It was hard enough to move your loved one into a nursing home or assisted living facility — but now you’re going to have to do it again?
At some point you may need to move your loved one from one nursing home or assisted living community to another. A transfer or move can occur for a variety of reasons, sometimes people move a loved one from one senior care facility to another. It could be closing or no longer accepts Medicaid. You may find that it’s too expensive. You may feel the quality of care is lacking. Your loved one’s health may be worsening, and you may want a facility that can better handle their health condition. Or you may simply want them closer to you.
If you end up relocating a parent to senior living, you’ll quickly be wondering: How are we going to move to a facility with the same level of care, if not better?
That can be a challenge, especially if you have to make the transfer in a hurry. But here are some rules of the road that you’ll want to consider.
[READ: The 30-60-90 Day Timeline: What to Expect Emotionally After Moving a Parent to Senior Living]
A 30-Day Timeline: Leading Up to Moving Day
There’s no blueprint that anyone has to follow as they move a relative from one nursing home to another, but there is a lot to do. Here’s a guide to give you a sense of how things will build up over the weeks before the move happens to make moving day go more smoothly.
| Timing | What to Do |
| 30 days out | Give notice to your current facility that your loved one is leaving. They often require a 30 day notice — provided, of course, that you have a new facility ready for your loved one. |
| 20 days out | Confirm with the moving company — if you are using one — that they’ll be there at the current facility to move any possessions to the new one, like a dresser of clothing or a television set, to the new nursing home. |
| 15 days out | This would be a good time to ask the current nursing home if they’ve sent your loved one’s medical records to the new facility. |
| 12 days out | Have you arranged for transportation from one facility to the other yet? If not, this would be a good time to do that. |
| 10 days out | Contact the post office to tell them about your parent’s move and establish a forwarding address. |
| 10 days out | Have you contacted the pharmacy to make sure any medication they deliver will be delivered to the right facility? |
| 10 days out | Contact Social Security, your parent’s bank or any other company that would need to know about their move. |
| 7 days out | Begin packing your loved ones belongings into boxes. |
| 3 days out | This is another item that would be good to do earlier, but if you haven’t talked to the new facility staff about your parent’s medical needs, dietary restrictions and daily routines, now is the time. Also, check to make sure they received your parent’s medical records. |
| Move-in day | Not only will you be transporting your loved one and their belongings, you may want to plan to stay at the new place with your parent for a few hours — and for family members to drop by several times that first week to help with the adjustment and to combat any loneliness. |
[READ: 10 Things to Look for When Touring a Senior Living Facility]
Knowing Your Rights: Senior Care Facility Eviction & Discharge Rules
There are six legal reasons that a nursing home can evict or discharge a resident, which came about after the Nursing Home Reform Act of 1987 was passed:
— The needs of a nursing home resident are greater than what the facility can provide.
— The nursing home resident isn’t paying for nursing home care and hasn’t applied for Medicare or Medicaid.
— The resident is healthy and no longer needs a nursing home.
— The resident is jeopardizing the health of other residents.
— The resident’s presence is jeopardizing the safety of other residents.
— The nursing home facility is closing.
In some situations, you may be requesting the move, but if you didn’t ask for the move and you feel your loved one is being unfairly evicted, you’ll want to know your rights and know what senior care facilities can legally do — and what they can’t.
“Nursing homes can only involuntarily discharge someone for a few legally defined reasons and usually have to provide 30 days written notice and a safe discharge plan,” says Seb Frey, a certified senior advisor and certified aging in place specialist in Silicon Valley. He also runs Team Sixty Plus, a professional network and resource platform for adults over 60.
“You can appeal, and you should call your local long-term care ombudsman the day that notice comes. The ombudsman program is free and is one of the most underused resources in senior care,” Frey says.
Most states have a Department of Aging, and that’s generally where you’ll find the ombudsman program. Also, Medicare has a list of each state’s ombudsman program online.
[READ: How to Know Your Loved One Is Getting the Senior Care They’re Paying For]
How an Elder Law Attorney Can Help Prevent Eviction
If you believe you have a case and shouldn’t be evicted, an elder law attorney can advise you. You can find a lawyer at the National Academy of Elder Law Attorneys’ website. Check out their “resources” page.
There are so many ways an elder law attorney can help a nursing home resident. For starters, if you have a parent facing an eviction, they can file an appeal to halt the process and buy you some time. But even beyond that a good elder law attorney can help with a variety of services including:
— Asset protection, so your parent doesn’t lose all of their savings to healthcare costs
— Applying to Medicaid
— Fighting an unjust Medicaid rejection
— Renegotiating a bad or unjust contract with a nursing home
— Connecting you with free government advocates, who can help you navigate senior care
[READ: How to Pay for a Nursing Home With No Money.]
Senior Care Facility Transfer Checklist: Organizing the Paperwork
Organizing and requesting necessary paperwork for the new nursing home or assisted living facility could potentially save you time and money: time, since later, you won’t have to hunt for paperwork; money, since, well, you never know what hidden fees you might uncover.
One common hidden fee is the bed hold fee.
