It would be considered a “lateral” transfer by Medicaid. It can be done, I did it for my mom at abt mo 10 at NH #1. Not simple, but is do-able. ,
As a first step, you need to find out if the new place you want to move her to has open Medicaid beds AND can provide the level of care that she needs. My moms old gerontologist suggested a couple of NH that other docs from that practice were medical directors at. Those were the ones I looked at. One had beds and I as POA signed off for them to send over a2 person assessment team of RN & SW to visit w mom at NH #1 to see if they, the new NH #2, could provide the level of care needed. Also signed off for medical chart & records to go to NH #2. Duet called me from moms bedside to say all was ok. Mom was on retrospect (she’s dead) a very easy care resident. Her care needs could be done at any NH.
IMPORTANT imo, If your Sis has mental health issues that hasn’t really gotten a medication management set up that keeps her stable; well the assessment may be that no new NH will want to take her in as a new resident. That her care needs are too challenging. Facilities can get pretty selective on lateral transfers. If she has a lot of psych issues in her chart or has had intense write up on conflicts w staff or other residents, personally I think she’s toast on moving into another place.
I didn’t have any of that w my mom. I went over the afternoon after the assessment to sign off admissions transfer paperwork and set a date to move in (5th of new mo.) Sent fax to NH #1 of move out date. If they are on Medicaid you can move them out without 30/60 day notice or any penalty. But HAVE to be current with copays required by Medicaid.
This is why we set move date at the 5th. Mom got both SSA on the 3rd and a separate retirement annuity (on 3rd or 4th), so $ all in by 5th. NH #1 was paid to the penny their copay for 4 days and NH #2 for the rest of the month. They must pay the copay for each NH and based on butts in beds days. Mom did NOT have the NH 1 become her rep payee but instead had her incomes go direct deposit into her old checking account I was signatory on & I wrote a check to NH #1 for the exact copay required ea month. If mom had allowed the NH to become her rep payee, she would need to have all that changed by SSA before the move. SSA does NOT recognize POAs. If that is your sisters situation and they aren’t competent and cognitive enough to deal with SsA, I think it will be very difficult to get thru what is needed to change a rep payee in a short & sweet amount of time. If the old NH wants to foot drag on all this, they can. But the financial part can be dealt with by you, may not be easy but you can wade thru it.
BUT medical assessment aspect, well, that is out of your hands. Again if Sis has write ups in her chart that she is & has been a challenge for her care plan, a regular NH may not want to deal with her. It may be that she would need to move into a long term care psychiatric facility. Those tend to be few and far between. If this is at all your Sisters situation, it may be that there is no easy place to move her into. She & you will need to do whatever to make her current NH work out for her. Please, pls pls realize that IF current NH finds her care not feasible at all, they can get her into EMS on a ER run and then refuse to take her back under “inability to do level of care needed” reasons. Even in theses Covid times this is still being done. Then the discharge planner at the hospital will have to find a place that will take her unless they can convince family to come and take her out & into their home.
As a first step, you need to find out if the new place you want to move her to has open Medicaid beds AND can provide the level of care that she needs. My moms old gerontologist suggested a couple of NH that other docs from that practice were medical directors at. Those were the ones I looked at. One had beds and I as POA signed off for them to send over a2 person assessment team of RN & SW to visit w mom at NH #1 to see if they, the new NH #2, could provide the level of care needed. Also signed off for medical chart & records to go to NH #2. Duet called me from moms bedside to say all was ok. Mom was on retrospect (she’s dead) a very easy care resident. Her care needs could be done at any NH.
IMPORTANT imo, If your Sis has mental health issues that hasn’t really gotten a medication management set up that keeps her stable; well the assessment may be that no new NH will want to take her in as a new resident. That her care needs are too challenging. Facilities can get pretty selective on lateral transfers. If she has a lot of psych issues in her chart or has had intense write up on conflicts w staff or other residents, personally I think she’s toast on moving into another place.
I didn’t have any of that w my mom. I went over the afternoon after the assessment to sign off admissions transfer paperwork and set a date to move in (5th of new mo.) Sent fax to NH #1 of move out date. If they are on Medicaid you can move them out without 30/60 day notice or any penalty. But HAVE to be current with copays required by Medicaid.
This is why we set move date at the 5th. Mom got both SSA on the 3rd and a separate retirement annuity (on 3rd or 4th), so $ all in by 5th. NH #1 was paid to the penny their copay for 4 days and NH #2 for the rest of the month. They must pay the copay for each NH and based on butts in beds days. Mom did NOT have the NH 1 become her rep payee but instead had her incomes go direct deposit into her old checking account I was signatory on & I wrote a check to NH #1 for the exact copay required ea month. If mom had allowed the NH to become her rep payee, she would need to have all that changed by SSA before the move. SSA does NOT recognize POAs. If that is your sisters situation and they aren’t competent and cognitive enough to deal with SsA, I think it will be very difficult to get thru what is needed to change a rep payee in a short & sweet amount of time. If the old NH wants to foot drag on all this, they can. But the financial part can be dealt with by you, may not be easy but you can wade thru it.
BUT medical assessment aspect, well, that is out of your hands. Again if Sis has write ups in her chart that she is & has been a challenge for her care plan, a regular NH may not want to deal with her. It may be that she would need to move into a long term care psychiatric facility. Those tend to be few and far between. If this is at all your Sisters situation, it may be that there is no easy place to move her into. She & you will need to do whatever to make her current NH work out for her. Please, pls pls realize that IF current NH finds her care not feasible at all, they can get her into EMS on a ER run and then refuse to take her back under “inability to do level of care needed” reasons. Even in theses Covid times this is still being done. Then the discharge planner at the hospital will have to find a place that will take her unless they can convince family to come and take her out & into their home.