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My grandmother has been in a nursing home for nearly 2-3 years but I have only been visiting her for the past year. Two months ago they notified me that she only had 2-3 months to live and they were moving her to hospice. She was never moved and later I was told it was because her Medicaid would only pay for one of the two (the home or the hospice).


I am not POA or anything special legally but today I was approached/cornered by the staff to be told they plan on kicking my grandmother out due to lack of funds. Saying she has over $200,000 in medical bills. I asked where would they take her and they responded that they "don't know." My uncle is her POA but I have been unable to get in touch with him and frankly don't know what to do or if what he has been doing is 'above board.'


My grandmother has severe Parkinsons (unable to move at all, can't muster enough strength speak low enough to be heard) and the care she requires can not be provided at home. Not to mention that she is divorced, kids don't talk to her, and I live with someone else so she doesn't have a 'Home' to go to. What do I do at this point? They home was asking for a letter to prove that some bank account belongs to her ex husband and not her? But he is completely out the picture for 20 years (restraining order against my Grandmother) so he won't be of help. How do I find out what's going on with her Medicaid and why it's not covering her bills? What can I do to ensure my Grandmother received the respect she deserves in death.

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I’m going to guess that gran was approved for Medicaid 2+ years ago when she entered the NH. She was already on Medicare, so she was a “ “dual”. And in theory “duals” have all costs covered.

If she needed hospice, that’s a Medicare benefit. So all good in theory.

Something has happened to change her eligibility.

The DPOA Uncle probably got a series of time sensitive letters from the state for details as to her finances as I’d bet her estranged husband has assets over the limit allowed by a community spouse. It took a while but the state probably has been able to do a match up with granpas SS # and any real property owned in his name, and it has him way way over the spousal limit of 120k in assets. Dpoa uncle did not file what documents the state needed. He could not prove that estranged spouse was not subject to Medicaid regulations. So grannie got ineligible for Medicaid AND Medicaid retro’d a clawback on payment back to day 1 of admission.

Thats is why it’s 200k. Medicaid clawed back every penny.
NH now totally knows they are taking a total loss on her stay even if she’s dutifully paying her monthly SS income to the NH. It’s a tiny drop in the bucket for 2+ years of room & board.

Hospice medical fees could be paid for by medicare. But hospice does NOT pay for the custodial room & board costs for her to have a bed at the NH. Those charges need Medicaid in order to be paid for at a NH.

Pixel - run away from any legal involvement in this. If you sign anything, you could be held totally liable for her entire bill. It will make student loan debt look like a piece of cake.

TellNH to contact APS. APS can get her to become an emergency ward of the state and the court appointed guardian can deal with your dpoa Uncle and the estranged husband. Guardian can haul them both in front of a judge if need be.
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She has no money. To petition for POA in the courts you will need to hire a elder law attorney. Expect to pay a few thousand dollars. I am surprised the nursing home did not petition the courts. Something is missing here
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Ahmijoy Sep 9, 2018
I agree. To incur a bill of $200,000 is unbelieveable. Most business will go after you or send your account to collections after a few months. I don’t quite believe they would come after granddaughter like that unless she has misled them to believe she has some authority which she says she doesn’t. H-m-m-m-m.
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I do agree with others, APS would be the way to sort out this problem, as they you might have done with the Medicaid of grandmother. I remembered last year one of my cousins, mothers in law was also getting too sick and after diagnosis, it found that she was tensed about the wills and the belongings how to distribute them to her kids. As she was unable to take the decisions so my cousin decided to take some help from an estate planning attorney who is also eldercare lawyers ( http://www.scottcounsel.com/ )who understands the problem clearly and find out the solution and guide properly with the wills and property management.
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I agree that APS may be the best way to go - they have the authority and the clout to get to the bottom of this. And hopefully once they start investigating,  the nursing home will hold off on any eviction, thinking that this way they will get some action.  But don't offer to become in any way financially responsible or POA or anything like that.  It probably will be more effective if the state becomes guardian.
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JoAnn29 Sep 5, 2018
I agree, let the state take over.
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I agree with Ahmijoy. DO NOT sign anything or take on any responsibility at this point. If POA just left Mom, then the home should have called authorities saying she needed a guardian. Don't offer to get her Medicaid. You need to find out what is going on. You can ask if Medicaid was ever applied for. If so, paperwork should have the name of the caseworker on it. Call them. But I think you really need to call APS first.
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What a mess. First you need to understand Medicare and Medicaid.

