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Phoebe15 Asked April 2015

My Mom was transferred from a NH to a hole-in-the-wall AL. Does she have to pay the 3 days she stayed?

We were told that she was qualified to stay long term at the facility where she was at. Although I, her daughter, seen a lot of negatives there I felt better because she was physically doing better. All of a sudden,from one day to another,they say that she no longer needed much caring so they were sending her to an assisted living very far from me. I, being the only daughter that was watching over her, was confused, upset & felt discriminated. After I complained with the admissions, the social worker called me and simply said that my mom could not afford to stay. If I would have seen the place where they sent her to in advance,I would have never let her step foot in there. Now, is she responsible to pay out of pocket for the 3 days she stayed?

Chari7 Apr 2015
I agree with you, Sherry1Anne, and I am one of the hippy generation, too. So, we are sisters, in a way. :) That was when the protests, usually peaceful, had specific reaons that was for the good of our country. And, if we didn't agree with the "system," we let Caesar know. (I still do, too, by the way.) Our country and Caesar are out of control...you can see it on TV tonight. It was my experience with my mom that renewed my rebelious spirit. I wrote and called my representatives and senators and made it clear that the baby boomers are coming, and we need reform now. I think it is appalling that Phoebe15's mother was moved without her knowledge and that she has been shuffled around by the social worker's vague response to her. I have seen worse things than this happen to the elderly, though; and, it is all "legal." My mom passed away in the evening, and I reported her death to all of the places she had pensions and social security the next morning. Mom's SS check had been placed in her checking account, with me as second on it. I closed mom's accounts, of course. I didn't know it; but, if a person dies on a certain day of the month (the first, in my case), the SS check is refunded to the family. Much to my surprise, the amount of mom's check appeared in my checking account one day. So, the government agencies know everything about us and have access to our finances. If Phoebe15's mom's bill isn't paid, what do you suppose would happen, unless her mom is on Medicaid? We thought about putting mom on Medicaid, since the facility where she was accepted Medicaid patients as well as the rest. I went through all of the red tape involved and had to rush to get my mom's name off MY checking account. Because her name was second on my account, they were going to count it as income/assets of hers. After I realized what could have happened (my income and checking account taken away as mom's income/assets), I just decided to supplement her income with what I was earning at a part time job. I was nearing my mid-60's and retired by then. I was trying to plan for my own retirement. Rather than deal with Caesar, however, I decided not to have the government involved in any of our finances and rights. Phoebe, we don't intend to take over your thread. You have received some excellent advice here, and we all care about your situation. That's why I advised you to see someone who knows the laws and read every word of everything that pertains to your mom. Take back control of her. If you have POA, tell everyone involved that anything that happens requires your signature. If you don't have POA, get it ASAP. My heart goes out to you, because I had to learn these things for myself, too. I hope you get your mom closer to you soon; I know it will mean a lot to both of you. You have my thoughts and prayers.

sherry1anne Apr 2015
Caesar has robbed us blind. I guess I'm just a rebel with a cause. It's amazing what can be done by protesting. Get your congressman involved and the TV News. It's part of the hippie 1960's thing I guess. We refused to allow what was not right and fair back then and I'm still at it. Fortunately I have not had to put my mother into any kind of facility and I pray that I don't. My heart goes out to all those who have to deal with the bureaucracy.

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pamstegma Apr 2015
Most AL are private pay and need 30 days notice. But if they are tossing her out, she would only pay for her actual stay. Good grief is she signing stuff and not competent to understand documents? Get the Ombudsman on it. Don't sign anything, not even the eviction stuff.

