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My mother was living in an independent retirement apartment for 6 years. She was diagnosed with stage 4 cancer in September. I was told she could continue to live in her apartment, but her health decline had everyone concerned. I had her on the list for elevated care, but no beds are available. She receives in home hospice care and I make almost daily visits. This morning the facility sent her to the hospital, because she was lying on the floor sleeping. They said she cannot come back into the facility unless we hire around the clock care. Since they sent her to the hospital her hospice was revoked. They did not call me until after she was sent to the hospital. They were told not to send her to the hospital and if there was any incident that they should contact hospice and me. Their failure to follow the protocol for hospice will likely cost us and has resulted in my mother being taken off hospice. I have to take her to the hospice facility, over an hour from my home to have her reinstated. This is dangerous journey in her health state. Now the facility is stating that I have to pay another months rent, because I need to give them 30 days notice, but they are the ones terminating the lease. Does anyone know what legal recourse I have against her retirement apartment? I feel as though they should have to pay for any of the additional medical expenses resulting from them calling the ambulance. Additionally, I don't believe I should have to pay another months rent since they are the ones making unreasonable demands that are not stipulated in her lease.

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Lying on the floor sleeping? That's it? My mom used to do that when she just couldn't get back into bed. A few hours later, she'd be walking around, right as rain. They sent her to the hospital? What did the hospital do for her after this expensive ambulance ride, etc.?
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That's lawful they should be sued
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kickedout Jul 19, 2019
I agree maybe my sister will get her lawyer to help with that😘
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Hi kickedout:

I hope you are able to find an eldercare attorney who will offer you a free consultation. A lawyer should be able to quickly review your mother's lease and tell you whether the facility is acting within the law. If they are, fighting them on this is likely to be a waste of your precious time and energy.

Once you know where you stand, you may be able to negotiate with the facility about that final month's rent. They may be willing to work with you -- worth a try if you have the energy. And if you decide not to pursue it, that is fine, too. I hope you can find time to take care of yourself and not get too wrapped up in this upsetting episode.

Blessings and many hugs to you as you care for your mother...
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kickedout Jul 19, 2019
You are so sweet. I have been looking for her lease but no luck. The executive director of her apartment complex will be back in next week. He has always been reasonable. I don’t think he is going to agree with how this was handled.
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I had to pay an additional months rent for my dad when he was found on the floor in his IL apartment and taken to hospice. The IDL place said he had to give 30 days notice! they get a lot of extra money this way from seniors and am sure it's legal!
He went from hospice to VA hospice until stabilized, then to a local nursing home where the VA pays for his care. He is still on hospice care. A hospice nurse comes in to see him several times a week, too. He has heart failure, kidney failure, vascular dementia starting, and hallucinations at times. He is down to about 145 lbs from 190 for a six foot man, and cannot walk because his blood pressure plummets if he tries and he passes out. I don't know how much longer he has but am so glad he is getting good care. It's so nice to be able to just walk in and visit him for a while and then walk out, knowing he has good care.
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kickedout Jul 19, 2019
Thank God he is getting the care he needs. It is great to have piece of mind. For now mom is with me and hospice has been reinstated. Thanks for your reply. I will keep you and your dad in my prayers.
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If you haven't spoken to the hospice people, call them asap and tell them what happened. Then call your county ombudsman (in some states they oversee personal care homes, not just skilled nursing homes). Then call an attorney who knows elder law. This 'home' probably violated your contract rights as well as state regs somewhere along the way. Whatever you do do not give them another penny. You NEED TO stand up to them, though that's a tough thing to do when your biggest concern is your mother's well-being. Good luck as you go through this. I wish you would name this facility that your mother's been in because it's probably a for-profit chain and we need to be aware of which ones to steer clear of.
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kickedout Jul 19, 2019
Thanks for your reply. Hospice has been reinstated and were out to care for her today. I’m going to give the executive director an opportunity to make this right. He was on vacation this week. I kinda feel like this would not have happened if he were there.
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So, the trip to hospital was precautionary, unnecessary as it turned out, and against protocol. The protocol was written down, agreed in advance, and available for all members of staff to refer to. They just forgot or ignored it.

The whole point of protocols is to prevent people in a crisis from flapping around like wet hens and making everything worse.

