Monica’s mother was living in Florida when she fell and broke her hip. She was treated at a local hospital then sent her to a rehab facility to recover. There is a good chance that she will not regain full mobility and might need to move into a nursing home. Monica, who lives in Queens, wants her mother closer to her and hopes to transfer her into a rehab/nursing facility in the New York City area.
Monica’s situation is not unusual. Many adult children want their frail parents closer to them. However the situation and procedures often overwhelm them.
What are the steps that need to be taken? Is there a residency requirement to move a parent between state nursing homes? Will a parent’s medical insurance transfer?
Transfer Between State Nursing Homes
The good news is an out of state transfer can be done, but there are certain guidelines that must be followed. Here are seven steps that need to be taken.
- Select a Desirable Facility. Before making a move, you must identify a few rehab facilities/nursing homes where you would like your parent to live. There are several tools for evaluating nursing homes. One government website, Medicare Compare rates nursing homes on a series of factors such as size of staff, cleanliness, and safety. Other sites, including Yelp.com offer individuals the opportunity to air their personal impressions about specific nursing homes.
- Apply to the Out-of State Facilities. Ask the admissions staff at the current facility to send a Patient Review Instrument (PRI) to each of the selected nursing homes. A PRI is the standard medical assessment tool that summarizes a patient’s condition and needs. The desired facility will evaluate your parent’s care, determine if it can fulfill them, and if it have a bed available. Once the parent is accepted in a facility you can move on to the next step.
- Transfer the Primary Health Insurance. Most people aged 65 + are covered by two insurance policies, Medicare which is the primary insurance and a secondary insurance that covers supplemental costs and services not covered by Medicare. Medicare is the federal government’s health insurance program for older adults. It covers doctor care, hospital care, and 80% of in-rehab care. Medicare is managed by the federal government and is viable in all states.
- Transfer the Secondary Insurance. Some secondary insurances are nation wide programs and can easily be transferred between states. Other programs including Medicaid are not. Medicaid is a program that pays for health care for people with low income/assets. It is a federal program but is overseen by individual states. Each state decides on its own eligibility requirements determined in part by a state’s cost of living. In some instances a person might be eligible for Medicaid in one state and not in another. For this reason Medicaid cannot automatically be transferred. A person must drop one plan when she leaves a state and reapply in the new one.
- Apply for Medicaid in a New State. A person cannot be eligible for Medicaid in two states at the same time. A resident must first close out her Medicaid coverage in one state before applying in another. It is usually best to dis-enroll at the end of the month, because it takes until than to end Medicaid coverage.
- Understand Medicaid Residency Requirements. As soon as a parent is in the new nursing facility, she can apply for that state’s Medicaid program. Unlike residency restrictions for voting, federal law prohibits a residency requirement to apply for Medicaid. This means a perso is eligible for Medicaid immediately upon moving to a new state. The new nursing home can help with the application process. Medicaid acceptance might take as long as 90 days, but this should not a determent. Medicaid coverage is retroactive to the date of application. This means a nursing home cannot turn you down if your Medicaid registration is still pending.
- Move to the Out of State Residence. The move between two facilities is the easiest part of the total process. This can be coordinated through the nursing homes. It can be done by employing an ambulette to transport the patient or by having the patient escorted to her new location by plane.
Moving a parent between state nursing homes can seen like a formidable task, and in some way it is. It takes careful planning and coordination. Fortunately all the steps are possible and with help from the nursing homes and knowledgeable professionals, the job can be accomplished smoothly and effectively.