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Dad is in an assisted living currently and the facility has asked we start looking for a NH. They were vague on the timeline. This past week I found out the caseworker went to see him as requested by facility. Does anyone know why and was that for an evaluation? Should I be worried? I’m scared they are pushing for discharge I’m not the POA and cannot get details. Long story why I can’t ask POA.
Also is there a place you can look up what facilities have Medicaid beds free? Thanks!

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Carol, if you're not his PoA then the only place to get details is directly from him. PoA is under no legal obligation to tell you anything. AL cannot legally divulge info.

If your dad has enough cognitive decline, only his Durable PoA can give permission to move him. Hopefully, he will be moved to a facility that has the full spectrum of care, up until MC and hospice, so that he'll never need to be upended again.

The financial PoA is probably aware that your dad may be running out of money. Going onto Medicaid is not the end of the world but in my state there were waiting lists for the few Medicaid beds so we got my MIL into a nice facility before her money ran out because the inside people (current residents) get first dibs on those beds. I say beds because Medicaid only pays for a shared room. Once on Medicaid they cannot legally 'kick him out" and he will get all the same care as the rest of the residents. If he qualifies for Medicaid once in a new NH but there are no Medicaid rooms, the facility will expect his PoA to come up with the difference between the daily private room cost and the Medicaid portion. In our case it was $600+ per month. Luckily we had 3 families to split that expense and we had to pay it for about 8 months until a bed came available.

Sorry that you are not on good terms with the PoA. You can choose to worry about things not in your control, but maybe there are more productive things relating to your dad that you can put energy into? Wishing you peace in your heart!
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When you say caseworker, maybe you mean case manager. Nursing homes often will send out the case manager to meet and assess a potential resident for their facility. They want to make sure that they are able to meet the patients needs. This is often standard practice.
You can look up all nursing homes here on the medi-care website, enter your zip code, choose the facility name and here you can see if they participate in medicaid and how they rate: good luck.

https://www.medicare.gov/nursinghomecompare/search.html?
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Sounds like he may no longer be personal care appropriate as far as his level of care and needs a higher level of care now? If that's the case the expense at a NH will require Medicaid if he does not have the funds to pay for his care as a nursing home is a much higher level of care and more expensive.
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Sympathies for your difficult position. I think ultimately it will be the POA who decides where he goes. You might be able to get information from the facility, if they are asking you to look for a nursing home. You can ask them what the results of the evaluation were. Senior assisted living facilities and nursing homes are highly regulated. If your father is no longer to care for himself at the level of assisted living he may have to go to a NH, where they can provide a higher level of care. Medicaid provides a lot of free services, especially if someone is in hospice. A doctor would have to sign off on hospice. If you can speak to a social worker or someone at Medicare, perhaps they can advise. It will be more difficult to get people to speak with you without POA.
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I am so sorry that you have to worry about placing your Dad. It is a very scary position to be in.
Have you presented these questions to the nursing home social worker? In my experience I speak with the social worker almost weekly from out of town and she provides me with all details of my father in laws care and concerns. I am not the POA. I also talk with the nurses. If you have not personally asked these questions, that is where I would start. More than likely, it was a case manager that visited him, I don't think Medicaid has the manpower to send people out in the field for that. At least not here in my state of Missouri. The assisted living facility should be able to provide you with information to get the Medicaid ball rolling. It is a lengthy process but as we found, the NH also has people that will help you to file the paperwork. Is another family member POA? They need to get this going for the best care for your Dad. Best of luck.
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Best place to start is by asking the current facility. Perhaps he can no longer do the things he would be expected to do with assisted living - might need more personal care at this point. When they asked you to look for NH, didn't you ask why?

There must be much more to this story. You cannot ask the POA why dad has been asked to go to NH - yet you are involved in searching for a Medicaid bed.
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So the Assisted Living facility is no doubt noticing that your father needs the level of care that a Nursing Home can provide. I assume that no one has filed for a Medicaid application for him yet? If approved, he will be allowed to own $2K in countable assets. Also be prepared for the 5 year lookback, which is where Medicaid will want to look at 5 years of back financial/bank records.
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I do not have any idea of his finances but I do know that Medicaid does NOT cover the costs in assisted living, only a nursing home. They may realize his money is running out and need to remove him to a nursing home where Medicaid will help with the costs. Or, he could also be exhibiting bad mental and physical behaviors which require a nursing home. You need to try again to get a POA or you will be helpless in the future - you need a good attorney - but you must get the POA. Also, call the local Medicaid office and the Office on Aging. They can explain things and offer you help and advice. Also check with the local Ombudsman in the Office on Aging - they can often find out what is going on.
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worriedinCali Aug 2019
actually Medicaid in most states does help pay for assisted living.
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Whatever happens with Medicaid, I do NOT think that legally you, or the family, must come up with money. Check with an attorney but I do not think you are liable. Stand your ground.
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Dora1956 Aug 2019
I was told that the financial POA would be held accountable. This I heard from a gal in Michigan. I’m in Colorado, so I know The Medicaid rules differ state to state.
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I feel for you & your current situation with the POA. I’m in the same boat BUT my Sis was smart about it (I say this with sarcasm) she’s financial POA & I’m medical POA therefore she calls the shots on Moms SS income while Mom LIVES W/ ME! In my household Mom & I are drowning. Sis is concerned about paying Moms medical bills. I’m waiting for Medicaid to kick in so I / We can get some help. Mom is 24/7 & I’m her caregiver. Im tired & am on fixed income, disability.
The MAIN concern should be about your Dad! Will this POA not talk to you at all?? Obviously you don’t have a say but yet YOU’RE looking for Medicaid beds & STRESSING?? It was my understanding that by law the POA had to share info to family members? Regarding finances? If on Medicaid or Medicare.
I question myself b/c I started the Medicaid process a year ago right smack when Mom 1st came to live with me. I reached out to every government agency for help seeing how bad Mom really was! Dementia & Hemorrhaging stroke. At that time sister would NOT speak to me so I couldn’t get bank statements to fill out a Medicaid application properly.
I was given the above (law) info by a Medicare social worker.
Has your POA started a Medicaid application? Is your Dad on Medicaid?
oh boy what a long road.
GodSpeed
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worriedinCali Aug 2019
Your understanding about POA is wrong. The POA is NOT legally required to disclose any information and actually cannot disclose anything without permission.
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