North Carolina State Veterans Home: Who Qualifies, Cost, How to Apply

If a North Carolina State Veterans Home has a State home care agreement with VA, VA's payment is payment in full for a veteran rated 70% or more who needs nursing home care. The family then owes nothing for that care.1 If a doctor has just told you your dad or your husband can't safely live at home anymore, North Carolina's four open State Veterans Homes, state-run skilled nursing homes in Salisbury, Black Mountain, Kinston and Kernersville, are worth a close look, and North Carolina law decides who gets in and in what order.2

In This Guide

• Key Takeaways
• What a North Carolina State Veterans Home Is
• Where the Four Open Homes Are
• Who Qualifies for a North Carolina State Veterans Home?
• How the Waiting List Works
• Can a Spouse or Parent Live There Too?
• What Does a North Carolina State Veterans Home Cost?
• When the Family Pays Nothing
• How to Apply, Step by Step
• Frequently Asked Questions
• Learn More

What a North Carolina State Veterans Home Is

The name on the sign says "Veterans," but the operator of every North Carolina State Veterans Home is the North Carolina Department of Military and Veterans Affairs (DMVA), a state agency. Under the federal State Veterans Home program, the state owns, operates and manages each home, and the U.S. Department of Veterans Affairs certifies it and surveys it every year against VA standards.3

The U.S. Army's official benefits site describes North Carolina's homes as "four full-service, skilled nursing facilities for Veterans and their eligible family members."2 DMVA says its homes are licensed by the State of North Carolina and approved for Medicare, Medicaid and third party insurance, with care from registered nurses, licensed practical nurses and certified nursing assistants under the direction of licensed physicians.2

So a North Carolina State Veterans Home is not a VA hospital or a VA nursing home. The VA helps pay for eligible veterans there, but each state sets its own eligibility and admission rules for its homes.3 If you're weighing one against a VA Community Living Center, our guide to VA nursing home care explains what the VA itself runs, and our national guide to State Veterans Homes shows how the program works in every state.

Where the Four Open Homes Are

Distance matters more than people expect. A home you can reach on a weeknight is a home you'll keep visiting, and you'll be the one calling, touring and signing papers. Here are the four homes the DMVA lists as open, with the bed counts and phone numbers it publishes for each.2

If you live near Fayetteville, you may still see the Fayetteville State Veterans Home in search results. DMVA's page for it is marked closed: after finding significant repair needs and structural deficiencies, the Department decided "to close and replace the facility," and helped its 85 residents move to other State Veterans Homes or a facility of their choice.2 That DMVA notice gives no location or opening date for a replacement, so plan around the four homes that are open now.2

Who Qualifies for a North Carolina State Veterans Home?

This is the question families usually get stuck on, and the good news is that North Carolina writes its rules down plainly. Under G.S. 143B-1298, a veteran must meet all four of these to be eligible for a North Carolina State Veterans Home:2

1. Served in the active Armed Forces of the United States for other than training purposes.
2. Was discharged under honorable conditions.
3. Is disabled by age, disease or another reason, as found through a physical examination by a State veterans home physician.
4. Has lived in North Carolina for two years immediately before the date of application.

The residency rule catches families who moved a parent in recently. Say your father came to live with you from out of state 14 months ago: under G.S. 143B-1298, the two years are counted back from the day the application is made, so he'd need to wait until he has lived in North Carolina for two full years before he meets that requirement.2

The U.S. Army's benefits site, MyArmyBenefits, restates North Carolina's rules and adds two practical conditions: the veteran is referred by a licensed physician and determined to need skilled nursing care, and the home must be able to meet the veteran's needs.2 That site words the residency rule as two years before admission; the statute counts back from the date of application, and the statute is what governs.2 On the federal side, VA says eligibility for State Veterans Homes is based on clinical need and setting availability.3

How the Waiting List Works

Nobody likes hearing "there's a list," but North Carolina's list isn't a mystery. G.S. 143B-1298 sets the order:2

• Wartime veterans first. Eligible wartime veterans get priority over eligible nonwartime veterans and are admitted to the first available bed that can provide the level of care they need. Wartime veterans with the same care needs are ranked by the date the home received their application.
• Everyone else by date. All other eligible veterans are ranked by the earliest date the application was received. If two arrive the same day, the program's Administrative Officer orders them by medical need.

