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We are moving my mother-in-law with dementia to assisted living in NC from GA home (our home for 18 years) to be close to my sister-in-law. According to our research, she has to establish residency of 90 days to apply for Medicaid (she has no money/assets/anything and only $872 a month from social security). It seems to me this puts such a burden on the family as there is no place for her to stay to establish residency. Does anyone know if moving straight to an Assisted Living can bypass this 90 day residency rule when applying for Medicaid? My sister-in-law has gone to Medicaid office and this is what they tell her, but in my looking around I think I saw a form can be filled out to bypass this.

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Betty - "AL facility did tell us that they may not get a Medicaid bed approved", well my gut feeling is that there will NOT be a bed available and that you all better be prepared to private pay for a year at least. See if you can find out the waiting list #'s for the waiver beds.

You know I would suggest thinking about all this from a NH viewpoint, that Sissy start looking around for an MD for mom and narrow the list to MD's that are also medical directors of NH that take Medicaid. I say this as, I'd bet that mom may not meet the criteria of ability that a AL requires. For those that have been living with family, moving to AL is a real challenge as so often family have been helping/doing/excusing her daily activities and that she can't adjust to what is required by the AL and the AL really don't have the staff capabilities to work with her…..so family gets a 30 day notice that although they just love, love, love mom she needs to move to a higher level of care. And that type of letter is a total panic situation. I'd look into whether mom could in fact enter a NH from the get-go rather than going into AL. Also realistically, they are eventually going to need a NH if they live long enough, so one less move. Having a MD who is also medical director of a NH, well they are going to know just how to create the fat medical file needed that shows the medical necessity for skilled nursing care.

Most NH admissions are from a hospital discharge to the NH for rehab and then the patient ends up staying at the NH. The classic is :mom broke a hip walking her dog" scenario. They have the nice fat medical file from being in the hospital. But for those coming from living at home (or living in IL like was the case for me with my mom), well they do not have a medical file to show "need" and that can cause an issue for Medicaid. Medicaid requires documentation to establish "at-need" both medically and financially. The financial at $ 872 a month, is there. But the medical may not be there, so you want to do whatever to create that. For my mom, it meant that about every 4 - 6 weeks she left her IL apt and saw her gerontologist. At about mo. #6, she had a 10% weight loss, a bad H&H lab report and a couple of other issues, so he wrote the orders for "skilled nursing care needed". Comprende? Just being old or incontinent, or incapacitated may not be enough to qualify for needing skilled care, so you may need to get mom to have a medical file created to work for however NC Medicaid evaluates.

Has anyone explained how the co-pay or "SOC" (share of cost) works for your mom's monthly income of $ 872 & Medicaid?

Also Mom will likely have to still provided financials for the Medicaid application, so be sure to keep all her banking records and awards letters for the past 5 years & any life or funeral policies. So don't throw those away when you are moving. My experience was that the NH gives prospective residents a list of the items needed to accept them as a Medicaid pending resident, so see if Sissy can get this list from the possible NH so you have that to work from in document collecting.

Geez, 18 years, so basically she has been there the whole time of your son's life - I imagine that although with some good times - has been most challenging. It will be interesting to see down the road how her being there all those years affects your son's views on aging - (we have a graduating HS senior too)
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Thank you igloo572. Mom owns nothing and has no home or car or land or assets or anything, other then her now $872. We have supported her for 18 years, building her a m-in-law house next to ours. Her dementia has gotten very bad and it is time to move her. We choose to move her by my husbands sister because we will be selling and not sure where we will land. The last 8 years have been very stressful on us and now our son has gone off to college as well. You explained it nicely and will do whatever we can. The AL facility did tell us that they may not get a Medicaid bed approved when we are ready for her to come. Thanks.
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FIrst of all, the fact that NC Medicaid will even pay for AL is a big, big deal. Most states Medicaid programs do NOT ever pay for AL - for most states Medicaid is first & foremost a program that pays for skilled nursing care in a NH facility. The Medicaid AL payment is a waiver option program and as a waiver program, it can have very strict rules on participation. So if having mom move in with family for 3 months is required along with whatever else is needed to establish legal residency in NH, then all that's what's going to need to be done.

Most states are shifting waiver programs totally away from AL and going to PACE or CDS (consumer directed services) type of funded programs. My state (louisiana) has a waiver list of about 7K persons and maybe 2% may find a AL waiver bed.

You want to be very clear with the AL as to mom's waiver participation guarantee too. Most AL that take a waiver seem to have it set up that the resident is private pay at the facility for 1 -3 years prior and their name goes on a waiver-bed list. The AL usually have a limited # of beds that are on the waiver too.

You may find that once mom has moved, that you all just have to private pay for her stay at the AL for an extended period of time till she fully qualifies for residency and a waiver bed is available.

Also if mom owns any real property in GA (like a home or a car or land), that ownership will keep ineligible for Medicaid as they are non-exempt assets for the new state. She will have to sell them (or transfer auto to NC registration) and use all the $ as a spend down before Medicaid will pay.
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