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My mom is 73, multiple sclerosis, wheelchair bound, self catheters, and showing signs of dementia. She lives in NY, my sister is in Oklahoma and I am in GA. The decision has been made (at mom's request) for her to move closer to one of us and we decided closer to me makes the most sense. She has a very limited income, $860 a month. Where do we start in finding her a place to live? She will need assisted living and likely memory care.

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I’d suggest that you as a priority get a “needs assessment” done on her while she is still in NYS. Her MD or perhaps someone within the MS support community should be able to get the name of an assessment team, it usually a RN & SW duo that do these. I mention this because if it is that via the assessment your Sis is found to be NOT be suitable for living in AL but instead is better suited to be in a NH or MC, then that the type of placement / facility you want to start looking for.

This is kinda important cause if she is looking for Medicaid to pay for her room & board at a facility, it varies by state as to IF that states Medicaid will cover AL or MC. Most states Medicaid program do not cover AL at all. Others do but the amount of funding is narrow as is the criteria to be in AL with Medicaid coverage. MC seems to be covered by most states. It is only Skilled nursing care aka being in a NH that is specifically required to be covered in the laws & administrative codes for LTC Medicaid.

If states want to include AL, or MC, or even in home health care, all those are done by the states via “waivers” to move some dedicated federal Medicaid NH $ to instead get “waived” and go to fund other initiatives in that states Medicaid system. Waivers have been around since forever for the states to use. But they do require more oversight by states to be done as they run on set time periods (like 3 yr trial programs, 5 & 7 yr continuing programs) and they get tweaked and evaluated before they get renewed. Because of this, if a facility like an AL or MC, can easily fill their beds without dealing with Medicaid waiver system, they will opt out of ever participating in it or will have it that is a teeny # of beds available as they don’t want to get caught out if the program stops after 5 years.

big trend in Medicaid waivers is funding PACE programs. If you hear PACE bantied about as an option for Sis, I’d be wary. The issue with PACE imho is that as the individual is still living at home (theirs or a family members home or IL low income housing), they are still very interdependent on family or someone to provide time, care & oversight when the person is not actually at the PACE center. If the elder has $ to pay for extra help, and their needs aren’t too too demanding well maybe it can work & as its community based Medicaid they still have their mo income and their assets to use to do this. Your Sis at $860 a mo is extremely low income. I don’t see her having any real $ left after paying living expenses to ever have left over $ to hire an aide.

My point is if the decision isn’t fixed as to the move is definitely to be GA, I’d try to use the assessment to clearly find out if GA or OK have the level of care facilities that the assessment shows she needs & that if it likely & easily available for her to get that that states Medicaid to pay for it.

Also start gathering up her past 5 years of financial & legal records plus whatever life insurance polices she has and her will. Facilities that take Medicaid will have a list of all the documents needed to accompany the LTC Medicaid application. If you just know that stuff is likely to be MIA, I’d suggest that you plan on doing 1 or 2 long trips up to NYS to start finding stuff and getting whatever MIA records from banks and courthouses with her when you are up there visiting.
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Here is a link to your Area Agency on Aging. They will have lists of licensed facilities and advise on the services you may find in your area for you as a caregiver and your mom.
They can help you decide which facility is best based on her needs, understanding that Medicare doesn’t pay room and board anywhere outside of rehabs after hospitalizations.

If your mom is now on Medicaid, realize that the services will be different in different states. Not sure if that was part of the factors you examined when it was decided that Ga was better than NY or Ok for her to relocate. Medicare is the same but not Medicaid.

I know it may seem a necessity that she move closer to one of you but if I were you I would research her access to medical care and housing in all three locations in great detail before making a final decision. There is an Area Agency on Aging covering each county in the nation. Some are more helpful than others.

https://www.areaagencyonaginginnwga.com/

Barbs idea of a certified elder attorney consult is a very good one.
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Start by contacting the Area Agency on Aging in your community to find out what the resources are.

You might also consider getting in touch with a local eldercare attorney who knows the ins and outs of Medicaid qualifications.
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