Nursing Home and Long-Term Care
Care in an Institution
The Medicaid program offers a broad set of services for those who have special health care needs. Sometimes the best solution for a person with a severe disability or medically unstable condition is care in an institution, such as a nursing home or an intermediate care facility for people with mental retardation and/or developmental disabilities (ICF-MR).
When applying for institutional care through Medicaid, applicants will need to show proof of income, resources, disability, citizenship (if not a U.S. citizen) and other health insurance. Individuals must also meet Transfer of Resources provisions. Once it is determined that financial requirements are met, a level of care assessment will be conducted to identify the appropriate type of long-term care Medicaid will provide. Once the care needs of the individual is determined, an additional computation is completed to establish how much of their income will be applied to the cost of care in the institution. This is called the Patient Liability.
How will this affect family members?
If an individual is in need of care in an institution, and has a spouse or dependent family members, it is possible that some of that person's income and assets can be kept to support those who remain at home. This is called Spousal Impoverishment and was established as a provision in the Medicare Catastrophic Coverage Act (MCCA) of 1988. Its purpose is to protect the community spouse from becoming "impoverished".
How does Nursing Home and Long Term Care work?
A resource assessment is conducted to determine the amount that will be given to the spouse and dependents at home. The spousal impoverishment law allows one year for the institutionalized spouse to transfer assets to the community spouse. From here, the patient liability is determined. Family or authorized individuals should contact the local job and family service office to apply on behalf of those needing this care.
In Gallia County, call 740-446-3222 to request an application be mailed to you or come into the agency during regular business hours to complete an application.
An appointment will be scheduled for you to complete a face-to-face interview with an eligibility worker as soon as possible.
For further information, call the Medicaid consumer hotline at 1-800-324-8680 or log onto the Ohio Health Plans website at http://www.jfs.ohio.gov/ohp