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My mother went to a rehab facility after hospital stay. During her stay she had chest pains and went to the ER. They found 3 blockages and fixed them. She then went back into the rehab facility/SNF. She was supposed to be discharged Wednesday. My father went to the facility and agreed to private-pay for a month. However, he did not return with payment and is not returning their phone calls.


I spoke with him yesterday and this was what he said


His attorney advised him to not pay and not to have contact with them.


The facility would have no choice but to keep her. He also asked me not to have any contact with the nursing home and if I did not to tell them anything.


My father has been her caretaker for the last year-and-a-half due to a leg amputation. He wants to put her in a nursing home permanently so he does not have to care for her any longer.


He has been working with an attorney to separate the assets and whatever else needs to be done legally so that Medicaid will pay for her to be in the nursing facility.


All legalities should be finalized next week.


My mother was okay with staying another month so she could get physical therapy with her leg.


As of yesterday, she is extremely frightened and scared of what's going to happen to her because they have not heard from my father. Because of the unknown, and his lack of response, now she wants to go home.


Basically he is not going to pay and just left her there.


I also have a power of attorney for my Mother's medical and financial.


My question is:


What are the options for the SNF if he doesn't make the payment today and he refused to tell them anything? Which I already know, he will not. From an SNF standpoint what happens to my mother?


Are they legally obligated to keep her? Do they contact legal officials such as social services etc?


If pick her up and take her to her home, well that make me legally responsible for her care?


Once all the legalities are finalized early next week, and if she is home and does not want to go back once Medicaid is setup to psy. Can he force her to return to the SNF against her will?


If not, what happens if he simply leaves the house and refuses to care for her?


I realize I have lots of questions, but if you could give me the legal answers to the above I would appreciate it.


Should I inform the SNF that he has been advised by his attorney not to make this payment and all legal paperwork will be done early next week so Medicaid will pay? Are they legally responsible to keep her if I tell them what's going on?


What options does the SNF have if no one picks her up today?


Is there an organization or person that I can speak with that can advise me on what to do?


Thank you

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The SNF might sue for payment..at least give them the phone number of Attorney you’re dealing with. Tell them you want her to stay there & unwilling & unable to do at home caregiving. Tell SNF you are in process of applying for Medicaid. If you don’t talk to SNF the bill will still be mailed. I think communication is always better...not talking won’t stop the bills. They need to at least take her Social Security & any pensions she gets every month. Good luck...your Father probably feels overwhelmed. Hugs 🤗
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question: is it explained why the daughter has POA instead of the husband? And does daughter have both medical and financial POA or just one or the other?
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mstrbill Aug 2020
No. OP hasn't responded to this thread. Some information is missing regarding father's health and capacity to care for wife and daughter's relationship with father.
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There are differences from state to state, but I can't imagine any state is able to legally discharge a patient without ensuring that someone is accepting responsibility for them. They may put quite a bit of pressure and guilt on you or your father to come get your mom or start paying.

You are getting into tricky territory if you insert yourself in the middle of this.

Keep in mind that the people who care for your mom are separate from the people who run the business office of the nursing home. You, of course, can continue to visit her, discuss her care with the staff, make requests on her behalf... But, I would NOT get involved in the plan that your father and his attorney have in the works.

If you pick her up, you take responsibility for her. You would solve the nursing home's problems, but would likely start friction with your father and commit yourself to your mom's full-time care. That is a BIG job, especially for someone whose health is as compromised as your mom's sounds.
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You, daughter to your mother...Call Adult protective Services. The snif should have done this
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I didn’t read all of the responses here so I might have missed something and let me say up front states differ on these things, I don’t know anything about Ohio’s (I think that’s where this family is) laws and procedures. However I think it’s important to remember that POA’s are often used for all kinds of things including younger people and couples who can’t be around to take care of certain business, my son and his GF who closed on their condo during lock down gave POA to someone else for the closing because they couldn’t be there in person for instance. All three of my mother’s children have a POA for her power of attorney isn’t limited to one person nor does it supersede the rights of a spouse to make decisions unless specified that way. Just because this OP has POA for her mother doesn’t necessarily mean her mother was choosing her “over” her father and in fact I wonder do you (OP) also have POA for your dad? If so and maybe even just as a representative for mom, you might start with contacting that attorney to ask what the thinking and plan are here. Your dad sounds like he may not fully understand why he is supposed to do what he is doing which is why he isn’t explaining it to you and maybe he is missing part of the puzzle maybe the atty said “refuse to take her home” and the only way dad knew how to do that while still making sure she was ok was to promise self pay and then disappear. Maybe the atty will tell you as mom’s medical POA to tell the rehab you are biding time till something is in place next week and this is the way to protect them as well as mom. I don’t know this is the case but it certainly could be, there may be time extensions or wiggle room in your state or their circumstances the attorney knows about and you or I wouldn’t.

