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After being in rehab for a while, my mom is being discharged next week & her AL won’t take her back because she has a level 3 wound & still is a 2-person assist on her weaker days.


We are going to need to move into long-term care. My question is if the facility doesn’t actually control the resident’s finances, why do I need to provide account numbers? We are paying & will be using the assets from the trust I established for her care, but I want to be the one who manages it & decides how to pay for what… any insight?

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You do not have to provide account numbers. The facility will try to make it sound like the law insists upon it, but it does not. You also do not have to provide your mother's social security number either.
If you are the financial POA then you can insist that whatever care facility your mother is in must send you a written bill each month. If you are paying cash-pay privately, pay by a bank or cashier's check every month. Don't even allow them access to the routing numbers on a personal check.
This happened to me when I was a POA and I learned. Absolutely refuse to give them any of your mother's financial information. You insist on a written bill every month thatyou pay every month.
What care facilities always do is collect from everyone. If it's medically necessary for your mother to be in a care facility Medicare and her secondary insurance will pay for up to 100 days. The nursing home or LTC whatever will collect from insurance and will also pull out the monthly cash-pay cost from a bank account (if you let them have the info which I truly hope you don't). Or they will send you the bill even though it's already been paid.
You have to stay in regular communucation with Medicare to make sure both of you aren't paying for the same services.
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MP1976 Feb 2023
Thank you so much! I accidentally posted a new comment but wanted to thank you for replying!
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MP, my mom had a stroke while in Independent Living, was diagnosed with dementia while in rehab. We moved her to a lovely Assisted Living place where she fell with TWO aides in the room, and broke her hip.

Had to go to a NH for rehab, but it was clear that that this was her last stop.

I, too, was heartbroken. The stats say "you enter a NH, you're dead in 6 months".

Except...my mom lived for 4 1/2 happy years there. Got to see 2 more great grandchildren born. Enjoyed the Thanksgivings, Christmases, Mothers Day and birthday parties we brought to her there.

Yes, it was sad to see her grow more frail. But she was well-cared for, loved by all her nurses and aides and died a fairly peaceful death after an I ther fall.

Take heart. (((Hugs)))).
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MP1976 Feb 2023
Thanks, Barb. That’s my primary concern is finding kind people. She is in a facility that has short-term rehab on one floor, and LTC on another. And the rehab floor has been great. Kind,
compassionate, the staff has all been there for many years.

The idea of my very young mom giving up the only independence she had left (her own apartment, her own furniture, bed, etc) is hard. She’s 66, but her body is more like 86 or 96.

I want to her to be as comfortable as possible for whatever remaining time she has left.
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I don't remember being asked to see Moms finances and if I was, the acct# were whited out and copied. All they saw was what was in her bank acct. I agree with Burnt, better to not even write a personnal check. A bank can always verify that there is enough money for the persons care. They will not be doing any Medicaid applications so don't need it for that purpose. And if Medicaid ever is needed do not allow the facility to apply. You apply and make sure you know the process.
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MP1976 Feb 2023
Thank you!
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We never provided any financial information to ALF for my brother. I am certain they likely looked at his credit report and they did want to know he had assets able to pay his way for some time as they did not accept medicaid or anything other, and he would have had to leave. I basically told them they were looking at about a million on the hoof (you have to be a farmer to get it) and he was in quick. They wanted that money, hee hee.
You don't have to provide this. Just say no.
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Thank you! That’s sort of what I thought. But needed someone who has been there to validate!

She’s been in rehab for almost 100 days between the first stint in December where she got COVID & Medicare kicked her out… she was home for 2 days & back in the ER… then 2 weeks in cardiac ICU. And then back to a better rehab. So we’re at that limit, but she’s not better. AL won’t allow her to come home, so it looks like long-term skilled nursing is her only option. It breaks my heart.
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BurntCaregiver Feb 2023
@MP1976

You do know that the 100 Medicare days start up again in January 2023.
So your mother might be covered in the LTC for a while. Even if she is going into LTC permanently and not returning to her AL, do not allow them to take charge of her finances.
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@BURNT We have received 2 denials from the third-party Medicare processors (Livanta & Maximus). I'm still trying to understand how/why it's being denied when she has a level 3 wound that requires care (in addition to her mobility issues).

She definitely isn't making enough progress to satisfy them, I get that. She is very weak, and her bone-on-bone arthritis causes her to be in extreme pain... unfortunately, the long-term care was inevitable. But I thought we'd get more time than her being 66!

The elder care attorney I spoke did confirm I can black out all account numbers for this application; I will be the one paying but they still have the right to ask to see an overall picture of her assets.
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