Program Descriptions
Program Number
64.010
Title
Veterans Nursing Home CARE
Federal Agency
VETERANS HEALTH ADMINISTRATION, DEPARTMENT OF VETERANS AFFAIRS
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.
Status
Active
Objectives
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.
Types of Assistance
Provision of Specialized Services.
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.
Application and Award Process
Preapplication Coordination
None. This program is excluded from coverage under E.O. 12372.
Application Procedure
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 Procedure
Not applicable.
Deadlines
None.
Range of Approval/Disapproval Time
Not applicable.
Appeals
Not applicable.
Renewals
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.
Obligations
(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.
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.
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.
Web Site Address
http://www.va.gov
Related Programs
64.015, Veterans State Nursing Home CARE
Examples of Funded Projects
Not applicable.
Criteria for Selecting Proposals
Not applicable.
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