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Due to a messup my sister was appointed a public administrator as a guardian and in order to become her guardian we would have to go back to court and pay $1300 for an attorney. We decided her care at the nursing home she is at was very good. This is in Springfield Mo.She had pancreatic cancer and had surgery to remove her pancreas and since has become a diabetic and needs insulin everyday.She is on Medicare and Medicaid with SS disability Yesterday she called me and said the doctors had told her the cancer has spread to her liver and stomach and they were going to have hospice come in.I spoke with the doctor and she said 6 months or so remained for her.She wants to come here with me in Little Rock, AR. to spend the remainder of her days. I am her brother and wanted to know if hospice can be transferred here and how would I go about doing this? Thank you and God bless

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I'd like to add a bit to Carol's spot-on comment.

Medicare is federal (national) so doing anything that Medicare pays for in whatever state is easy. Hospice is a Medicare benefit.

But Medicaid - although a federal & state program - is managed by each State under each state's rules. One issue is that you have to be a resident of the state in order to obtain benefits of the state. So that is something you have to deal with
if she moves from MO to AR.

If your beloved sister is going to move in with you and at your home, then she likely will only need Medicare hospice benefit as you and your family are providing the room & board and other non-hospice caregiving for her. But if she is currently in a NH and Medicaid is paying for her stay, then when you transfer her from MO to AR there will be an eligibility issue for AR Medicaid to pay for her. You likely will have to apply for it. This is kinda a sticky issue for NH in that accepting her as "Medicaid Pending" with state residency issues can take longer. Often the NH will require private pay or a large deposit in order for her to become a resident.

I would suggest you call the LR Area on Aging office (it's part of the Pulaski County Council of Governments which does regional co-ordination) to see how to do this best. I'm sure this must be hard to deal with but you kinda have to be realistic as to whether or not you can afford to private pay for her if that is what she needs and until her Medicaid status is worked out.

If your mom owns any tangible property in MO (like she still has her house or a car), those items are exempt assets for Medicaid for MO. BUT if she moves to another state, those items are now non-exempt assets and will disqualify her from Medicaid in the new state. We went through Hurricane Katrina, my MIL New Orleans NH moved en mass to Houston area. Some of the ladies still had their homes or a car in Louisiana - which is totally OK for Louisiana Medicaid. Now the NH didn't reopen and most stayed in NH in Houston area. State of TX Medicaid paid for them for several months and then they got a disqualification letter from State of TX because of the assets in LA (their house & car), so to stay on Medicaid they needed to either: move back to a NH somewhere in LA or they had to sell the property and spend-down the $ to qualify for Medicaid TX or private pay for the NH in TX. Medicare and Medicaid can be quite maddening to figure out!
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I'm so sorry about your sister's ordeal. I'd call your local hospice organization and talk to them. Medicare and Medicaid pay for hospice care, so I'm not sure you would have any problems getting her moved. I can't imagine why the public administrator who was appointed her guardian would object to her being close to family for her last months of life. This person should have your sister's best interest at heart. The move will take some paper work, but I hope not too much. You have enough grief now. Call your local hospice and ask where to start. They may have suggestions about making the legal transfer.
Good luck,
Carol
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