What steps should be taken to move an aunt from one state nursing home to another who has living children? She can't walk and they can't determine why. She's about to move from rehab to the nursing home. Please tell us what to consider first. Thank you.
https://www.agingcare.com/articles/Moving-to-A-New-State-Can-Affect-Medicaid-Eligibility-174671.htm
1. Medical - You need to clearly & carefully speak with her MD and any other specialists that have evaluated her in MI to see what they anticipate her ability to walk & do any ADL's will be or if she is going to be bedfast & what level of care within that and will they discharge her to move. Then with that information in hand clearly speak in person with admission & nursing staff at the NH that you are looking to move her into in AL.
When I moved my mom from NH#1 to NH#2, the nursing staff went for a site visit to see if mom would be suitable for their facility, basically to determine if she was OK for the level of care they provide. And my mom was still able to do her ADL's and was pretty cognitive as she had Lewy Body Dementia. I would be concerned that if you are not being bluntly descriptive with the needs required for your aunt to the NH's in AL, that once she moves in, you end up getting a call & letter within a couple of weeks that although they just love Auntie, they cannot provide the level of care she needs and you have to move her (she gets a 30 day notice). That is a total panic situation as once that happens, she will needs placement in a specialty facility.
Ask if Auntie could be evaluated for hospice - if she is OK for hospice, moving her to another state may not be in her best interest.
2. finances - right now being on rehab, your aunts stay is being paid by Medicare. the first 21 days @ 100% and the rest of the 100 day maximum @ 80%. How is she paying her 20% & how is she going to pay for any facility once discharged from rehab & Medicare coverage? As others have said, NH are expensive and are paid either from LTC insurance, Medicaid or private pay. Does Auntie have the funds to private pay for several months at the new place in AL - I'd say 80/90K for 1 years stay & medical transportation from state to state. Medicaid is state administered so you need to see just what needs to be done to have Auntie eligible for AL Medicaid (become a resident of the state, etc.). We dealt with some of this for my MIL when her NH closed in LA due to Hurricane Katrina and they moved enmasse to TX - everybody was covered by TX Medicaid, but within 6mos all had to become a resident of TX and any who had a home in LA were not approved for TX Medicaid as the property in LA was not an exempt asset so they were ineligible. Medicaid's approval can take months and the facility may require a contract to be in place for you to be financially responsible to pay for her stay if she should not be approved by AL Medicaid.
You will need quite a bit of information and documents on your Aunt for the Medicaid application - like her awards letters from her SS and any retirements - if you have not been involved in her life on an intimate level before all this, you may find it daunting and very difficult if you do not have DPOA paperwork already done.
The AL NH should have a list of the documents needed for AL Medicaid. Remember that for Medicaid, all of Aunt's monthly income is required to be be paid to the NH as her co-pay or SOC (share of cost). All she will have in extra $ is whatever AL has as it's personal needs allowance (runs from $ 35 - 105 a month depends on state). If Auntie needs new clothes, or personal care items, etc and it runs over the allowed monthly PNA, then you are expected to pay for this.
3. legal - she probably will need new legal done that will be acceptable for AL. If you are not already named her DPOA or guardian, that may need to be done in AL courts. Guardianship is somewhat cumbersome and has more costs than getting a DPOA & MPOA done. But if she is bedfast, then doing the POA's likely isn't feasible anymore. Guardianship maybe 7-10K to be done and you pay for all costs up-front and if you are awarded guardianship then you can be reimbursed for your costs IF Auntie has the funds to do so. If there are any issues in your or your households past (like any felonies, bankruptcy, foreclosure, etc), the judge may not award you guardianship but instead place Auntie as a ward of the state with a vetted by AL courts guardian.
I'd suggest starting with the medical to see if really truly it is feasible for her to move out of state. Good luck, it's going to be daunting if Medicaid is needed.
Consider that her insurance stops at the state line. Medicaid stops at her county line. All the expense will be on you.
Alabama is not cheaper than other states. But it is poor and has many on Medicaid. The state is in financial trouble which may or may not be a problem.
I am sure it can be worked out. I start by contacting SS/Medicaid/medicare for information. I am sure someone who has been there and done this will have a great deal more advice than I do. Good luck to you.
She is now living in a nursing at assisted living facility did not work for her after she fell three times in one week injuring her hip. We now pay $6000 a month. When she runs out of money we will apy for Medicaid.
We needed to transfer my MIL from Fla to Atlanta. SS at the rehab were big help but we kept hearing "we don't take her insurance". After hearing this 5x, it was found they didn't except her insurance because it was only good in Fla.
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