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Step-Grandfather has only me living in this country. He makes less than $12k/yr from Social Security and has no other assets. He fell in his home and was unable to move. We found him on the floor ~3days after he fell. He was unable to push himself up to call for help so he laid there for 3days. He had no broken bones and after 2 days in hospital he has improved. He was moved to In-Patient rehab to see if he can walk and live on his own. They have a 20day evaluation period (we are day 6 today and he has not walked on his own). The Social Services people are telling me about the possible next steps which are likely Gov't Nursing care because he is unlikely to be able to care for himself. They suggest I be his Durable POA but I really don't want to take that on, I feel at risk and exposed. I don't want to make decisions about his ongoing care or be responsible for his financial situation/debts. What happens if I don't do it?

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Don't take on POA if you don't want to. It does come with responsibility. You don't have to care for him but u will be in charge of his finances and medical decisions. He also has to be able to make that decision. Otherwise, its guardianship. Which is expensive. If he has children, let them handle him.

Tell the SW you r not willing to take on POA. If there are children, give the SW their names and phone nos. If not, tell them the State will need to take over. You can not be forced to take on any responsibility.

POA does not mean ur responsible for debts personally. If there is no money, he can't pay debts.
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Only the gentleman himself can appoint you as his DPOA, is point one. Unless your stepG/F has suggested it or gone along with the idea, it's a non-starter anyway.

But even if he did, you are under no obligation to agree to do the job. It is burdensome, and it is a major responsibility (although it will not make you financially responsible for him or his debts). No wonder Social Services would rather you did it than that they had to!

If need be, the state will apply for guardianship in due course. Whatever happens, your sGP will still have the rights of any other citizen which includes the right to a relationship with you. You will not be cast into the outer darkness for being realistic about your ability to contribute.
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He will get a state-appointed guardian. Usually they are professional social workers who have a case load of people for whom they make decisions. If you don't want to be DPOA then don't do it. My husband is his dad's POA (both medical and financial) and it takes a huge chunk of time and energy.
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Follow your heart. If you don’t feel this is appropriate then don’t force yourself to get involved in that way.

I wish you and your grandfather well. Hugs!
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A government guardian/conservator can be appointed. If you don't or can't realistically take this one, then he can become a ward of the court.  How much do you know about his affairs, etc.  Sometimes elders are very secretive and you could walk into a real mess, or he could be stubborn and difficult to work with. In these cases, a court appointed guardian/conservator might be able to work more effectively and efficiently.  Can you talk to the social workers about this possibility of emergency guardianship by the state?
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State or courts (not sure which it is in US) will appoint someone in your place.
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He's lucky he didn’t die from shock or exposure - gets cold lying on a floor for hour after hour. Let alone dehydration etc. after 3 days.

Not sure why you feel at risk and exposed. However if no family takes on responsibility the courts will.

Actually if he is going into permanent care it’s not that difficult. Sell house. Cancel utilities. Invest his money. Set up direct debit payments to care home.

Many older people don’t want their life prolonged. I’ve no idea if you’ve ever even chatted about what he’d like. For my uncle as long as pain free as much as possible, we refused any other medical intervention since he would have been distressed and confused by it.

However, should you still feel it’s something you’d rather avoid then courts will deal with those aspects.
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