Bryn Asked October 2011
How do I transfer Mom to another nursing home if she is already on Medicaid?
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I keep looking for info. over the internet about Medicaid/Nursing Home's rule about transferring Mom to another nursing home to no avail. Mom has Alz's Disease and is in Memory Care unit at a nursing home. They placed her there from hospital last April. The problem is it's too far and there are two nursing homes that have Memory Care close by. How do I start the process of transferring her to one close by so that I can be with her more often? I am her POA. Thanks in advance.
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I believe Medicaid is a daily reimbursement in most states, so that shouldn't be an issue. But so much of Medicaid has whatever particular spin each state wants to do - quite maddening.
My update from oct, 2011 is that I did move my mom in Dec 2011 from 1 NH to another. She is on Medicaid & in TX. It can be done but you will have to co-ordinate with the new NH on all this, as they will have to do a review of her care plan to see if they can provide the level of care that she needs first & foremost & also review the financials to accept them (as some places have a limit on active Medicaid beds). If your elder is private pay, the new NH & the move will not be an issue just as long as you can shell out the substantial $$$$ to do all this.
But if they are on Medicaid, it is a whole different game plan. We did my mom's move to a set specific day in planning so that her co-pay was the exact amount each NH had to be paid under Medicaid rules. If you don't do this, you or other family will have to private pay the difference. Medicaid (for TX) is a daily reimbursement so the NH only gets paid by the # of days they are their, so their co-pay (the "SOC") is also paid by the # of days. You have to get all their medications - this is another critical thing. Most med's @ the NH are in a 90 day dispensation pack and Medicare, Medicaid & insurance will only pay for their med's once. So if you don't get ALL their med's, you will have to private pay for them. I went with zip loc's to put them in and the old NH staff was totally less than helpful on all this but I was not leaving with out mom's med's.
Now my mom was in the same city & state so that was relatively straightforward and my mom was totally good on her ADL's so was a good fit for the new NH. BUT you are looking at 2 states and it will be challenging. If they have significant health issues, you may have to get a copy made (at your expense) of their medical records for the new NH to evaluate if they are a good fit for the new NH. Really if they are still OK on their ADL's, it may be easier to take them with you to CT to make the rounds of the limited list of NH you are looking at for them.
If your elder is on Medicaid, they will need to become a resident of CT and then apply for CT Medicaid. Each state administers their Medicaid program under their own rules and requirements too. It is not automatic either and really this can be quite the hurdle to go through unless there is someone in NY & also someone in CT to do all that is necessary for them. If they own any property (home or auto's) in NH, they are exempt for NY Medicaid but not for CT Medicaid. So the car will need to be legally transferred to them in CT along with CT insurance. The house will have to be sold and then the proceeds from the sale used for their spend-down for CT Medicaid. Good luck.
So we had the transferring facility round up what remained of all her existing medications. Everything was boxed up, clearly labeled, and placed in a clear plastic bag, but the staff had also stuck large, bright red stickers reading "DISCONTINUED" on everything. Once we arrived, however, the new facility, much to our confusion and dismay refused to accept them.
If we had it to do over, we would've contacted the new facility before transporting our loved one, and asked them to confirm (preferably in writing, so as to avoid any miscommunication) their policies regarding medications for newly-transferred residents. While they assured us that our family would not be double-charged, and that Medicaid would be covering any medication costs, it was an unsettling experience that we would not want to repeat.
One unfortunate reality with residential facility medications is that each facility has their own outside contract pharmacy, which is often different from that of other facilities (particularly if they're located in different geographical areas); and they are not interchangeable. These pharmacies ensure that the medications are available and delivered in a timely manner, and supply them in individual packaging along with proprietary record-keeping systems and med dispensation carts, etc. (supposedly to make things more convenient for the facility staff). But the result is that those medications cost MANY times more than the same exact medications purchased at a licensed pharmacy in the local community -- in our personal experience/observations, up to almost *twenty times* more! :( At the same time, most group residential facilities either disallow or make it extremely inconvenient for their residents and families to purchase and use their own meds. It is absolutely outrageous, what these pharmaceutical companies are charging; and our elderly and government (i.e., we, the taxpayers) are getting fleeced, IMO.
Her Medicare - which is totally federal - works in whatever state, so she is good on that but Medicare will not pay for her long term care stay @ the NH.
payingforseniorcare/medicaid/state-transfer-rules.html
The Table of Contents includes.
1. Medicaid State Transfer Rules Overview.
2. Recommended Process for Transferring Medicaid.
Can she move? How? Please help. Thanks
Crossing state lines: Do Not Attempt. Medicaid stops as soon as you leave the state. Again, no transport coverage.
Moving within the state: If you cross a county line, services must be coordinated with two different social service agencies. There must be an available bed. Transport is not covered, you pay.
neck operation on the 23rd of May, however, it has been determined that he may not be strong enough. Instead he will have an MRI and blood work to determine the fate of suggested service. I feel he will be able to get more proper treatment if he had some family member to make decisions in my brothers behalf. I am his POA in reference to his health care. An expedient reply will be greatly appreciated.