The practical lesson is simple: the date your application arrives counts, so don't wait to send it once the veteran qualifies. None of the North Carolina sources we cite states how long the wait is at any home, so ask each home you're considering how many beds are open and where your parent would fall on its list.2

Can a Spouse or Parent Live There Too?

Many couples hope to stay together, and North Carolina does make room for family, within a limit. Under G.S. 143B-1298, nonveterans may occupy no more than 25% of the total beds in a North Carolina State Veterans Home. When space for a nonveteran opens, the statute gives priority in this order:2

1. The veteran's spouse.
2. A widow or widower whose spouse, if living, would be an eligible veteran.
3. A Gold Star parent, which North Carolina defines as the mother or father of a veteran who died an honorable death while in active service to the United States during time of war or emergency.

One thing to plan for: VA does not pay for the care of non-veterans in a State Veterans Home, so ask the home how it would bill a spouse's stay.3

What Does a North Carolina State Veterans Home Cost?

North Carolina puts the resident's bill in statute, even though it doesn't print the number. North Carolina's G.S. 143B-1299 says each resident of a State veterans home "shall pay to the Department of Military and Veterans Affairs the cost of maintaining his or her residence at the home," in an amount the North Carolina Veterans' Affairs Commission sets.2 Neither that statute nor the DMVA home pages we cite publish a dollar rate, so ask the home for its current daily rate in writing before you sign anything.2

The veteran's share is lower than the full cost because VA helps pay. Under federal rules, VA pays the state a per diem for each eligible veteran in a State home: the lesser of one-half of the daily cost of the veteran's care or the basic per diem rate VA sets each fiscal year, and by statute those payments can never exceed half the cost of the veteran's care.1 The cost to the resident varies by state.3

DMVA also says its homes are approved for Medicare, Medicaid and third party insurance, so ask the business office which of those it would bill for your parent.2 Don't count on Medicare for a long stay, though: Medicare Part A covers skilled nursing facility care only on a short-term, post-acute basis and does not cover long-term custodial care, so Medicare alone will not pay for months or years in a North Carolina State Veterans Home.4 If your parent may need help paying from a VA pension, our guide to how Aid and Attendance helps pay for a nursing home in North Carolina walks through that money.

When the Family Pays Nothing

For some veterans, the honest answer to "what will this cost us?" is nothing for his nursing care, if the North Carolina State Veterans Home has a State home care agreement with VA. Under 38 U.S.C. 1745(a) and 38 CFR 51.41, VA contracts with State homes to pay for nursing home care for these veterans:1

• A veteran who needs nursing home care for a service-connected disability.
• A veteran with a service-connected disability rated 70% or more who needs nursing home care.1
• A veteran with a rating of total disability based on individual unemployability (TDIU) who needs nursing home care.

Under 38 CFR 51.41, for a veteran who needs nursing home care and is rated 70% or more, is rated TDIU, or needs that care for a service-connected disability, VA's payment to a North Carolina State Veterans Home that has a State home care agreement with VA is payment in full for that nursing home care, and under that agreement the home may not charge the veteran, the family, an insurer or anyone else besides VA for the care VA paid for. Ask the home whether it has one.1

Two things help here. Bring the veteran's current VA rating letter when you apply, because the rating is what triggers the rule. And if a claim is still pending, a late decision can reach back: under 38 CFR 51.41, a retroactive rating that brings a veteran within these rules lets the State home ask VA to pay back to the rating's effective date or February 2, 2013, whichever is later.1 If you're not sure what VA already pays for, our page on VA long-term care copays explains who pays nothing.

How to Apply, Step by Step

You apply through the home itself. MyArmyBenefits' North Carolina page says simply: "For more information and to apply, please contact the Veterans home directly."2

If you can, go in person the first time. You'll meet the staff, see the rooms, and get a feel for whether it's right for your parent before you commit.

Learn More

Find personalized help choosing and applying to a North Carolina State Veterans Home at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.