Can a senior care facilty refuse to discharge? Can they transfer someone to an out of state facility?

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My aunt is in a senior care facility in a city that no one in the family lives in. She is in the last stages of Alzheimer's, and seems to be giving up on living. Her son won't take off work to go get her, because he can't take care of her while waiting for state aide. If someone was to go get her and take a flight to a place where family can go visit her will the facility discharge her? I mean her bill I'm sure is overdue, and her mental and physical capacity has diminished drastically. So my idea was to take her to a place where family can visit her. Maybe take her to the hospital and she could stay there while waiting for state aide?


Can a senior care facilty transfer someone with Alzhiemer's from their facility to an out of state facility? If there are no family around, and no guardianship then the facility applies for aide for the senior. If some of the family who live in a different state pays for airline ticket and the facility contacts another facility in the state where the family is and has them accept the senior then apply for aid wouldnt that work? Im just trying to get my aunt closer to her family instead of where she is now.


Please any suggestions would be appreciated. She is in Reno, her son lives in Wyoming, I live in Arizona, and we have family in Texas. She is in late stage Alzheimer's and in a state where no one can visit her. Please help.

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Dawn you sound absolutely desperate on your aunt's account, and I'm very sorry for it.

You don't say how long your aunt has been living with Alzheimer's Disease, or how long she has been in this facility, or why the family has decided at this point that they would like access to her.

I do really hate to say this, but it sounds like it's much too late. Wouldn't it be better for the family to use its resources - time and money - to visit her?

Were you very close to this lady in earlier years?
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Dawn,
I speak from recent experience....DON'T move her.

People in late stage Alzheimer's do NOT adapt well to being moved.

I just did that. We could no longer afford the memory care mom was in, so we took her home with us. Big mistake! Her confusion got much worse and her behavior became more irratic.
After 3 months, we realized we could not handle her and put her in a different memory care facility. She is much more confused, loosing weight from not eating, etc.

Each move causes more stress and confusion. Your aunt doesn't know any of her family anymore so I wouldn't put her through the stress. The patients get their "routine" established at the NH and they don't like to deviate from it. That's all their poor little brains have to hang on to is what the routine is every day.

Also, these days, you have to meet strict criteria to be admitted to a hospital. Gone are the days when a doctor could put you in for a "rest". (Yes, that was still happening in the hospital I worked at in 1978!)
Unless she has an "acceptable " admitting diagnosis that an insurance company would approve (and pay for), the hospital would send her back to the NH.

Please let her live out her remaining time in the facility that she's used to. The nurses and aides are her family now.
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If her Son cannot take time off to get to NV to physically visit with her or do her Medicaid or other at-need application for state services, then perhaps she should become a ward of the state of Nevada. At the first NH (TX) my mom was in there was a Son who flat refuse to deal with issues with his mom’s Medicaid eligibility. The lady had transfer penalty and bill way way past due. Sonny sent & ignored “30 day notices” by NH which they also CCd to APS and ombudsman and county low income law clinic. APS got judge to issue emergency ward of the state order. State appointed guardian took over. It’s not a common occurrence but does happen & there’s a system to have it done.

No to sound all jaded....but are you getting the full backstory on Auntie on the situation from Sonny? Facilities in my experience are not going to just wait weeks much less months before they get paid or know what the Medicaid application status is looking like. For my mom’s NH, the facility went over all the info submitted to Medicaid BEDfORE submission to determine IF they would even accept her as Medicaid Pending. She was fine for Pending & as a requirement for Pending (this seems to be a blanket policy for all states Medicaid btw)is that all my mom’s monthly income (SS & retirement) was paid to the NH less $60 every mo. ($60 is TX personal needs allowance). But if mom had had a glaring issue for Medicaid Pending there would have been need some sort of contract done & signed off on to take financial responsibility by mom &/or myself. Facility cannot afford to be casual about admissions & billing. 
Could Sonny’s reticence be due to his financial responsibility on the existing bill? His living in WY will make it harder to get him nailed to pay....
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Dawn, I agree with BarbBrooklyn above. Please note a person who had advanced Alzheimer's needs to stay in the facility that she is use to.

Moving your Aunt elsewhere would only cause mass confusion and frighten her, as she no longer has the ability to adjust to new surroundings. Plus with advanced Alzheimer's chances are high that your Aunt may no longer recognize family, nor be able to speak.

Leave your Aunt where she is. The Staff already know how to help your Aunt, where if she went some place new, the Staff would have to start of scratch "learning" your Aunt.
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Dawn, is your Aunt on Medicaid in Nevada? Why do you think she owes money to the facility?

A patient with advanced Alzheimer's is in no condition to fly on a commercial airline; she would need to be transferred by medical transport, which is quite expensive. She would be ineligible for Medicaid in a new location for whatever waiting period that state deems its residency requirement.

She cannot be admitted to a hospital just to wait out that period. If the family has money to private pay for transport and to pay for or provide care in a new location, that might be feasible. But moving someone with advanced dementia is usually inadvisable and can cause steep decline, because the patient has lost the ability to accommodate to new surroundings.

I'm so sorry that your Aunt is declining.
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