My Mom's former ALF is trying to get money from me. Do they have a right to do that?

One other thought on costs of ALF's: they should come up with a model whereby you can specify a "limit" to what the resident can spend that month, so you can stay on a budget.

PaulaK and Countrymouse, thank you for chiming in. I still don't have my parent in an ALF....but I have one sibling who seems extremely determined to make that happen, and they are the one with the DPOA. Sigh. But the Healthcare POA is assigned to me, so I feel like at least I have the right to say, not this or that facility.
The failure of ALF's to fully disclose their pricing should be illegal. In my state, all the brochure packets had a "Uniform Disclosure....." something made up by the state, in an effort to make it easier for consumers to understand, try to compare apples to apples.
But it is impossible to say what future needs our parents will have, and the stress of feeling like your parent might run out of money, is agonizing, especially for those of us whose parent might only have about $225K depending on the market, and still 10 years, or is it 5, or is it 14 years, of life left.
I guess I need to "Ask" a new question, and that would be something like, how do you plan for an unknown length of Life, when you have a finite amount of money.
Another thought: most of the ALF's I looked into, were "private pay only," and they did NOT accept Medicaid. There was one or two that would accept it, but ONLY if you could prove private pay for 2 or 3 years; however, the nice room with a view that you moved in at $4,000(plus)/month, would most definitely NOT be your room anymore when you went on Medicaid.....you would be moved to a room in the lower level with 2 or 3 roommates.
It is truly difficult to "take care" of my parent, given their limited finances, and the astronomical !!! cost of care, AND not knowing how long they will Live!
And the sibling with the DPOA has the utter Audacity to question my sanity.

Generally, you are only responsible for using your mothers money for her expenses and are not obligated to use your money. Ask for an itemized bill, what 'extra' did they do, what was her level of care, did it increase and if so were you notified. You can also contact your office of health care quality or regulatory agency in your state and ask that they check into this issue.

Grace, I completely agree - the covert (they call it "discreet") pricing is an utter disgrace in this market especially and "there should be a law…" It's a fight I've had with home adaptation companies, too. The b******s WILL not even give a range of prices for their products; they give you "all that" about impossible to say, depends on the customer, don't want to "confuse" people (HA! - au contraire, methinks); it is flagrant fleecing and makes it so much harder for us all to do our homework and accurately cost options. Drives me wild. Thank you for calling it.

Hallelujah, GraceH. Extremely well said.

I had exactly the same experience and worries when I started researching places for my Dad a year and a half ago (who is still living independently at his home, but for whom some kind of 24-7 care is going to become necessary soon). As you say, the first uncomfortable red flag is these places' unwillingness to be upfront about their pricing on either the website OR email, but to push you hard either to come in to meet with them or at least to speak with someone on the phone (I live in another state, so often, they had to settle for having a sales person talk to me on the phone). When I WAS in town and able to come in (which I did in numerous cases, because of course, I needed to see the facilities), the disappointment on the faces of the sales team that I did not have my Dad with me when I came was always palpable.

I found the contracts (when I was even given them to look at) almost incomprehensible. The "point" systems at many facilities seemed impossible to follow ... and I had exactly the same worry you did: My father already (of course) had serious memory issues even back then -- how on earth would I be able to contest ANY bill the facility might decide to present for any amount of additional "services" they might claim to have provided over the course of a month? And the degree to which such additional services were charged for was mind-boggling ... at at least one place, it was calculated by intervals of minutes spent with the resident (like an attorney might charge in 6-minute blocks of time). I had visions of my father having leisurely conversations with staff members he thought were just being friendly as they chatted with him "on the way" to showing him (again) where the dining room was, or helped with a shower ... all services that I understood WOULD take a caregiver time, and WOULD be charged for, but that I couldn't figure out how to keep from becoming more drawn out and expensive than they needed to be, without hurting my Dad's feelings (what was I going to say? "Stop talking to them, Dad! They're not really your friends! They're just trying to get more money from you!")?

And who would decide what services my father needed? Would it be my father? Would it be me? No, it would be some kind of services coordinator at the ALF, who would "meet with the staff every month or two" to "re-assess" my father's needs and then call to inform me what additional services they had decided he must have. I had visions of my very gentle, polite, and accommodating father being asked, "William, would you like Bonita to come and help you every day with getting your bed made up?" and smiling broadly (again, because he'd think someone was just being kind and friendly, and also because it would mean that nice Bonita would come in every morning to talk to him), and there would be another X number of points or minutes or dollars on the bill that might or might not really need to be there ... and while I wouldn't object to the ones that were REAL, any that weren't necessary -- but had been proclaimed such by the "on-the-ground" services coordinator -- would be sucking money away from things he actually did need.

Most of the places in Dad's town were combination facilities -- independent retirement with assisted living floors or "wings" and even "memory care" buildings nearby. Every place was anxious to have Dad come in and have a meal in their dining room. On every single place I toured, the tour just "happened" to run into an extremely happy resident who insisted on taking me to see her rooms so I could see just how individually decorated they could be, and how much like "home" a person could make them feel, while chatting on and on about how much she loved living in the place and wished she had moved their earlier. I did actually take Dad back to see one or two of the places in his town after he expressed an interest in at least seeing what they were like ... and on the first one, noticed that my SECOND "tour" (with different tour guides, because I was there on a different day), just "happened" to wander down the same hall on the same floor by the same resident's room ... which made me realize that probably some number of residents at these facilities get a price break for being sales "evangelists" to touring candidates.

At the end of the tours I took my Dad on, we were always shepherded back to the facility's office, where we were presented with lots of glossy marketing materials and information about move-in specials that would soon be ending, but we could get a particular deal if we signed today, and usually a folder that included lots of "activity calendars" and dining room menus and whatnot ... and I could see that my father understood none of it. The pricing information was always presented with much emphasis placed simply on the cost of the apartment, with the add-on service costs typically mentioned separately (usually in "points" or "minutes" systems that made no attempt to explain what any specific type of service generally cost in terms of a number of points or minutes).

Because we were not close to being at a point of signing, I wasn't paying attention to the termination clauses in the contracts ... but now that I read what GraceH writes above about the rental only terminating with 30 days' notice, rounded up to the end of the month -- even if you die rather than voluntarily move out -- I find myself grinding my teeth even more. And that full YEAR rental is even more draconian. Ouch!

I understand these places are businesses (some of them very large businesses, with shareholders), and in business to make money ... but there is something just distasteful about policies that seem designed to prey upon the specific vulnerabilities of a vulnerable population ... and shady about pricing that can't be published (so you always wonder if the pricing sheet you're being shown is the same one everyone else sees) ...

I don't have an inside perspective, and I don't know what the business costs are to run an ALF. I don't know whether most of these places are ultimately really profitable or just scraping by. You can't help feeling a bit squeamish about your contact with them though, for sure ... and yes, from everything I read, you want to watch very carefully how you sign anything "on behalf" of someone else.

GraceH, I've had similar experiences in the researching phase - I have yet to move my Mom to one because she can't afford any around here.

The more I hear about ALF's, the more I become very wary about them. I have spent gobs of time trying to find an affordable one for my parent, and 99% won't even list their prices online, nor will they divulge it over the phone. Then when you go there to get their information, they cloak it in terms so you think you're getting "only" the care you need (from a menu), which the uninitiated might think will save them money (as opposed to a full-service plan, like a nursing home). But in reality, once they have you signed up for the room you want, check the contract....some will charge you rent beginning 10 days later, others the 1st of the very next month (even if that is 4 days away).
Then they will charge you for every little item on the menu....give you a key fob so you don't even need to use your credit card or cash.....and send you a bill at the end of the month (what elderly person can remember how many times or where they swiped their key fob, for an entire month? how can the family outside the ALF contest that month's bill if it seems very high?).
Then, when you are taken to the hospital for a few weeks (because the ALF can't deal with bronchitis, they don't have adequate medical staff) you will still pay for your room (I get that) but also for a minimum # of meals....that you didn't eat.
At all of the places I interviewed, you paid for your room (and a minimum # of meals and certain other services) whether you were occupied or in the hospital, because it is a Rental.
Your Rental only terminates when you give them a full calendar month notice----meaning, 30 days **after** you die, rounded **up** to the end of the month.
At a couple places the Rental was for a full **year** and if you died with 10 months left, they could charge for the rest of the year if they couldn't find anyone else to rent your exact room (there's no incentive for them to fill that room if they can collect from you).
So the lesson is, be very wary of what you sign, read it completely, and if you are the DPOA be sure to include that designation before during and after your own name.

iluvdogs - well it is good that you now know you are in the clear.

The facility will continue to hound you, they don't care as they know that just so often family pays. If I were you, I would send a certified letter to them with a return registered receipt (the green post card) @ the USPO. This runs maybe $ 8.00 to do. In the 1 page letter, clearly state that you are NOT personally responsible for any bills for your parent, that your responsibility is limited to being her DPOA. Any outstanding bills must show your mom's name for you to even consider paying them as required by your fiduciary duty as her DPOA. And this notice is such that their bills must be sent within 30 days of the receipt of this letter. (this 30 day stuff is key so put that in).

So you snail mail this from the USPO. They have to sign off on the green card when they get delivered the letter and it gets returned to you by USPO. That puts them on notice that whatever needs to be provided to you within 30 days then it's toast. Most facilities can't get their shit together to do this. So if they sell the debt to a collection agency, you then send them a copy of this and they "debt" is invalid. They legally cannot contact you further. Best $ 8.00 investment ever!

I was told by an elder care lawyer that each state has it's own rules regarding parental finances. For example, in FL, children are never responsible for the parent's debts when the parent passes away. I wonder if the AFL in California is trying to go after you regardless of what you signed. And they probably can't, legally, but hope you or someone will pay the bill out of fear or something. When my father died and left credit cards in his own name (and Mom had a stroke a month later and lost her job) the collection agencies called all us kids trying to get payment. And I lived out of state at the time!

Know your rights and then stick to them.

Just because you signed her into the nursing home does not make you responsible for her debt. Medical debt (which is what nursing home is classified under) is not transferrable to another person. For example if a Husband places his wife in the nursing home or hospital on his wife is responsible for the debt. Medical facilities try to manipulate this law and bully you into paying but when push comes to shove they cannot force you to pay the bill. The debt also dies when the person dies. Medcial facilities will try and make family or caregivers pay but by law only the person that received the treatment is responsible. Check with an elder law attorney for help.

Oo. MamaBug, in that scenario you'll also want to make it crystal clear that you are not guaranteeing or underwriting your mother's debts. Rule of thumb: if in doubt, for example if the phrasing on the form seems in any way ambiguous, don't sign.

Thanks Countrymouse. I just worry about getting in a situation where she won't give anyone POA and mess up signing my name then being held liable for any debt. I want to make sure that doesn't happen.

Mamabug - In no circumstances is it "all right" to forge someone else's signature, not even your mother's, not even if she has dementia. If all else fails and you don't have POA or guardianship or anything, sign [your own name] [your relationship to the person in question, e.g. "daughter" or the capacity in which you're acting for him/her, e.g. "caregiver", "neighbour"] p.p. [the name of the person you're acting for]. If there are likely to be enquiries or some other sort of comeback, and people will want to contact you, you can always append your contact details to the document - "in case of query, please contact etc."

"P.p.", in case anybody's wondering, I know most people won't be, stands for "per pro" = for and on behalf of. This useful little phrase explains exactly what's going on with the signatures, without making any extravagant claims about what authority the signatory has to sign on behalf of the named person.

