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Is this a facility for rehab, and was that the purpose of being there? If so, it would be advisable to get a doctor's confirmation that you're moving for specific reasons (i.e., care inadequate, etc.) to ensure that Medicare coverage is continual through the move.
This is what I was advised when I had to move my father from what I thought was a very good nursing home but was wholly inadequate. The NP for the orthopedic doctor advised getting a letter from them addressing the move, just in case Medicare challenged the move.
I got the letter, made the move, and Medicare never raised an issue. But I was prepared.
Family moves residents from 1 place to Another for various reasons. It can be done. I moved my mom from her 1st NH to a 2nd an eons better NH within her first year and within a couple of months of her clearing eligibility for LTC NH Medicaid. But just how involved it will be is very much dependent on how his stay is being paid and IF the new NH can meet his medical needs.
If he’s private pay, the admissions contract has an advance notice to the NH clause & this will be important as it will state if there’s a 30 or 60 day written notice required. Or he will be required to pay for the 30 or 60 even if he’s moved. You need to make sure New place will without question hold a bed for him for the 30 or 60 and what type of deposit needed. His medical needs are important cause if he’s real sick, things change & they may want to reevaluate him again.....
If he’s Medicaid, the NH cannot require a 30 or 60 day notice. Medicaid allows for lateral transfers without penalty. Medicaid payments follows the person so if it’s 10 days in 1 that’s what they get paid and new NH gets the rest of that months Medicaid reimbursement. But you as his dpoa will have to make sure his copay or SOC (share of cost) is paid properly to the penny for each. Otherwise NH can place a fine and fines are outside of Medicaid regulations. If the old Nh was made his rep Payee for his SS and retirement $, all that will need to be changed back to be deposited into his bank account and that could be a beast to get through.
My mom’s new NH sent out a RN / SW team to evaluate her at her old NH to determine if they could meet her needs. I signed off a document requesting the evaluation and Hippa access to her health chart. I also provided New NH in advance a copy of her health history and a list of her current meds (these from screen shots from her last care plan meeting). The team called me from mom’s bedside to tell me all ok, mom totally could get her care needs provided at New NH, out mom on the phone too and we set a date for the move & they would place a bed hold. No worries. I moved mom within the first days of the next month, so after she got that months SS & retirement. Each NH got pAid to the penny for days in that month. I already had zero’d mom’s personal needs trust account at the oldNH months prior, so no worries on that front. I did send as a courtesy a notice via fax & email to NH administrator as to the date of the move.
One thing I hadn’t considered was her meds. The new NH stressed that I HAD HAD just HAD to get all her medications. MediCARE and Medicaid are strict on meds and they are usually done on 90 day blister packs or in large jars held in locked closet at nurses station. M&Ms won’t pay for duplicates so you have to get all his meds. If you have to get New meds this could be very very expensive. I took ziplocks and a sharpie & scissors to get them & cut off labels & oh such a good thing as the floor nurse was totally pissy about getting the meds...like dumped them onto the countertop. Outta there abt 9/9:30 & before butts in bed count. Mom was totally able to walk on her own with a footed cane, so easier than if she was bedfast. If their bedfast, it’s ambulance transfer & that’s on you to pay, not Medicaid or Medicare. It will not be inexpensive.
New NH let me set up mom’s room the night before. So I got everything but her & he meds out & over in advance. She was into new NH about 10:30 AM and in time for lunch & meet her lunch table as they came into dining room. Totally good.
Sue I think it depends on your state. I noticed recently that Florida ( as an example) uses that term. The principal assigns someone to be their medical surrogate.
FF also has valid points about dementia.
MPurdy Since we don’t have very many details we are all trying to give you things to consider when you make this decision. Tell us the back story and you will get better answers.
I'm not sure what a medical "surrogate" is. Do you have Power of Attorney for healthcare? You would have to have POA (if he is unable to make his wishes known) to make ANY decision for him.
As Ahmijoy said, unless moving him would cause danger to his health, (which is unlikely), there should not be a reason he could not be moved.
