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mikkimcgee Asked August 2011

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

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.

grandmamary2 Oct 2016
My 90 yrs old aunt is under Hospice care, she is confined to a bed,she is in NY and wants to go live in Ohio,since that is the only niece that can take care of her. Is there any service out there that can transport her?

Veronica91 Mar 2015
You can only be in one hospice at a time so to move you will be discharged from one and admitted to the new one on arrival. During your journey you would use any other insurance you have probably Medicare or Medicaid. You would not be in hospice on the journey so could get needed medical care through your regular insurance.
As Jeannie said no one is going to pay for the transport of a dying patient anywhere. Flying can be difficult and dangerous, a long car ride is totally exhausting when you consider the nursing care needed on the way. One option is to rent a camper which will give you all the facilities you need for care rest and feeding along the way. Many Walmarts allow you to stay overnight free of charge in their parking lot.
Having your loved one die on the journey need not be anymore of a hassle than say having a heart attack and dying on vacation. It will be expensive but other than that you call 911 and the police and ambulace will come and transport the patient to the nearest ER where they will be pronounced dead and any other necessary formalities. A local funeral home of your choice will be called or even the one in your own home town to transport the body to the desired location. Expensive of course and you will be paying for everything. Another option is to have the body cremated at the place of death and the ashes can be sent home or you can collect them. This is probably the cheapest option if cremation was planned anyway. A memoral service can be arranged at a later date. this is not an easy subject to adress but if you plan ahead for any being prepared will make this process less devastating. As jeannie also said in NYS hospices are licensed by medicare to cover a certain geographic are usually one county although some do overlap and try to "Poach" patients in bordering counties. So if you live in county A but have a summer camp in County B you do have to change hospices while you are away from your usual residence. A few days to a week are usually just ignored especially if the patient is relatively healthy at this time. pre planning is the key to all this and your hospice is the place to start. Arranging for the new hospice to be available on arrival will ease things alone especially if you arrange on a weekday.

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ljr11268 Mar 2015
My mother is in a hospital in vegas and they told me that she is gonna need long term hospice care.I want her home with me in florida .i know she rather be with her family then there and the traveling back and forth is costly,especially sine i am a single mom.my question is how can i transfer her to florida safely from vegas.and i just found out she has medicare part a and b.

pamstegma Oct 2014
Sampson, you pay for it. Totally on your own. Hospice does not move dying people anywhere.

sampsonisaih12 Oct 2014
what kind of answer is that that "miki" gave. That is not helpful at all and not even relevant to the question and basically stupid!!!!!

sampsonisaih12 Oct 2014
it sounds like she is eligible to sign up for QMB which would pay the $105/mo for m'care part B. That would at least give a little extra money and she should be eligible for the possibility of a medicaid waiver. check out with hospice social worker!

sampsonisaih12 Oct 2014
someone please respond to how it is paid for one hospice patient to be transported from one state to a cross country state--not able to fly commercially. Will medicare cover cost or will secondary insurance cover some cost??? Thanks for any info

pamstegma Sep 2014
SueRahn, we could not even leave the county on Hospice. Here in NY Hospice is run county-by-county. Transport alone can kill him, and if you end up in a highway rest stop with a dead body, the cops won't be happy.
We took our daughter to OBX for a week will full knowledge that we were waaay outside the care zone and totally on our own for a week. She died 36 hours after our return. You may not be so lucky, and you better have nerves of steel to attempt this.

suerahn Sep 2014
If my relative lives in MN and is planning on going to AZ for the winter, can he be in hospice in both places. Thank you, Sue

pamstegma Mar 2014
mikki, her wish to live with you may not be a desire to physically move but an unrealistic idea that if she is at your house, everything will be all right. It's important that you consider and accept the reality that she is in denial of. She wants to "get away from Hospice" and no one can give her that. Travel will be difficult and risky, paperwork will be even worse. Let her be, encourage her to make her peace and not try to run from it.

Veronica91 Mar 2014
Grandma can certainly travel as long as she is well enough. If you want to continue hospice care she will need to transfer to one near your home. If this is just for a visit she can still transfer back and forth between two hospices

bhutch Mar 2014
My grandma is 90 and we recently found out she has cancer, she has chosen to have no treatments. Hospice has stepped in, as far as I know she has not been given a certain amount of time to live. My question is she lives in Michigan, we are in Ohio, normally we go and bring her to Ohio 3 times a year with hospice can she still come to Ohio or does hospice mean she can no longer travel

Veronica91 Feb 2014
Check with both hospices because you could have to pay for this yourself

Trector001 Feb 2014
If transferring from one hospice to another hospice by ambulance how pays for the ambulance transfer.

Veronica91 Dec 2013
First of all Medicare pays hospice a daily rate for a patient's care. This has to cover all the patient's needs including medications, equipment, nursing care etc. The patient is usually encouraged to have a DNR in place but. it is not a Medicare rule She may continue to see other Drs who accept Medicare . You are encouraged not to call 911, rather call hospice first. If it is an emergency you can call the EMTs and have her taken to an ER for such a thing as a bad fall, fractures wounds that may need suturing etc. Some patients will have long term feeding tubes in place that need to be changed regularily or may come out. Usually the family is expected to transport the patient to the hospital for this to be done or a volunteer may be requested.The patient may be admitted to the hospital if necessary often at the very end of life some families may not wish their loved one to die at home for various reasons and the patient may request this themselves. Such a hospital stay is usually limited to five days after which they will be transferred to a N/H. There is also a respite of five days in a hospital every so many weeks. I don't remember how often. A hospice has a medical director but he/she may not be available for home visits. These visits are usually handled by a RN who consults with the medical director as necessary for medications etc.
The transfer from one hospice to another should not be very complex or involve a great deal of paperwork for the family. As previously advised contact your local hospice preferably a not for profit. Give them all the patients information and they should contact the distant hospice and between them the arrangements will be made. You should also notify the Florida hospice about the transfer. Your mom will be discharged from the Florida hospice when she leaves and immediately enrolled in the one near your home on her arrival. the new hospice will arrange for any needed equipment to be delivered to your home prior to Moms arrival. Of course something may go wrong but it should be a simple process. Good luck

Jenniferjones1 Dec 2013
Before recommending VITAS I would do some research as they are currently under a criminal fraud lawsuit by the US Department of Justice. It is unfortunate that these websites continuing to advertise for such as unethical agency that exploits the elderly. Just enter VITAS and fraud and start reading. I am sure the Hospice of the Treasure Coast can recommend a more ethical agency.

mikkimcgee Aug 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.

mariesmom Aug 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.

igloo572 Aug 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 Aug 2011
Mikki I would start by calling your local hospice in Greenwood.

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