By: Sanford R. Altman, Esq., retired

My mother, who had lived almost all of her life outside of Buffalo, New York, had gotten to the point where she was having difficulty living on her own. She was considering moving into an assisted living facility in her area, but we finally convinced her to move to a facility here in beautiful Orange County. After several years, her condition had worsened to the point where the assisted living facility could no longer take care of her and she needed to move on to a nursing home. They told us that we would need to apply for Medicaid for her – in Buffalo! Is that right?

Believe it or not, that is absolutely correct. You must apply in the county where
a person resides. Even though she may have lived in an assisted living facility here in Orange County and considered it her home, it simply does not count as far as Medicaid is concerned. She may even have received her mail here and voted here and filed her tax returns here. The rest of the government may well have considered this county to be her residence, but not Medicaid. An assisted living facility does not change your residence, no matter how long you live there. Not surprisingly, time spent in a nursing home does not effect your residency for Medicaid purposes either. Counties are generally very strict about refusing cases from other counties since they do not want to take on their portion of Medicaid expense, if they do not have to.

As if trying to further confused us, there is an entirely different rule if you are coming here from another state.

Recently, a client came to us with a problem she was having with her mother who is applying for Medicaid in a county further upstate. While the problem had nothing to do with her residency, it came out in our discussions that her mother had been moved directly from a hospital in a nearby state to a New York nursing home. And after several months, when they applied for Medicaid in New York, the county processed the application, no questions asked. Whatever county you land in from another state is considered your county of residence for Medicaid purposes. Unlike other states, we have no waiting period requirements.

There are two key reasons why it is important to be aware of these anomalies in the Medicaid Law. First, of course, is that you will know the proper the county in which to apply for Medicaid. Medicaid procedure can be long and complex as it is and you do not want it further complicated or delayed by being told to pick up all of your papers and go to another county. It is almost always easier to deal with a local office where you can appear in person and, of course, avoid long distance traveling or mailing. An application that a client of ours had to mail to New York City, with its high volume, is still pending after six months – unheard of in the Hudson Valley.

Second, having advance knowledge of the residency requirements in the Medicaid Law means that there are some steps that can be taken beforehand to remedy the situation. While moving a parent into an assisted living facility in your area is not enough to establish residence for Medicaid purposes, moving him or her into your home, even for a short period of time, may well be sufficient. Medicaid will still look for proof, as they do with every application, such as receipt of mail at your address. However, if this is at all possible, it is well worth considering to somewhat lessen the ordeal of the Medicaid Application process.