VA Nursing Home Eligibility: The Veterans Health Administration (VHA) of
the Department of Veterans Affairs (VA) has reissued the eligibility
requirements for nursing home care, and clarified Nursing Home Care
eligibility and the definition of 70 percent service-connected (SC)
disability rating.
Public Law 106-117 (The Veterans' Millennium Health Care and Benefits
Act) amended the VA statutory authority for providing nursing home care to
eligible veterans. This included tasking the VA Secretary to ensure that
the staffing and level of extended care services provided nationally in VA
facilities during any fiscal year is not less than the staffing and level
of such services provided nationally in VA facilities during Fiscal Year
1998. The VHA implemented the provisions of Public Law 106-117 as set out
below:
(1) VHA will provide nursing home care either directly or through
contracts when clinically indicated to:
n veterans who needs nursing home care for a Service Connected
disability
n veterans who have a combined SC disability rating of 70 percent or
more, is rated 60 percent SC and unemployable, or is rated 60 percent SC
and Permanent and Total Disabled (P&T).
(2) VHA may provide nursing home care based on available resources,
either direct or through contracts, when clinically indicated to all other
eligible veterans who need nursing home care.
(3) Patients will be placed in Home and Community-Based Care (HCBC)
when clinically appropriate and patients receiving VA Nursing Home or
Community Nursing Home (CNH) care will be transferred to appropriate
assisted living or home and community-based care settings when nursing home
care, at any level, is no longer clinically indicated.
(4) VA facilities will determine the need for nursing home care based
on a comprehensive interdisciplinary clinical assessment.
(5) After admission to a VA Nursing Home Care Unit (VA NHCU), veterans
described in paragraph (1) may not be transferred or discharged from a VA
Nursing Home unless:
n The patient no longer needs any nursing home care; or
n The patient, or the patient's designee, has given informed consent
to the discharge or transfer.
(6) VA NHCUs will admit, as a matter of firm priority, patients who
meet the following clinical and/or programmatic criteria:
n post-acute patients
n patients who cannot be adequately cared for in CNH or HCBC, and
n those patients who can be cared for more efficiently in VA NHCUs.
(7) All VA facilities will maintain an active CNH Program.

NOTE: Nothing in this VHA Directive may be construed as authorizing or
requiring that a veteran who was receiving nursing home care in a VA
Nursing Home on November 30, 1999, be displaced, transferred, or discharged
from the VA Nursing Home Care Unit. [Source: MOAA's Benefits Information
Update for January 2003]