State Nursing Homes For Veterans

March 13, 2009
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Nursing home coverage for veterans is available from two sources within the Department of Veterans Affairs – the veterans healthcare system and the state veterans homes system. Last week’s issue of the Oast & Hook News covered the veterans healthcare system. This week’s issue will cover the state veterans home system.
State Veterans Homes
State veterans homes fill an important need for veterans with low income and veterans who desire to spend their last years with “comrades” from former active duty. The predominant service offered is nursing home care. VA nursing homes must be licensed for their particular state and conform with skilled or intermediate nursing services offered in private sector nursing homes in that state. State homes may also offer assisted living or domiciliary care which is a form of supported independent living.
Every state has at least one veterans home and some states, like Oklahoma, have a number of them. There is great demand for the services of these homes, but lack of federal and state funding has created a backlog of well over 130 homes that are waiting to be built.
Unlike private sector nursing homes where the family can walk in the front door and possibly that same day make arrangements for a bed for their loved one, state veterans homes have an application process that could take a number of weeks or months. Many state homes have waiting lists especially for their Alzheimer’s long-term care units.
No facilities are entirely free to any veteran with an income. The veteran must pay the veteran’s share of the cost. In some states, the veterans contribution rates are set at a certain level, and, if there’s not enough income, then the family may have to make up the difference. Federal legislation, effective in 2007, also allows the federal government to substantially subsidize the cost of veterans with service-connected disabilities in state veterans homes.
State Veterans Homes Per Diem Program
The Department of Veterans Affairs pays the state veterans homes an annually adjusted daily rate for each veteran in the home. This is called the per diem. The 2008 nursing care per diem amount is $74.42, and for domiciliary care it is $34.40. Adult Day Health Care – up to one-half of the cost of care – cannot exceed $66.82 per day. The goal of state veterans homes is to get Congress to increase the per diem rate for nursing care to 75% of the state private nursing rates. In most states the per diem falls well short of this goal.
The per diem program and construction subsidies mean that state veterans homes can charge less money for their services than private facilities. Some states have a set rate, as an example $1,400 a month, and they may also be relying on qualified veterans receiving the pension benefit with aid and attendance plus the per diem to cover their actual costs. Other states may charge a percentage of the veteran’s income but rely on other subsidies to cover the rest of the cost. Some state homes can receive Medicaid support as well.
Most of the states with income-determined rates are selective about the veterans they accept. These states may rely on a variety of private and public sources to help fund the cost of care.
Eligibility and Application Requirements for State Veterans Homes
From state to state, facilities vary in their rules for eligible veterans. And even in the same state it is common, where there is more than one state home, for some homes to have stringent eligibility rules and others to be more lenient. These different rules are probably based on the demand for care and the available beds in that particular area.
Some homes require the veteran to be totally disabled and unable to earn an income. Some homes evaluate the veteran on the basis of medical need or age. Some evaluate the veteran entirely on income – meaning applicants above a certain level will not be accepted. Some accept only former active duty veterans, while others accept all who were in the military whether active duty or reserve. Still others accept only veterans who served during a period of war. Some homes accept the spouses or surviving spouses of veterans and some will accept the parents of veterans but restrict that to the parents of veterans who died while in service (Gold Star parents).
Federal regulations allow that 25% of the bed occupants at any one time may be veteran-related family members, i.e., spouses, surviving spouses, and/or Gold Star parents who are not entitled to payment of VA aid. When a state home accepts grant assistance for a construction project, 75% of the bed occupants at the facility must be for veterans.
Domicile residency requirements vary from state to state. The most stringent requirement seems to be a three-year prior residency in the state, whereas other homes may require only 90 days of residency.
All states require an application process to get into a home. Typically, a committee or board will approve or disapprove each application. Many states have waiting lists for available beds.
A current contact list of all state veterans homes is available atwww.longtermcarelink.net/ref_state_veterans_va_nursing_homes.htm.

Ask Allie

O&H: Allie, we’ve been hearing about stem cells in the news this week. I understand you’ve heard some news about stem cell treatments for animals. Please tell us more!
Allie: Sure! The stem cells in the news this week are human embryonic stem cells. There are adult stem cells, however, that are also being used for treatment in animals (as well as people). A dog named Zoey has been receiving treatment with stem cells extracted from his own fat, which are then injected into his hip joint to alleviate pain. The stem cells stimulate repairs to the joint area. The process is not inexpensive; an injection and anesthesia to sedate a dog before and after stem cell extraction and injection can cost between $2,500 and $3,500. Follow-up treatments usually cost less because stem cells are usually left over from the initial treatment. Not only is this treatment good news for animals, but humans may ultimately benefit from similar technologies. These technologies are being studied in experimental stages in humans. One goal is to go beyond alleviating pain to restoring joint cartilage as a way to avoid surgery. Another goal is to help breast cancer patients undergoing reconstructive surgery; one company is working with the FDA in hopes of beginning clinical trials of this process in humans later this year. It’s interesting to see scientific advancements helping animals as well as humans!


Please feel free to e-mail your pet- and animal-related questions to Allie at:allie@oasthook.com .

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