This current nursing home represented the patient (my brother) to getting Medicaid Approved. It is a below average rating. He wants to move back to a Nursing Home that required an already Approved Medicaid. I am the POA. Can we move him and the Medicaid to his desired Nursing Home?
If they have a Medicaid bed available there should be no problem with the transfer.
My father was put into a far below average rating nursing home by the hospital after he had a stroke. He was there for a few months and the nursing home did the Medicaid application and it was approved.
I then had him placed in a better facility that was closer to where I live.
Here's the thing about nursing homes. All of them will get a person on Medicaid because no one can afford to pay what they charge. They take everything a person ever had and then they see them onto Medicaid so they continue to get paid.
That doesn't mean a person has to spend the rest of their life in the nursing home they were in when Medicaid became available to them.
- my moms 1st NH wasn’t beyond awful, nursing staff was ok but administration was a s-show w 3 administrators & admissions staff leaving and back office / billing always wrong on bills, yada yada. Then abt mo 8, SW let me know that she was leaving as did activities gal and that sealed it for finding a new NH.
- my mom did NOT make the NH her payee for her SS$ & retirement income. Mom kept old checking account where these were direct deposited. So every month I wrote out a check to NH to the penny for required co-pay. NH had no control over her income. This can be real important, more on this part below…
- it took 5 1/2 months to get Medicaid approval for LTC. It seems best to get beyond Medicaid application and get approved so that you have a set fixed copay done & up to date on the bill before any move. Personally would NOT move him until this happens as move will totally muck up processing his application and reimbursement system btw the NH and the state. Otherwise He will leave with a outstanding bill which NH can place for collection. If NH is vindictive or incompetent, they can basically not do any follow up if Medicaid contacts old NH.
- Medicaid allows for a move, if it’s considered a “lateral continuum of care”. So the new NH needs to be able to meet the same level of care as the old NH.
What new NH did was to send out their internal needs assessment team (RN & SW) to visit my mom at old NH. I had to as DPOA & MPOA sign off a document to allow for this and for them to access her chart from old gerontologist. They call me from her room to tell me all good and that I had a 30 ish day window to get her moved.
- New NH emailed me paperwork & I went over to new Nh next day to sign all and look at rooms mom would likely go into. Had it set up she’d move in on the 4th & before lunch.
- I faxed the old Nh that mom would be moving on 4th of incoming month and also sent via verified mail with the return registered card.
Why the 4th???
Remember they are REQUIRED to do a copy ea month of their income to the NH. Mom got her $’s on the 3rd. So I wrote a check for exactly 3 days of copay to old NH and to the new NH for the exact $ due rest of the month. Copay has to be current in order for no financial compliance issues with Medicaid or the the NH.
If your bro has made current NH his representative payee, then he is going to have to contact SSA to get that changed. SSA does not recognize POA so he will need to do this request. Old NH doesn’t necessarily have to be helpful on this……
- I basically started taking &/or jettisoning stuff from moms room once I started looking for new NH. A local cousin came and got things too so by the 4th, it was easy.
- one thing that would never have occurred to me was on medications. New NH told me it was really really important to get all meds when she left as Medicare/Medicaid will not pay for duplicate medications. So I took a sharpie and zip lock bags. The floor RN had to unlock them to give to me. Was somewhat hostile.
Pay attention to his meds, so u for sure get them all.
- at the time my mom was totally ambulatory on her own or with a 4 footed cane. So she could easily walk out of NH or get in & out of my SUV on her own. If your brother cannot walk unassisted, you might have to arrange for non medical transport service. I doubt MediCARE will pay for this as he’s making a choice to move; he’s not being required to move.
- new NH let me come over & set up her room day before. Rooms I had looked at before had all gotten filled, but was fine.
- entry time seems to be important. I’m remembering had to be there by 10:30 AM for daily census which Medicaid bases reimbursement on.
Moving them is a bit of a ballet, but do-able. Good luck
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