Mom placed in nursing home without preplanning. What do I do?


It's complicated; Can an elder lawyer help? In January, I arrived at my Florida home to find that my mother was gone. After I filed a missing person report, the investigating officer said that my mother was safe in my home state of Pennsylvania, and did not want to disclose her location. I shortly found out that my younger niece had come to my house and spirited her away. Since I thought my mother wanted to be there, I left the situation alone.

Fast forward to late April. My mother has psychiatric issues and stopped eating and drinking out of fear that her food was being tampered with. My brother had her admitted to a psychiatric hospital. I assumed that she would go back to my niece's house; instead, she was sent to a nursing home that was an hour away from the closest relative.

My sister had her transferred to a nursing home within a reasonable distance, but did not make any arrangements to get my mother's current financial information. At the time of her transfer, my mother only had Medicare. Now I'm told that Medicare will not pay for any of her nursing home days because a psychiatric inpatient stay does not qualify her.

There's so much going on--there's no POA, family members are scattered, and I'm concerned about my mother being in a nursing home, which she had never wanted for herself. Her finances are limited, so she would qualify for Medicaid--if we could get my niece to return my mother's purse and financial information. What's the next step? I'm on the verge of just taking her back to my house in Florida and going from there. She eats on her own, needs assistance walking, and is continent (she uses Poise pads, but doesn't need diapers).

Any helpful advice or suggestions would be greatly appreciated. Thanks in advance.

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Brief update: Mom's back home with me. There'd been no guardianship or POA proceedings; still not sure why family members alleged that. Maybe just personal reasons for not wanting her out of state and living with me?

We're back; took the trip back in several stages, stopping for breaks and staying in handicapped hotel rooms overnight. We got back a couple weeks ago, but I've been busybusybusy ever since! Thanks so much to everyone who answered. I don't know what I would have done without the elder law attorney, and I am sooo glad I found this website! It's such a helpful resource.
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Really wish I could have edited that last post! I did a few rewrites--everything after the smiley is text that I had written earlier but thought I had deleted.
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Long story short--my younger sister had been determined that my mother would stay in that particular nursing home. She was insistent that my mother needed to be in that nursing home and no place else because it was close to her (my sister's) house. However, she was also insistent that she did not want to be involved in any financial aspect. She even balked at making a phone call to my niece to facilitate the return of her purse. When the nursing home discovered that my sister was standing in the way of them receiving payment, I got quick results. My sister came in within an hour of my conversation with the social worker, suddenly agreeable to the idea of my mom returning to Florida. She had a long talk with some of the nursing home staff. She almost sounded gracious when she said that she had removed herself from the situation and "suggested" that I be the one to deal with the nursing home.

I'm researching the best way to get me, mom, and my tiny little car back to Florida. Riding in it for 16 hours would be torture for her, so once again the situation is complicated. Thanks to all who contributed. :)
However, she wasn't inclined to accept responsibility for securing their payment
I had a long firm talk with the social worker about the inconsistencies and delays. I informed her that the business office had requested that I do the legwork to get them the financial info needed to process their insurance claim.
Once my mother expressed her intention to return to Tallahassee, we made headway.
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If the Social Worker is calling the shots, then the county DSS already has custody and control.
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Update...saw the attorney today. During the consultation, she was able to find out that there's no guardian ad litem. She called the nursing home and was able to find out that my brother does not have POA. I don't know about their operations...the social services worker who she talked to was under the impression that the eldest sibling got to handle the decisions. Then when the order of listing changed, my younger sister was put as the first contact.

One of her first actions upon finding out that I had seen a lawyer was to call and ask if I was taking Mom to Florida. I said that I didn't have a set intention to take her there, but I wanted to make sure her housing, health care, etc. were squared away. She wound up flying into a rage, then calling the nursing home to veto my planned dinner trip with my mother. The home claims that they follow the [absurd] policy of contacting the first person listed in her records, then going by whatever they decide. However, this is a place that acted as if my brother had POA based on a phone call and/or a mistaken belief that the elder gets to decide.

Niece #2 says that there's a fear that I'm going to spirit Mom away to Florida. But no one wants to keep up with her medical team, make sure she has health insurance,and handle her other affairs. My sister specifically declined to handle Mom's finances and said that she avoided signing anything except the transfer request in order to avoid financial responsibility. When I mentioned filial responsibility, she said that they'd go after my brother. She didn't seem worried.

Younger sister doesn't want to talk about mom's affairs, keeps trying to talk up the nursing home. ("Wanna go to the sun room? Isn't that pretty? Look at the chapel!")

