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Mother is currently in HCBS after multiple falls. She doesn't want me as POA, what happens next?

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Have you asked her who she plans on handling her financial affairs? Will she appoint someone else as POA? If she has property or other assets, is she prepared to have them seized for payment of her bills?

I’m not sure what HCBS is, but if there is a social services department and /or a financial office, I’d go in and forewarn them that Mom has no POA.

If you have no POA, you are free and clear of responsibilities to your mother and her affairs. You are not responsible for any bills she incurs. This is between the medical institution and her.
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Mom pays. If on Medicare and this is a rehab situation then Medicare pays the first 20 days 100%. 21 to 100, 50%, after that its private pay. Even with my Moms suppliment, she pad $150 a day. Her last Rehab stay after a 4 day stay in hospital, I told them she would not be able to pay past the 20 days. (I was pinching pennies to keep her in an AL) She was only there to get her strength back. I have been told for every day in the hospital, its 3 days of rehab. Mom was discharged at 18.

If Mom has money for AL, she may not qualify for Medicaid. If you feel that rehab is not helping her, you can have her discharged back to the AL. You can have therapy come to the AL with Dr. order. If she is a continual fall risk she may have to use a wheelchair.

The other thing is she maybe past an AL. She may now need LTC. If so, you will need to spend down her assets and then apply for Medicaid before her money is gone.
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I am not sure if the question is about power and responsibility, or about the mechanics of getting money from Mother's bank account to pay current bills. Three ways to go:
1) Ask Mother who she would like to handle this, if she doesn't want it to be you. There are Trustee Companies who will do this, for a fee.
2) If it's mechanics, ask HCBS. They must have had experience of this before. Just don't let them invoice you yourself.
3) Ask the bank, once again if it's mechanics. They also must have had experience of this before. There is a difference in getting a necessary hospital bill paid, as opposed to passing total control over finances to a POA.

There is a good chance that going through this with Mother will result in a decision. Remember that a POA can be for more than one person, both to sign. This may reassure her that she is not putting herself totally in the power of one person.

If there is a lot of money at stake here, the Trustee Company may be the most appropriate, and it may be a good idea to get a lawyer to give your mother advice in person. If it is just a natural wish to keep control, 2 or 3 to sign is more likely to solve her worries.
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