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Hi all,


My father was admitted to a nursing home and I received his admissions agreement. It's really long so I asked the admissions lady if I can take it home and bring it back because I wanted to read it thoroughly. She said that was fine but marked the areas that needed signatures. I told her that I was my father's POA and that I would sign as the POA under the "resident" signature line (father's name, by my name, as agent). However, the lady said that the "responsible party/resident representative" signature line also needed to be signed. I told her I would look into it at home and fill it out accordingly. She insisted that the responsible party/resident rep needed to be signed. I don't understand why I would sign under the responsible party/resident rep, if I can just sign as POA on the 'resident' signature line. I thought I am signing on his behalf? Wouldn't a signature on the 'resident' line be good enough?


Also, the lady assured me that I won't be financially responsible to pay for services with my own funds, and it would only come out of my father's funds. She said to read page 1, where it indicates that "responsible party refers to an individual who has legal access ot the Resident's income and resources." Honestly, I do not feel comfortable signing as "responsible party/resident representative." Can they discharge or kick out my father because I refuse to sign as responsible party? I live in the state of NY.


The contract also states that, "The responsible party may be held liable to the extent that the facility relies to its detriment on false, misleading or incomplete information and documentation supplied by the Responsible party regarding matters, including, but not to limited to, the Resident's financial resources, and for third party insurance coverage."


I am not sure what to do, I cannot afford to pay for an elder attorney. Any help would be greatly appreciated. The nursing home wants me to complete the admissions paperwork ASAP.

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Is your father able to private pay or is he filing for Medicaid?
Does he own a home you plan to sell to help pay for his care?
You do have access to his income or assets right?
Do you know of some reason he wouldn’t qualify for Medicaid?
If your father has any funds, there is probably not a more important expense to spend it on than a naela or CELA attorney, a certified elder attorney with experience in Medicaid application. It’s not your money you would be spending but his for him.
Give a bit more information and hopefully a NY resident with NH experience will respond.
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caregivernyc Mar 2019
Hi, sorry for the confusion. He was admitted to the nursing home as a Medicaid/medicare patient. Medicaid is currently paying for his care at the facility. He doesn't have any assets or resources. His income goes to his wife, because she doesn't work and would not survive without it. Basically, he has no funds. Thanks for the response
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Sign as POA, your name, AS POA for dad's name.

Sign everything this way or you will find some sleazy company trying to make you personally responsible.
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caregivernyc

When you filled out the Medicaid application did you submit all the information about his income and his wife etc? I got a little nervous for you when you said his wife would need all his income.
She is considered a community spouse. Medicaid will not leave a community spouse without income is what I have read on this forum.
Are you working with a social worker at the NH?
Is he already on community medicaid?
Medicaid is managed slightly different state by state.
Hopefully someone from NY with Medicaid experience will see your post and weigh in. Keep answering and giving more info to make it clear where you are in the process so they can help you.
This link has an article about NH contracts. It states that it is against federal law to ask you to sign that you are responsible. Go over this with the Social Worker.

My understanding is they can’t kick him out.
The person you are dealing with may not have the authority to take the contract any way but how they explained. So if they can’t make you comfortable, ask
to speak with someone else who might be able to help you.
Here is an excerpt from the link.
Two critical pieces of advice for caregivers:
Make sure you aren't personally binding yourself to any financial responsibility. Sometimes, nursing homes may try to get a caregiver to become a "responsible party." In most cases this means that the caregiver will be responsible for their loved one's nursing home expenses. Caregivers should avoid signing these kinds of agreements as federal law prevents nursing homes from requiring such commitments.If there's something in the contract that you don't understand, make note of it and ask the nursing home to explain it to you. Or contact an elder law attorney before you sign.
And remember—even when you feel pressured by time, finances, or nursing home staff members—you always have options.
If you don't feel comfortable with the document you're being asked to sign, Polinsky says, "A caregiver needs to have the wherewithal, even during that stressful time, to say that they will not sign the contract."
https://www.agingcare.com/articles/nursing-homes-prevent-suing-arbitration-causes-150390.htm

EDIT; did you already offer to sign as Isthisresllyreal suggested in both places or you just didn’t want to sign under any capacity in the second space?
Remember as his POA you are signing or committing for him. Not yourself.
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caregivernyc Mar 2019
Thank you for the detailed response! You are absolutely correct that she is the community spouse. The medicaid application was done a while ago but it was filled out correctly, and they determined that Mom is entitled to dad's benefits because she is the community spouse. No issues here.

The issue I am having is signing as "responsible party" on the nursing home admissions agreement. I do not want to be the 'responsible party' because I have read and heard horror stories about nursing homes later suing the responsible party, when necessary. I know that there's a chance that nothing will happen because I work well with the nursing home when it comes to renewing dad's benefits. However, I do not want to take any risk and become liable for my dad's expenses/bills during his stay at the nursing home.

