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I recently got my mother’s bill from the nursing home to discover a huge credit balance. When I called the business office, I was informed that she was put on skilled nursing care for edema about three weeks ago. While this status saves my mother some money (and pays the nursing home a higher daily rate - yeah I get it!) I was not notified of the change in her status before she was placed on skilled care. Managing my mother’s care is completely anxiety producing for me, so I tend to get all worked up, and I don’t want to call the staff with an attitude. I sometimes feel like people just don’t do their jobs well! Or I’m being gaslighted somehow (my own issues for sure). When I worked in health care, if I didn’t keep the family informed I would have been skewered and barbecued!

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Yes, you should have been notified about a change in her care level.

Are you having regular care plan meetings or is that just more then you can handle?

Sometimes we just have to let go, especially in a situation where you are caring for your abuser. She is being taken care of and you can decide what level of involvement you are comfortable with.

Maybe the facility is aware of the situation and decided that it would not really matter if they just did what was needed?

Thankfully they were honest about the money regardless of what motivated them to do this without your knowledge or input.

Try to let go of your anxiety about her care and trust the facility to do their job. She doesn't deserve to continue to hurt you and you have the ability to not let her. You have done far more than you needed to. You are a stand up person for this. You deserve to be set free from worry about her.
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Mepowers Jun 2021
Thank you so much. We do have regular care meetings and overall they have been good at communicating. I sometimes blow a gasket and go from zero to sixty (mostly in my head) because I’m responding to the past instead of to the present and have to step back before I speak. I just wanted to get some insight before contacting the facility. I did call the nurse and tell her I wasn’t notified and was confused about the change. I was nice and she apologized and explained why there was a need.
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Yes, you absolutely should have been informed prior especially if you are also her medical PoA as well as financial. I realize that some facilities are quite small and independent and not as sophisticated as larger operations. My MIL was in one such place where her *care* was very good but their admin process was awful. They assumed we (the family) knew all the ins an outs of Medicaid billing (puh-leeze!) and we had a very unnecessary go-around over a miscommunications over a balance. Nonetheless, if a facility is going to operate as a business, they must have their crap together. The best approach is to never have an attitude until they flub it a second time after being corrected a first time. At that point you ask to speak to people higher up in the food chain. They must be made to understand that managing another person's affairs is stressful and like another full-time job for which one isn't getting paid, in fact the opposite: one is often making a personal sacrifice. As my southern Auntie used to say, "You catch more flies with honey than vinegar." So, polite but firm decorum is more likely to get you what you need. Remember that you will be dealing with this facility for a while. Hope it goes well moving forward!
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Mepowers Jun 2021
Thank you! Because of the history with my mother I sometimes have to step back and take deep breaths for several days before responding so indeed I am using sugar instead of vinegar!!
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I would not take this personally. Calmly call and remind them that you are your Mom's POA; I am certain they have all this paperwork? And that you should be informed of all status changes, especially changes in health care/care that affects her health. Also remind them that as her POA you must meticulously account for every single penny INTO her accounts and every single penny OUT of them. That this is crucial for your record keeping, and it is.
You should have been informed. I was informed of EVERYTHING when I was POA for my bro in his assisted living. Administration knew me, knew my emails, knew I was POA and had explained how billing works. I received a monthly copy of EVERYTHING from them with explanation. So clearly some places are better than others.
If you were inappropriately angry a simple call or email (establish if you are able to a personal relationship with administration; it was invaluable to me) to someone there telling them what you told us (this POA is new to me and anxiety provoking; sorry if I was inappropriate.
Trust me. No one there has time to gaslight you, and where would be the gain for them?
I feel for you. I was in no way prepared to take on Trustee of Trust and POA for my bro. At late 70s I had a steep learning curve for something I never had done, and boy, did I learn a lot fast. It was VERY anxiety provoking for me. We are talking twitching-eyes, heart-pounding fear and dread more than anxiety. But I did it, I learned a lot, and am proud I could do this for him before he died. It takes a good year to get things runnning smooth. I wish I could say "Don't worry" but given the amount of needless worry I DID, then moving into executor, I know you will. I wish you the best.
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Mepowers Jun 2021
thank you! No matter how much I understand the reality of the situation - my “twisted” thinking can take over! I just have to step back and say to myself - it’s okay.
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I’m going to guess that your mother was covered during her acute illness by Medicare?

This happened during my LO’S 2 bouts of Covid and her c.Diff care.

I also get very disturbed by ANY change in her status, but things were so very difficult at the beginning of the Covid lockdown I sort of let that one pass, and by the next time, I was comfortable letting the notification go.

If you are otherwise content with your interaction with her care and those who provide it, I think you can feel pretty confident that especially now, with the vaccine, things won’t come unraveled.

I have enormous admiration that you are doing right for someone who was unkind to you, and hope you treat yourself extra well and pat yourself on the back OFTEN.
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Mepowers Jun 2021
Thank you!!!
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