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Do they need to do paper work in a timely manner?

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The facility has no obligation to do out of state paperwork. Medicaid is run state by state. They have no obligation to arrange transport, because it is all at your personal expense. When you get to the new state, you start from square one on a new Medicaid application, with different rules at the new state. You dig up five years of financials and the other papers the new state wants. You can expect a waiting period of several months or even a complete denial. The patient does have a right to refuse the move. Sorry.
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That is not what I am asking. The facility she is leaving refuses to do the paperwork in a timely matter or at all. So we cannot get her moved because they will not comply with what the state needs that she is going to. They are preventing her from transferring. They work to talk her out of it leaving, and they won't get the paperwork signed they won't return calls. They send only part of the paperwork so everything has to be updated again so the transfer can never happen
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Also NH are regulated by the states. So NH in state A doesn't necessarily have to do or provide what NH in state B does.
Medicaid is funded jointly feds & state, but administered uniquely by each state. So programs state A does may not be available in state B. It's somewhere that 60 -70% of NH stays are paid by state Medicaid. It's a real budget issue foratats, so taking in out of state residents is an issue.
Medicare is federal so is portable from state to state IF the facility or provider takes Medicare. Medicare is more about hospitalization & medical provider costs. LTC costs like room & board is not a benefit of Medicare.

This site has really good articles on the M & M's btw.
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Whitfield - what is going to be central in this is how the NH is going to be paid and their medical chart forwarded to new facility.

If they are totally private pay, then whatever admissions needs to make them a resident financially needs to be done. Could mean a deposit, admissions contract with financial responsibility signature done by local family/DPOA and 1st month paid in full. I'd say allow for 15-25k. If they are on Medicaid, they will need to become eligible for the new states Medicaid & this could be difficult or straightforward - it will all depend on the new states Medicaid program. Personally in my experience - unless there is a major emergency like from a natural disaster so the Feds require states to be accommodating (we dealt with this for my mil post hurricane Katrina) - they are going to be ineligible for admission as "medicaid pending" at the new NH so will be private pay till their new legal residency is established & they fully qualify for the new states Medicaid. And getting eligible & residency will not be simple.

For the medical, you would have their medical chart forwarded in advance do that the new NH can evaluate being able to provide care. They will look at the NCD codes to determine this along with with current care plan. If its a multi state corporate facility, this could be oodles easier & coordinated by social services.

Private pay much easier to do. Medicaid will be complicated IMO.

Transportation will be all on family to pay or do. Transfer or air ambulance will be pretty expensive.
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