What do you want to do now? Where do you think your mother will be best cared for? What is hospice advising?
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kickedout Jul 19, 2019
At this point I just want to move her out. I will care for her as long as I am able in my home. Hospice has been reinstated and I have supplemental care set up on an as needed basis. As for the damages I want to just vacate by the end of the month and wave any notice requirement on either side.
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None of this is making any sense to me, if you feel you and your mother were wronged by the IL facility a good attorney will right the wrongs for you financially and otherwise. At least consult with one, you should be able to talk to one over the phone, relay the information you have given to us here, and get a better understanding of whether it would be worth it or not. The attorney will tell you whether you have a case or not and can offer placement ideas for your Mom. If not, and you feel you can care for Mom at home 24/7, I wish you the best of luck. As far as the bills you may get, do the best you can, pay what you can or try to work out a payment plan with them I guess. Good Luck!
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Kickedout, you can do this!

Hugs, remember to take care of your basic needs during this difficult journey.

May God grant you strength and wisdom during this hard time. May your mom be comfortable and peaceful during her passing.

Hugs!🤗
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kickedout Jul 19, 2019
Thanks I appreciate the prayers
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Kickedout, have you moved all of her belongings out of the facility?
If not get that done before it is time to pay rent again and then tell them to take it to court.

I would find out who you can file a complaint with and do that. Not letting her return even though her rent is current and wanting more money needs to be made public. People need to know what they will be dealing with at this facility.

Get mom reinstated asap to hospice and contact some agencies to get an aide so you can have a break.
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kickedout Jul 18, 2019
Thank you that is exactly what I have done.
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Wait, what? How is your Mother with you? Are you equipped to take care of her? You need to call at least an attorney ASAP, maybe APS as well.
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kickedout Jul 18, 2019
If you know a good attorney let me know. Most of my attorneys have been money holes
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Whatever is in the lease agreement your mother signed are the terms to which she agreed. Read the lease agreement.

Why was she lying on the floor?

