Can a Healthcare Agent Choose a Nursing Home or Long-Term Care Facility in Ohio?
Direct Answer
An Ohio healthcare agent may have substantial authority to participate in decisions about nursing-home or long-term-care placement once the healthcare power of attorney is active, particularly when the placement involves the principal's healthcare. But a healthcare power of attorney does not necessarily give the agent control over every financial, contractual, or property issue involved in moving someone into a facility. Those issues may also require authority under a financial power of attorney or another legal arrangement.
This distinction matters because moving into a nursing home or other long-term-care facility is rarely just a medical decision. Someone may need to select the facility and consent to care while also dealing with contracts, payments, insurance, personal property, and the person's home.
A coordinated Estate Planning in Ohio strategy can make sure the people helping you have the appropriate authority if incapacity makes long-term care necessary.
If you would like help reviewing your powers of attorney or planning for incapacity, you can schedule a free 15-minute phone call with an attorney.
A Healthcare Agent Can Make Healthcare Decisions Once the Power Is Active
An Ohio healthcare power of attorney allows you to designate someone to make healthcare decisions if you lose the capacity to make informed healthcare decisions yourself.
Once the document is active, and subject to its specific limitations and Ohio law, the healthcare agent generally can make healthcare decisions to the same extent you could make those decisions yourself.
Ohio law defines healthcare broadly as care, treatment, services, or procedures used to maintain, diagnose, or treat a person's physical or mental condition. Ohio's healthcare power of attorney statutes also expressly recognize nursing homes as healthcare facilities.
That gives a healthcare agent an important role when nursing-home placement is connected to the person's healthcare needs.
If you want to understand when that authority actually begins, When Does a Healthcare Power of Attorney Take Effect in Ohio? explains why signing the document does not ordinarily mean that the agent immediately takes over your decisions.
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Choosing a Facility Can Involve More Than One Kind of Decision
Imagine that someone suffers a serious medical event and can no longer safely live at home.
The treating professionals may recommend skilled nursing care or another long-term-care setting. The family then needs to decide where the person should go.
The healthcare agent may be the appropriate person to make healthcare decisions associated with that transition. The agent can evaluate the person's care needs, available facilities, treatment options, and the principal's previously expressed preferences.
But choosing a facility can also create financial and contractual issues.
Someone may need to access bank accounts, arrange payment, deal with insurance, manage property, or handle other financial matters. A healthcare power of attorney is designed for healthcare decisions. It does not automatically give the healthcare agent general authority over the principal's money and property.
That is why healthcare and financial powers of attorney often need to work together.
A Healthcare Power of Attorney Is Not the Same as a Financial Power of Attorney
This distinction becomes especially important with long-term care.
The healthcare agent may be involved in determining what type of care is appropriate and where that care should be provided. A financial agent may separately have authority to manage the money needed to pay for that care.
If the same person serves in both roles, the practical distinction may be easy to overlook. Legally, however, the authority comes from different documents.
If different people serve as healthcare and financial agents, cooperation can become particularly important.
The healthcare agent might determine that a particular care arrangement is appropriate while the financial agent handles the accounts and transactions necessary to implement the plan.
Our Powers of Attorney in Ohio resources explain how these different forms of authority fit into a broader incapacity plan.
The Healthcare Agent Should Follow Your Wishes
Having authority does not mean the agent should simply choose the facility the agent personally prefers.
Ohio law generally requires a healthcare agent to act consistently with the principal's desires. When those desires are unknown, the agent generally must act in the principal's best interest.
That can matter significantly with long-term care.
You may have strong preferences about staying near your spouse, children, or community. You may prefer care at home for as long as reasonably possible. You may have religious, cultural, medical, or personal considerations that affect where you would want to receive care.
Discussing those preferences with your agent can give the agent considerably more guidance than the legal document alone.
You Continue Making Your Own Decisions While You Have Capacity
Signing a healthcare power of attorney does not ordinarily give another person immediate authority to decide that you should move into a nursing home.
