How do you transfer hospice care from one state to another state?

Asked by mikkimcgee  |  Aug 22, 2011

My 83 year old mother with terminal colon cancer is under Treasure Coast Hospice Care in Port St. Lucie, FL. She wants to come live with me in Greenwood, Arkansas. I have been going back and forth caring for my mother and it would be best for my mother and my husband and I if she were to come live with us. We're in our 60's and, I was diagnosed with breast cancer and had many weeks of radiation therapy. I am getting very tired traveling to Florida, staying for a month at a time caring for my mother. It is my mother's wish she passes on under my care and since I am an only child, it is my responsibility to care for her until her last breath. Please provide me with all necessary information on how to transfer Hospice Care Services for my mother from that of Florida to here near my home. We were also told my mother can only see Hospice physician and not to call 911 or go to the hospital since Medicare will not accept the change. My mother's only income is Social Security for $875.00 per month after Medicare payment is taken out.

Thank you very much for your kind assistance in this urgent matter.

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mariesmom

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Aug 22, 2011

Mikki I would start by calling your local hospice in Greenwood.

 
 

igloo572

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Aug 22, 2011

Yes as Marie said, contact hospice in your area. See if there is one which is under the same system, like VITAS or Compassus (all over the US), that also has a facility near the Treasure Coast one. (I cannot say enough good things about VITAS. ) They may have a facility in FL and AK so that could help deal with the evaluation and transfer of paperwork.

Hospice is palliative or comfort care ONLY. That is what Hospice is all about. Medicare pays for all or almost all Hospice related expenses. But it is for
COMFORT CARE. If you go and do things, like get her into the hospital or other actions that change her from comfort to actively doing things to "cure" then it is not in compliance with hospice regulations and she will be discharged from the Medicare hospice program. She will have to request to be put back into either regular Medicare or into Medicare hospice again. Another bundle of paperwork. Then likely will find yourself or your mom responsible for the hospital charges till all that is sorted out. That is the problem with having her seen by an MD not in the hospice system, non-hospice MD have to do what they can to cure a patient. You almost have to have her DNR around her neck 24/7 to keep this from happening.

If she is in hospice and living in her home this is going to be easier as you don't have both state's Medicaid system to deal with. But if she is under Medicaid to pay for the room & board portion of her care then it will be a bundle of paperwork and she will have to reapply for Arkansas under their rules. You may find you have to private pay the room & board portion for the NH or LTC until she is approved under the new state's rules if you can't find a place that accepts Medicaid pending.

It can be done but it won't be simple. Again, best bet is to find a hospice near Port St Lucie that also is affliated with one by your city and get them to help you do this.

Medicare is pretty much the same rules nationwide as it's federally administered.
Medicaid is tricky when they move from one state to another. Especially if they own a home. The home is exempt as a Medicaid asset if it is their homestead which you have to be a legal resident of the state to have it as a homestead but if they move out of state then it is no longer exempt so you either have to sell or rent it and use that $ to pay for care. Good luck.

 
 

mariesmom

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Aug 22, 2011

Mikki - didn't mean to be short with my answer - dropped my mouse and had to rebuild.

Igloo this is wonderfully useful information I am going to keep. Thank you so much.

 
 

mikkimcgee

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Aug 22, 2011

Thank you for great informative answer. My mother lives in her own home, and when I go down to bring her to my home, only Medicare is involved. I have asked Treasure Coast Hospice to give me transfer guidance to enable bringing my mother here to our home will happen without putting any stress on my mother.

Thank you again for helping me.

 
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