Veterans Nursing Home Care

To accommodate eligible veterans who are not acutely ill and not in need of hospital care, but who require skilled nursing care, related medical services, supportive personal care, and individual adjustment services (including social, divers ional, recreational and spiritual activities and opportunities)
in a homelike atmosphere.

Agency - Department of Veterans Affairs

The Department of Veterans Affairs strives for excellence in patient care and veteran's benefits for its constituents through high quality, prompt and seamless service to United States veterans.

Office - See Appendix IV of the Catalog for Veterans Hospital Facilities listed under Veterans Health Administration.
Website Address

http://www.va.gov



Program Accomplishments

In fiscal year 2007, 91,096 patients were treated with an average daily census of 34,579. The projected corresponding levels for fiscal year 2008 are 92,144 patients treated and 34,633 average daily census. For fiscal year 2009, the levels are 93,002 patients treated and 34,970 average daily census.

Uses and Use Restrictions

Veterans in need of care in a VA, State Home, or Contract Nursing Home Care Unit may be admitted or transferred according to the following priorities: (1) Any veteran who has a service-connected disability for any disability: (2) Any veteran whose discharge or release from the active military, naval, or air service was for a disability incurred or aggravated in line of duty for any disability; (3) Any veteran who, but for a suspension pursuant to 38 U.S.C.

1151 (or both suspension and the receipt of retired pay), would be entitled to disability compensation, but only to the extent that such veteran's continuing eligibility for such care is provided for the judgment or settlement described in such section, for any disability; (4) Any veteran who is a former prisoner of war, for any disability; (5) Any veteran who served in Vietnam during the Vietnam era and who may have been exposed to Agent Orange or other toxic substance and who, during such service needs care for a condition possibly related to such exposure, and to veterans who were exposed while on active duty to ionizing radiation from nuclear testing or participation in the American occupation of Hiroshima and Nagasaki following World War II and who are in need of care for a condition possibly related to such exposure; (6) Any veteran of World War I, for any disability; and (7) Any nonservice- connected veteran who is: (a) in receipt of VA pension, or who is unable to defray the expenses of necessary care as determined by the Category A threshold amounts; or (b) eligible for VA hospital care, who exceeds the income threshold amounts if the veteran agrees to pay the applicable co payments for the care rendered by the VA.

Eligibility Requirements

Applicant Eligibility

The need for placement in a nursing home is based upon medical and nursing care considerations.

The eligible veteran should require skilled nursing supervision, observation and care by an interdisciplinary team, and/or rehabilitative programs and supportive health services found only in a hospital based nursing home program.

Beneficiary Eligibility

There are two categories of veteran eligibility (Mandatory and Discretionary) for VA hospital care. VA shall provide hospital care to veterans within the Mandatory Category and is permitted to furnish care on a resource-available basis to veterans in the Discretionary Category. The Mandatory Category consists of all veterans including those nonservice-connected disabled with annual incomes below $22,064 for a single veteran and below $26,480 for a veteran with one dependent plus $1,476 for each additional dependent. Nonservice-connected veterans with incomes above the established threshold for mandatory care are in the Discretionary Category. They may be treated by the VA on a resource-available basis if they agree to pay a copayment.

Credentials/Documentation

Military discharge papers.

Aplication and Award Process

Preapplication Coordination

None.

This program is excluded from coverage under E.O.

12372.

Application Procedures

Submit Application for Medical Benefits, VA Form 10-10, to nearest VA medical facility. A medical determination as to need for nursing home care will be made by a VA physician.

Award Procedures

Not applicable.

Deadlines

None.

Authorization

Public Laws 88-450, 89-311, 89-358, 91-500, 93-82, 94-581, 96-22, 97-37, 97-72, and 97-452, 38 U.S.C. 610 and 5010.

Range of Approval/Disapproval Time

Not applicable.

Appeals

Not applicable.

Renewals

Not applicable.

Assistance Considerations

Formula and Matching Requirements

Not applicable.

Length and Time Phasing of Assistance

No limit.

Post Assistance Requirements

Reports

Not applicable.

Audits

Not applicable.

Records

Not applicable.

Financial Information

Account Identification

36-0160-0-1-703.

Obigations

(Salaries and Expenses) FY 08 $3,518,428,000; FY 08 est $3,895,145,000; and FY 09 est $4,003,488,000.

Range and Average of Financial Assistance

Not applicable.

Regulations, Guidelines, and Literature

VA Manual M-1, Part I, Chapter 12, "Nursing Home Care"; VA Manual M-5, Part II, Chapter 2; VA IS-1 Fact Sheet, Federal Benefits for Veterans and Dependents, available from the Superintendent of Documents, Government Printing Office, Washington, DC 20402.

Information Contacts

Regional or Local Office

See Appendix IV of the Catalog for Veterans Hospital Facilities listed under Veterans Health Administration.

Headquarters Office

Chief Consultant, Geriatrics and Extended Strategic Health Group (114), Department of Veterans Affairs, Washington, DC 20420. VA Nursing Home Care Program Chief. Telephone: (202) 273-8540.

Criteria for Selecting Proposals

Not applicable.



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