In any event, I called the admissions lady and told her I am refusing to sign the responsible party. I told her that I can sign as his POA on the resident section. In the end, I will have to seek an elder law attorney to help complete the admissions agreement. There are so many pages to it, and it gets confusing.
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I think you are very wise to be cautious, and I applaud you for sticking to your guns. I HATE it when officious administrators stick forms under your nose, say sign here, and then roll their eyes and huff when you're so picky as to want to read it first.

Having said that, I do have a twinge of sympathy for what I think the contract is getting at - that they have been burned before by (ir)responsible parties getting their charges admitted by telling shameless taratiddles about the person's insurance, assets and income.

Not your problem! You are signing for, with power of attorney. That is the limit of your responsibility, and good for you for minding those lines don't blur.
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PrivateCitizen Mar 2019
yep, have seen this myself in a family member. What anyone forgets is IF assets are hidden that truly are the patient's, then what is being asked is the taxpayer of that state, or the nation, to cover costs for your parent/loved one, while (they) escape legitimate costs. the ones who raised and cared for us did not steal from neighbors to raise us, but when the reverse is happening family wants to take all that grant had and spend it, as their "DUE" and they deserve it, thus sticking eveyoe else to pay for their last months or years of care. There is some evil finagling going on by all relatives often to keep all the assets that SHOULD be used for granny's last year of life. but when it is seen as Medicaid" socked for it, no one usually care. this is theft, sad but true. No one should beggar themselves, but ask"how much is my mother's care worth to me?" isn't SOME cost born by the family worth it to see them properly cared for..landing in a state ward..I shudder.
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What that means is in the event of your father's death, any outstanding bills owed to the nursing home have to be settled by you. You'd also have to send back his full SS benefit for the month he died. Be prepared.
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JoAnn29 Mar 2019
I made my Moms NH payee of her SS check. That way it was their headache when Mom died.
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I would either sign it the same way you are on the "resident" signature line or you name POA for his name. Making sure you are being clear that you aren't accepting personal responsibility you are accepting responsibility on his behalf.
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When dad went into MC I signed everything as POA.. no arguments allowed. Take it or leave it. They took it.
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Hi

It is another way of you making sure they are paid through his finances.
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Some people will attempt to hide their loved one's money, which can be seen as fraud; in most states, all a person can have in their account is $2,000 or less to be on Medicaid. There are a lot of hidden charges a nursing home will not tell you such as cost of TRANSPORT such as to a doctor's office, and other non-emergent issues. If your loved one is hospitalized, and is ready for discharge either you will have to take them back to the nursing home in your car, or you pay for cost of transport since going back home is non-emergent. Medicaid will also not pay for hair cuts. ALSO if he owns his own home and is under his name, when he passes everything will go into probate and the nursing home will seize it. This is known as an estate recovery law, which is Federally mandated. If your name is also on the deed then it will not go through probate so Medicaid can't touch it. that's why it is wise to see an eldercare attorney prior to getting him on Medicaid for estate planning. I did..and it wasn't that bad only a few hundred dollars BUT it saved me a great deal in the long run and prevented headaches.
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Bottom Line: They want to Make Sure you are Not Holding back anything Financially with Them paying His way...That's It. It is All about the Money, honey. Just be Sure to be Honest in Every Department, They don't Miss One Slick Trick.
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Check to see if you or your dad is eligible for Legal Aid. You may be able to get a free hour consultation. Your local college or University may have access to Legal Aid.
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I did this for my mother and had POA. They need someone who will make decisions as needed that your father may not be capable making.
I was not responsible for my mother financially, but needed to make sure her monthly payments to assisted care were made. They need to make sure the meds. they give are given correctly. I assume that you are the person they call if they have an issue or concern. In all these cases are you the responsible person they can call on?
I think you said you were told that you are not responsible financially and assume you understand they can’t care for your father unless you know payments can be made.
Knowing he is safe and cared for is a blessing. Ignore the horror stories some like to tell without having the whole story and all the facts.
Your father is blessed knowing you’re there for him.
God bless you with the guidance, strength and love you need.
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I have been to an elder attorney, to discuss just these things. He advised that I should never sign any document as:
Jane Doe, POA FOR John Smith

