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If you are seeking 24/7 care in her home provided by Medicaid I doubt that that will happen.
If she is in rehab now and they accept Medicaid for Long Term Care she may be able to remain where she is.
If she is living in a facility and is in Independent Living she may have to move to AL or LTC if the facility has it and if they accept Medicaid.
There are a few that are well versed in the Medicaid process and I am sure you will get a response from them.
I get the impression that you feel she will get less care because she is a Medicaid recipient. My daughter has worked for LTC facilities in Del for 20 yrs as an RN and she says residents are all treated the same. Staff is not suppose to know who is on Medicaid and who isn't. They may put 2 and 2 together but the care should not be any different. My Mom was cared for very well. If sister had been at this facility for a while, then I don't think her care will change. Be aware though, if she has not been sharing a room, she will be on Medicaid. Medicaid does not pay for private rooms. I did read somewhere though, that if family want the person to have a private room, they pay the difference. Not sure if that is true.
How do you oversee ur sisters care if you are in Va? Be aware that in NJ $50 of her SS will be placed in a Personal Needs Acct. This is for her personal needs only. You as her guardian should be able to have access to it but must show receipts to be reinbursed.
My daughter has explained...your sister is not a patient she is a resident. As such, the facility is considered her home with all the rights that go with that.