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My mom had a stroke a little over a year ago and has been in the nursing home since. The stroke, along with early onset dementia has really effected her mental state. My dad is still living, but not in very good health himself, so when she first had the stroke, before she lost the mental capacity to do so, she named my sister and I as POA’s so my dad didn’t have to be present every time we needed a piece of paper or a signature. The nursing home has been pushing for me to allow them to act on mom’s behalf, as far as her Medicaid and Medicare goes.


Has anyone had any experience with this? I’m just not sure I trust them to act in her best interest, but I could just be a bit paranoid because I don’t care for the NH administrator.


TIA for any input

There should have been paperwork signed that the facility has permission to talk to Medicare and Medicaid for billing and payment purposes. This is not uncommon. Dr office request it to. That way you don't have to sign paperwork everytime they talk to an insurance company. I allowed them to become Moms payee for SS and pension. Otherwise, I was her POA and anything else was run by me.

Legally, you cannot hand over your POA to anyone else. Mom needs to assign someone.

I have never heard of a NH being able to change Medicaid. I think once ur in a NH its pretty standard. Medicaid pays for everything.
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Reply to JoAnn29
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I think we need to know exactly what you mean by “the facility wants to act on her behalf as far as Medicaid and Medicare goes”. Did you ask them to explain? Are you saying they want to make medical decisions? Because I don’t think that’s what this is about. If she’s on Medicaid & Medicaid is paying the bill, it would make sense that they would manage that and take of re-certifying her every year. I don’t think they are asking to make medical decisions for her, not when she has family that appears to be involved.
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Reply to worriedinCali
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Don't trust them any further than you can see them! Only interested in getting as much $ as they can. NEVER give up your control.
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Reply to Redronie
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I wonder if the NH is asking to become rep payee for, Medicaid or, are they asking for the power to make medical decisions that an outside (family member) would make who is the medical POA/has health care proxy? Here's information from the Social Security Administration about the rep payee process. https://www.ssa.gov/payee/

Basically, if a person is unable to handle their own finances there's a process to have someone else appointed as "rep payee" for handling the SS payments. This can be done whether the person has appointed a POA or not--it's a separate process. If a person is covered by Medicaid in a NH, the person's entire SS payment needs to go to the NH for their care except for a small persnal needs allowance each month. If a family member or other outside person is the rep payee, they are responsible for making sure the NH gets the required amount each month from the SS payment. In some cases, it's more convenient for all involved to have the NH be appointed as rep payee, which would be just for making the payment from the SS--not any other decisions about Medicare, Medicaid, or medical care. The POA would still be able to do all that, as well as handle any other finanacial matters if they also have DPOA.
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Reply to newbiewife
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Shane1124 Aug 12, 2019
Agree with newbiewife.
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dont ever give the nursing home any kind of power over the family in making decisions, especially control over medicaid and madicare. First thing i need to ask you if you have a health proxy, Power of attorney and notarized agreement between you or other family members and your loved one that has this illness. Once a facility takes over as POA/ HCP you and your family will basically have no rights over your loved one and they will have total control of any dds (monthly money) and just more stress you and your family dont need. If you dont have a POA OR HCP look for one asap and have two witness to be there and yes they will come to where your love one is and get it donw asap. once you have that you can tell the facility what you want as for care acute or long term and they will also every time its needed re register her with benefits when its time. trust me i went thru this and lucky i got it done 4 years ago with out a expiration on both. This places yiu have to remember is a business and they will try to drain as much benefits out of any client as possible and even bang out insurance they claim they did this and that and always ask for proof and dates on what they did and why they did it. The system is ment to stress you and yes it sucks. If your loved one can make decisions on her or his own still do it. take the time to explain to them why this is urgently needed and never trust any place to have control of care and financial. Trust me there not your friends and when time comes and benefits such as rehab run out they will stop. Its there job to help the family and the client recertified, give accurate care and safety for every client thats there but thats not the truth. unless your super rich and take care of aides and others weekly or monthly always ask how there doing and even if she or he has a roomate ask them to find out whats really going on. Medicare and medicaid does need someone that knows what there doing to get it done. make sure you never throw out ur love ones bank records and any other government letters that come.

DO NOT GIVE THEM THAT POWER!! trust me u will thank me later you never did and its best to get a notary asap and get power over them before they do and trick ur loved one into signing a POA & HEALTH CARE PROXY ASAP!!!!
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Reply to AnotherYear
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I hope this won't sound unkind or unfair, but the only reason I can think of for the NH to be pushing for this is that you and your sister are not doing something that needs doing.

You and your sister have Power of Attorney for your mother, quite properly. Between you, what are you doing about your mother's Medicare and Medicaid management? How are your mother's NH bills paid? You can't, in any case, transfer your authority to another person so perhaps it would be best to find out what the NH wants done.
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Reply to Countrymouse
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AnotherYear Aug 11, 2019
POA with medicare or medicaid is not good! YOU NEED HEALTH. CARE PROXY and if you call medicaid they will ask you if you have one also or wont release info or help. you can also get this done online through there website. good luck
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I'm a social worker in a LTC facility. We always want the family to manage the benefits, there's just too many patients! The only exception is when there is no family, then we (I) become the representative that has the ability to complete the annual re-determination paperwork on behalf of an incapacitated patient. The only other time is when there is family, but they are not following through and are not reliable to complete the paperwork, I'll ask them if they would want the facility (me) to be added as a representative so I can help them with the process, this rarely happens. But if the paperwork is not done timely and medicaid is lost, then the facility doesn't get paid, so the facility is thinking of their own interests. Other than that, there is no reason for the facility to "act on your moms behalf".
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Reply to SofiaAmirpoor
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AnotherYear Aug 11, 2019
she is right. facility needs to get paid and family must bring what is reguired for them to re certify your loved one. but poa or health care proxy should never be given to any place unless the family lives in another country or state and never visits or cares... (sorry to say it but i seen this alot, they put there family member in a place and never visit or save there families needed yearly financial papers for the facility to show medicaid and medicare for recertification..

The system sucks! alot of stress yes, thats why you need to know what month and year they will need paper work from family to help your family member get benefits. other wise also the facility can look into a judge and grant them the right for them to have all finances come to then for there client and they will take over from any poa/ HCP and living family member, that way any money owed and not available in the bank they can sell to auction off anything of value to pay any past debts owed..
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In my experience, the facility healthcare manager/nurse calls to discuss any changes in medication or health and to get approval for my MIL. I'm not sure what you mean by their wanting to "act on mom’s behalf, as far as her Medicaid and Medicare goes." Do you mean making medical decisions? Or applying for Medicaid for your mom? Can you please clarify?
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