That said I am suspect about there being a way to shelter more than half their assets but then again I don’t know the ins and outs of your state or how long either your dad or both mom and dad have been working with this attorney to prepare for just this situation. Your dad knowing he can no longer care for his wife at home doesn’t mean he is “dumping” her or doesn’t care anymore, he may Even be in a tremendous amount of emotional pain feeling guilty but this is what he has been advised to do by the professional he put his trust in. It may even be that he’s carrying out the wishes your mom expressed to him before her situation got so bad too and one of those was that you not be put in the position of making these decisions, you never know. If she is competent you as POA can carry out her business on her direction, if she is not and your POA is either durable (and meets any requirements for that outlined) or springing you can act on her behalf but really what you need is to understand from this attorney what the plan being executed actually is and then go from there. I wouldn’t be acting against Dad or making assumptions about his motives until you have more of the facts than he seems able to provide, wether that be out of guilt or inability due to lack of understanding.

Just my thoughts based on my experience.
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Imho, as PoA you should hire an attorney for yourself, Good luck and prayers sent.
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Since you accepted the responsibility of being your Mom’s POA for financial, you need to immediately go to an elder law attorney to speak about Medicaid and learn the ropes. I had to do this. It cost me about $250.00 for a one hour consultation so I would know where to start. Go to your state’s website and read about eligibility for Medicaid for someone IN a nursing home. Educate yourself On it and see that attorney. Knowledge is power as they say. Carry a notebook and pen to write down what he says especially the “spend down” of your Mom’s liquid money and any other assets that Medicaid might want to know about. I dealt with it and it is a MAZE unless you get guidance. My Dad was living too and at their home. Medicaid can be state specific so if you Google or search info, be sure to include your state as a keyword. Otherwise, you may find yourself on a site that doesn’t have the same rules/laws as your state. Good luck to you! It is time consuming to start. Once you see the attorney, things will start to gel but trust me, you will still have questions.
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Talk with an Elder Law attorney. Congress established a period of 60 months Medicaid ineligibility for those who transfer assets. Medicaid officials look at transfers made within the 60 months prior to the Medicaid application.
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Dad is tired and ready for her to go to facility. If you or another member of the family is willing to take on this 24/7 responsibility, then go tell dad. If not, he has contacted an elder attorney to help him with financial decisions and the path to nursing home facility.

I think it would be better to tell dad you understand that he's tired and you're willing to help him with placement (if no one else is stepping up to the plate) and that you would like to go w/him to the attorney so you will understand what the end goal is for the finances and nursing home payment. -- You need to know this anyway, in the event something happened to dad during this whole process.

Two choices - you take care of mom (and ask dad for her share of finances to do so) or you get on board with dad to put her in a facility. Perhaps even a small private elder care home if finances allow.
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You wrote, "My father went to the facility and agreed to private-pay for a month. However, he did not return with payment and is not returning their phone calls." If he signed something, that's a problem. breach of contract.
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mstrbill Aug 2020
He has an attorney that is handling that.
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having read your profile, I see that your mother has a lot of physical problems as well as dementia. That is a LOT for your father to handle and I suspect he’s burned out. My husband is physically healthy but his mind is galloping away from him and there are days I don’t think I can stand to have one more insane conversation with him, answer the same question one more time or hear AGAIN the story of how he came to Washington. It must be so much worse for your dad, who’s also handling several physical ailments on top of the dementia issues.