Is there a doctor connected with the facility? Have you spoken with him/her for a medical reason? I'm assuming you have spoken with the administrator. What reason did he/she give you? I would speak with the Ombudsman for the facility. If that doesn't work, I'd alert APS (Adult Protective Services) and the police.
It's one thing to try to keep your nursing home full but quite another to refuse to let residents go. Unless the move would kill him, they HAVE to let him go.
No offense, is any money owed to the facility? Are they trying to keep him until the bill is paid? If so, you might need to speak to a lawyer about arranging for payment.
I would check his contract to make sure you have given the proper notice etc Are you self pay or Medicaid? The NH you are moving him to could probably give you a heads up as to any problems that might occur as a result of the move. But I would ask the proper person at his current home if they need anything more from you by way of notification. Aside from reading your contract that is probably the quickest way to find out if they will have a problem. I’ve never moved anyone from a NH. I have from hospital to rehab. I always want to know that the meds are available at the new place and have been given to the patient at the one I’m leaving behind. Plus a copy of the medical records with the most recent med list and orders in hand or faxed over or whatever the preferred method is. For the sake of your loved one it’s better to leave on friendly terms. I see Shaking has had the experience and I’m sure is bringing up some valid considerations. I totally agree about being an advocate for him regardless of where he is. Good luck.
MPurdy, is your love one self-pay, or on Medicaid? Is there a lease involved or is the rent month to month?
If this is Medicaid paid, then you would need to find another nursing home that also accepts Medicaid. I would check first with your love one's case worker at the nursing home regarding this. If you are moving out-of-state, then your love one would need to re-qualify with the new State, as each State handles their own Medicaid programs.
I see from your profile that your loved one has Alzheimer's/Dementia. It is always recommended NOT to move a person who has such memory loss. Moving would worsen their Alzheimer's/Dementia as the person will be in a place that they do not recognize, they could become fearful, all the Staff would be new and the Staff would need to learn from scratch how to deal with your love one, and the food would probably taste different.
Now, if your love one had only been in the current nursing home a very short time, you might be able to make this work with limited issues from your love one.
I don’t see how they could stop you, unless the actual process of moving would endanger his safety or well-bing He’s not being held prisoner there. Why do you want to move him? Poor care? Move him closer to you?
The social worker or administrator may speak with you and advise you against moving him and offer reasons to support their opinion, but they cannot stop him from leaving unless they feel he’s in danger.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
This is what I was advised when I had to move my father from what I thought was a very good nursing home but was wholly inadequate. The NP for the orthopedic doctor advised getting a letter from them addressing the move, just in case Medicare challenged the move.
I got the letter, made the move, and Medicare never raised an issue. But I was prepared.
If he’s private pay, the admissions contract has an advance notice to the NH clause & this will be important as it will state if there’s a 30 or 60 day written notice required. Or he will be required to pay for the 30 or 60 even if he’s moved. You need to make sure New place will without question hold a bed for him for the 30 or 60 and what type of deposit needed. His medical needs are important cause if he’s real sick, things change & they may want to reevaluate him again.....
If he’s Medicaid, the NH cannot require a 30 or 60 day notice. Medicaid allows for lateral transfers without penalty. Medicaid payments follows the person so if it’s 10 days in 1 that’s what they get paid and new NH gets the rest of that months Medicaid reimbursement. But you as his dpoa will have to make sure his copay or SOC (share of cost) is paid properly to the penny for each. Otherwise NH can place a fine and fines are outside of Medicaid regulations. If the old Nh was made his rep Payee for his SS and retirement $, all that will need to be changed back to be deposited into his bank account and that could be a beast to get through.
