Is a skilled nursing facility asking for a disclosure of all my father's assets for sub-acute rehab care a red flag?

they want to know what your plans are for him...long term or short term? Tell them you are working with a lawyer and can't reveal that information as yet, due to privacy.

It would depend on what was first agreed to when he went in. Some facilities provide lifetime care but only after all assets have been signed over. To get Medicaid approval full disclosure is required.

hi
here’s what I would do, I would keep my Dad at home. I would hire a full time caregiver that has RN nursing skills. I found that to be way cheaper. Plus, you won’t be feeling like this facility is going to suck him dry of his money. He’s got the comfort of home, all medical supplies and you have a peace of mind. I noticed that this works for many people. This has been working wonderfully for my sister taking care of our Dad. I’m not going to give any more details. It will take time, but it’s worth it. I noticed that too many people are gullible when some drs are full of …… just to make money. I don’t personally trust any rehabilitative facilities. I have a friend, older gentleman, had Covid and went to a rehab facility. They took away and refused to give him his required medication, insulin!!! When, he left the place his blood sugar was over 500. We gave him his insulin. The same thing happened to another patient too. They tried to take his phone. I have this question, why do these facilities have locked doors and security guards? I have a gentleman friend said that a nurse came in and cleaned his genitalia, and made him have a orgasm. He was angered by how she “cleaned” him. I got her fired for sexual assault, I made sure she got charged for it also. She is currently in jail for 3 years. If your free to leave on your own, then why are they refusing to let patients leave with family members waiting to pick them up? Why the locked doors with security guards?? This sounds like a American concentration camp. I had to call the police and say this rehab place is holding a person against their will. Kidnapping?!! Locked doors all day? Why? How come family cannot visit? To me, sounds like this rehab place needs to be shut down. Who can speak for these people that want to leave, but are held there against their will?? My gentlemen friend said he was leaving and to let him out. Where can I file a complaint against this facility?? The abuse, that’s covered up? Medicine is not given to some patients?? If your family member is telling you that they are being mistreated, get them out of there immediately!! Your insurance will pay for anything you need. Please, understand, you have rights and to choose to go to another place and or home, until decisions can be made about proper care. This experience was a nightmare, and just reminds me of that movie, I care a lot. On Netflix. Any advice is welcome. Thanks.

MomtoMNS: Perhaps you will have a care meeting with them soon.

PS: Assuming your father can afford this, look into CCRCs for your dad. If the time comes that he needs full skilled nursing care, then can provide this.

It is not the home that should be making decisions about your father's care. In theory, HE should be the decision-maker. If he's not able to do this, someone, preferably a very trusted family member, should have his POA. Do not let this home pressure you into following their recommendations. Get your father's personal GP or his speciaists involved. Good luck.

Personally my financial assets are no one’s business. However if I did not have any assets I do not see a problem proving that.

Great advice! I will absolutely be asking them for written confirmation that full asset disclosure is standard policy for rehab patients and get a written estimate of LTC. My fear is that they have a sense of how few spots are available in rehab right now and they're trying to pressure us. A statement that this is standard policy would make me trust them slightly more (but they'd still seem questionable - and this a non-profit faith-based facility). Thanks so much!!

I just read Alva's post. I do agree that letting them know ahead may help you in them finding him a nice Longterm care facility. But if the LTC facility is associated with them, I would give them nothing at this point. If your Dad is "fairly wealthy" then you will have no problem finding him the best LTC facility. And with a feeding tube, I doubt if you can get him into an Assisted Living unless its one with a Nurse willing to do a feeding tube. CNAs are not medically trained so cannot do them.

Again, I think they are assuming alot at this point that Dad will transition to LTC or that it would be their facility. You should have a care meeting within the week. See how that goes.

I have never been asked to disclose my Moms finances when entering a Rehab. One Rehab was in another State.

Is Dad on Medicare? If so, all they need to know is his Medicare and supplimental info. From that info, they know what Medicare will cover and then its calling his supplimental to see what they cover. At Moms Rehab, I was given paperwork. It showed what Moms responsibility for payment would be after speaking to her supplemental. It was $150 a day at that time. I was her POA so I signed that Mom would be responsible for that payment as her representative. Did not make me responsibility for the payment. Always put POA after my name.

IMO I would say No they are not entitled to Dads financial info. Tell them at this time you are not considering Longterm care for Dad. If and when you are, you will be glad to give them that info. You may want to allow them to think it will be them when and if this happens. If Dad eventually needs a facility, you can choose any Longterm facility you want. It does not need to be the one he has therapy in. All you need to do is tell them Dad is capable of paying the 80days that Medicare only pays 50% or what the supplemental won't cover. If they want an affidavit from his bank saying that you will be happy to get that from them. But for now, they are putting the cart before the horse.