When he met with the facility, I’m sure they pressured him into agreeing to pay for the month. Once he got out of there, he may have realized he needed a long term plan and consulted an attorney. I agree with the posters who encourage you to talk with your dad if that’s possible. I don’t understand the posters who are anxious to see that your mom get her share of the marital assets. Anything she gets will disappear VERY quickly to pay for NH care. Unless your dad has been abusive or neglectful of your mom, I would encourage you to do what you can to ensure that he is financially protected as he seeks appropriate care for your mom. You say he’s cared for her for the last year and a half. Based on my own experience, I’d bet life with her got pretty challenging for him LONG before she was diagnosed with dementia. My husband and I went to marriage counseling more than once before I realized he had cognitive impairment. Friends from my support group said they had the same experience. Long before you identify the real problem, you wonder why your loving spouse has become so self-centered. To others, they often seem fine for years, when the person who lives with them is going crazy at home. One reason they seem fine is that their spouse is taking over so many tasks they used to handle and helping them in so many ways. In my situation, my husband became an incredibly cheerful guy without a care in the world, while I got more and more stressed, snappish, and negative.

I definitely agree with the posters who tell you not to take your mom home. Once she’s home there is zero incentive for anyone to help you find a suitable alternative and, if you haven’t done it, you can’t possibly know how difficult it is to care for someone. You won’t be able to leave your house without having someone there for her. I now pay someone to come for 4 hrs (the minimum) once a week so I can get out. Unfortunately, this I usually spend this time grocery shopping. The isolation of caregiving is debilitating all by itself. I’m lucky in that we can get out with friends once or twice a month since my husband is not physically disabled. You may not get this luxury with your mom.
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mstrbill Aug 2020
That is a great response, thank you
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You (We) all need to remember that a certified Elder attorney is taking care of things. He is ethically bound to do the right thing for all involved. The daughter should be consulting with the attorney. He/She would be able to clarify the situation for her. We should assume he knows exactly what to do to satisfy the nursing home. Remember he has a law license at risk, so I would assume he would know what to do.
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FloridaDD Aug 2020
WRONG.  The attorney is ethically bound to the best for his client, which appears to be the father, not both parents.  He is ethically bound not to recommend breaking any laws.  Huge difference.  DD needs to get a lawyer to represent her mom/her as POA
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Your POA doesn't kick in until your father is deemed incompetent. Your father has retained an attorney. Your parents remain a married couple and he remains his wife's next of kin. For you to take control away from your father you need to hire an attorney yourself and go through the court system, which in most states remains closed and limited to emergencies mostly regarding children.

"...the OP's mom appointed HER POA and not her husband..." That is a false assumption, in my opinion. My husband had POA both medical and financial for both of his parents while they were still both alive and had all of their mental faculties intact so that, in the event they needed his help, he could act swiftly on their behalf ***if they asked him for help***. Your father has asked you for your help in that he asked you to NOT tell the SNF anything.

Do not open a can of worms for your father. You will regret going behind his back and, perhaps, making things harder for him and causing unnecessary friction between you.

If your father were the poster on this forum instead of you, the same folks who are accusing him of neglect, abandonment and money grubbing would be the same ones telling him to hire an attorney (done), get Medicaid (almost done) and place her where she will get the professional care he cannot provide anymore!
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FloridaDD Aug 2020
The can of worms is already opened.  If it is true that father agreed to a month of private pay and reneged, the situation is already problematic.
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OP - Any update? Any action on your part?

As your mother's POA, you do have responsibility to oversee her affairs. That does NOT mean you have to take her in. Your dad also doesn't have to accept her return to him. He may feel that he is no longer capable of providing her care and wishes her to remain in a long term care facility. Care-giving is difficult, and given mom's cognitive and physical disabilities, it may be well beyond his capability.

Without knowing all the details, it is hard to say what is going on or what will happen, but given what information you have provided, it sounds very similar to what my mother had to do when dad required extra care. In their case, it was in process, but had to be hurried up (should have been done already!) when she wanted him to stay in NH. The EC atty handled everything, so I am not privy to all the details, but he did ensure the condo was transferred to her and "split" the assets. He was left with the minimum and his pension and SS were used to cover part of the cost, with Medicaid picking up the rest (unclear if she was able to keep some of his income - we were not part of the whole process other than taking her to this attorney and getting the ball rolling.)