My mom’s new NH sent out a RN / SW team to evaluate her at her old NH to determine if they could meet her needs. I signed off a document requesting the evaluation and Hippa access to her health chart. I also provided New NH in advance a copy of her health history and a list of her current meds (these from screen shots from her last care plan meeting). The team called me from mom’s bedside to tell me all ok, mom totally could get her care needs provided at New NH, out mom on the phone too and we set a date for the move & they would place a bed hold. No worries. I moved mom within the first days of the next month, so after she got that months SS & retirement. Each NH got pAid to the penny for days in that month. I already had zero’d mom’s personal needs trust account at the oldNH months prior, so no worries on that front. I did send as a courtesy a notice via fax & email to NH administrator as to the date of the move.
One thing I hadn’t considered was her meds. The new NH stressed that I HAD HAD just HAD to get all her medications. MediCARE and Medicaid are strict on meds and they are usually done on 90 day blister packs or in large jars held in locked closet at nurses station. M&Ms won’t pay for duplicates so you have to get all his meds. If you have to get New meds this could be very very expensive. I took ziplocks and a sharpie & scissors to get them & cut off labels & oh such a good thing as the floor nurse was totally pissy about getting the meds...like dumped them onto the countertop. Outta there abt 9/9:30 & before butts in bed count. Mom was totally able to walk on her own with a footed cane, so easier than if she was bedfast. If their bedfast, it’s ambulance transfer & that’s on you to pay, not Medicaid or Medicare. It will not be inexpensive.
New NH let me set up mom’s room the night before. So I got everything but her & he meds out & over in advance. She was into new NH about 10:30 AM and in time for lunch & meet her lunch table as they came into dining room. Totally good.
It can be done but it’s a ballet in planning.
I think it depends on your state. I noticed recently that Florida ( as an example) uses that term. The principal assigns someone to be their medical surrogate.
FF also has valid points about dementia.
MPurdy
Since we don’t have very many details we are all trying to give you things to consider when you make this decision. Tell us the back story and you will get better answers.
As Ahmijoy said, unless moving him would cause danger to his health, (which is unlikely), there should not be a reason he could not be moved.
Is there a doctor connected with the facility? Have you spoken with him/her for a medical reason?
I'm assuming you have spoken with the administrator. What reason did he/she give you?
I would speak with the Ombudsman for the facility. If that doesn't work, I'd alert APS (Adult Protective Services) and the police.
It's one thing to try to keep your nursing home full but quite another to refuse to let residents go. Unless the move would kill him, they HAVE to let him go.
No offense, is any money owed to the facility? Are they trying to keep him until the bill is paid? If so, you might need to speak to a lawyer about arranging for payment.
Are you self pay or Medicaid?
The NH you are moving him to could probably give you a heads up as to any problems that might occur as a result of the move.
But I would ask the proper person at his current home if they need anything more from you by way of notification.
Aside from reading your contract that is probably the quickest way to find out if they will have a problem.
I’ve never moved anyone from a NH. I have from hospital to rehab.
I always want to know that the meds are available at the new place and have been given to the patient at the one I’m leaving behind. Plus a copy of the medical records with the most recent med list and orders in hand or faxed over or whatever the preferred method is.
For the sake of your loved one it’s better to leave on friendly terms.
I see Shaking has had the experience and I’m sure is bringing up some valid considerations. I totally agree about being an advocate for him regardless of where he is.
Good luck.
If this is Medicaid paid, then you would need to find another nursing home that also accepts Medicaid. I would check first with your love one's case worker at the nursing home regarding this. If you are moving out-of-state, then your love one would need to re-qualify with the new State, as each State handles their own Medicaid programs.
I see from your profile that your loved one has Alzheimer's/Dementia. It is always recommended NOT to move a person who has such memory loss. Moving would worsen their Alzheimer's/Dementia as the person will be in a place that they do not recognize, they could become fearful, all the Staff would be new and the Staff would need to learn from scratch how to deal with your love one, and the food would probably taste different.
Now, if your love one had only been in the current nursing home a very short time, you might be able to make this work with limited issues from your love one.
The social worker or administrator may speak with you and advise you against moving him and offer reasons to support their opinion, but they cannot stop him from leaving unless they feel he’s in danger.