I know states have different Medicaid programs. The facility I chose for my LO a few months ago is proving to be very poorly managed and there have been a couple of incidents of them dropping him off (has dementia) at his doctor's office without following the instructions to hand him off to me. I can't get them to return phone calls. Right now he is in the same city as I am but my job now may be in question so I may be moving to a different state. Which states are friendly for Medicaid assistance for those living in skilled nursing facilities. I know it's a completely new application process but it may be something I need to consider.

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Are the states adjoining? If so, I’d move him to a NH in whatever city close to your part of your new state. Lateral in state transfers can be done. It’s a real ballet to accomplish but can be done with planning. I did it for my mom.

Out of state is going to be challenging. I’d suggest you start by having him move his banking to a bank group that is in his state AND your new state. He has an a account with you as signatory on it that gets his direct deposit for SS and any other retirement. This account has his current address on it but all done on-line. He gets a smallish separate savings account, under $200, that has your new address. You open your own account at this bank as well. This way when you need to show he’s a resident of new state, you have banking done!

Find out what new state needs to establish residency. If it’s that he needs to turn in his drivers license or state issued ID, I’d be ready to do this ASAP. If you cannot easily find his ID, request & pay for a duplicate one ASAP. Ditto for his SS card - these take 3 weeks. Personally if I didn’t have them in my hands right now, I’d just go ahead and assume their MIA and get duplicates sent to your current address. If new state wants some sort of utility bill with his name, then just add him as a secondary name on one of your new accounts at the new city.

Hopefully he does NOT have NH as his representative payee for his SS. If that did happen, well gird up cause he’s going to need to change that & ASAP. SSA does not accept DPOA, so he’s either gonna have to be able to do this on-line or be competent enough to do over the phone or in person at a SSA office. Otherwise you will need to file to become his representative payee. If it’s this (you become rep payee) that needs to happen, please try to do this now while you still have in state, same city ID. It’s not hard to do but does take time. SSA has pretty good info on the process.

if NH is the rep payee, I wouldn't be surprised if there is a lot of foot dragging by them to do the switch. They cannot keep him from changing rep payee but they can make it difficult to get any overage received reimbursed to him if he moves away. If this place is really subpar, I bet they will try to pressure you to sign off a financial responsibility contract as they are no longer his rep payee. They cannot require this to be done under Medicaid rules.

Now there are some things beyond your control. In theory, the NH should do a needs assessment to determine if he needs skilled nursing care and if they can fulfill his needs. And state Medicaid program will themselves do a needs assessment to determine if he is “at need” for skilled care as Medicaid is both “ at need” financially AND medically. I’d be somewhat concerned about this if he’s currently able to go from the NH to see a MD in a practice in offices or clinics outside of the NH. It kinda comes across as he’s independent and ambulatory and ok enough on his ADLs to be sent off to & left alone at doctors offices. Dementia alone often is just not enough to be at need for skilled care. If he’s kinda more needing Memory care, I’d be very cautious about moving him out of state. MC often is like AL in that Medicaid in facility LTC does not cover it. If you really really want to move him, I’d suggest he get an independent needs assessment done by a geriatric specialist- usually it’s a duo of RN & SW. You can use the report when your looking for a new place. It will give new places an idea on what his needs are & if they can meet his needs and if new state Medicaid will find him sufficiently “at need”. Good luck.
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