Are VA Nursing Homes Free for Veterans?

Q. My father is a Vietnam Veteran who will almost certainly need nursing home care in the future. Will the Department of Veterans Affairs (VA) nursing home system take care of him for free? Are VA nursing homes as good as private ones? Are there many VA nursing homes in the DC Metro area? And do they take all Veterans, or only certain ones? I’m hoping my family won’t have to worry about planning for how to pay for long-term care because the VA nursing home system will be there for us if and when needed. Thanks for your help!

A. As Veterans age, approximately 80 percent of them will need long-term services and support, similar to your father. According to the VA, a VA nursing home is designed so Veterans may stay for a short time or, in some instances, for the long term. The VA maintains that these facilities are places where Veterans can receive nursing home level of care, which includes help with activities of daily living such as bathing and dressing and skilled nursing and medical care.

According to the VA, the mission of these nursing homes is to restore each Veteran to his or her highest level of well-being, to prevent declines in health, and to provide comfort at the end of life. Although VA officials argue that the VA nursing home system “compares closely” with private nursing homes, recent research shows that this may not be the case. A recent USA Today article exposed VA nursing homes, many of which were rated substantially lower than their private nursing home counterparts. These were some of the findings, which are surprising and disheartening:

  • More than 40,000 elderly and infirm Veterans stay in the agency’s nursing homes each year.
  • Low Ratings: More than 100 VA nursing homes scored lower than other nursing homes in 2017 on a majority of quality indicators, such as residents having more bedsores and pain than those in private facilities.
  • Patients aren’t treated with dignity: Inspectors cited a handful of VA nursing homes for failing to meet standards of care in as many as 10 key categories, such as treating residents with dignity.
  • Causing harm to veterans: Inspectors from a private contractor cited 52 out of 99 VA nursing homes for deficiencies that caused “actual harm” to Veterans. In three facilities, they found Veterans’ health and safety in “immediate jeopardy,” and in eight, inspectors found both Veteran “harm” and “jeopardy.” Another study cited in USA Today found that in more than two-thirds of VA nursing homes, residents were more likely to have serious bedsores, as well as suffer serious pain.
  • One facility cited is in DC: The facilities cited for shortfalls that caused harm are in 25 states, the District of Columbia, and Puerto Rico.

For some VA nursing home case studies, click here for another USA Today article.

In a statement issued with the inspection reports described above, VA officials said residents in their nursing homes are more difficult to care for than residents in private facilities. They said 42 percent of residents had conditions related to military service that have left them 50 percent or more disabled. This is no excuse for the poor ratings and treatment of our nation’s heroes!

Where Are the Local DC Metro VA Nursing Homes?

There are only a few VA nursing homes in the DC metro area. The one in DC is called the Armed Forces Retirement Home. There is also a facility in Charles County, Maryland, called the Charlotte Hall Veterans Home. There is no VA nursing home in Northern Virginia, but one is being built (the Puller Veterans Care Center) in Vint Hill, expected to open in late 2022; the Jones & Cabacoy Veterans Care Center being built in Virginia Beach is also expected to open in late 2022. The only other reasonably close VA nursing home is the Sitter & Barfoot Veterans Care Center in Richmond, Virginia.

What are the Qualifications to Get into a VA Nursing Home?

Career military personnel have priority. Enlisted, Warrant Officers, and Limited Duty Officers with a minimum of twenty years of service at age 60, Veterans incapable of earning a livelihood because of a service-connected disability incurred in the line of duty, Veterans who served in a war zone or hostile fire zone and are later found to be incapable of earning a livelihood, and women Veterans who served before June 12, 1948, may be eligible.

Are VA Nursing Homes Free?

Unfortunately, many Veterans and their families believe that the VA nursing home system will take care of them when they need nursing home care but, unfortunately, this is not always true. Care for most Veterans in Veterans nursing homes is not free; It is merely subsidized by the VA. Unless the Veteran has a service-connected disability rating of 70% or higher, the Veteran must pay his or her share of the cost. So, most Veterans still need Medicaid to pay for their care, even if they are in a Veterans nursing home!

Why sacrifice quality care or distance from family when there is really no advantage for most Veterans to go to a VA nursing home as opposed to a private nursing home, as long as you engage our firm to do Medicaid asset protection?

Qualifying for the Veterans Aid and Attendance Benefit and/or Medicaid

Here at the Farr Law Firm, we work with Veterans and their spouses to evaluate whether they qualify, or may potentially qualify in the future, for the Veterans Aid and Attendance Benefit and/or Medicaid, and we deal with all the paperwork. Although there are new rule changes that make qualifying more challenging, you can rest assured that the Farr Law Firm Elder Law experts are at the forefront of working through the new VA regulations and implementing the newest asset protection strategies that are required to help our clients obtain these important benefits that they have earned by serving in the United States Armed Forces.

Living Trust Plus® for Veterans

Since Aid and Attendance is harder to qualify for now with the three-year look-back rule (similar to the five-year look-back rule for Medicaid), the Living Trust Plus® asset protection trust is often the best option for Veterans’ asset protection planning, as well as Medicaid asset protection planning. The Living Trust Plus® is a very special type of irrevocable asset protection trust that you create while you are living that allows you to retain full control over all of the trust assets, including the right to live in or use any trust-owned real estate. Read more about Living Trust Plus® here.

As a Certified Elder Law Attorney and an Accredited Attorney with the U.S. Dept. of Veterans Affairs, I understand both the Veterans Aid and Attendance Benefit and the Medicaid program and the interaction between both entitlement programs — and this interaction between the programs is of crucial importance because most Veterans who start off needing Aid and Attendance will eventually need Medicaid, so all asset protection planning that is done to make a Veteran eligible for Aid and Attendance must take future Medicaid benefits into account. Please call us at any time to make an appointment for an initial consultation:

Veteran’s Aid and Attendance Attorney Fairfax: 703-691-1888
Veteran’s Aid and Attendance Attorney Fredericksburg: 540-479-1435
Veteran’s Aid and Attendance Attorney Rockville: 301-519-8041
Veteran’s Aid and Attendance Attorney Washington, D.C.: 202-587-2797

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About Evan H Farr, CELA, CAP

Evan H. Farr is a 4-time Best-Selling author in the field of Elder Law and Estate Planning. In addition to being one of approximately 500 Certified Elder Law Attorneys in the Country, Evan is one of approximately 100 members of the Council of Advanced Practitioners of the National Academy of Elder Law Attorneys and is a Charter Member of the Academy of Special Needs Planners.