that?

Since Medicare pays for rehab but not nursing homes, it is often financially better to use the rehab benefit before transferring to an NH. Is this something that has been discussed among you?

I hope you can listen to POA's reasons, and discuss this decision with her on that basis.

I don't believe that financial POA gives one authority to make medical decisions, so it is important to know who has that authority.

This article on this site helps explain the differences between types of POA: https://www.agingcare.com/articles/difference-between-POA-durable-power-of-attorney-living-will-140435.htm

My FIL had rehab in a nursing home and Medicare paid for both the rehab there and the nursing home for 100 days. Are there states where this does not happen?

OncehatedDIL. I'm guessing that although your FIL was physically located in a nursing home, the Medicare benefit was paying for Transitional Care. Sometimes this is located in a hospital or nursing home (and called a "swing bed" -- because the room can swing back and forth between uses.) In larger cities it may be a stand-alone facility or a separate unit. My husband used a transitional care unit that was in an assisted living facility (a separate floor); my mother has been in TCU on a separate floor in a nursing home and in a separate building in a nursing home/assisted living complex. Even though the family may think of it as "Mom's in a nursing home," probably for medicare purposes Mom was in a transitional care unit or a rehab facility.

I think that Medicare benefits are the same in all states.

They did use the phrase swing bed - it was a couple of years ago. There were 3 options, the hospital in "swing bed", a short term facility that had rehab, or a long term SNF with rehab. For MIL when we brought her to Texas she was given her rehab in a long term facility. Here, one hall is dedicated as the Medicare hall and the rehab rooms are in the same hall. Most residents either leave or move off the Medicare wing when their 100 days have passed and they are remaining.

I wonder if Kayne1's sister is moving their mom to a long term nursing home with rehab? (Swing bed)