What do I do if I can no longer give my MIL safe health care?

I'd just tell SIL you can no longer do it in a safe manner and that you'll have to take MIL to her house. The other option would be that SIL could pay for memory care and get her money back when house sells.

Ilegal would be you leaving mil in a place that you know is not safe. I would assume that you believe SIL would be kind and helpful to her own mother. If there's ever been issues otherwise, then you'd be in the wrong to put her there.

The other option would be to figure out what mil's total income is and use her money to pay for the NH care. If she makes more than enough to cover cost, she is just a self pay patient. If she doesn't make enough, you apply for Medicaid to cover the difference. She will have to spend down the money in bank accts, liquid assets to a balance of about $2000 or less (could be more in your state) before Medicaid will start. At the time you apply the house won't count against her. Other property...like lake lots, anything other than the property where her house is....will have to be sold at fair market value and monies spent on her care.
There is a form in the application packet called MERP - it says that the state will have the right to get money from estate to be reimbursed for what state paid on the Medicaid bed. So primary house doesn't have to be sold right now, state can get their money back when mil dies and probate is opened.

One thing to remember is: if MIL or anyone has made money gifts to others in the past 5 years, you have to explain who got it. If someone in family wants a good deal on her home and wants to get it for peanuts, that won't fly either. These types of transactions create penalties that are calculated by amount of the 'gift' and how much state has to pay to cover costs of facility. So, total gifting was $50K and state has to cover $1,000 per month for the bed, you're looking at 50 months mil or family has to pay the $1000 out of pocket before Medicaid coverage kicks in.

An elder attorney can do all the math for your family to determine how facility care could be paid for. Much easier....and hopefully SIL has kept good records of how MIL money has been spent.

Is SIL POA for Health as well?
If so the ball is in her court. Tell her that you will be packing up mom's things and bringing her to SIL's house.
Another option...
Contact the Attorney that wrote up the documents appointing SIL the POA and tell the attorney that SIL is not doing what needs to be done to keep MIL safe.
You would have an option at that point. Tell the attorney that you want to file for Guardianship so that you can make the proper, safe decisions for MIL. Or that you can not longer SAFELY care for MIL and the Court should appoint someone to manage MIL's care.
OR
If MIL has to go the the hospital for ANY reason (a fall, a fever, a complaint of a headache...) once you get there you tell the medical staff and a Social Worker that you can no longer SAFELY care for MIL at home. And you can not take her home. Give your SIL's information so that MIL can be picked up when she is ready to leave.

If this were the UK, I would get social services involved, saying that I could no longer provide safe care for my MiL and ask them to help me place her in a suitable facility. The SiL with POA would be forced to act. Is there any authority with responsibility for the elderly who could intervene where you are?

If I thought that the person with POA were abusing their position, I would report it, or apply for guardianship.
Basically, the SiL has no right to keep dragging her heals, putting her mum in a potentially dangerous situation because her needs cannot be adequately met.

BOllie: Contact an elder law attorney.

Since your MIL is living with you, she can revoke the first POA and change it to yourself if she wants to do that. In Texas all you have to do is have her revoke it in writing and then turn the responsibility over to you by signing another POA in front of notory. You can also become her SS payee since you're supporting her. You just have to get MIL's permission and call the SS Administration to explain what MIL wants. If the SIL gives you hell, tell her you're sending MIL to live with her and then you stand by that promise.

For now you could tell your sister in law that moms social security needs to go for some respite care for you and your husband. Next discussion should be about the sale of her house. Not a fair situation at all.

If you think SIL is taking Mom's SS for her rent, I would be concerned, it appears she is denying fair market value offers, it's because she wants more money for herself and remember when Mom is out of money and in a facility she will need to apply for Medicaid and with a 5 year look back if they see money was taken or just given away they could deny her or penalize her and unfortunately whose going to pay the bill? What your SIL is doing is called financial Exploitation

Saw ur reply to me. It does not matter what category you put your post under, they all go to the same forum. You now have 3 of the same question being replied to. For you, it must be confusing. Maybe you can ask Admin to shut down two of them for no more responses. Using your original to post to. Better to keep to one post.

I would say, you are probably correct in that SIL uses Moms SS for her rent. You should be getting the SS since ur doing the care. Its against SS criteria to use someones SS for your personal use. If you want to, you could call SS and tell them Mom is living with you. Is there a way to become payee. SS does not recognize POA. Then maybe you could use the SS to hire help.

Are there clear reasons for SIL's delay? Has she said? Has SIL asked for specific help? Or for more time?

Does SIL need practical help in the way of professionals eg Accountant, Elder Lawyer, Home Organisers, Real Estate Agents?

Or are there other, more emotional & sensitive reasons? Eg Reluctance due to grief over selling the 'family home'.

If a facility has been chosen, is it possible for MIL to get a room now (as a short term respite stay) while funding for permanent care is being arranged? A deposit is needed, right?

I'm sure someone could pen a nice speech to SIL that effectivly means "Make this happen ASAP or MIL will be on your doorstep Friday"...?

When you post under several categories we all see them. The categories are there to research what others have written on the subject. Often, we see your question just stacked up. Rarely will we see an elder lawyer response to the question. The problem with elder law is that states laws are different

First, I would look around to see what managed care options you have...and to narrow the selection to 1 or 2 places. I don't know if this is wise or not, but I would invite your SIL to come and help you research.

Many of the good places have over a year waiting lists, therefore, your SIL would have a better idea of the costs and the timeline, if 1 or 2 places were selected.

When you are visiting these places, make sure you ask the difficult questions especially about the care of your MIL. Ask about doctor's visits (who takes her and who is with her), cost of incontinence supplies, meals, the activities, what happens if a person doesn't show up for a meal, what is their policy or process if something happens that she needs to be taken to the hospital and which hospital, etc.

The cost of services is definitely eye opening.

When the time comes, you want to move your Mom someplace that both you and SIL agree on. That is NOT the time to argue about it.

So I'd start the research on where you would like to place your MIL, preferably with the person who has POA. Once your SIL is more comfortable with the idea, the selling of the house for funds will become a little more urgent and explainable.

If your sil has POA then you have no power.

If your mom falls or something you can bring her to the ER then wash your hands of it all and tell the hospital who the POA is.

That's just the way it is. I'm going through something similar

Best of luck, I know it Stinks

Consult an elder care lawyer if you're looking for specific legal advice OP. Me, I'd drop the old woman off on the POAs stoop and call it a day.

This is your 3rd post pretty much about the same thing. You received replies on the other two. Not sure what more we can say.