Moving elderly parent with Medi-Cal in California to Nevada. Will she get disqualified getting NV Medicaid?

According to Nevada, the home based services have a waiting list. Her income is well below the limit of $2199 a month. You will wait about 2 years before getting services in Nevada. It is not first come, first serve though. People with the greatest need get services first. Therefore, it could be several years before you get services.

Wow, 90 hrs a mo of in home care for free. $ 300 for housing. And between Medicare & Medicaid, she should have no medical care expenses. Very generous.
CA's IHHS system is pretty organized, comprehensive and set in place county by county for several decades now. If I'm remembering correctly from my health policy / certificate of need days, CA's IHHS (medicaid paid) came about around in the 70's & 80's about the same time that Kaiser was setting up it's innovative for the time HMO system. Between the two and Medicare, there would be some sort of health safety-net for CA. Most states did not take this path, fought big time against any HMO's and most have very fractured systems. I doubt your mom will easily get the level of services, housing and only contribute $ 300 a mo in NV. I'd really suggest you dog finding out in clear exacting detail what's what before you move her as once she's off CA system it will be a beast to get her moved back to CA and become re-eligible.

So right now your 78 yr old mom living alone gets 90 hrs of IHHS a month. 22.5 hrs a week, and she has gone through some sort of detailed evaluation to get that 22.5. She does not show to be "at-need" for more hours, otherwise IHHS would have her get them. To get into a NH, probably need to be 32/34 hr of care needed per week, is what I'm remembering (as it needs to be a certain level of hours to make it cost-effective to place in a NH rather than stay at home). Your mom isn't even close to that. Short of her having a major stroke & hospitalization, she is not going to qualify for a NH.

At 78, could live another decade. And the way you describe her, she's good on ADL's as she can fix meals, walk, potty, dress on her own even w/COPD & heart condition.

So that leaves living in your home, which is what you want to do. If NV counts all household income to establish medicaid "at need" finances, between your & hubs 2 full-time RN salaries plus her tiny $ 800 SS, probably too high to qualify. She may have to live on her own to have the low income level needed for state assistance. If all caregiving fell to you & hubs - either by you & hubs personally doing it or paying for it - can you do this and for possibly years & years? If hubs still has his mother, would caring for yours be a point of contention?

I'm wondering if mom's concerns are related to loneliness? 78 is still young! Those times she's gone to the ER, what prompted it? is there a pattern? (as an aside on this, my mom when in IL would be "robbed" the morning of the last day of any of our visits & call frantically that I needed to return to speak to police). If she's still pretty competent & cognitive would mom perhaps do better if she was living in congregate housing rather than solo in her own little apt? IHHS worker should have someone higher up in the county program to contact to find out about other housing options in her area. I'd suggest you look into that as a possibility at the same time you are trying to figure out what NV would definitely provide. Good luck.

Quite sure NV residency is established by being there and intending to stay. Period.

thank you all for your comments! her ihss is separate from her ssi and she doesn't pay her caregivers from her ssi, with the 800 she gets she pays for her apt with section 8 which is about 300 and the rest is for her living expenses which goes quick in california. she currently has about 90 hours of ihhs/month but her concern is she's feeling very weak, almost to giving up, she's eating like a little bird, basically she just is able to prepare food for herself, feed herself and take herself to the bathroom, sometimes she'll walk outside with caregivers for 10-20min at a very slow pace if she's feeling strong but those days are drifting away. the ihhs caregivers clean and cook for her, do light chores in the house. my mom is concerns that she's needing 24hr care because she's scared she'll fall and also contemplated if it's time for hospice but i don't think she has a diagnoses that has worsened for her to make hospice criteria. she does have COPD and a bad heart, she's gone to the ER about 3-4x this year for heart issues but she doesn't use oxygen. i'm not sure if it's just her being depressed and feels weak because she can't do what she used to do as she's not 'as bad' as others that go into nursing facilities. in nevada she would stay in the home with me, i'd need to figure if they have ihss too or if she'll qualify if she's living with family as she needs someone to stay with her to make sure she doesn't fall while we work. she's pretty alert but forgetful as with most 78 year olds. I'm very scared to take her out from california with all the benefits they have for her there because we are not able to afford any private pay for very long if she were to move to NV.

You're smart to get the details and requirements upfront. I think I would consult with an expert in your state on Medicaid, like an attorney who handles it. The rules are so complex. Then there are the exceptions to the rules.

What has your mom been diagnosed with? My cousin was living on her own when dementia struck her and rendered her unable to live alone anymore. Her doctor said it wasn't even a close call. She was not able to take her own meds, bath, cook, etc. Her memory was very impaired. Does your mom have that kind of problem?

I would explore if people who are disabled have different standards for benefits than others.

I'd really suggest that you ckearly find out just what NV can provide for her BEFORE moving her. Medicaid although it is funded by both the Feds & the states, is administered uniquely by each state so what programs TX has & will pay for & eligibility requirements could be totally different than for Minnesota. If NV has pretty exacting residency requirements, it could mean mom has months till eligible and either you & hubs take on all things mom 24/7 for months & months and she lives with you plus work....or...if she needs to be in AL or NH you will have to private pay for her stay till she's eligible. At $800 a mo with NV residency to be established, I'd doubt any facility will take her in "medicaid pending", so you are going to have to sign a private pay contract to get her in. NH run from 5k -15k a month and you will be held to the contract.

Plase keep in mind that Most states medicaid do NOT pay for AL at all. Or if they do the # of beds and participating AL is small with long waiting lists. AL Medicaid is done via a waiver program so is not dedicated funding (like NH Medicaid), so facilities aren't inclined to participate. Right now the trend for medicaid waiver funding is PACE or other daily community based programs usually run by a non-profit partner with the state. There is one by us (the Benson Center in New Orleans) which is run by a health care division of Catholic charities. In theory it keeps elders who orherwise would be in a NH or AL to continue living at home but are picked up by van to the PaCE center 2 - 5 days a week for a 6/7 hr day & whatever therapy, health monitoring, meals, etc all done at the PACE. However family has to provide all care & oversight for all the days and hours they are not at PACE. Unlike an AL or NH which have 24/7 staff.

Your mom really has all sorts of state aid in CA between her housing taken care of via Section 8 and plus she has IHHS coming to her home/apt. CA actually has a well established community based statewide system through its IHHS. Most stats don't. Do you know how much of her $800 a mo SS is diverted for her IHHS? What her copay is for her section 8? It could well be that CA state funding for her is very very generous with her keeping almost all of her $800.

I'd be concerned that NV doesn't have a system like CA does. I'd also be concerned that as your mom is still living on her own that she may not meet the criteria to be "at need" for skilled care so she can't qualify for entry into a NH. For her IHHS, what type of caregiving is being done? As an RN in your view what is going on & realistically what would a move likely do for someone your moms age & health? I'd suggest a heart to heart talk with whomever is the IHHS person as to what their take is for mom.

It could be that she totally "showdogs" for your visits. My mom did this & seemed perfectly fine in IL. For us, it took about 6 mos of visits to her gerontologist to establish in her medical chart a history to show the need for skilled nursing care.
When they are living at home or in IL, there just isn't the fat chart like for those coming from a hospitalization to a facility for rehab and then stay & become a NH resident. I'd try to get a look at her last IHHS review to see what's what. Good luck and keep a sense of humor going!

Kluv, doesn't your mom have Medicare? That should be her peimary healthcare payor if she's over 65, yes?

Nevada Medicaid has a dedicated Elder Healthcare line. Go on the website, get that number and call them to find out about qualifications for Medicaid for persons over 65. I believethat it is a different criteria.