Medicare (Federal Program) is gotten usually when u turn 65. It covers only 80% Medical bills. A supplimental policy is needed to pick up the 20%.

Medicaid (federally funded but state controlled) Is usually applied for when health insurance is needed or for the care of someone in a NH that can't afford the cost. When on Medicaid for NH care, health insurance is included.

So if Gma is on Medicaid there is no outstanding debt. The NH should be receiving Gmas SS and any pension to help offset costs.

If they are telling you that Gma owes for care, then she is not Medicaid covered. 200k is about right for 2 yrs of care.

It looks like the POA dropped Gma off and left her there. Legally, they cannot "kick" her out. They haven't yet have they? You show up and they are hoping you take on the responsibility. Without a POA u have no authority and since Gma has to assign someone, it won't happen now.
A guardian? but thats expensive and she maybe gone before you can get thru the process.

By the way, Medicare pays for Hospice in NHs. Medicaid pays for care and medical bills. They have nothing to do with Hospice. Please get an advocate that can help u sort all this out. Call Adult Protective Services/Office of Aging and see if they have or know of someone who can help you sort this out.
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Thank you for the response.

Is there anything I can do to make this process go easier for her? As I stated before I am just starting to get involved but am unsure what to do?

Can I check the status of her medicaid? If for some reason she isn't signed up can I sign her up for medicaid at this point? Why wouldn't she be signed up? Is it possible to be signed up and the expenses just surpass you allotted amount?

Can I become her POA without taking on her debt. It's hard to get her proper care when noone can talk to you. Can I be granted POA even thou my Uncle is already POA?

If there is nothing I can do what will happen when she become a ward of the state? Will i be able to see her? Will she be moved to state facility? Will they just toss her on the street?

I understand that this is a business but what am I in the position to do?
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rovana Sep 5, 2018
POA has to be given to you by the person you are POA for. I think at this point, POA would not be feasible. So, guardianship.  Do you want to go that route under these circumstances?  Ward of the state may be much more practical.  After all, if the nursing home is paid, then she may be fine where she is, unless the state guardian insisted on moving her. 
I'd ask APS to see about uncle POA's neglect and what he has been doing with her money.  Doesn't sound like he has fulfilled his responsibilities. I think that POA is basically responsible for filing for Medicaid, though I'm surprised the nursing home let this go on for so long.  Is there some kind of problem with her Medicaid eligibility that uncle doesn't want to touch?
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Unfortunately, a nursing home is a business and not a charity. If she’s that much in debt, her bills must not have been paid for years. No Medicaid? You have no legal responsibility in this, just a moral one. The nursing home had no business approaching you; they should have put a skip trace on your uncle to find him. Or hired an attorney and let them do it on their behalf.

it sounds like Grandma is personna non grata in the family and that no one is going to step up for her. If your uncle has gone underground, she will have to become a ward of the state.

Accept no responsibility for her. Make no promises of payment or say you’ll find someplace for her to go. If they keep pressing you, you may need to hire your own attorney.
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anonymous839699 Sep 5, 2018
Thank you for the response.

Is there anything I can do to make this process go easier for her? As I stated before I am just starting to get involved but am unsure what to do?

Can I check the status of her medicaid? If for some reason she isn't signed up can I sign her up for medicaid at this point? Why wouldn't she be signed up? Is it possible to be signed up and the expenses just surpass you allotted amount?

Can I become her POA without taking on her debt. It's hard to get her proper care when noone can talk to you. Can I be granted POA even thou my Uncle is already POA?

If there is nothing I can do what will happen when she become a ward of the state? Will i be able to see her? Will she be moved to state facility? Will they just toss her on the street?

I understand that this is a business but what am I in the position to do?
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