Chari7 Apr 2015
I agree with you, Veteran'S, but I know from experience that "the system" makes a lot of these decisions unless the family intervenes. I was given a list of acute care facilities for my mom to go to after her hospital stay. I immediately started personally visiting the ones that were fairly close to me. If I had not made the choice, or if my mom had unknowingly signed over her right to decide, that decision would have been made for her. The same process went into action when she was discharged from the acute care/rehab facility and sent to ALF. Medicare covered a certain amount of days, then her supplemental insurance took over for a certain amount of days. Some insurance covers more than others, but you can bet the financial office or a computer counts those days carefully. If the family or the patient doesn't know this information and keep a calendar of everything that occurs, it is amazing what "the system" can do. If someone doesn't comply with paying, their social security and other sources of income are up for grabs. Is it right? No, but is it done? Yes...more times than any of us realizes. When my mom was in acute care, I bought her pampers, did her laundry, provided her gowns, etc., paid the beautician and nail technician, always made sure she had tickets forr extra functions....and I made it clear to the administration and staff that nothing was to be done, except routine care, without my knowledge. Patients are vulnerable and sometimes naive in these situations. I have watched other patients asked, "Would you like...?" The part that was unspoken was that there were extra charges for some of those choices. My mom was covered with Medicare, Blue Cross/Blue Shield Federal, and Tricare. I hit the ceiling one month when our out-of-pocket charges were over $5,000 for 15 days! When I asked the financial director, very nicely but firmly, to explain the charges to me, all she knew to do was to pull up my mom's account on the computer. I asked for a copy of the bill, which was coded and labeled ambiguously, and the director was unable to tell me specifics. When I checked with the proper people, I was told that yes, my mom/family was responsible for the bill. If one is not covered by Medicare and supplemental insurance, "the system" has even more control over the person and their finances. As someone else said, I learned by our experience and from watching how other families were treated, some ALFs, nursing homes, etc. are very smooth with the way things are explained. That is why my advice was to contact a lawyer, legal aide, insurance contact, or Medicare/Medicaid rep. to get answers to her questions. I agree she and her mom are being manipulated; and, regardless of anything, her mom should not have been arbitrarily moved to another facility. Elder care is very complicated and specific. We should read every word of information that affects our loved ones and, eventally, us. I am an only child, whose husband is almost twenty years older than I. I am trying to secure my future wishes by having a DPOW, revocable living trust with several backup named executors, health care surrogate, and living will. Everyone's needs for such planning is different. It is worth it to seek legal assistance with these documents which will affect our futures. Hope this explains my agreement with you, Sherry1Anne. I know that we are going to have to abide by current elder laws, though. We owe unto Caesar that which belongs to Caesar.

Litldogtoo Apr 2015
p.s. just let the billing cycles go through even if you get bills. They are computer generated and sometimes Medicare/Aid needs to play 'catch up'. Medicare/Aid will send a statement telling you what they paid and what you (she) owes. Most of the time, it's ZERO. Even if you get a bill, don't pay it if medicare/aid indicates they did.

Litldogtoo Apr 2015
This is like Do I have to pay the rent when I go on vacation. Of course, someone is going to pay. If she doesn't have Medicare/Aid then it's going to be whoever signed her in.

If you mother signed herself in and she has no money, then they can't get anything. This is why you do NOT sign anything as her caretaker. If she can sign, she signs. You need to get POA and health care proxy. Talk to an elder affairs attorney (consultation is usually free...most are very helpful and will not charge).

As for where she is now -- I'm going to sound like a broken record to those who've heard me before -- get someone who knows their way about Mediaid and how to apply, etc. Then go to the Medicare website and find nursing homes/assisted care, whatever, near you. Then see if you can get her transferred. If she is already on Mediaid, start looking for her to be transferred out of the bad one into a better one.

Please update us on how it goes. I'm thinking about you and hope everything will be fine at some point. This is not easy. It's damned hard. It's stressful and shouldn't be! Our elderly are with us and these issues need to be addressed.

Please, write an email to your representative (that's what they are there for!) i.e., senator, congressman, whomever, telling them the situation so they can look into this for you. Sometimes it helps, other times, it doesn't. But as her advocate, you may just need an advocate for yourself. They might as well do something!

Now, why on earth is the assisted living facility so far from where you live?