Ilovedogs (so do I, by the way!) - it is true that these companies often have no compassion (or at least manage to suppress it very well). They have vast overheads instead, and shareholders, and compliance with regulatory requirements, and staff training, and so on and so on… and all of these things cost money. Who should pay if the resident can't? The other residents? But I'm not getting at you - this is a question without a good answer.

The contracts that most assisted living facilities use, state that a 30 day notice is required before moving a resident out. The responsible party usually initials "here" and then signs the document. If she did not give a 30 day notice of intention to move her mom, she is liable for the sudden empty room. These places provide a very needed service, and small facilities with maybe 6 residents have a tough time making making a decent profit, therefore MANY close down!

Thanks for all the answers. I was pretty sure that I'm in the clear, now I'm sure of it. I only signed as DPOA for my mother and I have the agreement and there is nothing saying that I'm responsible financially.And yes, it is sad that after everything else we are going thru with parents who are in these situations, witih dementia, spending all their money on facilities etc., it is a shame that companies only try to get more money out of the family. They have no compassion.

Mamabug - most facilities seem to require that they have a DPOA & MPOA and sometimes also a DNR type of paperwork on file PRIOR to any admission. Most of the times, family has an attorney who does this for them, these will reflect whatever your state needs the wording to be so that you can do any financial transaction for your mom and so that it can never be considered a "springing" DPOA. BUT if you don't or mom is past this point of her cognitive level, then you are kinda stuck in your options…..you can go the whole go to court & become guardianship route, which is totally kum-ba-ya in being all legal but some facilities will provide a more generic POA for you all to do and fill out which mom signs to the best of her ability. If mom is already certified for Medicaid or her situation is she's a slam dunk on acceptance into Medicaid (most NH require that they review and they submit the mom's application so they have an good idea on if it's gonna go through easily), they are going to have something that they can put into the file as a POA to get past this hurdle. Technically you should not sign their name for them without a POA in place.

I have a question as far as signing papers. My MIL has Alzheimer's but has no DPOA in place at all. If she ends up in a NH with no POA in place and is unable to sign her name when/if she goes in a NH, would someone be able to just sign her name for her, instead of signing their own?

I would strongly suggest that you visit the website of the agency in your state responsible for issuing license to Assisted Living Facility. The have mandated Agreement (used by the licensee) between resident and licensee and check the Refund section, which clearly describes when and how refund is handled. Now, check the Agreement that you signed against the state's mandated Agreement. If the ALF Agreement does not contain refund policy or if it deviates from the state's version, then you can file a complaint to the licensing agency. Also, as a responsible party to your mother, you are responsible to comply with the Agreement, financially or otherwise. But don't worry. It looks like the facility erred based on your side of story. I know this because I am a licensee and a Certified Administrator, as well. I can't and won't tolerate abuses and/or fraudulent practices.

I am so thankful for this site, I learn from every post I read.

Like we do not have enough on our plates with our loved ones and their dementia - makes me furious - greedy companies - they can rot in hell - ruin my credit?? Who cares. I would have a very hard time not calling the assisted living and giving them a piece of my mind. Probably would not help but I may feel better.

I am not an attorney, but when I signed as my mom's DPOA, I was assured that this did NOT make me the financial party responsible for any costs related to her care. If you are unsure, ask to see what it was that you signed when your mom was admitted to the long term care facility. don't let someone terrorize you into paying for what is not your responsibility.

Of course they are going to ask because they may get some more $$$$ from you. Let them try - if your Mother has no assets they will just be wasting their time.

ilovedogs - you need to carefully review the contract that your signed with the AL.
That is going to be central as to what can be done. You do have a copy of the contract and all the paperwork?

Now if you signed as "Jane Jones Smith as DPOA for Mary Ann Jones" or Jane Smith in her limited capacity as DPOA for Mary Jones" then you personally are not responsible but you mom is from whatever funds she has. If she is on Medicaid - like what MediCal probably is - then mom is impoverished and the AL if out of luck.
But if you signed off as "Jane Smith" then you have signed off to be personally responsible for any bills.

