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Hi, this forum has helped a lot. Please forgive me if my question is a bit redundant. My head is all over the place right now.
My moms rehab accumulated a 50k balance and they are pressuring me for payment. Mom has dementia so can I help her pay the bill from her bank account?
I am considering getting an elderly law attorney but not sure how to finance that or it is worth pursuing. Perhaps an accountant can handle her finances?
The idea is to hold on to her home as long as possible before having the state take control. Thanks again

Often an attorney will give you an initial hour of consultation at no charge, although she might be less likely to do so if she knew you were not planning to use her services beyond that one hour. Others on this forum are more experienced with this situation than I am!
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I am VERY confused about how your mother stayed in rehab past the number of days Medicare would pay for. Normally, she would have been told before her Medicare-approved days were up, and she would have been encouraged to leave AND told that she would otherwise need to pay privately. What's worrisome is that they told you she is incompetent, yet they still let her stay and pay privately when according to them she was not competent to decide to stay! This seems very unethical, although perhaps since she had no POA they had no one to consult. I am bringing this up even though it has already occurred because it seems to me there is some possibility of disputing the bill if your mother decided to stay when she was not competent to make that decision.

As has been pointed out, the rehab itself cannot declare her incompetent. Was she tested/evaluated by a neuropsychologist, a neurologist, or a geriatric psychiatrist there? If not, she may not be legally incompetent and could still assign you POA. In fact, if an attorney finds her competent to make that decision, she could still assign POA after having been declared incompetent.

These things are definitely worth checking on, because if you could get POA, your problems would be simplified. And if you can go to the bank with her (I realize this means making a trip to where she lives) and can tell the bank (and sign) that you can be a signatory on her checking account, that would still be helpful, That does not normally require a POA: my mother had me as a signatory on her checking account long before she assigned me POA.
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InlandMeg Nov 29, 2024
“Unsafe discharge” can be a reason why someone is kept in rehab after their Medicare-paid days are over. That happened to my mom. If the facility knows there’s no caregiver at home, they can’t discharge the patient until there’s a caregiving facility found for them.

im editing because I agree with you.

I was told mom’s Medicare was ending. I was also her POA and that’s why I’m sure they called me but I think they would have called any other family member mom would have named. I appealed with Medicare for more time. However mom WAS responsible financially for any days they didn’t cover while I looked for an ALF.
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Sorry for the delay.
She has no POA that is the main issue. Her bills are on autopay.
The dilemma is, legal consultations cost $300-500. I don't have that cash on hand and she has a pretty good savings but I need a way to pay for the lawyer.
The local Action for Older Persons is a joke. You have to be below the poverty level to get help. I am thinking about getting her permission to pay a lawyer and helping her with the transaction so we can get some direction.
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AlvaDeer Nov 26, 2024
You pay the attorney through the funds of your mother. Please read your document. It will (SHOULD )_ say that you have a right to expert advice, and you do.
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kenmtb: Retain an attorney.
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Igloocar Nov 28, 2024
Kenmb says he has no funds to pay an attorney.
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In 6 years of facility care all mom’s resources had to be sold and rent paid for AL and then MC. As her POA that has been my job. Mom then was transferred into their Nursing Home {LTC building} and the state medicaid pays the bills. Many of us will outlive the cash and assets. Sounds like an attorney counsel makes sense.
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Reply to Sadinroanokeva
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They can pressure all they want but they do not have a legal claim. If you are rich and can afford it the do it but let the fight be with the facility and the insurance companies.
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Sooner or later, rehab will petition probate for have a judge appoint someone who will do the work for you. The appointee us usually a law office who will spend down and even sell property all while collecting any professional fees. Then someone will apply for Medicade and she will go to a SNF somewhere in the state. It might be too late to get her in a really good facility but at least she will be safely placed. Next time you get a call, you might just want to tell them that they will have to petition probate as you are not assigned to do anything for her.
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Why isn't your mom's stay being covered by Medicare or Medicaid. Was she hospitalized prior to her stay?
Sorry, but your mom's house needs to be sold and the funds go towards her care. Why hold on to the house? This is a dilemma for who? Your mom needs to live in assisted living. That is all out of pocket unfortunately. I had my mom hospitalized and became her guardian. The judge declared her incapacitated and I sold her house to pay for a personal care home. Not sure why you weren't notified about her stay in skilled nursing no longer being covered.
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kenmtb Dec 2, 2024
You are probably right. I am exploring the possibility that I can arrange home care for her. She is miserable in the rehab and roommates have been a big problem. Her friend is living in the house and takes care of her cats. I think she would do fine with some help for now. I will discuss this when the attorney calls back for the consultation.
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What state is she in and where are you? It sounds to me like you need to fly out there for a week, meet with the rehab, meet with an elder care lawyer, and get a handle on what your options are asap. The daily rate for rehab is astronomical. If you are a family member you may be able to get more done for her than just a friend. Elder care professionals usually at least give you a free, short consultation and then would require you to gather certain information before meeting so your time is used efficiently. This is complicated. It will be money well spent.
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Reply to ShirleyDot
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A "facility" (rehab) doesn't declare one incompetent, a doctor or lawyer does. Your Mom has to meet the legal definition of incapacity, which is determined by a lawyer because one has to be able to comprehend what they are doing and in my experience the attorney privately interviews the person to determine this. The bar for having capacity is low, and one can have very mild memory impairment and very mild dementia and still have legal capacity.

