The VA aims to provide health care to veterans throughout the different stages of life after the military, and works with veterans to meet their specific health needs. Some veterans may be eligible for home health care, live-in health care, assisted living, or other long-term care services through the VA. One type of assisted living veterans may be able to access is board and care homes. Board and care homes are a type of long-term care that can provide a living arrangement that allows senior veterans to receive assistance with daily tasks. These are also known as residential care homes, personal care homes, or adult family homes. Care is provided for veterans in a small environment that is more similar to a home than a medical facility. Most homes are located in residential neighborhoods, and are single-family houses that have been converted to provide veterans with a place to live and receive the care they need.
Board and care homes are different from assisted living facilities because these homes generally house fewer than 20 residents, while there may be over 100 units in an assisted living facility. Additionally, the ratio of staff to residents in board and care homes is often much lower than assisted living facilities. Board and care homes are not able to provide skilled nursing care, and do not have licensed health care professionals on staff.
What services are provided?
Board and care homes provide a place for senior veterans to live, as well as assistance with personal care and supervision twenty-four hours a day. Some board and care homes provide specialized services for veterans with developmental disabilities or cognitive impairments, but these services may vary based on location and are not provided in every facility.
In board and care homes, residents will either share a room with others, or have their own private room. On average, six to ten residents will live in a home together, and have their meals together in a shared dining area. Other services provided can include:
- Assistance with daily activities such as getting dressed, bathing, and using the restroom
- Reminders from staff to take medication and assistance with administering medicines
- Cleaning residents’ rooms, bathrooms, and common areas; some facilities assist with laundry as well
- Group and social activities like board games, movies, arts and crafts, and more to help veterans feel connected to their fellow residents
Additionally, the VA provides other long-term care services for sick or disabled veterans such as physical therapy, comfort care and pain management, as well as support for caregivers. These are not necessarily provided at board and care homes, but veterans who live in these homes may be eligible for these additional services.
Applying to be a resident in a board and care home
In order to be eligible to live in a board and care home, veterans must be signed up for health care through the VA, and the VA must determine that assistance is required with daily living activities. Additionally, there must be space available in a board and care home near where the veteran currently lives.
In order to apply to be a resident in a board and care home, veterans must complete an application and answer various health, financial, and personal questions, including the following:
- Where do you live currently?
- What is your former or current occupation?
- How much are you currently paying for rent, and what is your income?
- Do you own any real estate?
- Do you have debt or other financial obligations?
- What type of assistance do you need? Do you require a special diet?
- Do you have any health problems or medical issues?
As part of the application process, potential residents may be asked to undergo a physical exam to assess their health and to determine if their health care needs can be met through a board and care home. Once the application has been submitted, the board and care home staff will usually set up an interview with the potential resident in order to determine if the facility will be a good match for the resident’s needs and living preferences. If a resident is accepted, they sign a contract outlining the services to be provided, monthly fees, policies and any other terms and conditions.
Paying for a board and care home
Monthly costs for a board and care home can range from $1,500 to $4,500, depending on what services the home provides and where it is located. Usually, residents pay for their living expenses with personal funds, but veterans or surviving spouses may be eligible for a monetary benefit called Aid & Attendance to help cover the expenses of living in a board and care home.
Aid & Attendance is a long-term care benefit that can be used to help pay for a board and care home, and is tax-free. To be eligible, veterans must have war-time service with an honorable discharge, and meet the VA’s income and asset criteria. Additionally, the veteran or their spouse must require assistance with two out of the following five activities of daily living:
- Getting dressed
- Using the restroom
- Getting in and out of bed, a chair, or wheelchair
Depending on marital status and other factors, veterans and spouses can receive up to $2,846 in monthly reimbursements for the cost of a board and care home. While not all long-term care services are covered by the VA, paying for these costs can be supplemented by Medicaid, Medicare, or private insurance.
Making the decision to move into an assisted living facility such as a board and care home can be a difficult one, not only for veterans, but for their families as well. The VA offers more information and resources to help in the decision-making process, and can provide guidance on finding a board and care home that is the best fit. Veterans can also contact their VA social worker, or call 877-222-8387 for more information.
Heather Maxey works at a non-profit that addresses military ineligibility. She is an Army spouse, and met her husband while working as a Health Educator at Fort Bragg.
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