Father in law has been in nursing home for 7 years, his physical condition is advanced Alzheimer’s. He is restricted to the bed and cannot speak or attend to himself. When his wife, my mother in law, had to go into the nursing home it created a problem with Medicaid. Long story short, the facility is evicting him due to non-payment from Medicaid or not enough payment from Medicaid. They are telling me they are going to drop him off at my place of business because we are the only known family they can find. Can they do this? My wife and I do not have any power of attorney over him (his wife is the only one able to sign for him) but we are listed as the point of contact. They tell us because we are the point of contact he will be transported to the front door where I work and leave him. The people telling me this are from the nursing home, they are very rude and call all hours of the day and night demanding money. Because we are in personal bankruptcy we cannot hire an attorney at this time. Any suggestions?
- short 1 page letter to NH that states in P1:
that Mary Jane Smith, wife of John Smith, is to your understanding - the DPOA for both medical and financial for John Smith (SS#1234566). As such all decisions regarding his situation at Shady Acres NH & Rehab should be directed to his wife, Mary Jane Smith, whose contact details are on file at Shady Acres. Should Mary Jane Smith be unable to provide the compliance needed for his continued stay at Shady Acres - which to your best understanding is under Medicaid LTC program - then Shady should contact Adult Protective Services regarding John Smith placement as a ward of the State of Panic.
Then P2: Persons representing themselves as staff of Shady Acres have contact me (& my spouse) both at my place of employment and at home with inflammatory language and threatening to “leave him at the door”. As such, any further phone calls will be recorded and this is your notification of this future action. Should follow through happen on this perceived threat, all actions will be filmed and sent to APS, State Dept of Health & Human Services Medicaid Division, Area on Aging NH Ombudsman Program and local media.
P3. Thank you for your attention to this. With your receipt of this letter, I consider this matter closed with no future communication or future contact from Shady Acres to happen. Sincerely, Louise Smith Reynolds
Make copies, cause you are going to attach it to the next letter...
Letter #2 - to Area on Aging NH Ombudsman. If your not familiar with them, it’s that every county in the US is within an Area on Aging. AoA are a program funded by your Council of Governments. Every state has at least 1 COG. Some states have several, like TX has abt a dz COGs. COGs are basically regional planning bodies that funnel/flow & determine federal, state, grants, corporate & private $$$ to various programs within your COGs footprint. AoA tend to be the biggest spend for COGs with full time staff. Most COGs have the NH Ombudsman program with staff under their umbrella. It’s your tax $ at work.
You can google AoA & “State of Panic XYZ county COG” to find addresses.
But back to letter #2: this is sent to your AOA.....
P1. Good Morning, This letter is regarding the situation of John Smith, a vulnerable elderly adult (put in his dob) residing at Shady Acres NH (put in full address). John Smith is my father who was married to my late mother June Garcia Smith (her DOD). He remarried Mary Jane Smith in 19?? and she is his DPOA and contact point for any financial &/or medical information. Please see attached certified letter sent to Shady Acres NH dated May 1, 2018.
P2. I cannot provide the level of skilled nursing care needed nor oversight required for John Smith. In addition, I cannot provide any financial assistance to him as I am currently in bankruptcy proceeding (put in the case #). As noted in my certified letter to Shady Acres, I am not his DPOA.
Persons claiming to be staff of Shady Acres NH in several phone calls to me over the past 123# of weeks has made what I consider to be threatening & intimidating phone calls as to “leaving your dad at the door of where you work”. This is an unacceptable action by any NH. I am asking AoA through whatever Ombudsman program or other senior health care oversight program to look into this behavior and the situation of John Smith at Shady Acres. Thank you for your attention to this matter. Sincerely.....
You really need to send each certified mail with return registered card. They have to sign the RRC and that’s a legal signature. By doing this your giving the NH notice and starts the clock ticking for what they can or cannot do. If they should contact you again, record the phone calls, you’ve notified them your going no to record phone calls, so your good to go no matter what your states laws are on taping conversations.
If you want to be totally OCD, you can track the letter to Shady Acres via USPO tracking # on the receipt. The day or two AFTER letter is delivered, you can do a follow up by faxing the letter to Shady Acres. For the fax, this you send at a FedEx office store as their fax machines will provide a “transmission report”. The transmission report shows it was received by date and time and duration of transmission. So they were notified twice. If they still contact you tell them to stfu and pound sand.
I bet what has happened is that your mils family have washed their hands on anything of your fathers as he’s not their family. He’s just some guy their mom married..... So NH is totally screwed as they have no recourse from mil as she’s in her own “at need” situation. So NH casting casting a wider net and its you as his family. Problem is legally you are not responsible for him as you did not do his Medicaid application or paid for his copay or SOC (share of cost); he is still married to her, it’s her legal issue. Also I’d bet it’s a debt collector whose making the phone calls but implying they are staff of the NH. The NH can get off their duff and contact APS to get them involved in doing a emergency ward of the state action done so dad gets a court appointed guardian who can take over his finances (like his SS $). But that means NH has to let APS look at all their records - both billing and medical - in detail. If this is a less than stellar NH, they have all kinds of problems they don’t want exposed.....
Call the NH yourself and ask to speak to whoever's in charge of billing. Find out if the outstanding fees have been referred to an agency. Take it from there.
Have you spoken to the social worker at the facility? I would contact the social worker immediately.
Find out if leaving your FIL at your work is legal or if it constitutes neglect or abandonment or something.
Here in St. Louis we have a phone number, 211, that if someone calls they are immediately connected with someone who can offer resources to all sorts of situations: low income families, mental health assistance, rehab, Meals on Wheels, etc. They might even have resources for free legal advice. Maybe your state has such a number?