This is where you need the elder law attorney. Because the facility's determination of her incapacity might not meed the legal one. If she is indeed legally incapacitated them she can no longer assign a PoA or fiduciary herself. You would now need to pursue guardianship through the courts. And this is expensive. Or, a judge will assign her a 3rd party guardian.

"Medicaid will allow her to move to a better place"... no.

If she currently has funds this can be used to get her into a good facility on private pay that has Medicaid beds. Once she has spent down almost all her cash assets (and this varies by state) then if she is assessed as needing LTC (which is what Medicaid will pay for) then she must also qualify financially. If she does, her SS income will pay for her custodial care and she can stay in that good facility. The worst case scenario is she is not in a facility when she qualifies for Medicaid. Then she may only be able to get into county run facilities and they are usually not very good ones.
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Reply to Geaton777
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A lot of great replies to look through.
To clarify, mom's Medicare payments to the rehab ran out and she started accumulating a charges. The rehab applied for Medicaid. I was not in the loop when this happened so I saw a huge bill recently. I am not on her account but she knows I pay her bills from her account. I do not take a penny for myself.

The issue is, rehab declared her "incompetent" and there is no POA so official access to her funds for paying rehab/attorney/fiduciary is not possible right now.

This is what I gathered from the replies:
* I need an attorney to set up a fiduciary to handle her finances
* A fiduciary would be preferred a court assigned POA or guardian.
* The fiduciary would be paid an ongoing fee to handle her finances. This would have to come from her account.

Unclear about:
* If she gets a fiduciary, can I move her to different facilities after paying her rehab.
* Is a fiduciary better than an accountant or bookkeeper
*Will she have income to pay for her fiduciary's continued services.
*I found some local elder attorneys that list free consultation. Would they be better than trying to get help from the local Aging care programs.
*Will she immediately loose the house. I have to move the current person out, find homes for her cats etc.

Thank you very much for helping. It is taking some time to wrap my small head around all of the replies.
Ken
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Igloocar Nov 28, 2024
I again missed something and I wrote you about something you already know about. Yes, use the free elder-law attorney consult; no reason to wait for the aging care program.
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Is your Mom on Medicare? I'm assuming she's over 65... so she should be? I'm just wondering how she accumulated a $50K rehab tab.
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kenmtb Nov 19, 2024
She is on Medicare, that ran out. I think she can not go home without professional care there which would take some effort if it is possible. I have gotten little info on what the rehab has been doing. It would be great to pay them off, hopefully Medicaid will allow her to move to a better place.
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Are you on Moms account? If so, ask the bank if you are a signer. If so, you should be able to write a check. If you are planning on Mom entering LTC, paying this bill fully or partially will spend down her money for Medicaid. Actually, if she has no assets, Medicaid may have paid this bill.

"I guess she may need a nursing home but I am not in the rehabs planning loop." I so hope you are in this loop unless you want the State to take over her care. If the State assigns a guardian, then you will have no control over what happens to Mom. Keeping her house would mean someone paying the bills because once she is on Medicaid, her Social Security and any pension go to the NH to offset the cost of her care. If her house is sold, the proceeds go towards Moms care.
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kenmtb Nov 19, 2024
Hello,
I am not on her account. The rehab she is has only one line in and everything goes to voicemail. Sometimes they respond days later if at all. They will call randomly while I am at work to inquire about when payments will be made.

