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How to Qualify for the VA Long-Term Care Program

The VA extended care (long-term care) program includes such services as nursing homes, assisted living facilities, adult family homes, domiciliaries, adult day care facilities, and other programs. Depending on your financial situation, however, VA extended care may cost you.

VA long-term care options

The VA’s nursing home programs include:

  • Community living centers: These centers are designed for veterans with chronic stable conditions including dementia, those requiring rehabilitation or short-term specialized services such as respite or intravenous therapy, or those who need comfort and care at the end of life.

    The centers’ primary purpose is to restore residents to maximum function, prevent further decline, maximize independence, or provide comfort when dying. Generally, they are designed to provide short-term, restorative, and rehabilitative care up to 100 days.

  • Contract community nursing homes: Intended for longer-term care than community living centers, community nursing homes are commercial operations that are under contract to a VA medical center to provide nursing home services to enrolled veterans who reside in the community. They provide compassionate care and an entire range of medical services to veterans who can no longer care for themselves.

  • State veterans homes: A state home is owned and operated by a state. The home may provide nursing home care, domiciliary care, and/or adult day care. The VA pays a percentage of the cost of construction or renovation and/or per diem costs to the state.

    In addition, the VA checks up on state homes through annual inspections, audits, and reconciliation of records to make sure the state veterans homes are meeting VA standards for quality of care.

Qualify for VA long-term care

To receive extended care under the VA nursing home program, you must be:

  • A veteran who has a service-connected disability rating of 70 percent or more.

  • A veteran who has a 60 percent service-connected disability rating and is unemployable, or has an official rating of “permanent and totally disabled.”

  • A veteran with a combined disability rating of 70 percent or more.

  • A veteran whose service-connected disability is clinically determined to require nursing home care.

  • A veteran with a service-connected or non-service-connected disability with income and assets below the VA’s national income limits and HUD’s geographical income threshold.

  • If space and resources are available, other veterans on a case-by-case basis with priority given to veterans with service-connected disabilities and those who need care for rehabilitation, respite, hospice, geriatric evaluation and management, or spinal cord injury.

Domiciliary care is a residential rehabilitation program that provides short-term rehabilitation and long-term health maintenance to veterans who require minimal medical care while they recover from medical, psychiatric, or psychosocial problems. Most domiciliary patients return to the community after a period of rehabilitation. An example would be a residential drug or alcohol treatment program.

Other VA long-term care options

Other services under the VA’s extended care program include:

  • Hospice/palliative care, which provides comfort and support in the advanced stages of a terminal disease.

  • Respite care, which temporarily relieves the spouse or other caregiver from the burden of caring for a chronically ill or disabled veteran at home.

  • Geriatric evaluation and management (GEM), which evaluates and manages older veterans with multiple medical, functional, or psychological problems and those with particular geriatric problems. Veterans enrolled in this program receive assessment and treatment from an interdisciplinary team of VA health professionals.

  • Community residential care, which provides room, board, limited personal care, and supervision to veterans who don’t require hospital or nursing home care but can’t live independently because of medical or psychiatric conditions, and who have no family to provide care.

  • Home healthcare, which provides long-term primary medical care to chronically ill veterans in their own homes under the coordinated care of an interdisciplinary treatment team.

  • Adult day care, which provides health maintenance and rehabilitative services to veterans in a group setting during daytime hours.

  • Homemaker/home health aide services, which provides health-related services for veterans needing nursing home care. These services are provided by public and private agencies under a case management system provided by VA medical staff.

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