What I don't understand is why they transferred her to assisted living without your knowledge and why it is so far away.

sherry1anne Apr 2015
If you didn't sign anything or your mom didn't sign anything, then where is the legal obligation. I say screw them. Let them charge it to the dirt and the rain settle it. Our freedom is in question here. If nobody agreed to send her to either place, it could be viewed a false imprisonment if she was kept against her will (assuming they had not declared her incompetent). I'm sick and tired of institutions making decisions and taking the rights of people away. What's worse is that we believe that we have to let them. This sounds like someone overstepped their authority. Who gave them the right to choose if she went to assisted living or came home or went with a relative? Who transported her? Just because she's old, she didn't lose her basic rights as a citizen.

JoAnn29 Apr 2015
If possible, don't bring her home. Will be easier to transfer her from one facility to the next. Talk to the state dept that checks these facilities. They maybe able to tell u if your Mom was handled correctly. If not, put in a complaint. If you don't have POA you need to get one. Make sure the hospitals she goes to have a copy, every doctor and any facility she is in.

malloryg8r Apr 2015
Yes the 3 days in rehab or NH has to be paid. If patient has Medicare plus supplemental ins, let the bill get processed according to the Terms of Medicare, and the according to the Terms of her Supplemental Insurance. If she has no Medicare and/or no Supplemental then the NH should be billing your mom. If your mom needs help they can set up a payment plan. If she has no money the she needs to apply for Medicaid. The NH may have already figured out the financial situation and that could have entered into moving her to the AL. As for you having a choice of which AL your mom goes to, well, if she is penniless there is little choice. My friend's mom's on Medicaid have all been moved around, with no input from family members. You can talk nicely with the Social Worker to find out more.details, but most likely, in your area there are very few.options for those who are not self-paced (which it sounds like is the case). Please write back with more details, there's lots of other people here on AC who may have better ideas, who knows. One thing to keep in mind--Medicaid varies from one state to another, what works in my state could be totally different in yours.

Christine73 Apr 2015
My guess is no, she will not have to pay for those 3 days. If she is over 65 she has Medicare. Medicare will pay up to 100 days in a nursing home to have physical rehab. They will generally send a senior to rehab for 3 dsys after a hospital stay to make sure they are well enough to go home. I'm guessing that might be your mother's situation, esp since you mention her doing better physically. They had no legal right to just put her somewhere else without your knowledge or permission! ! Nor sjpipd tgey have been able to admit her somewhere else without consent. However, if your mom is of sound mind and she consented, that's another story. People in nursing homes are on a power trip, but heres the thing. ..they have no real power!! Dont let them push you around! Call the social worker back and demand to kniw the curcumstances surrounding your mothers mive. Be nuce but very firm. Dont even mention the money. You'll never get a bill. And that would be handled by the business office anyway, not social work. Is there a reason why your mother could not just go home? Does dhe need nursing hone care? If so, uou can start the process by visiting different nursing homes and applying. Good luck.

JoAnn29 Apr 2015
They had no right to just send her anywhere. You should have been called and options given. Hoping u have a POA. They handled this all wrong. Why did she qualify and then not. Couldn't they have found a bed closer? You don't have to leave ur Mom in the AL. If she doesn't have money check with Medicaid. Then do research in ur area. And yes, she will have to pay or those 3days if medicare doesn't pick it up.

Chari7 Apr 2015
A lot depends on whether your mom is on medicare or medicaid. To answer your question, someone has to pay for those three days. You deserve to be more informed than you are! Check with a lawyer or legal aide about your rights and responsibilities. Good luck...take control of your mom. Don't let a social worker get by without explaining the details to you. I was told that my mom had to be transferred from the hospital to acute care after hip surgery, because most insurance companies wouldn't cover more than three days in the hospital....that information came from a hospial staff member. Going through this process with my mom was quite an education. Talk to a lawyer or your insurance contact, and read every word you can find about the system.

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