As for hospice, talk to the palliative care team at the hospital where she is now. Is all her DNR paperwork in order? They can implement comfort measures.
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kickedout Jul 18, 2019
There are a lot of gray areas in the lease. She did need care I just don’t agree with the method used by her ILF. Her DNR and hospice instructions were on the refrigerator where I was told everyone would look for them.
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Lots of good answers here. Going forward, meet with your mother's case manager at the hospital. Together with your mother's hospital social worker she or he should be able to place your mother in an appropriate facility upon discharge (likely a hospice or palliative care facility). If your mother has Medicare and supplemental, it should cover the ambulance. As for the rest, arrange a consultation with an elder care attourney. I am so sorry you are having to go through this and hope you will let us know how it is going with you and your Mom.
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kickedout Jul 18, 2019
The hospital would not admit her and her ILF wouldn’t let her back in without 24 hr care. It seemed I had no choice but to take her in. Hospice and the hospital made that happen after all it was what they wanted. I’m not sure how the expenses are going to work out. She is presently living with me.
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It sounds like there could be any number of different things at play here and I would urge you to explore all of your resources, sometimes it's a matter of not sharing information and dialogue enough that causes these situations and sometimes it's more easily fixed than you think. So first what is in writing with the ILF? Was there anything put in writing either with you or between them and Hospice when Hospice came in? Typically when someone goes on hospice they have a DNR and there are specifics about what situations a trip to the hospital is made and when they aren't and given the ILF works with Hospice (they were good with them coming in for mom and I imagine other residents have had similar care) but even if it was a worker who wasn't as experienced with that unique set up who called an ambulance (and no one canceled it or refused transport for whatever reason) or it was a perfectly reasonable thing to do there should be some fix here. Obviously there was not a meeting of the minds when mom went on Hospice at home in her apartment and I'm wondering if perhaps part of it has to do with the IL managements understanding of how long that would go on, is she on a waiting list for more skilled nursing on the same campus, a facility they also run or a totally separate place? I have to say mom being on hospice does lend it's self to the idea that she probably isn't well enough to be on her own much if at all did the length of time it was going to take to get her a bed elsewhere come as a surprise to everyone or was that expected from the beginning? The ILF may seen this as an unsafe situation with no close end in sight and taken the opportunity to help the family rectify that by forcing your hand. It may be a more caring thing than it seems, though my first reaction is right there with you and they are doing what is often suggested here to caregivers who's LO's wont take the next step they really need, send them to the hospital and be clear there is not enough care at home for them to go back there. It may be that it's just going to take too long for a bed in the place you are waiting for for the current arrangement to stay in place, by sending her to the hospital they are forcing a plan B or forcing the discharge people to get involved and maybe getting a bed to open up sooner or help you find an acceptable one for her while you continue to wait. If it's their facility maybe they know that by making her a patient with no where to go she will move up on their list, IDK but it may be time to consider alternatives and you need help doing that, this is their way of helping you? Now that said something seems odd to me that the Hospice coordinators knowing the situation and how/why she ended up in the hospital wouldn't be able to help you find the right situation and expedite getting her back on Hospice somehow (I know they have red tape but they also know how to work with it) without having her make a trip 1 hr away. Hospice will come into the hospital to evaluate around here so I'm wondering if perhaps they aren't being clear enough or you have misunderstood something. The other possibility being they are suggesting she become a resident in a Hospice facility and they don't have one closer and or also agree the set up in her IL apartment needed to change and don't want to go back to that either. Is there a family member who could move in with her temporarily until she get this bed you are waiting for or could you hire a caregiver when you or hospice aren't there until she get's a bed? Use the resources you now have, hospital, doctors office, Hospice, ILF, skilled care people to formulate a plan you all feel good about moving forward and perhaps the ILF will step up, maybe they will either find or aqueous the fees shouldn't apply here or maybe you will all find a way for her to go back until she can be elevated, especially if it's the same group but even if it isn't you don't want to alienate them unless you really have to.
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I agree with them that your mother needs 24 hour care now. She should be placed from the hospital in an in-facility hospice. Be certain that the palliative care instructions are followed in the hospital setting and that they understand she is a hospice patient. There was, in the beginnings of hospice, so many more facilities that were in facility instead of just visits. To me this whole "you are dying; we will see you once a day and send an aid to help bathe you" isn't working well for most. I would contact the social worker in the hospital at once; you are going to need her to work for placement as your Mom is not allowed back to her apartment. If your Mom paid a fee to get into the apartment living, instead of just monthly, I think that this should be refunded as they are refusing her right to die "at home" with "hospice". I do understand their concerns of no 24 hour person there. I have heard bad things of late about facilities that ask for a big payment for these apartments going in and then kick the senior out when there is any concern so they can collect the fee on the next senior. You will, yes, be charged as long as your Mom's possessions are there. What a sad situation. But Mom now needs 24/7 care while she completes the dying process. It is no possible to do it with hospice visits and no one on site the other hours of the day. So sorry for all the grief and all the pain.
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kickedout Jul 18, 2019
Mom is with me. No one wants to take her on and I feel ill equipped.
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I would get all of her belongings out of her apartment if they have kicked her out, however, they are required by law to give a 30 day written notice, they can't not allow her to live there during that time period.

Your profile says that mom has Alzheimer's, is she safe to live alone? If not, you need to make other arrangements for her.

I would not pay the facility for her apartment if they won't let her return. Let them pursue payment, it would not go well for them.

I am sorry that you are having to deal with this at this time, but it is time for a close look at how to provide mom with the proper care to keep her safe. Independent living is not going to provide the care she needs, it's not their job, she needs at minimum an assisted living facility that is more a care facility than not.

I won't worry about the bills. Medicare kicks in, that's why hospice kicked her off, to ensure she has coverage.
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TXGirl82 Jul 18, 2019
Written notice to quit laws vary by state.

It may very well be that they can't kick her out immediately, but they might be able to require that she has someone staying with her if she is going to stay.

Again, what saith the lease?
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While I agree that the situation is extremely frustrating, the righteous anger people are expressing seems a bit premature (at least given what I've read in the OP). I think we may be missing some key information here.

The ILF may be obligated to call 911 if they find a resident on the floor. So because OP told them to call hospice and him/her, they are supposed to wait for one of them to come? How long would that take? Five minutes? Thirty? Longer? Were they to leave her on the floor while they waited or help her into bed? (Could they even wake her?) Was someone on staff supposed to wait with her?