These are fees a nursing home will sometimes charge your loved one for leaving the facility temporarily, such as if your parent is in the hospital. If you haven’t signed a bed-hold agreement, your loved one could return, only to find their bed was given away to somebody else.
If you’re trying out a new facility, you might want to sign a bed-hold agreement, so your relative has somewhere to return if it doesn’t work out. That’s a fine strategy — nothing wrong with that, but Frey cautions to be careful with signing the agreement and especially to not forget about it.
“Those bed-hold charges are adding up at the daily rate, so decide up front if that safety net is worth the cost,” Frey says. “Make sure any prepayments will be refunded, ask for a final detailed statement and don’t treat the account as closed until you have checked it once your loved one has left the facility.”
[READ: Nursing Home Requirements: Who’s Eligible?]
Recommended paperwork when relocating from one senior living community to another
| Paperwork | Reason Needed |
| A physician’s order for admission | If you’ve ever wondered if you could just go to a nursing home and be taken care of, even though you’re as healthy as a horse, the answer is — no. A doctor has to approve your living there. |
| A list of prescriptions and doses | The current nursing home will have it, but you’ll want to make sure they send it to the new one. |
| Contact information with your relative’s doctors and emergency contacts | The new nursing home needs to know who to call. |
| Your loved one’s Social Security card, as well as documentation related to Medicare and/or Medicaid, and insurance cards | The nursing home needs to know they’re treating the right person. |
| Medical power-of-attorney paperwork | The nursing home needs to know you have the legal say-so to make medical decisions on behalf of the resident. |
| Dietary requirements | To ensure your loved one gets the nutrition they need |
| Any advance directives your parent might have: do-not-resuscitate paperwork, end-of-life care wishes and medical orders for life-sustaining treatment. | Be prepared for end-of-life questions |
Mid-month transfer strategies: tips to avoid paying double rent
Similar to moving from one apartment to another, where you could have rent overlapping with each other, and security deposits to pay or get back, you’ve got a lot of money transferring when you move from one senior care facility to another.
Social workers and case managers can point out if they see you about to make a decision that is going to waste money. You want to avoid paying two nursing homes at the same time, and that can happen, especially in the middle of the month, since housing is typically paid for monthly. You don’t want to experience overlapping nursing home costs.
If you’re working with experts, they can suggest mid-month transfer strategies and tips to avoid paying double rent, such as requesting prorated billing from each facility when the move is occurring.
[READ: Transitioning to Assisted Living: A Guide for Seniors and Families]
Expect Stress — and Try to Plan For It
Moving a relative from one senior care facility to another can be anxiety-inducing for everyone. But if you know that from the outset, you might be able to make decisions that make the transition less overwhelming. For starters, don’t be a hero. No need to feel like you have to do this all by yourself.
“Moving a loved one with mobility challenges can be complicated, but families are not expected to navigate the process alone,” says Lori Kemp, owner of CareBuilders at Home North Central Texas, an in-home care company for seniors. “Social workers, case managers and care teams often help identify what level of care the person needs and what resources will make the transition smoother.”
And you really are being smart to lean on professionals for help. They know what money traps to look for.
And when you’re looking for a new facility, Kemp suggests trying to find one that offers multiple levels of care, which may help prevent future moves as your loved one’s needs change.
“It’s also important to consider location carefully,” she says. “Keeping a senior close to family members and loved ones can help prevent isolation and depression.”
[READ: What Is Transfer Trauma?]
Comparison Shop
You may not have much time, but ideally, “the same research process used to choose the first facility should happen again,” says Kemp.
You can start with U.S. News’ best senior living communities. It’s an exhaustive look at the quality of nursing homes and other senior living centers. U.S. News analyzed data from more than 540,000 resident and family survey responses at more than 3,200 senior living communities nationwide. The survey asked residents and family members about their satisfaction with community safety, caregiving, activities, management, staff, food, value and other aspects of community life.
You can type in your zip code or search by region, and see what senior living communities are near you, and can see what amenities they have and what they’re recognized for. Or if you have a specific senior living facility in mind that you want to learn more about, type the name in, and you’ll quickly get a full picture of the place you’re interested in.
Another great resource, Kemp says, “is Medicare’s facility comparison tools at Medicare.gov, which provide star ratings and other information for licensed facilities. These ratings are based on factors such as inspections, quality measures and feedback from people who have used the services.”
She also recommends looking into working with senior placement services or senior relocation services.
“Many of these organizations provide guidance at no cost to families because they are compensated by the communities they partner with. Caregiving agencies can also be valuable resources when navigating the process,” she says.
Once the Move is Done, Don’t Exhale Yet
You know the drill. You’ve done this before. You’ll want to make sure your loved one is really receiving the care they deserve.
Frey suggests showing up unannounced at least twice, to the facility. “Go once during a mealtime and once on a weekend or evening when staffing is often at its lightest,” he says. “Federal law gives nursing home residents open visitation rights, so no one can turn you away for showing up without an appointment. Watch how staff address the residents, ask about caregiver turnover, and if you’re an outgoing person, talk to family members you see in the hallway. They’ll tell you things no admissions director ever will.”
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How to Move Facilities at the Same Level of Care: Checklist and Resident Rights originally appeared on usnews.com
