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You know, with families living all over the country now, it would be nice if Medicaid in each state worked with the other, like a reciprocity thing. I live in NJ my brother lives in NC. Lets say he has no family there and he needs care. Its not fair to me to have to go to him when I do have family here in NJ. Lets say NJ requires one year of residency before I can apply for Medicaid for him. I am unable to care for him in my home, so NC allows me to move him here in a LTC facility and pays for the year. Once residency is established in NJ, then NJ takes over.

I also don't like where a person is on Medicaid and their home is sold. Family then has to stop Medicaid, spend down, and go back on Medicaid. Why can't Medicaid take the proceeds and offset prior care.

Insurance, you cash in a policy with a face value of 100k to receive maybe 10k that needs to be used for a persons care. Why can't Medicaid be made main beneficiary with secondaries. Then when the person passes, Medicaid is more likely to recoup money they extended. Monies left over goes to secondaries.
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Reply to JoAnn29
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First, check with your State Medicaid and find out how long a person needs to reside in your state before they can apply for Medicaid. Medicaid does not go over state lines.

When my Mom was in an AL, 2 yrs ago, the cost was 5K a month and 7k for memory care. LTC was 10k a month.
Sister's SS and pension probably will not cover the cost. In my state, Medicaid does not pick up the cost in ALs unless u have paid privately for "at least" 2 yrs.
So moving your sister, unless u want to care for her in your home until Medicaid kicks in, may not be a good move.

I may first call Adult Protection Services in her County. Ask them to evaluate her and living conditions. You may need to get her to a neurologist to test her for Dementia and get a formal diagnosis. If he says 24/7 care, then u may want to consider placing her in LTC in her state under Medicaid. All her needs will be met. She will get a small PNA acct., in my State its $50 a month. This can be used for a hair cut, snacks, clothing. Anything for her. All you need do is visit.
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Reply to JoAnn29
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You are far better off moving her before she goes on Medicaid paid nursing home or ALF paid.   She has substantial assets which can be used to self pay.  Make certain whatever facility you pick for her takes Medicaid so when her money runs out, they will move her to a Medicaid bed.
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Reply to FloridaDD
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Your profile details state:

"My sister lives out of state, she’s in her own house but alone with no family or friends. She is a hoarder and her house is falling apart.She has Dementia but not been diagnosed as far as I know. I have recently been able to get POA and I would like to bring her to Illinois where I can take care of her. How do I even start the process? I’m overwhelmed."

If you have durable PoA and she was a hoarder, I would move her where it is convenient to YOU, if you are able to physically get that to happen. You don't say just how advanced her dementia is, which would be helpful info. I think you can bring her to IL at any time but the larger question may be what to do about her hoarded house... you may want to contact an agency in her area that specializes in cleaning up those types of homes to get an estimate so that you may be able to sell it for a little more than just a lot? Maybe contact her area's Council on Aging for resources.

You will need to check at the website for your county's Dept of Health and Human Services to ask questions about how long someone needs to be a resident before she can apply for Medicaid in your state. She needs to be close to running out of resources first, which won't be a while if you are successful in selling her home. Hopefully you have durable PoA and have authority to manage real estate transactions for her. In the meantime, you will need to physically visit facilities to check them out and find out costs (which they mostly do not make public on their websites or quote over the phone). Ask about waiting lists. If at all possible, get your sister into a facility that has a continuum of care (from LTC to hospice) and verify they accept Medicaid (not all do!). She will have a better selection and probably no waiting if she enters on private pay first. Once her funds run out and she qualifies for Medicaid, they cannot kick her out, but she will be moved to a shared room. All other care and attention will be the same as private pay residents.

Have you thought about how to actually get her physically to IL? Will she be willing? Hoarders aren't too keen on being unearthed from their squalor...

Keep checking back here as you need more advice on other challenges. Blessings!
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Reply to Geaton777
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Sister, for years I dealt with both parents from 600 miles away. It’s not easy especially with dementia involved. I got them in an assisted living near their home about 3 years ago, mom died a while back and I just moved dad to a nursing home near me 3 states away.

I sold the house and land on an AS IS basis. No way I was going to clean out and fix up a falling down house.

A lot of how you proceed will depend on her finances. Expect to pay as much as $5 to $6 grand a month depending on her care needs. You may have to exhaust her funds and then apply for Medicaid. If you go the Medicaid route do it in the state where she ends up. I don’t think Medicaid is transferable state to state.
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Reply to Windyridge
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Of course they can if they have ability to pay out of pocket for a time. Check with Medicaid on how to receive long term care benefits should cash be exhausted.
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Reply to gladimhere
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Sisterlove2019 Dec 6, 2019
Thanks for your reply. She has SS and a small pension and a tiny paid for house that is falling apart, she could perhaps sell it for the beautiful wooded lot it’s on. It’s been a challenge trying to help her from 400 miles away.
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