Now whether the AL goes after you will be dependent on many factors. The biggest factor is the amount…if it's a nominal amount, maybe under 1K really isn't worthwhile for the AL to turn it over to collections. THose bills seem to be that they hound you by sending bills with late fees for several months. It will likely go on your credit report but no future legal issues. But for anything with a comma in it, and several thousand, those are worth them doing and getting a judgement against you so they can attach your bank account or garnish wages if you are still working at worst or turning it over to collection. The collection agencies are relentless.

BTW mom's SS income cannot be garnished, attached, etc by creditors as SS is federally protected from having this done.

If you don't have the contract, then you are going to have to send a fax or registered letter to them to have a copy sent to you. They can charge you for doing this too….really they can.

For others reading this, it is very important that you get a copy of every page of any admissions paperwork whether for NH, AL, IL or hospital. My mom's at NH # 1 was about 2 dz pages and her current NH # 2 was 15 pages. Don't leave or give them a check or deposit until you get a copy of every single page. At NH costing between 5K to 15K a month, this contract could very well be more than whatever the mortgage on your home ever was.

Yes, read what you signed at the ALF. Also, read your DPOA document. They vary greatly so you need to know what yours says. I'm DPOA for my Dad and it says specifically that I'm only responsible to handle his assets for him. I'm not personally liable for his debts.
My understanding is that a facility agrees to take what Medicaid/MediCal gives them when they accept a patient who has that coverage. You or she would be getting a notice from them (MediCal) if you could be liable for extra charges. It sounds to me like the ALF needs to cease and desist, but you may need to consult an elder care lawyer.

I am my mom's POA. My attorney told me to read everything that I sign and for me not to sign anything that indicated that I would be responsible for bills. He said if I signed that I would be responsible then they could bill me and I would be responsible for the bill. If signatures are needed I always sign everything with my mom's name by my name, POA.

They can ask. Others might fall for it. But unless you signed something that made you personally liable for her fees, as opposed to signing on her behalf as her agent to agree to her paying her own fees from her own assets, you don't owe them a bean of your money and they can keep their sticky paws off it.

I hope you read anything you signed very carefully.

My mother in law was in a rehab nursing care for a month, and after her release they kept sending me bills..but no explanation or details describing what it was for. They sent the bills to me. I called and said I was refusing to pay unless I knew what she was paying for in detail.
I finally got an itemized bill...and another. So after another phone call, all was ok and acceptable. About 2 months later, I got another additional bill...no explanation again. I'm starting to wonder if they send these out in hopes that the elderly just opens their wallet......in any case, I threw that one away, since they had already told me she was paid up and no further funds were due.
So make a phone call, refuse to pay, or ask what the extra care was for. Honestly, for as much money as these places charge ($10 a day for diapers when they should have been taking her to the bathroom but just left her in bed!) vs. the care they get- then they come after YOU..nah. I wouldn't pay it.

Arrgh, sorry, wanted to note that I did see you said your mother is on Medi-Cal now, so I know that means she's currently in California ... does that mean the ALF is also in California (I'm guessing probably yes)? And are you?

I am very sorry to hear you are going through this. :-( I don't have any experience or knowledge to offer, but this sounds very much like something that could happen to any of us, and I am hopeful that someone "in the know" will have some useful insights to impart.

In case additional information might help that possible "someone" ... I know you wrote that you signed as the responsible party on the rental agreement ... but did you sign your own name (full stop), or your own name with a string of text immediately after your signature along the lines of "as POA for [your mother's name]" or "signing as POA for [your mother's name]"?

Also, it might be helpful for someone more knowledgeable than I to know what state the ALF is in, and whether you live in the same state?

Again, I hope someone with some experience in this sort of matter will chime in here ... and I wish you the best of luck with what sounds like an extremely frustrating and stressful situation, and I appreciate your bringing it to the board, because I might have a chance to learn something here, too.