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Acknowledgment of Disclosures and Authorization
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment. You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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Mostly Independent
Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
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Yes. It matters. The guardian or POA signs as usually a resident is unable to understand what they are signing. But it is important legally how you sign. I signed for my brother but signed, say Dee Deer, by Alva Deer under POA (or POA). That means that Alva is signing for Dee as he cannot, but she is not assuming the responsiblity of PAYING. Dee is paying, even if Alva is the one who makes out the checks, or OKs the automatic withdrawal. So if the person can understand, they can sign. If they cannot, then their POA or their Guardian signs their name using POA to sign. It is important you do not personally take on liability.
AlvaDeer Thank you for your response. I thought the guardian of an incompetent resident is the one who signs the admissions paperwork. However, that is not what happens. For some unusual reason, whenever my BIL transfers from place to place, the Administrators and Social Workers ask my husband to sign instead of his guardian. I thought that was odd. Thank you again.
I would tell them no. The guardian should be signing these forms. If you read carefully I guarantee that there is a financial responsibility statement in those admission forms.
You have to watch these places they are dirty dealing dogs.
Isthisrealyreal Thank you for responding. You said a mouthful about them being dirty. You are absolutely right. I really feel like that are playing dirty but before I gave them the benefit of doubt, I came here to see what you all thought.
The last Memory Care Unit my husband's brother was in, The Administrator had my husband to sign the Admissions paperwork. However, the Administrator of that facility "dumped him at the hospital" and refused to accept his back.
The thing is, Whenever the Administrator "dumped" him, she refused to give my husband any paperwork, claiming he was not the guardian. My husband and I recently were able to get our hands on the "discharge notice". She covered up what she was doing by putting on the discharge notice that she was discharging BIL to another Memory Care Unit when in fact that is not what she did.
I feel like they are trying to keep things covered up by having my husband sign all the paperwork although he is not the guardian. Thank you responding. At least
If a person has a Guardian that means that they in all probability can not sign a contract. The fact that you are a Guardian does not necessarily mean you are financially responsible personally for the cost. I was Guardian for my Husband and any costs that I incurred came out of his account and I was paid back. (I kept receipts and at the end of the month I would total them up and write a check from his account to mine, this was all reviewed and had to be approved by the court about every 6 or 12 months) When the house we lived in was sold the money went into HIS account (my name was not on the deed) In this case I would sign and indicate "As Guardian for....." But any expense has to be approved by the court so I would suggest that this be brought up and prior approval be given.
It has been my experience as guardian / conservator for my dad that they always have me sign. They will not allow him to as he would have no idea what he is signing. I always sign my name and then 'guardian' or 'conservator' at the end, depending on the situation.
If a person has a guardian and the person himself is forced to sign then the facility just created an illegal contract; make certain your papers for guardianship are turned in. Whatever happens, whatever you sign ALSO sign what who you are signing for, so that you are not help personally responsible for bills.
Having the same problem. Mom in rehab now and being discharged in to Respite Care on Monday. They sent me admission paperwork to sign. I'm not her guardian and don't have POA. They are saying my mom has dementia, so wouldn't that mean she can't sign the papers either? Don't know what to do.
If you have DPOA, HEALTH & FINANCIAL, you can sign on their behalf. I was told to sign this way: John Doe, by Jane Doe, Agent. This way you aren't seen as the responsible party.
If there is a DPOA in effect, then that person signs as their agent. If there is no DPOA but a guardian, then the guardian signs as their agent. If neither of these apply, then the next of kin signs as the agent. Sign it as the agent for the person not the responsible party.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
You have to watch these places they are dirty dealing dogs.
The last Memory Care Unit my husband's brother was in, The Administrator had my husband to sign the Admissions paperwork. However, the Administrator of that facility "dumped him at the hospital" and refused to accept his back.
The thing is, Whenever the Administrator "dumped" him, she refused to give my husband any paperwork, claiming he was not the guardian. My husband and I recently were able to get our hands on the "discharge notice". She covered up what she was doing by putting on the discharge notice that she was discharging BIL to another Memory Care Unit when in fact that is not what she did.
I feel like they are trying to keep things covered up by having my husband sign all the paperwork although he is not the guardian. Thank you responding. At least
The fact that you are a Guardian does not necessarily mean you are financially responsible personally for the cost.
I was Guardian for my Husband and any costs that I incurred came out of his account and I was paid back. (I kept receipts and at the end of the month I would total them up and write a check from his account to mine, this was all reviewed and had to be approved by the court about every 6 or 12 months) When the house we lived in was sold the money went into HIS account (my name was not on the deed)
In this case I would sign and indicate "As Guardian for....." But any expense has to be approved by the court so I would suggest that this be brought up and prior approval be given.
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