Rather, he stated to sign all legal docs as:
John Smith BY Jane Doe, POA

He said this would insure that the doc was clear that the parent was responsible for payment, and NH could not come after me for unpaid bills. I live in Texas, and have done all my POA signing for both parents in this way. Best of luck.
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jacobsonbob Mar 2019
Excellent point!
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My advice is see an attorney. Yes, there will be an expense but you will have a greater peace of mind. I went to see the attorney who prepared my parents wills and Aldo their financial and medical POAs. So, we already had a relationship. I paid for this out of my parent’s funds. It was not expensive....And I always felt sure that I knew what I was doing. Peace of mind is important when you’re looking after your loved ones. I was always distrustful of the nursing home office staff and with good reason. Please get good legal advice for yourself.
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It is worth seeing an elder law attorney. Check in your town where there may be free advice through some institutions at weekly meetings and etc. But as I understand it you are not responsible to pay out of your funds. BUT as POA you ARE responsible to apprise those caring for your relative of their funds, which are now in your control basically. So what they are saying is that you are responsible to divulge your relative's financial things when money is needed for your relative. In the case all funds are exhausted you would be responsible in divulging this to the federal government, medicare, medicaid as well, and then those funs would take over care. It is sometimes a good hours pay to get the opinion of an attorney and be able to rest assured.
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and I thought buying or leasing a car was a challenge.
I'd be seeing the elder law attorney for guidance. This is too serious a matter, and it sounds very much like they are smooth talking but in the end, even if out of the residents funds, they'll still hold you accountable for accessing and paying from them. Don't sign without a legal review.
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CONTACT YOUR LOCAL CHAMBER OF COMMERCE FOR A REFERRAL TO ASSIST YOU WITH THE DOCS. CHAMBERS MAY ASK FOR YOU TO BECOME A CHAMBER MEMBER AND IF SO, THE COST IS IN THE LOWE $100-200.00 RANGE FOR A 1 HOUR CONSULT! SOME ALSO OFFER A NO COST, PRO BONO CONSULT FOR NEW MEMBERS! HURRY...THE CLOCK IS TICKING!

COPPERTINO
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Three words - Elder Law Attorney.
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I suggest that you sign every line as "Dad, by Caregivernyc, POA." He's the resident, so that line probably applies to the conduct they require of him--not being violent, etc.
They also want someone to sign as being financially responsible. That's also "Dad, by Caregivernyc, POA." This makes him financially responsible, not you.
As POA, you are only his agent, responsible for taking care of his financial affairs in a responsible and honest manner. ALWAYS sign as POA.
Never let anyone pressure you into signing just your name. I don't think the NH is expecting you to do that, I think they just want all the lines filled in, and the POA signature will satisfy them.
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Don't do it. They will eventually sue you for any issues with payments. They are stinking crooks in NJ. Never sign anything with your name. Sign as the patient agent only under POA. I am being sued even though I am as a child NOT responsible for my parent's health bills.. they are STILL suing regardless costing me $5000 so far just on my defense for their BS lawsuit. Their own contracts state they can't get money from you but they still sue! Hate to say it.. but if you sign anything..they will likely set their sights on you downstream should there be a single bill not paid. Health care in the US is the worst financial burden besides legal defense. Good luck!

Ps.. the NH admin person may call a bunch of times... state such things as " I don't know what will happen to your loved one if you fail to sign these papers" or "everyone must have someone sign" .. but... nothing will happen to your loved one.. and someone else will or has already signed or the NH wouldn't have accepted your loved one in the front door... avoid them.. they are just setting you up for their lawsuit..
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jacobsonbob Apr 2019
I can believe it. I used to say that it's getting to the point that "USA" is, unfortunately, starting to stand for "U Screw All".
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I was POA for my dad.  When he went into the nursing home, my mother and sister went to the office in the NH and did all the paperwork - without telling me.  They got there first.  My mother signed everything in her name.  Had I done it, I would have signed "My name, POA for my father".

Now, my dad passed away in September and now the NH is billing my mother for what Medicare/Medicaid didn't cover.  (He went in while on private ins/Medicare and then he got onto Medicaid before he passed away)  It says she is she is 'responsible party'.  Had I signed it, my lawyer said we would not have had to pay. 

The NH was quick to put those papers under my mother's nose on her first visit to see my dad at a time when we were all stressed and confused.  I wish I had gotten there first.
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Facilities can not require that a family member be held financially responsible for a resident's bill. As stated below anything you sign, sign as their POA. If they are telling you not to sign a particular item as POA, this is a red flag. Most facilities know that they can not require a family member to be financially responsible but their are still a few who will try.

I have often had situations where families have been told something by a "staff member" at the time of admission and later the family has found that what they were told was not true and they have no recourse. Example:

Families who place a loved one into a home as private pay but will need Medicaid down the road are often told "If you use all your money at our home when you need Medicaid bed we will have one for you." So the family puts their loved one in the home spends all the money and when they go the staff and ask for a Medicaid bed they are told "we don't have one available at this time, you will have to move your loved one." When the family tells them they what they were told they then said "no one here would tell you that or do you have that in writing?" No one will ever put that in writing!

Again, as many have told you in this post, sign as POA. If you do this you should be fine. If the admissions person does not accept this ask them: If I sign without the POA will you sign a statement acknowledging that I am not going to be held financially responsible for any bill. I am pretty sure they won't.
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Do not sign your name as responsible party. Sign as POA for your father only. They will attempt to tap into your $$$'s
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I have signed many of those forms and always sign on the representative line and add POA after my name. Just make sure you do NOT sign any forms making you the guarantee for funds and do not give them your social security number.
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Do not sign as "RESPONSIBLE PARTY"- Sign only as AGENT, POA... if they are insistant, request to speak to the Director or Executive Director. If they still are "giving you the run-around" call the state . You are the POA, and AGENT ....only. Make that crystal clear to them... YOU are not a responsible party.
I ended crossing out the responsible party on my moms AL contract and sign as POA only..
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