If you can, discuss with your father what is going on. If he won't talk to you, contact his attorney and ask what you are allowed to do/know as your mother's POA. If they won't discuss anything with you, then you need to find an EC atty to represent your mother. She should be allowed some assets, her income and hopefully be Medicaid accepted. The current facility may not be a Medicaid facility, so she may need to find another long term care facility that does accept Medicaid.
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Can you pay for the week or month it takes to get Medicaid set up? Your father said not to contact the NF, but adds "if you did don't tell them anything," so he must be anticipating that you will contact facility. You don't need to "tell.them anything" about your father's stand in this matter. You just want to cover the additional time and care needed for your mother's welfare.
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In all the answers to the request for help from this poster, not anyone of you mentioned that the father might be affected mentally himself--he may have dementia and have a mindset that he won't budge from. He may not understand all that the attorney told him, and he also may not have an elder lawyer that can really help as it is their profession. And, the process to get Medicaid is not easy and takes months. Father may have some issues that cannot resolved, like downsizing his/her assets to get Mom approved. If not already done, try to talk with father to find out more of what lawyer told him, but in fact, get the lawyer's name and contact him/her yourself. Best of luck.
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You have her POAs. Time to use them. Talk to the SNF about her situation. Talk to an lawyer that specializes in elder care. Ask them to help you with having her placed somewhere legally and above board not this furtive, secretive way. Be the advocate for your mom. Please realize that something in very wrong with your parent's relationship and your mom deserves more than "just enough assets for Medicaid."
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disgustedtoo Aug 2020
"...something in very wrong with your parent's relationship..."

Huge assumption. The dad may just be heeding advice from the attorney and is doing what should have been done long ago. He needs to protect himself and assets, so that he is not impoverished or rendered homeless. My mother had to do something similar, also on an emergency basis, to ensure dad was cared for AND she wasn't left with nothing.

Later, after dad had passed and she was in early stages of dementia, we had to revisit everything and ensure she would be cared for. There was no relationship problem. Paying for long term care is expensive, and can ruin finances for both parties. Thankfully our parents had saved money and by protecting those assets at the time, we are now able to fully cover mom's care in a private pay facility.
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One of the major problems here is the laws are not always the same from state to state. I have been able to get valuable information from my local Alzheimers association., There are lawyers that specialty in Elder care And they can help you find one. I also suggest you get into some therapy or join a local CareTakers group ASAP. You are in a situation every one of us would dread . And “Ah but for the grace of god” we could either be in your position or you moms .. prayers are with you ..
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At this point somebody has created a lot of bad blood between the facility and your family. If Medicaid will be finalized then it usually goes retroactive three months; unless you need to spend down assets. Personally, if your Father offered to private pay one month then he should have honored that commitment. He would probably be reimbursed if Medicaid went retroactive. There is no guarantee Medicaid coverage is covered until final approval is given. Why put your Mother in the middle of all this? Is money more important than her well being?
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Apeter Aug 2020
Unfortunately money is the most important thing in the world to the majority. My Mom is living with me going on 21 years now. She was in the same boat as this poor woman. Dad told all 3 of us kids as Mom was lying in a bed at a not so clean nursing home that she was dying. I’m the middle child and now 63. Moms 82. I’ve always been the go to person & caretaker of our family. I told the staff I’d be back in a couple weeks to bring Mom home with me. I told them get her up & walking. Get her stronger so I can take her. They did as Mom is a handful. Born with mild schizophrenia. They were celebrating when she left. I’m serious, I saw party hats & those whistles. Mom was too demanding. Come to find out Mom was addicted to opiates as she’d been Dr. hopping & demanding drugs. This was when it could still be done. Mom is doing pretty good these days as I enforce she take her meds & I’m kind and reasonable. My father managed to get all Moms assets in his name. My brother & sister feel no shame in abandoning Mom. The entire family seems to think it’s just fine for me to have taken full responsibility for our Mother. It’s caused strained relationships. I raised my sisters oldest child. I was an unmarried teen when I took him on.. he’s now 47. People are selfish & come up with a 100 excuses why they can’t do what they should. I’m going on 64 now. I’m old enough to have witnessed what goes around comes around. No one wants to die. People feel they need their time. Their life to fill in all the many things they think they need & that they think will make them happy. At the end of the day we all just get old feeble & need care. Dad is now 88 & he looks old at that stage where I can see he isn’t long for this world. Dumping my Mom didn’t make him any happier. He still got old. It does hurt my heart to see him failing as he is my Dad. But people need to look at the bigger picture. Everyone is always scrambling to find happiness. Just do what you’d like others to do for you one day when you can’t take care of yourself.
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Saying you cannot provide the care and refuse to pick her up IS NOT abandonment, neglect or abusive. It is the opposite, dad has reached his end and may actually be preventing the same. He cannot be forced to provide her care, by doing this he is trying to get the care she needs and deserves.

