So as I posted, Richard's son is considered next of kin and will be making decisions for him unless he snaps back out of this. Richard's sister is saying she may move back to town to help take care of him, so what happens if she wants him to come stay with her, but the son wants to put him in a facility? Who gets to decide?
You wrote on your profile: "I am caring for my friend, living at home with age-related decline, anxiety, arthritis, depression, diabetes, incontinence, and mobility problems." You do not mention dementia, so Richard is still free to make his own decisions.
You are not going to win the battle for power over your friend, Richard, that you have engaged in with his son. The son is on his bank account. That in and of itself is a big deal and indicates Richard's intentions of wanting Tyler to make decisions.
Given Richard's clear neurological deficits and limited financial resources, his family may have no choice but to find an affordable nursing home that you will consider cheap. His son will have a hard time going after you for any money just because you helped pay for his father's groceries.
Yes his SS and pension could go to pay for a facility, but only if he or his PoA acting on his behalf arranged it and he could afford it out of pocket. Medicaid does not "step in" unless he or his PoA/authorized representative or the facility fills out and submits an application. Medicaid has nothing to do with incapacity, only financial assistance for care. It does not act as a guardian, the county does that. You helped him apply for Medi-Cal but didn't qualify because he makes "too much income" and this may continue to be the case as long as he is receiving a pension. He should see an elder law estate planner who is familiar with Medicaid.
If he has the power to decide whether to go home or not, then they cannot deny him, BUT if they talked to you and you agreed to try to provide some care, they thereby sidestep the "Unsafe Discharge" accusations that all SNFs fear (they can lose the licensure).
I tried to tell you some time ago that as a friend you are too deep in the business of this family. That they have now done a discharge that is UNSAFE after speaking with you, and without speaking to his son, has just proven my point.
At present you are going to need to call the EMS to get him back into care. At that point please remove your name from his records. They should now be dealing with patient and with family ONLY. Later, if he returns home you can come by and ask if there are ways you can help that may BE a help. This man sounds way too much care for a Sister who is somehow hoping to move her entire life here to take care of him.
Please step away from the middle of this, and let Tyler, the son, be the person handling this for his Dad.
If he is not, the son, who you point out is considered next of kin, lives in the area and has been doing duty heretofore.
You are a "friend" of Richard. I think that it is time that you step away from this situation and let Richard and his family decide together what is best for him.
You mention "his sister". I am assuming that is Richard's other child, a sister who does not live in the area and has not been involved in care. And where her move and care of Richard is concerned, I am certain she has made this offer to the other sibling, and the sibling currently doing duty in same town has decided placement would be best.
This is then a matter for the two children to settle with their father. You have offered your services. Now it would be best to step away before you end this family in a court battle which could lead to POA and guardianship given to the state. In that unhappy circumstance Richard will be placed with NO ONE having the slightest say of where and how.
I understand that you feel that Richard is your friend. But you have been accepting some payment for some care, and that takes things into the iffy area of not pure friendship, but of something other.
Please let this family deal now with what is clearly a hard decision.