You've gotten excellent advice from each of the posters. I have a few suggestions if the harassment continues, which I suspect it will.
1. Turn the Medicaid issue back on them and ask them to specifically advise you what the issues are, i.e., and specifically what the payment deficit is, what is required to stop this harassment and make the account whole (until you find someplace else), etc. Make them elaborate. They probably won't, but at least try to turn the tables on them.
2. Contact Medicaid and advise of the actions being threatened. I would think that Medicaid has certain standards, and threatening to dump someone off at a nonmedical facility wouldn't be acceptable to Medicaid. My concern first though would be that if the facility loses its Medicaid contract, other residents would be at risk, so I'd address that with Medicaid as well.
3. This is a more risky move, but if they continue to threaten to "dump him off", ask for a specific date and time so you can be prepared for him. Then call local tv stations and alert them. They'll probably jump all over this. And the facility will get some very, very bad publicity, and more than likely the publicity will start before the dropoff.
4. As Eyerishlass suggests, call 211. Now. And also ask if they can refer you to a pro bono attorney who can get injunctive relief, a TRO (temporary restraining order) preventing the facility from dumping your FIL at your workplace. BTW, are they planning to keep your MIL there or are they threatening to dump her off as well?
5. I think this is elder abuse; you might want to raise that issue not only when you call 211 but in a call to the local police department.
6. Also ask your bankruptcy attorney for advice; sometimes attorneys know other attorneys who can act quickly; even if you can't pay now, you might have to agree to a payment plan.
7. I agree with CM; I don't think these are nursing home employees but probably hired guns; they're skilled in harassment. This is also why following Igloo's advice with an immediate demand notice should be done ASAP.
8. If you have access to the admission documentation, check the name of the facility to see if there's a d/b/a, LLC or other ownership information included. Typically the state of incorporation would be included for an corporate ownership. Either search your state's website and find the corporate division; try to get the names of the owners of record, and their contact information. You may have to pay to get this information though.
My thought is to go above the local nursing home and contact the corporate office (assuming this isn't an individual facility but is part of a larger entity holding title) and notify them of this behavior, as well as the potential for public embarrassment if they drop off a vulnerable adult.
If your state has an elder law agency, or any agency dealing with vulnerable adults, contact it as well and ask for advice.
9. If you have a camcorder or video on your phone, and if others at your workplace do as well, be prepared to video the drop off and post it online so it goes viral. And threaten to do so. I wouldn't think any facility would want to be documented with a video showing them dumping off a vulnerable adult. The negative publicity would be overwhelming.
10. Is his wife able to be involved at all? Does she have any dementia that might prevent her from doing so? I'm assuming there aren't any assets in their family or they wouldn't be on Medicaid. Does your wife have any siblings who might be able to help out financially just until the situation stabilizes and another facility can be found?
One of my concerns is that a state guardianship or takeover might result from the situation, but I confess to having little knowledge of how this might play out. It wouldn't hurt to ask your bankruptcy attorney. Even if he/she isn't familiar with it, he/she might have attorney friends in this area who (as attorneys can do) give some brief, free advice.
I hope that you and your wife are able to have at least some quiet, peaceful moments while this horrible event is resolved.
Bet you anything Medicaid made assumptions when MIL was placed that she and FIL were a package. It's a Medicaid error, isn't it? Go to MIL's place, get *all* the paperwork together, get on the phone to Medicaid and retrace the steps right back to November. Then call FIL's NH, tell them what you've found out, and - spit-spit-spit, God willing, fingers crossed - that will be that Medicaid will be correcting the faults.
The "we'll drop FIL off at your office" thing is a threat to frighten you into moving him. What kind of place of work is it? - office, workshop, factory? But in any case this is bullying, almost amounting to demanding money with menaces, aka blackmail. Make a formal complaint.
If, unbelievably, they actually did do that..!!! Call the police. If they've removed the man from his home without the knowledge or consent of his next of kin (MIL), the only person with authority to make decisions on his behalf, you could arguably call it abduction.
In addition to all the good advice above, I'd check if the Goveror's office has someone who specifically deals with issues if the aging. Also State Attorney General.
You need to do several things, first, call the home and tell them to send you a 30-day discharge notice. I don't know where you live, but once you get the discharge notice, you need to call your local Long-Term Care Ombudsman Program. The Ombudsman is federally mandated advocates for residents in nursing homes. They can help you by talking to the nursing home about your rights and the rights of your loved one. There is no cost for their services.
Legally, a nursing home can NOT go after you for non-payment of a Medicaid resident. Even if the resident is not Medicaid, a family can Not be forced to pay their bill unless they agreed to do so upon admission.
You can also call the Adult Protection Agency (Elder Abuse Hotline) and tell them that the home is threatening to drop the resident off at your job. They can call the home and inform them of their responsibilities.
The fact that you are not the Power of Attorney is key. Since you don't have this, you legally can not make medical decisions for your loved ones. If your loved ones are unable to make medical decisions on their own and they don't have a Power of Attorney for Healthcare (is his wife competent enough to make the decisions for him), then the home has to get them a Guardian. Only the Guardian would be able to make decisions on where they will live. Nursing homes don't like to have to file for Guardianship - it costs them money.
I hope this helps!
There is always an appeal process when Medicaid turns something down. If you never got the denial of payment notice you would not see the directions of how to appeal. And why would you get the denial notice? You have no responsibility for MIL or FIL.
The fact that the facility had a management problem is not your fault and not an excuse for their mistakes.
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