It's a fairly common scenario: an older person, whose adult children may live in different states, begins to need more care than they can get at home. The older person and their family make the decision that nursing home care is needed, and a place is selected. Often, it's near the older person's home, perhaps in the hope that they will be well enough to move back to their house at some point. Perhaps one of the adult children lives nearby and can visit regularly.
The older person gets settled in long-term care, and time passes. The nursing home resident qualifies for Medicaid assistance to pay for their care. But eventually, it becomes clear that they will need to move to another facility, one in another state. Maybe it becomes clear that they will never be able to live independently in their home again. Perhaps 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. Maybe the adult children decide that it would be better to have mom or dad closer to one of them in a different part of the country.
Whatever the reason for the move, families need to be aware of the financial implications of moving a nursing home resident across state lines. And if possible, the move should be planned in advance, to ensure the resident qualifies for coverage in the new state as soon as they can and to protect assets from the nursing home.
Medicaid is a joint federal and state program, so many people assume that once you qualify for Medicaid, your coverage follows you even if you move across state lines. This assumption is incorrect, and could cause serious financial distress for a family that moves a loved ones between nursing homes in different states.
The reason moving across state lines is an issue for Medicaid is that, while a joint federal and state program, Medicaid is administered by the individual states, and each state has its own specific rules. In order to qualify for Medicaid in Ohio or any other state, a person has to be a resident of that state. So in the case of a nursing home resident moving from, say, Michigan to Ohio or Ohio to Kentucky, the person would need to establish residency in the new state in order to qualify for Medicaid assistance.
Hopefully, the need to move your loved one to a new nursing home in a different state will not be a crisis decision. That will allow you time to put the Medicaid process in place. The first step you should take is to contact the Medicaid agency in the state your loved one will be leaving and request to have their Medicaid services in that state terminated. The termination process typically takes at least 30 days. You should inquire about the length of the process when you contact the agency, as you do not want to terminate assistance too soon.
As soon as the nursing home resident moves to the new state, they can apply for benefits under the new state’s Medicaid eligibility rules. The new state will need to receive verification from the old state’s Medicaid agency that Medicaid benefits in the old state have been terminated. You will also want to contact the new state’s Medicaid agency in advance of the move to learn what their rules require in terms of establishing residency and Medicaid eligibility.
You may want to take other steps to establish your older loved one as a resident of the new state. For instance, it may be a good idea to open a bank account for them in the new state. If there is a bank with branches in both the old and the new state, you can probably establish the account while they are still a resident of the old state, and then just change their address with the bank when they move to the new one. If there is a family member living in the new state, you might want to make that person’s residential address the nursing home resident’s address for purposes of receiving Social Security and other retirement benefits, at least until the older person is established in the new nursing home.
Be aware that if your older family member still owns property in the old state, that could be a sticking point. Real estate or vehicles that were considered exempt property while your loved one lived in the old state might become non-exempt upon a move to a new state. Consult with an experienced Medicaid planning attorney in the new state to discuss what you should do about non-exempt assets. Having your family member transfer them to you or another relative is not an option, as doing so could run afoul of the Medicaid look-back period.
Transferring a nursing home resident from one state to another can be a complex process. If you have any questions about how to begin, or about qualifying for Medicaid in Ohio, we invite you to contact Gudorf Law to schedule a consultation.