They will be responsible for discharge planning. And yes, these places ALL have connections with places out there providing such care long term. You will start to see visitations of the men and women in suits before discharge, in all likelihood.
And THOSE places WILL require full disclosure of his assets.
So the truth is that they ARE thinking ahead and were so honest as to tell you that. You do not need to provide this to them, but do understand that you may actually benefit by their knowing, and if there ARE assets they will call in those places able to provide (for a price) the best care his money can buy.
You do not have to give them this info now, but unless YOU YOURSELF are going to do all the hoof work of getting out there now and seeking care for him (at which time you will need to have an eyeball view of his assets) they should know. Social services and discharge planning will need the numbers, an eyeball figure, at hand when they seek placement options.
The truth is that yes, this is invasion of privacy and you don't HAVE to give them this info. But there may come the day they tell you that there is no more coverage, or no more progress and you have 5 days to find placement.
Will you be able to do that? If so, start looking NOW. You are forewarned that this likely will be needed.
I got used to, when my brother was diagnosed with early Lewy's after a severe car accident (while he was in rehab after this accident) telling people he was "basically a million on the hoof "(think cattle auction, where the term is used.) They liked that number. They wanted that million. Remember, they are in business.
It feels invasive, and you are dealing with an ILL loved one, and it strikes a hot iron of anger into your heart, but the truth is that yes, it has come down to this. His care now depends on how much he has. For all the glorious things we are, welcome to the USA. Where everything depends on how much money we have, and what we want, and how much we can pay for it. Might as well accept the truth of all that and make it work for you the best way you can. I know how it hurts. I know how invasive it feels. My heart goes out to you and I wish you the best.

I would not provide a rehab with financial information.

If dad can self pay, what he has is none of their business.

I would ask them if they accept Medicaid when dad runs out of money. If the answer is no, you will need to determine, if he needs LTC, where he will go, how long he can pay and make sure they accept Medicaid to ensure he can stay.

Just because they ask doesn't mean you need to comply. I have seen where people with money are charged more for the same services as someone that doesn't have much.

I pray your dad gets better and can go home or at least to an AL.

I have found that what the business office is doing does not affect the rehab. They only know if he isn't meeting Medicare requirements and that they need to plan discharge from rehab. Because dad will have to meet certain requirements for Medicare to pay for rehab. Self pay for 100% wouldn't be affected.

Is your Dad cognitively competent right now? If not, are you his DPoA?

My Aunt recently fell, was hospitalized for a few days and then transferred to a rehab facility. She has advanced dementia and broke her hip that requires surgery to treat, but we said no to that. Turns out this facility does not have permanent placement for LTC. I've been dealing with their Social Services person, and their Business Office Manage. I'm still waiting for UHC (UnitedHealthcare) to call me to discuss who is paying for what and for how long. The facility asked for a DNR signed by her current doctor, even though she had one created with her other legal docs.

If your Dad has no desire or need to stay at this facility I'd say to call up the Bus Off to talk to them about the trajectory of his care after he completes rehab (if he is able).

If you are not his DPoA I would be very careful about what documents and contracts you are asked to sign going forward. Even as PoA you should sign them as "Your Name as PoA for Your Father's Name". I hope everything works out as you find care for your Father.

I can understand wanting to protect what privacy you can.

The fact that they are the only facility offering acceptance makes it trickier.

If they are concerned about the bill getting paid if his stay is extended, you may be able to reassure them by providing proof of ability to pay for a longer period, e.g., 12 months and offering to provide more information if he is still a resident long after you anticipate his stay will end, e.g., 6 months.

Proof of ability to pay would include his guaranteed income (SS, pension, annuity) for the time period plus checking and maybe one other account. Some financial advisors will provide letters documenting that one’s assets will provide a level of income greater than or equal to a specific amount for a period of time without disclosing the details on the underlying assets. (I think Ric Edelman said on his podcast that his firm did this for retirees acquiring mortgages.)

We were asked this by discharge planning.

So, here's my experience.

When my mom, post stroke, post broken hip repair was in the hospital, we POA brother, MBA sIL and I) met with the discharge planning nurse.

"How much does mom have?" was her first question.

My brother and I, brought up never to discuss money sat there in shocked silence. My sil asked why she needed to know.

The nurse explained that she would be sending mom's information out to a variety of places, some of which would accept her as a Medicaid resident after a period of Medicare-paid rehab. She needed to know how long after rehab (which is rarely paid for by Medicare for more than the 20 days it covers in full; it covers days 21-100 at 50%-there is $150 co-pay for those days) mom's money would last before an application for Medicaid would need to be filed. My mom was also seen as being likely to remain as a long term resident.

We gave the nurse the general picture of mom's assets and she was satisfied with that.

If you guys hold POA. YOU, not the NH, are the decision makers of where dad resides. The therapists will note progress or lack thereof in therapy and Medicare's decision to pay for continued rehab is based on that, and is appearance.

See if they will be satisfied with a general picture of his finances; the rehab is most likely wanting to know how soon dad might become an unprofitable Medicaid resident.

Tricky! My first inclination would be to invent a list for Dad, and at the same time ask them for full details of their long term care charges. Ask for an in-writing statement of why they want Dad’s finances details, just for a rehab stay. In other words, underestimate Dad and put some disclosure pressure on them. Dad’s underestimate could backfire on you if you change your mind about long term care with them, although saying there’s more money means that they would probably be more keen, even if a bit PO that the first list was wrong. If they can’t give a good reason for asking for it, no I wouldn’t like it at all. If they just say it's standard policy, ask for written confirmation that it is requested for all rehab patients. And you say that you already have other plans for future long term care - you can make that up too.