Medicaid issues aside, they will get straightened out. It would be abuse and unlawful if rehab kicked her out without a plan for care that all have agreed to. Rehab would be getting the attorney to defend their actions, abandonment of a vulnerable person.

Mom has dementia she does not knw what is going on. Though i am sure this is hurtful to daughter.
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mstrbill Aug 2020
Exactly. Glad your here too. Some of the comments here implying the father is next to evil without knowing all the facts and details are beyond infuriating.
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It is neglect. They can appoint a guardian/Conservator after Petition to Probate Court. You will only get to see her and know about her issues when Guardian says so. If you can do this first and have attorney put all changes on hold until proper best interest is done for her.
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I agree: DO NOT TAKE HER HOME! As POA, you are legally responsible. Yor father walked away because the stress got too much for him. I think help is available, but these professional people are scared to get infected. What about their using AVAILABLE PPE?? COVID-19 carries this non-help excuse too far. You need to call an elder attorney and social worker to deal with Mom's emergency situation.
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disgustedtoo Aug 2020
"As POA, you are legally responsible."

Not sure what you meant with this statement. To clarify for others:

POA doesn't *really* make anyone "legally responsible."

What POAs are for is to allow the person appointed to help make decisions, sign paperwork, and manage health and financials for a person, in the manner they would want, when they are no longer capable. It doesn't make you responsible for their care, just oversight for them.

As an example, some people either don't have family/friends to appoint, don't trust any family/friends, or just prefer not to burden family/friends, so they appoint another party to be their POA. Often this is the attorney who set it up. Do you think any attorney would agree to this if it meant they have to take in and care for their client?

One more point about POAs: these are not all encompassing powers. You can manage finances for the person. You can sign documents for the person. You can coordinate their medical care. You CANNOT force them to do anything THEY don't want to do. Our mother developed dementia. In the early stages, she denied having any problem and REFUSED to consider moving anywhere. We tried bringing in aides, to keep her in her condo as long as we could, but after a short time she refused to let them in. They were only there for 1 hour (min) and mainly to check on her and ensure she took her meds. After refusing to let them in, we had to find a MC facility and move her. The EC attorney told me we could NOT force her to move. He suggested guardianship, but the facility we chose would not accept committals. As a result, we had to get creative to make the move happen. Facility said to just get her there, they would do the rest.

So, POAs need to be fully understood. Too many people think this is the answer to everything and it isn't. It is something that should be in place, and it does help greatly when the situation demands it, but it does NOT give you superman or wonderwoman powers.
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I am thinking about what I would do in this situation. I would call my father and tell him as her POA you need to meet with his lawyer to understand what all is going on and bring your questions. You are being left out of the decisions here it seems.
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gladimhere Aug 2020
Attorney would be in violation of attorney/client privlege. Only dad would be able to allow a conversation like that.
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Check the terms of your POA. It may only be applicable if your mother is mentally incompetent. Since that was not indicated in your explanation, mom may have to make her own decisions.
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Nanulinda1 Aug 2020
My suggestion is to check which POA you have. There are multiple different POA’s . Mine allows me financial and medical decisions until he passes ..
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I apologize I have not read as thoughouly as I usually try to - legal matters go straight over my head.

What's the relationship like between the OP & Father?
Sound alike he's reached his line in the sand. Could they join forces to get Mom the care she needs?

It's heartbreaking to realise your Dad feels he has no other choice but abandonment.

This started happened to a friend. The Father just couldn't go on. When he admitted that to the family, councelling & more help was found & the Mother was able to stay home. I would hope I can find the right accommodation for my folks if care at home is no longer working for one of them.

