I want to move my mom from FL to VA so I can help with her care. Advice?

JanMartin, read your bio….so the home in FL your sister lives in, is it actually your parents home and mom owns it as your dad died in ‘20? And it’s the situation that mom has moved from this home into a NH facility sometime since then? So Sister still lives in the home.
Is that accurate?

If so, the home will be an issue for VA LTC Medicaid as it will not be exempt asset anymore (as it is for FL Medicaid). I’d clearly find out… like get it in writing from VA Medicaid…. exactly what the conditions are for out of state property (home in FL) for moms eligibility for VA LTC Medicaid.

Some states will not allow her eligible at all as the value of FL home (usually it will be base on the last tax assessor value) is completely an asset beyond the 2k max LTC Medicaid allows for.
Other states will, but the home will have to be on the market with a Realtor with MLS listing. No FSBO nonsense either. So listed and showing and eventually sold. And for more fun, some states will limit the timeframe for this… like 6 months max to have the property listed & sold. Although you can apply for an extension. In the current real estate market, IMO it will sell and likely multiple offers even its a real POS.

Please Realize when it sells, all the $ from the Act of sale is all moms $ if she is 100% owner and she will need to spend down the $ till she is once again impoverished enough for Medicaid (2k).

If Sissy is living there, she may need to be paying rent. Like fair market value rent to mom as mom is the property owner. You need answers in writing from VA Medicaid on this.
Sissy needs to be made aware of all this as well.
If Sissy was your parents caregiver for 2+ years and is expecting to get the home for free as the heir under the caregiver exemption to Medicaid estate recovery, that I’m pretty sure only works IF mom is in FL Medicaid program.

Again need to clearly get answers on this from VA Medicaid in advance of ever having your mom leave the NH in FL. Or hire an experienced elder law attorney in VA, like that is CELA, to do all this on moms behalf. If mom owns the home in FL, she has assets to use to pay for an attorney. Personally I think you have way too many moving parts to ever DIY any of this.

You say in your profile that mom refuses to enter a facility in Florida.

Do you think she will be more amenable to entering a facility in Virginia?

What will you do if you you get her to your home in Virginia and she refuses to move?

Might not you be better off calling Adult Protective Services in Florida and asking them to do a forced placement? Or taking her to an ER and asking for a "social admit"?

I had a friend who moved her brother from Florida to Colorado via a medical transport service. In his case, it was a motorhome with a nurse on board. He had Alzheimer's and couldn't fly but was able to get in and out of the motorhome on his own. It was the best option, but it was very hard on him.

Are you sure this is a good idea?

I just looked at your profile page to understand the situation better.

What's happened? Are you sure you're not making decisions in a hurry?

What ITRR posted is super mucho importante ….Right now she is a FL resident enrolled in state of FL LTC Medicaid program. She will have to become a legal full time resident for State of Virginia to be eligible for their state programs.

it could be simple or quite complicated. I’d look at State of VA website to see what the requirement are for this… like what she will have to do to get a VA issued ID.
All of her SS and banking info will need to get a change of address done as well. If mom has made the NH to be her representative payee for her SS$ as often that is done as it makes it easier Medicaid paperwork, well, that will need to be changed back to her and getting SSA to do this will not be easily as SSA does not recognize POA…. they want to deal with the actual SS recipient.

If she owns any “real property” in FL, like a home, a car, land, all those are exempt assets for FL Medicaid.
BUT
they will NOT be exempt assets for VA. If she does own property in FL, well personally I would even start to move her till the property was sold. Even if it means she had too much $ and got taken off LTC Medicaid for a bit while she does a spend down in VA to be impoverished for VA Medicaid.

Any “non emergency transfer” type of transportation is private pay in my experience. It has to be a medically necessary move for Medicare to even think about paying for an ambulance or EMS. So say she fell at the NH & is unconscious so NH contact ambulance service to take her to the ER, that’s a run MediCARE will pay for. But loading her up into a ambulance or speciality van to go from 1 state to another is a non emergency transfer, MediCARE isn’t going to pay for it. It will be very $$$ expensive and if she cannot do any transitioning on her own at all, she will need to have a RN or CNA beside her the whole time to oversee her care needs. Nobody will work over a set # of hours, so if it takes over 10-12 hrs, you’ll need a second set of driver & RN. You will likely have to pay for the van and personnel return costs too. It’s going to be serious bank. I’d run the #’s and them look at LifeFlight costs to do this. life flight is expensive but may not be that much more expensive than a two day drive with stays and return cost from FL 2 VA.

Have you at all spoke with nursing staff & the MD at the NH regarding moving her out of state? They are going to have to do a safe discharge and transfer of care paperwork on all this as she is on MediCARE & Medicaid. If she is very fragile, they could determine it would be AMA aka against medical advice to move her. She sounds as if she is totally bedfast, so can she do any of the other ADLs? Whatever the case, I’d suggest that you speak very clearly in person with folks at her current NH to evaluate moving her is truly at all feasible and safe to do.

Yes medical transport is very expense (in the thousands of $). Not sure if Medicaid would pay for this (or any of it) so maybe have this discussion with a Medicaid Planner in FL (first). If your mom has some assets (like a home she will sell or other assets) then research reputable NHs close to your home and then ask if they have Medicaid beds. She can get in most places on private pay and when her money runs out can stay there on Medicaid when she applies and is accepted (as long as they accept Medicaid recipients).

Check the facilities in your area.
Ask if they have Medicaid beds available.
Ask if they can help with application process for Medicaid.
(I am also assuming you are looking for Skilled Nursing Facility rather than Memory Care. )
Medical Transport is expensive. (Google is your friend here, call around and ask. I did see one the other day that mentioned taking a patient on the other end of a trip so it would not be as expensive. Might be an option if there is no rush)
Also consider with mom's advanced age, advanced dementia and other medical conditions that there is a possibility that she would not survive the trip.
It might actually be safer to hire caregivers to help your sister out and keep mom in Florida.

You should contact Medicaid in VA to find out how she becomes a resident of VA to be eligible for services.

I know that you have to be a resident to get services and that needs to be sorted out 1st.

Then they can guide you to the resources you will need.

There are medical transport services that will go long distances in a van similar to an ambulance. I haven’t used this, but understand it’s pricey. Call nursing homes near you and ask for the business manager. Ask about Medicaid beds and the application process. My mom's nursing home business manager was a very knowledgeable person and helped us easily transition to mom being on Medicaid when funds ran out. She also knew a lot concerning other local nursing homes and their reputations, availability, and services.