My fil got this form at his address opened it and put it down. He didn't know what it was. I looked at it, and I was confused. It sounds like somebody is trying to put him in the nursing home! He is in rehab now. I called the business office to find out what is going on. We are taking care of him after his 120 days of rehab is over. He is mentally still there, I say get a POA, now!