Gilmer Nursing Home

Information Summary: Calendar Year 2014

1. What is the process for admitting my family to the nursing home?

If your family is in the hospital, inform the Discharge Planner that you are interested in Gilmer Nursing Home for placement. When we receive the referral, we will review financial and clinical information and determine if we can meet your family member's need.

From home, just call the nursing home directly and ask for the Admissions Coordinator. You will be asked to have the doctor's office fax over recent records, and the process is the same from there.

2. How can I afford to pay for nursing home care?

Short Term:

If your family member has Medicare and is coming for short term rehab and has a three day hospital stay, they should qualify for a skilled nursing stay. Medicare will provide coverage for up to 100 days as long as they do not fall below a skilled level of care. The first 20 days will be covered at 100%. Residents that have a supplemental insurance policy will usually be covered for days 21-100. With no supplemental insurance, the cost for days 21-100 is currently $152 per day.

Long Term (Individual with no surviving spouse):

The daily rate for a semi-private room is $185 per day/private room $195 per day.

If your family member needs long term care, and the family cannot afford to be private pay, completing a Medicaid application may be the solution. For 2014, the individual's income cannot exceed $2,163 per month (social security, retirement, any other source of income), and they may not have over $2,000 in checking, savings, IRAs, etc. Gifts of cash or any other disposal of assets, including transfer of property, within the last five years could result in a penalty or denial. The individual may own their home (up to $543,000) at the time of applying for Medicaid; however, once approved, any money spent by Medicaid for their care would be subject to recovery by the sale of said home after their death by Medicaid. Once approved, the individual would be able to pay for their supplemental insurance policy (if applicable) and keep $50 cash for personal needs each month. The remainder of any income would be due to the nursing home and Medicaid would pay the balance.

Long Term (Individual with a living spouse in the community):

While you must spend down to around $2,000 in cash if you are an individual, many people are unaware of the leniency regarding a community spouse. Your spouse can actually keep the homeplace (excluded from Medicaid estate recovery up to $543,000) and transfer it to the community spouse's name within 12 months after admission. The community spouse may also keep his/her own income and the income of the nursing home Medicaid resident up to $2,931.00 per month and have up to $117,240 in resources.

A short phone call to the Business Office can help you determine your financial options. Call 706-276-4741 and ask for Tammy Williams at ext. 6209 or Dianne Langston at ext. 6331.

Nursing Home Medicaid Eligibility