If they did not declare her incompetent then they would already have their money. As a last ditch effort I am seeing if I can physically assist mom with using her account to pay her bill. It should not be this hard. I can not afford an attorney and local so called legal aid has been a slow acting joke.

Also I was told to look at asking if her bank or tax prepare may be able to help take over some of her financial issues. It seems like there should be a simple solution that does not start of by feeding a layer $400 for an hour chat. Sorry for the whine.

I am beginning to think they want the state to take over and hand them everything.
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Other than a city or county selling a house or other property for back taxes the State does not want control of the house.
If mom will not return to her home sell it NOW there is no reason to wait.
Is anyone POA?
Since mom has dementia she can not appoint a POA for health or finances so someone will have to become her Guardian. If no one wants to take that on then the Court will appoint a Guardian. Assets will be sold to pay for moms care. once all assets are gone there will be an application for Medicaid.
Don't wait, make that appointment with an Elder Care Attorney. Mom's assets pay for the Attorney.
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Reply to Grandma1954
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not helping in this case, but a reminder for people to get POA and get on parents checking account

In my area, there are elderly law lawyers that offers say a free forty minute consultation. We met with her once and she not only gave us good information, but said there is probably not more we would need from her.

Dont know if that type of thing is available everywhere.
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Wow thanks for the details. She has no POA and the rehab declared her incompetent. What I meant was, can I assist her in paying her bill? I currently handle non auto pay bills.

I guess she may need a nursing home but I am not in the rehabs planning loop. I live out of the area and the facility is very hard to get in contact with.

Without accessing her funds, getting paid legal help wont work ($400 for consultation ). The local elder agency is good for leaving messages and sending links to national websites. Not dure if they have a caseworker.

I do not want her home, I was hoping to save it incase I could arrange home living assistance. Plus her friend lives there and helps out.
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CaringWifeAZ Nov 19, 2024
kenmtb, I'm curious, when you say you are currently handling bills that are not auto pay, how are you doing that? Are you able to write and sign checks from her account? Are you having mom sign the checks?

Follow AlvaDeer's advice!
Find an elder law attorney to help you with obtaining POA, and that means getting access to her bank account, as well as getting her moved from that facility, if you think she should.

But in the meantime, do not use your funds to pay any of your mother's bills! The facility will pressure you for payment - let them know you do not have POA and do not have access to mom's funds.
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I have no idea what you mean by can you pay your mother's bills for her.
Are you her POA? Are you on her checking account?
The answer to your question is no, you almost certainly cannot touch your mother's accounts in any way to do any thing without POA and property steps in registration as her signee.

Why is your mother in rehab private pay?
This isn't sustainable.
First of all, stop worrying about bills that come for your mother overall. They are her bills. If she doesn't have money she can't pay them. Eventually such as with this HUGE bill, the company will go to court for judgement and the home will have a lien. Too many liens and the house is GONE with the winds. And they cannot touch your mother's Social Security (but can get everything else). They cannot touch your money; see to it you do not personally sign as responsible party for anything.

If you mother is in long term care it cannot be rehab. She needs extended care facility placement if this is long term. And right now. SURELY some social workers there have contacted you or her POA????

Are you your mother's POA? If not, who is?
Because if so there is a whole lot you need to know and I think that you DO in that case need an Elder Law Attorney to learn how to set it up and function as a POA. If you are not, and bills are being racked up to this extent, there will shortly be nothing left of that home at all to try to save. Everyone out there will be collecting off it when mom passes.
Moreover, be certain NEVER to use your own money which you will badly need for your own care quicker than you can imagine (I am 82 and here to tell you).

Time to consider the basics.
1. Is your mother competent.
2. If your mother is not competent who is her POA or her Guardian responsible for placement and bills.

I would contact APS if your mother is newly needing placement. She may require guardianship of the state to manage all of this through a court appointed Fiduciary if you feel not up to doing this. It takes, quite honestly, a whole education in elder care to manage the finances and placement of another person. If no one in the family is up to these decisions of placement, when and where; of sale of home: when, where, how and why--then you need real qualified help.

50K is a lot. And it will become 100K in the snap of a finger. When the government medicare stops paying for rehab it is not sustainable for an individual to stay there and I am absolutely FLUMMOXED that a bunch of social workers are not already at you with information. Contact the rehabs Social Workers TODAY and let them know where you and your mom, her finances and needs stand.
And yes, if a Social worker cannot help and guide you you must have at least an hour of time from an Elder Law Attorney to get options, information, guidance.
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