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.

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. Place Cursor Here for Definition

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.

Pre-application 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:   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.

Obligations:   (Salaries and Expenses) FY 01 $1,978,934,000; FY 02 est $2,118,456,000; and FY 03 est $2,118,456,000.

Range and Average of Financial Assistance:   Not applicable.

In fiscal year 2001, 96,568 patients were treated with an average daily census of 33,670. The projected corresponding levels for fiscal year 2002 are 106,723 patients treated and 34,427 average daily census. For fiscal year 2003, the levels are 111,953 patients treated and 35,132 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

EXAMPLES OF FUNDED PROJECTS:

Not applicable.

CRITERIA FOR SELECTING PROPOSALS:

Not applicable.

	back to top