The Department of Veterans Affairs (VA) provides both short-term and long-term care in nursing homes to veterans who aren't sick enough to be in the hospital but are too disabled or elderly to take care of themselves. Priority is given to veterans with service-connected disabilities.
The VA is required to provide nursing home care to any veteran who:
Other veterans in need of nursing care will be provided services if resources are available after the above groups are taken care of.
Community Living Centers. Some VA Medical Centers have Community Living Centers (these used to be called Nursing Home Care Units or VA Nursing Homes). These centers are typically located within the VA Medical Center itself or in a separate building.
Contract Nursing Home Care. Nursing home care in public or private nursing homes is also available to some veterans. Stays in these nursing homes can be limited, however, for veterans with ratings less than 70% and for veterans who do not need care due to a service-connected disability.
State Veterans Homes. State Veterans Homes are nursing homes run by the state and approved by the VA. Sometimes the VA will pay for part of the care a veteran gets at a state veterans' home.
To receive care in a Community Living Center/VA nursing home, a veteran must:
However, meeting the above criteria does not automatically ensure admission. CLCs make decisions about whether to admit a veteran based on the following factors:
Veterans required to make co-pays are typically those:
This means that veterans who have service-connected ratings of 10% to 100% are entitled to full payment for a community living center, regardless of their income.
Typically a veteran's physician will submit the application requesting care in a CLC. Veterans who are not exempt from co-pays must complete VA Form 10-10EC, Application for Extended Care Services.
Any veteran who needs Contract Nursing Home Care for a service-connected disability or is receiving VA home health care after discharge from a VA hospital is eligible for direct admission. To be admitted, all that is required is for a VA physician or authorized private physician to determine that nursing home care is needed. Veterans rated 70% or more service-connected should also be eligible.
Other veterans are eligible to be transferred into Contract Nursing Home Care (also called a Community Nursing Home) if the VA determines the care is needed and:
Veterans who are not in the priority groups are technically limited to six months of care, but this may be reduced to 30 to 60 days if resources are limited. Veterans in the priority groups are technically entitled to unlimited free care, but again may receive shorter stays due to a lack of funding and resources to accommodate them.
Many veterans can extend their stay by relying on payments from Medicare and Medicaid.
Typically application will be made by a veterans' doctor, social worker or nurse, using VA Form 10-0415, Geriatrics and Extended Care (GEC) Referral.
In some cases, the VA will help pay for a veteran's care at a State Veterans Home. The payments the VA will make are called per diem aid. A home must meet the VA standards for nursing home care to receive per diem aid. In addition, the VA will not pay more than half the cost of the veteran's care.
State homes provide hospital care, nursing home care, domiciliary care, and sometimes adult day care. To receive per diem aid, veterans must meet VA eligibility requirements for the type of care they will receive.
States usually have their own eligibility requirements, in addition to the VA's requirements, such as residency requirements. The veterans home will apply for VA aid for a veteran's care by submitting VA Form 10-10EZ, Application for Medical Benefits.
The VA will pay per diem aid for a veteran's care indefinitely.
A veteran who begins to receive nursing home care will have his or her monthly pension payment reduced to $90 if: