Nursing Home Care - FAQs - VA Palo Alto Health Care System
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VA Palo Alto Health Care System

 

Nursing Home Care - FAQs

Who is eligible for nursing home care through VA Palo Alto Health Care System?
Admission to a nursing home at VA expense, either a VA run nursing home, a Community Living Center (CLC), or a community nursing home is prioritized based on the service connection status of the Veteran. The VA must provide nursing home care to Veterans needing admission for any service-connected disability and for Veterans who are 70% or more service-connected, who need a nursing home level of care. (“Service connection” means that Veterans Benefits Administration has determined that you became disabled during your military service). The VA will assist Veterans not meeting service-connected eligibility requirements in determining where their nursing home care can best be provided.

What is the community nursing home program?
In certain circumstances, VA Palo Alto Health Care System will contract with private nursing homes to provide nursing home care. Eligibility for nursing homes via the community nursing home program is the same as for community living centers (see “Who is eligible for nursing home care…”). Community nursing homes are most commonly used to enable nursing home care near a Veteran’s family, if their home is far from one of our community living centers and to meet certain special care needs.

How do I get referred for nursing home care?
You should start by talking with your care providers, especially your primary care provider, about your clinical needs and a social worker, if possible, about options for care. We also suggest you talk with your family about available options and possible alternatives that might allow you to live more independently outside a nursing home. If an admission to a nursing home at VA expense (either in a Community Living Center or through a contracted community nursing home) is sought, your provider or a social worker can make a referral.

For more information, contact the Extended Care Liaison, 1-650-493-5000, ext. 65495.

What if I need nursing home care and I cannot be admitted to a community living center or a nursing home via the community nursing home program?
Our staff will work with you and your family to find the best possible arrangements in the community. Veterans with Medicare may be eligible for short-term, post-hospital care through Medicare. MediCal, the California version of Medicaid, pays for nursing home care for MediCal enrolled patients. MediCal may be an option for Veterans with low incomes, who are over age 65 or meet certain disability criteria. A social worker may help in determining if you might be eligible for MediCal and may assist you in applying for MediCal. The application process may take several weeks to months, so if this is something you might wish to pursue, it is best to think ahead if possible. Having MediCal (or Medicare or other insurance) in no way compromises your eligibility for services through VA. However, having such insurance can broaden your care options. Some Veterans may have long-term care insurance that will pay for nursing home care. Higher income Veterans, who do not meet VA eligibility standards, may need to pay privately for some care.