Shocker of a phone call today about Medicaid application and her stay at the NH, how does this happen?

This monkey is on the back of the NH. She is a resident of the NH, she is their responsibility. I’m not clear if you are POA but even if you are, that position can be resigned & Auntie can be made a ward of the State. The usual thread for ward is NH finds itself in a situation where resident is unable to be competent or cognitive enough to do what’s needed & no immediate family who know enough about elder to get involved and/or have no existing solid legal authority aka POA to do anything on her behalf (more on this below); so NH contacts APS; APS in turn contacts probate court for an emergency ward of the state placement done; and a state appointed guardian from an already vetted list is named; if elder has assets guardian paid from that otherwise state pays BUT state takes over any & all assets (so if there is land or house or car guardian will dealt with it).

On the “on her behalf”, having a POA may not be enough to do things needed. The banks are especially loathe to let someone who just strolls into the bank with a POA to access an account. If the POA isn’t already a signature on the account, has some sort of prior use on the account, a bank can say sorry but this POA seems to be a springing POA so once you have medical documentation on physician letterhead & notarized that the elder is incapable then we’ll let you do stuff. Then after that hurdle, bank will want you to have your own account at the same bank and synched for dealing with overdrafts. And if there is any type of Social Security items to be dealt with, for more fun! SSA does not recognize POA; SSA needs the elder to themselves do what’s needed in some fashion. I mention all this cause if y’all are not POA or are POA but never really involved in her life and unsure if landmines out there, do not get involved. A POA can resign by sending elder a certified letter. The NH owns this, it’s their problem to resolved.

A NH is getting payments from Medicare (MediCARE not Medicaid) in some way to deal with fees & charges for health care. (Not custodial care costs as those are LTC Medicaid). MediCARE requires facility to do a continuity of care and provide for a safe discharge.
SO….
NH cannot just put Auntie out. They cannot send her to a homeless shelter as there is no continuity of care, not a safe discharge. They may call y’all repeatedly to come & take her into your home, so be forewarned. But what NH will more likely do is call EMS to obstensibly take Auntie to the ER as Auntie seems to have had something that appears to need to be seen outside of what the NH can do. The easiest would be to say she appears to have had a TIA, aka transient ischemic attack as they are very much subjective in how TIAs “present”. LSS NH does a ER dump. Auntie now hospitalized and is the discharge planner at the hospital problem now. They will contact you to come and get her, so again you have to stand fixed and firm that you cannot.

State Medicaid programs all are very time limited as to how long an application will stay open and will need documentation in within the “window”. It can & will time out and then have to be reopened and may need an appeal filed for this to happen. It sounds like this NH & or their new outside contractor clusterF this in a lot of ways, but unless you personally signed off to be financially responsible for the Aunt, there is zero the NH can do to make you responsible now.

fwiw Medicaid Done Right is based in FL and started by a couple of guys who had been in the mortgage industry till the real estate meltdown. They contract with facilities & tout themselves as a way to streamline the process and capture earliest payment from a states Medicaid program. Read the reviews…. toxic seems to be the overall takeaway.

They can't throw her out. And make it clear to them that she cannot come live with you. This is the nursing home's problem to fix, not yours. Do you have a photocopy of the application you helped with?

Yes it sounds like they dropped the ball.

They cannot discharge her if there is no one to discharge her TO. Are you POA? If not you aren't responsible and see to it that they don't discharge her to YOU. They will now have to get the State to appoint a guardian for her through the courts. This will be a Certified Licensed Fiduciary and will handle all financial and placement issues going forth. The good news is you aren't responsible. The bad news is that the State is and you will not have input.

Honestly, you really don't need to worry so much about this, and you certainly do not need or want to pay for an attorney. Your option is to let them handle it. Simple as that. They are not going to release her to the streets, a state social worker will get involved in necessary. What are you so worried about?

You can turn her over to the State. They will assign a State guardian to handle everything. You will then have no responsibility for her. Which you don't anyway. Really, once she is on Medicaid, you have no legal rights to make decisions for her without POA or Guardianship. Guardianship is very expensive.

I know this is hindsight but this may help someone else applying for Medicaid, you never allow a NH to apply for Medicaid. Help, maybe. But I never trust people to do their jobs. I always keep on top of things. There's a turn over in office staff and I doubt any of them are qualified in all Medicaid Procedures.

Yes, the NH dropped the ball big time. If u do not want the State to take over, I would ask the NH if the application had ever been sent to Medicaid. If yes, there should be a caseworker. Find out from the NH if they received any communication from the caseworker. If so, you want copies of all communications, letters and emails. If they won't give u the info or they never received any, ask for the office they applied to and call there. If info was inputted into their system, Aunt should be in it. If so, the caseworker assigned should be on the info. Ask to speak to them or anyone who can help you. You then explain the situation and see if you need to reapply or can continue with the first application. If Aunt has no assets, it should be an easy application. A house and a car are exempt. If they actually never applied, then I would go to Medicaid and apply. I did it and it was not hard.

No, Aunt cannot sign a legal document. And you sign nothing for her unless you can put POA behind your name, This is why allowing the State to take over maybe a wise decision. The process will go quicker with them involved.

The NH cannot discharge Aunt, IMO. First it would be an "unsafe discharge". Second, they dropped the ball. In my state you have 90days from the date of application to get the caseworker all the info he/she requests, spend down assets and find a place for the recipient.

Wow seems crazy but I am sure this happens more often that we think. OP sorry you are having to deal with all this as it seems like you are trying to do your best to make sure everything was handled in a timely manner. Good luck in whatever you choose to do.

Wow seems crazy but I am sure this happens more often that we think. OP sorry you are having to deal with all this as it seems like you are trying to do your best to make sure everything was handled in a timely manner. Good luck in whatever you choose to do.

I thought again of what I would say to OP if I was still practising law. It would go something like “The correct solution to this is to apply for Guardianship, which will cost about $X and take about X months. I know that some people in this situation would ‘help’ aunt to sign, but of course I can’t recommend you to do that. Let me know if you want to go ahead with the Guardianship application’. But then, I never did try to run up costs for people.

You could contact a Medicaid Planner for her home state to see if there are any other options regarding the signature, or a certified elder law attorney who may be able to tell you if something like "emergency guardianship" is a possible option since the only thing needed is her signature.

Wouldn’t she be eligible for Legal Aid if she were already Medicaid eligible?

You should definitely not spend any money but her own for her care.

Quite frankly in this situation I would hold auntie’s hand and ‘help’ her to sign. Then forget the ‘help’. There’s a good chance that it will be ignored. If they were at fault for the delay, the chances of them making a fuss are low.

Since she is not competent to sign you will need to apply for Guardianship. An elder care lawyer should be able to help you.

It might also be helpful to see if the Nursing home has a social worker to give you resources.