As I asked last night, how did the staff even know she was sleeping on the floor? Was she in her apartment or in a common area?

The term "protocols" sounds so official and medical. When the facility told the OP his/her mother could continue living in her apartment, was there an understanding that the mom would be left on her own much of the day, with hospice visiting once a day -- what? for an hour, maybe? -- and son/daughter visiting *almost* every day?

Frustration aside, the terms of the leasing agreement likely address all of this. I would think the OP should carefully read the lease before wasting any more of his/her precious energy on taking action against the ILF.

Again, OP, I am so sorry about your mother's situation and the considerable stress it is causing you.
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kickedout Jul 18, 2019
As I understand it lift assist can be called in lieu of ambulance. This team gets the person back into bed. When I told the facility not to call the ambulance but call me and hospice they agreed. I explained that it was to maintain her hospice an important service at this time. I have written instructions which were clearly post on the refrigerator but no one signed anything. Mom got reinstated to hospice today. We are moving her things out next weekend. She is going to stay with me until she passes.
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They panicked.
They forgot the rules.
They acted well outside agreed guidelines, and incurred expense on your mother's behalf without authorisation.
They have cost her money.
They have cost her disruption and travel which are detrimental to her wellbeing because of her frailty.
And now they are asking for more money in lieu of notice, and doing what to put right THEIR original, major mistake?

There's one point to check before you "go postal" on them: did they ask your mother's permission before they called the ambulance, and did she agree?

I wouldn't guess they can rely on your mother's permission to make all the other issues go away, because they *still* ignored the written and agreed protocol and failed to contact either you or your mother's hospice team, and the consequences of their doing that are serious disruption to your mother's care as well as the expense and ongoing difficulties. But in the heat of the moment, if your mother requested or agreed to the ambulance, they could make that out to have been a reasonable action at the time. It shouldn't make them any less liable for the expenses incurred by their error, but it would make what they did less reprehensible.

Neither they nor hospice will be able to pretend that a frail, ill, elderly lady, found in distress after a fall, was at that time capable of weighing up the choice between going to hospital by ambulance but being discharged from hospice, or delaying the decision until she had consulted her next of kin and her hospice team.

You must be spitting feathers!

Was the elevated care to be provided at her ILF, or where?

The hospital will have a discharge planner. Get hold of that person and nail down what the best option for your mother is. If it's possible to put together a good enough care package, what you want is to have every event since this morning reversed to the status quo ante their error in calling the ambulance: your mother back in her established home at the ILF, her existing hospice service reinstated, and supplementary care ready in place for her return.

Do you mean to say that the ILF is already demanding a terminal rent payment, when they sent your mother to hospital only *this* *morning*?
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kickedout Jul 18, 2019
it is very unfortunate. My mother was not admitted to the hospital. They ran some diagnostic tests and found no cause to admit her. Running the diagnostic tests made the situation worse. That said the excitement is all over and she was reinstated to hospice today. She is staying with me and I have her hospice team and supplemental care in place.
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You need a good lawyer, start by googling elder law attorneys in your area. Many will consult initially for free, and I think in your case it is worth hiring one.
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I agree. Don’t do or pay anything until you’ve contacted an attorney. You should not be held responsible for their mistakes. By paying, you are letting them know what they did is ok, and it is not. Hopefully, somewhere in yiur Hospice papers it’s written that they are to call you and Hospice and not send her to the hospital.
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kickedout Jul 18, 2019
Thanks
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I'm so sorry about your mother's diagnosis and the difficulty with the hospice.

How did they know she was sleeping on the floor?
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kickedout Jul 18, 2019
They check on all the residents in the morning and at night. When they did their morning checks they found her.
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May I extend my sympathies for your Mom’s condition. Also for the difficulty you’re having with the home.

I would check with the Ombudsman (their name and phone number has to legally be posted in a conspicuous place within the institution). Also contact an elder law attorney on this situation. Stop by your local Senior Center for low or no cost referrals. Also Area on Aging may have resources you need.
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kickedout Jul 18, 2019
Thanks I may look into that. The facility that she lives in has been great up to the last few months. As my mother’s health began to deteriorate they expressed concern, but never took any action. I had put my name on the list for elevated care. The executive director is on vacation this week so I am going to bring this up with him when he returns.
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