It is the primary duty of nursing homes to provide safe accommodations and expert medical care to their residents. In the United States, millions of seniors and at-risk individuals receive care at nursing home facilities. Unfortunately, nursing homes are somehow restricted in the amount and complexity of medical services they can provide to residents.
If a resident should need a higher level of care, it is crucial that the nursing home has adequate transfer and discharge protocols in place. Generally, nursing homes in the United States are prohibited from moving residents. They can transfer or discharge residents from the home only for certain reasons and, even then, only when they follow specified procedures.
Note that to lawfully transfer or discharge a resident, the home should prove that it complied with all the procedural requirements and that the transfer or discharge is for one of the few allowable reasons. In the absence of such proof, the transfer or discharge must be disallowed or, if the resident already moved, the resident must be allowed to return to the bed, room, and facility from which the resident was transferred.
It is a fairly common scenario for an older person whose adult children live in different states to seek transfer to enable them to stay close. Or the adult child who had been living nearby got transferred out of state for work, and now there is no family in the area to visit.
But irrespective of whose choice it is, both the nursing home and the family needs to be aware of the financial implication of moving a nursing home resident. And if possible, the move should be planned in advance to ensure the older person qualifies for coverage in the new state as soon as they can and to ensure that the nursing home stays on the right side of the law.
Usually, a nursing facility is expected to give the older person, their guardian, a conservator, or legally liable relative a written notice, at least 30 days, and no more than 60 days, before a transfer or discharge from one facility to another. A shorter notice is allowed in emergency situations or for residents recently admitted.
But if it is the idea of the older person or family to move, then they have to notify the nursing home and also ensure that the new state receives verification from the old state’s Medicaid agency that Medicaid benefits in the old state have been terminated.
Step by Step Guide for Transfering a Patient from One Nursing Home to Another
Indeed you can transfer a nursing home resident from one home to another, but there are certain guidelines that must be followed. If it is the choice of the family or older person to move, here are crucial steps that need to be taken.
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Choose a Desirable Facility
Note that before making a move, you are expected to identify a few rehab facilities/nursing homes where you would like the older person 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 the size of staff, cleanliness, and safety. Other sites, including Yelp.com, offer individuals the opportunity to air their personal impressions about specific nursing homes.
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Apply to the Out – of State Facilities
At this point, you will have to ask the admission staff at the current facility to send a Patient Review Instrument (PRI) to each of the selected nursing homes. Note that 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 meet them and if it has a bed available. Once the patient is accepted into a facility you can move on to the next step.
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Transfer the Primary Health Insurance
Have it in mind that most people aged 65 + are covered by two insurance policies, Medicare which is the major insurance, and secondary insurance which 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 percent of in-rehab care. Medicare is managed by the federal government and is viable in all states.
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Transfer the Secondary Insurance
Note that some secondary insurance are nationwide programs and can easily be transferred between states. However, other programs including Medicaid are not. Medicaid is a program that pays for healthcare for people with low income/ assets. It is a federal program but is overseen by individual states.
Note that every state decides its own eligibility requirements determined in part by a state’s cost of living. Sometimes, a person might be eligible for Medicaid in one state and not in another. For this reason, Medicaid cannot automatically be transferred. A person is expected to drop one plan when she leaves a state and reapplies in the new one.
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Apply for Medicaid (If you are moving to a New State)
A person cannot be eligible for Medicaid in two states at the same time. A resident is expected to first close out her Medicaid coverage in one state before applying in another. It is more or less ideal to dis-enroll at the end of the month because it takes until then to end Medicaid coverage.
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Understand Medicaid Residency Requirements
Immediately after a patient is admitted into the new nursing facility, he or she can apply for that state’s Medicaid program. Unlike residency restrictions for voting, federal law prohibits a residency requirement to apply for Medicaid. It simply means that a person is eligible for Medicaid 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 discourage you. 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.
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Move to the New Residence
Have in mind that the move between two facilities is the easiest part of the 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.
Conclusion
Transferring a nursing home resident from one state to another can be a complex process. It takes careful planning and coordination. However, all the steps are possible and with help from the nursing homes and knowledgeable professionals, the job can be accomplished smoothly and effectively.