What a stressful time. I hope it works out.
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That is one of the saddest situations I've heard of. He is still her husband, by law, and with that comes responsibility to care for her. In nearly all states, what is "his" is just as much hers. Your disabled mother gets near the end of her life only to be treated like a disposable object. Sounds like your despicable father has another agenda planned that does not include your mother. First, reassure your mother that she will not be left on a sidewalk. Explain the situation to the facility, (they want the space,) temporarily get her to a receptive relative"s home, then get legal help, elder abuse, etc., to protect her future access to care. If you don't stop him now, there will be zero shared assets left to provide for care, as his wife, she deserves. Don't be surprised if his plans include divorcing your mother.
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FloridaDD Aug 2020
If she is incompetent, it is very difficult to get divorced in my state.  A divorce is a contract.
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Do they have any money in a checking or savings account together because if he doesn’t paid, they will put her out. That is what they were going to do with my ex-mother-in-law because she wasn’t paying so we had to sell her house and pay the nursing home and once the money was gone, the state would pay for it. Your dad can’t hide money or assets to get out of paying.
you say you have power of attorney over your mother, well does she have money because someone is going to have to pay. If they own a house, it will have to be sold. You can’t sell anything up to 3 years before placing someone in a nursing home if you want Medicaid to pay for the nursing home. You need to talk to the nursing home since you have power of attorney. What your dad is doing isn’t right. It sounds like he wants to get rid of her. Is she of sound mind so you can talk to her.
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disgustedtoo Aug 2020
"If they own a house, it will have to be sold."
I'm not in the legal field, but this statement isn't necessarily true.

IF the person needing SNF, is single and will never be returning home, at some point the place will need to be sold and the assets used to pay/pay back what Medicaid covers. Often it results in a lien on the home, which would require sale/payback on the death of the patient. Sometimes if another family member were providing care for a given amount of time, they are also protected from being evicted so the place can be sold.

However, when there is a spouse, they are generally protected. We went through all that with mom and dad. The EC attorney was able to secure the home and enough assets so that mom was taken care of. Medicaid aims to get reasonably reimbursed, without impoverishing the spouse.

If Medicaid was able to take all assets, both liquid and real estate, we would have a HUGE homeless impoverished problem with the spouses who don't need NH. The best advice is to have this all set up BEFORE the need happens!
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Just so everyone knows it only makes sense to have a younger offspring or family member be the POA. Since they don't kick in until you are unavailable, yes, I know that they are valid from signing depending on what the POA states, but no elderly person knows when they will need their POA to step in, actually none of us do. Especially if dementia is involved, you can't change it if dad dies 1st. So having someone that has greater odds of being available for the rest of your life is very prudent.

Their is nothing said to indicate that dad is up to no good and even if he is, he won't get away with it. There is nothing financial that the government doesn't know about.

He is doing the right thing based on his legal counsels instruction. He isn't saying he is not going to pay, he is saying next week when he is protected then he will deal with it.

We are forever telling people to protect themselves from financial ruin by seeking legal advice BEFORE doing anything.

That is what he is doing, she will be getting her legal share, no attorney wants to risk their license for Medicaid fraud. They obviously don't have enough money to pay an attorney to lose his/her livelihood because if they did they would just pay for the care.
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I don’t know what state you are in, but in my mothers state legal action would be taken against your father and your mother could be penalized. I would consult an elder care attorney ASAP. A spend down of her assets would be necessary before Medicaid would kick in, but an application could be started. The state will usually ask for five years of records to show that funds are not hidden. In my mothers state liens could be placed on property as the taxpayers are picking up the bill for your mothers care.
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mstrbill Aug 2020
why legal action against the father? It is the daughter who has POA, isn't it the daughter's responsibility to oversee the financial responsibilities?
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Deanna, I apologize for not reading carefully. BarbBrooklyn brought it out that YOU are POA for your Mom. There is some reason for that I know, and while your father has a right to separate out his monies and his finances so that he is not wiped out with care of your Mom YOU also have not only a right but a duty as her POA to get your own lawyer to protect HER assets. I assume, as you say that you are her POA for financial that their money is already somewhat separated out? Do see a lawyer. This isn't something you can make a mistake on.
Again, whether this is second marriage, or whatever the reason, there must be a reason you and not the Dad is appointed POA. Protect your mom but do NOT bring her home. That will make more a mess to comb through. See a lawyer, and again I apologize for not reading more carefully and for having missed that you are the POA for your Mom.
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Suetillman Aug 2020
Don’t he doesn’t have a right to separate anything if they are married.
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