Meanwhile, my mom is sharing a room with 3 other women. She's stated that she doesn't like the room that they moved her to less than 24 hours after admission. It was a big step down from the first room. It has a friggin' crank bed instead of an electric hospital bed, so someone else has to adjust her head/leg position. Residents press the call button and routinely wait 30 minutes. Twice, I've arrive and had to wheel my mother out of the dining room because she was left there after lunch. Changed my mom yesterday evening because I could tell by the smell of her diaper that it was overdue. Sister wouldn't help, she went to get the nurse. By the time they returned, I'd done it myself.

Anyhoo, there's a case management meeting tomorrow (or something with a similar name). The social services worker told me that my mom has "fair decision making skills" according to the psychiatrist. She wasn't able to translate that into terms of which decisions my mother could make. I've asked the attorney to attend the meeting--the hourly rate is worth the piece of mind. Also, it seems to be the only way to get some things worked out in a reasonable amount of time. The lawyer said she can represent both me and my mother because my goal is to get her stabilized and have her make her own decisions. Ugh, this is a novel.

I'm trying to avoid guardianship proceeding because it sounds time-consuming and expensive, especially with me living out of state. Last night I got so pissed off that I was planning to leave town and leave the whole thing in my family's lap. But I feel that I have to sort things out first--I owe that much to my mom.
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Your attorney will certainly be able to put you in touch with the guardian ad litem. Involuntary commitments that convert to voluntary does not remove the guardianship status. Someone can petition for Guardianship, but a PA Judge will avoid an out of state guardian or someone with health issues. Sorry, but that's how they work. Been There.
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Hi GardenArtist,

I am 100% in agreement with you on my niece not being honest, especially since she didn't mention it at the outset. My mother says she never gave my brother POA. I've just resigned myself to the fact that there is something wrong with my niece. Admittedly, my family is dysfunctional and we all have our issues...but that's another story.

I will see an elder law attorney on Monday. She has great reviews on and she practices in both PA and FL. Thank you so much for following up. My mother never got a Pennsylvania ID or officially changed residency. She's been in Pennsylvania since January though.

It's a lot to deal with, and the suggestion to call an elder law attorney was right on the mark. The attorney said that my situation sounded like a law school examination question. :)

I'll update once I have more info.
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Wow, this really gets complicated, and more frustrating for you.

If your brother had either a medical or durable POA, he would have had to use it to place your mom in a psychiatric institution, as well as get 2 medical opinions under a medical POA, unless she was committed pursuant to an order of the Probate Court (which doesn't sound as it that happened), or on temporary placement pursuant to something the police witnessed and felt that placement was appropriate.

If he did have a POA, how could your sister have authorized the removal of your mother from the psychiatric placement and into a nursing home placement?

I don't think your niece is being honest, or perhaps she's just being deliberately misleading or vague. Something just isn't adding up.

I'm glad you've found 2 potential attorneys to help out.

As to jurisdiction, was your mother a resident of Florida when she lived with you?

Again, good luck on resolving this.
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Thanks Pam, Sunflo, and GardenArtist.

Pam:. I did have surgery recently, but this has been ongoing. I hadn't considered the idea that she might be a ward of the state, but I will certainly ask. The nurse that I spoke to on the day before her discharge said that her status had changed to voluntary.

The short version is...I was a caretaker for Mom for 14 months. My niece claims she thought she was helping my Mom when she came and got her from Florida and brought her to Pennsylvania. Neither of my sisters knew where she was, and they also live in Pennsylvania.

Mom's health declined while she was away. She lost weight, she has more trouble walking, and she has lost so much range of motion in her neck. She's been adamant about the fact that she didn't want to be in a nursing home. She has a mental illness and can be hurtful and mean at times. Previous hurts don't come into play when I see her looking so frail and unhappy. She called at 4am a couple of days ago, wanting someone to come pick her up.

Part of me wants to make sure my own oxygen mask is on firmly before going to help others, but I don't trust my Pennsylvania relatives completely. Neither my sister nor my brother wants to sign any paperwork for her current nursing home stay for fear they might be financially liable down the road. My sister says that it's better for her to stay in Pennsylvania--if that's the case, why is she in such bad shape now--unhealthy and unhappy?

I went to the police department, and they called but were unable to help because my niece now claims that my brother has power of attorney. First I've heard of it, and wow...someone with POA lets his own mother be discharged to a random nursing home without showing up or telling anyone? I'll have to talk about that with the elder law atty as well.

I don't want her last years to be sad ones because someone went about things in a half-baked way. It broke my heart to see elders in the first nursing home who looked abandoned. One lady kept saying that she wanted to go home, and she sounded so plaintive and hopeless.... Anyway, I have contacted two elder care lawyers and will talk with one of them tomorrow (hopefully). I'm a worrier, and now my concern is that having two different states involved will make things unbearably complicated.

I know I wrote a novel, but I'm really at wits' end and I love the fact that people understand and help so much here.
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I'm guessing this happened while Tally was in hospital. Tally, you need time to feel better. Mom is safe where she is.
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