State Veterans’ Homes

What are state-run veterans’ homes and how do they work? Are they run or overseen by the Department of Veterans Affairs? Are they operated and funded by state agencies? Who qualifies for care in these facilities? There are many answers and options for veteran care in these facilities.

Definition of “State Veterans Home”

According to the VA official site, the definition of a veterans’ home is essentially “facilities that provide nursing home, domiciliary or adult day care.” These homes are owned, operated, and managed by state government rather than the Department of Veterans Affairs.

Veterans’ homes date back to the post-Civil War era. Individual states created them to deal with the aftermath of the conflict. Their mission included helping homeless and disabled war vets.

Oversight and Approval of State Veterans Homes

While basic oversight of the day-to-day operation of a state-run veterans’ home is not the responsibility of the VA, there is a vetting process a state facility must meet in order to qualify under VA standards. The Department of Veterans Affairs surveys these homes on a yearly basis to insure they meet the VA’s regulations.

The VA official site states that the “VA must formally recognize and certify a facility as a State Veterans Home.”

This oversight is necessary since state-run veterans’ homes may receive payments from the VA for patient care based on patient need, eligibility, and other factors. The Undersecretary for Health assigns a VA Medical Center of jurisdiction for each State Veterans Home. A survey team is responsible for monitoring the quality of the facility on an annual basis. Each state home must comply with all VA standards in order to receive such payments.

Since state-run veterans homes are managed by each state rather than the VA, services and admissions standards may vary. Some of these veterans’ homes only admit veterans, some admit spouses, and others offer services to Gold Star family members in addition to veterans.

State-Run Veterans’ Homes and State Licensing

The Department of Veterans Affairs requires all facilities it recognizes to be licensed as acute care or long-term care facilities. According to the VA official site, “The nursing home facility shall be licensed as a skilled nursing home by the State and shall comply with Federal, State and local laws, rules and regulations for skilled nursing home care.”

Admission Requirements for State Veterans’ Homes

The specific requirements for admission to any state-run veterans’ home will vary depending on the facility, state law, and other factors. In general these homes tend to include an honorable discharge requirement or at a minimum that the applicant have a discharge not characterized as dishonorable.

In general, state run homes will require either a demonstration of need for the care or similar justification for admission. This may be accomplished via a doctor’s referral or by other means as acceptable to that veterans’ home.

Medical records, VA disability award letters, other VA notification of eligibility for disability pay and other compensation may be required.

In some cases, state residency may be required. While in others, the veteran’s home of record as listed in their discharge paperwork or other military documents may apply. Some state run homes may not require the patient to be a long-term resident of the state, but the rules in this area may vary and change over time. Check with the home you anticipate using for pre-need eligibility rules.

Some state-run facilities have no care options for patients on certain types of treatment such as a need for opioid painkillers, mechanically assisted breathing or life support, certain mental health issues, etc. Each facility has its own standards and restrictions. Applicants will need to discuss their needs with the administrators of that facility to see what is acceptable.

Cost of Care in A State Run Veterans’ Home

The specific costs charged to the veteran or family of the veteran will vary depending on the facility, location, demand, and other factors. VA rules state that the patient may be responsible for all, some, or none of the expenses depending on eligibility for VA assistance, use of VA funds, etc.

Specifically the VA official site states, “The State-operated facility may establish a maintenance charge system and collect from the pension, compensation, or other income of veterans.” These charges do not replace the state’s own operating funds required to maintain the facility according to VA regulations.

Circumstances When The VA Will Pay for Care in A Veteran’s Home

The Department of Veterans Affairs may offer qualifying veterans per diem aid which is intended to pay for or help paying for the cost of that care. This requires the veteran to enroll or already be enrolled in the VA healthcare system.

The VA advises that the funds it provides may or may not cover all expenses. The VA official site reminds applicants, “You may be able to pay for long term care services through VA, Federal and State programs (Medicare and Medicaid), and through insurance or your private funds.”

Applicants may find that VA per-diem care payment amounts are based on eligibility, need, ability to pay, VA disability rating, and other factors.

Similar to the admission requirements for veterans’ home care, the VA also has a need-based eligibility requirement. The veteran or other applicants must have a demonstrated clinical need for care and compensation as determined by the VA.

It is important to note that the VA does not pay the costs for non-veterans (surviving spouses, Gold Star family members, etc.) to receive state veterans’ home care.

Things You Should Know About Nursing Home Care for Veterans

• State-run veterans’ homes are technically classified (by the VA) as nursing homes. They are not considered community homes, hospitals, etc.
• VA per diem care payments are not made when the veteran requires treatment in a VA hospital or gets care outside the state-run home paid for by the Department of Veterans Affairs. Documents on the VA official site add the following which should be taken into consideration:

“If a veteran is furnished hospital care by VA and then is transferred to VA-furnished nursing home or domiciliary care, the period of hospital care shall not be considered as nursing home or domiciliary care.”

VA regulations add that in cases where there are transfers from VA-furnished nursing home or domiciliary care to VA-furnished hospital care, “then back to nursing home or domiciliary care,” such circumstances are viewed by the VA as “continuous nursing home or domiciliary care provided the period of hospitalization does not exceed six months.”

• A veteran who starts nursing home may have monthly pension payments reduced to $90 when the veteran has no dependents, the veteran is living in a Medicaid-approved nursing facility, and Medicaid pays for the care.
• VA per diem care payments are not the same thing as VA Aid & Attendance benefits, but such benefits (and several others) may be used to pay for or offset costs of care in a state-run home depending on circumstances, eligibility, state law, and other factors.
• Some of the VA services listed in addition to nursing home care may be used at a state-run facility in conjunction with other VA benefits in this area. These benefits are often designed to be used concurrently with other VA options, health insurance, pension payments, etc.