As long as you retain the capacity to make informed healthcare decisions, you continue making those decisions yourself.
This is an important protection.
A healthcare power of attorney is primarily incapacity planning. It creates a decision-making structure for circumstances in which you can no longer make the relevant healthcare decisions yourself.
If there is uncertainty about whether the document has become active, Who Decides When a Healthcare Power of Attorney Becomes Active in Ohio? will address that issue more specifically as part of this healthcare planning series.
The Facility Still Has Its Own Admission Requirements
Having authority to choose a facility does not guarantee that a particular nursing home must accept the person.
Facilities may have admission criteria, available-bed limitations, care-level requirements, financial arrangements, insurance considerations, and other requirements that affect whether placement is possible.
The healthcare agent's authority therefore should not be confused with the facility's obligation to admit someone.
In practice, the agent may need to compare several facilities and work with physicians, hospital discharge planners, social workers, financial agents, insurers, and family members before an appropriate placement is secured.
This is one reason incapacity planning involves more than simply naming someone on a form.
Family Members May Have Different Opinions About Placement
Long-term-care decisions can create substantial family disagreement.
One child may want a parent to remain at home. Another may believe skilled nursing care is necessary. A spouse may prefer a facility close to home while the healthcare agent believes another facility can better address the person's medical needs.
Those disagreements can be emotionally difficult, but family disagreement does not automatically eliminate the authority given to a properly appointed healthcare agent.
Our article What Happens If Two Family Members Disagree With My Healthcare Agent in Ohio? explains how competing family opinions interact with the authority of the person actually designated to make healthcare decisions.
Clear instructions from the principal can make those disputes easier to resolve.
The Healthcare Agent May Need Access to Medical Information
Choosing an appropriate care facility often requires understanding the person's condition.
The agent may need information about medications, mobility, cognitive impairment, rehabilitation needs, behavioral concerns, ongoing treatment, and the level of assistance required with daily activities.
Ohio law generally gives an acting healthcare agent rights to receive information concerning proposed healthcare, review healthcare records, and consent to disclosure of those records unless the healthcare power of attorney limits those rights.
That access can help the agent make an informed decision rather than choosing a facility based only on location or convenience.
For more on access to medical information, see Can My Healthcare Power of Attorney Access My Medical Records in Ohio?
Financial Planning Can Be Just as Important as Healthcare Planning
Long-term care can expose gaps in an estate plan that were not obvious when everyone was healthy.
A healthcare agent may know what care the person needs but lack authority over the person's bank accounts. A financial agent may control the money but have little understanding of the healthcare plan. A house may need attention while the owner is living elsewhere. Bills still need to be paid.
The strongest incapacity plans anticipate that healthcare and financial decisions may need to happen at the same time.
This is why estate planning should not treat the healthcare power of attorney as an isolated document. It should work alongside the financial power of attorney, living will, trust when applicable, and the rest of the person's plan.
Choosing the Right Healthcare Agent Matters
Long-term-care placement illustrates why choosing a healthcare agent deserves careful thought.
The agent may someday need to evaluate competing medical recommendations, visit facilities, communicate with doctors, consider the person's wishes, manage family disagreements, and make decisions during a stressful period.
The right person is not necessarily the closest relative.
It should be someone you trust to understand your wishes, ask appropriate questions, make difficult decisions, and remain focused on what you would want.
If circumstances change after you sign the document, When Should I Update My Healthcare Power of Attorney in Ohio? explains when reviewing your choice of agent may be appropriate.
Takeaway
An Ohio healthcare agent can play an important role in choosing a nursing home or long-term-care facility once the healthcare power of attorney is active, particularly when the placement involves healthcare decisions.
But long-term-care placement often involves more than healthcare. Contracts, payments, accounts, property, and other financial matters may require separate authority under a financial power of attorney or another part of the estate plan.
Planning for both sides of the decision can make it much easier for the people you trust to arrange appropriate care if you can no longer handle those decisions yourself.
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