Crossing my fingers. The day has finally come. Any advice?

So for those of you that have followed any part of my family's story - thank you LOL. For those of you that have never heard about it - the TLDR backstory is that my FIL is an (undiagnosed but pretty much confirmed narcissist) with a history of all kinds of abuse when it comes to my DH and SIL. A number of years ago BIL/SIL moved in with FIL due to their own hard times when FIL was still independent. And within 18 months FIL was completely dependent on them and losing his mobility.

Since that time things have deteriorated significantly. He should have been in an ALF many years ago. He moved beyond that quite some time ago. And we have desperately needed to move him to a SNF for at least 2 years now. But he is still competent and adamant that he would not go. And their continued dependency on him made for a perfect storm to keep him home.

Since right before Thanksgiving he has been in and out of rehab due to multiple falls. He fell, went to the hospital for a week, went to rehab where we had little hope he would even get out of the bed for the first week. But he rallied and after about 2 months (end of Jan) he came home. He was home 106 hours before he fell. Lather, rinse, repeat. This time he was there for 40ish days. Came home and was home less than 24 hours.

This time I told DH that I was out - if everyone agreed to continue this merry go round - I couldn't do it anymore. It was a danger to him and to them and to us when were helping.

We had a CTJ with FIL and told him that it was unsafe for him to return home. All medical staff agreed. Palliative care had been called in. They met with him and told him that he couldn't return home. And a meeting was called yesterday. EVERYONE (PN, PT, SW, OT, Family) but FIL was on the same page. He needed to be placed in a care facility.

Yesterday it was clear that he had "gently reminded" the SW and PN that HE was still in charge of his own decisions. The PT was miserable and at one point rolled his eyes when they actually tried to give us options for him to GO HOME when he said that was his wish (and the options were for outside care for no more than 10 hours a day)

And I finally had enough (remember, I tend to be the "spokesperson" for the family LOL) and I said, "Let me stop you there. We know he is competent and has the final word. We know he gets to decide for himself. And we aren't trying to make the decision for him. But let's be clear. BIL and SIL can no longer care for him in his home. That's off the table. At any point alone. So while he does get to choose for himself - you and he need to understand that as a family - we are not going to take him home unless he intends to hire care 24/7 to see to his needs. That is the only way he is going to be able to return to his home. Otherwise he is an unsafe discharge home."

I was honestly shaking. But I knew that my FIL had done what he always does, which was to lie to our faces and be calm and smile and tell us he understood. And then go behind our backs and manipulate them. He still believed he could tell them that HE was in charge and that everyone HAD to do what he told them. And that was that. And he IS still in charge of his own decisions. He is just also in charge of the consequences of those decisions. He can't have it both ways anymore because no one is capable of taking care of a 300lb immobile, incontinent, 90 year old man at home. ESPECIALLY not when they have health problems of their own. If he had his way, we would ALL stay there and take care of him 24/7. And that's not happening.

So after that, the entire tone of the meeting changed - we focused on the potential for ALF (there will be an assessment next week to see if there is any potential) and SNF, and the paperwork for the potential for a State run VA home was submitted by the SW. The PT continued to STRONGLY reiterate what he has been saying since the beginning - which is that FIL needs 24/7 Skilled Nursing. His assessment has not (continued in comments)