Can a Non-Service-Connected Veteran with a Catastrophic Disability Qualify for VA Community Nursing Home Care?

The VA claims to have extended care services for veterans -- in community living centers and in VA contracted community nursing homes. If the veteran is not service connected but has high needs, priority 4 catastrophic disability, andincome below the threshold, what are the chances of placement? Sources say the copy would be up to 97 dollars per day. Is this possible?
- Tami
Tami,
This requires a long response. The short answer is yes, the VA does provide extended care services—including Community Living Centers (CLCs), state veteran homes, and VA-contracted community nursing homes—but eligibility and costs can vary significantly depending on several factors. I am going to include a very detail response that I hope will help you
- Diane
I am writing a more detailed response to this question, because there are others out there that will benefit from this information.
Thank you so much for your thoughtful and important question. Navigating the VA system can be overwhelming, especially when you're advocating for a loved one in need of long-term care. Your concern about eligibility, costs, and realistic placement possibilities is valid, and I want to help break this down for you in a clear and supportive way. Challenges with the VA System
First, it's important to acknowledge the frustration many caregivers and veterans feel when working with the VA. Delays are common, communication can be inconsistent, and the process often lacks transparency. This isn’t due to a lack of caring—it’s often the result of an overburdened system, limited staffing, and rigid bureaucratic layers that slow things down. That said, persistence, documentation, and advocacy can make a real difference. I have dealt with the VA system many times, for my son, a disabled veteran as well as other wounded and recovering soldiers. It is a painful process for many. I am going to encourage you to contact your Congressional Representative or or U.S. Senator—especially if the VA process is delayed, unresponsive, or placing the veteran at risk.
For those that are unfamiliar with the military terminology, I thought I'd explain this first.
What is a Priority Group 4 Veteran?
The VA classifies veterans into eight “priority groups” to help determine access to care and cost responsibilities. Veterans in Priority Group 4 include those who:
- Are non-service-connected but have been determined to be catastrophically disabled, meaning they have a permanent and severe condition that substantially limits their ability to live independently (e.g., paralysis, late-stage dementia, multiple advanced chronic illnesses).
- Or those receiving Aid and Attendance or Housebound benefits.
To be placed into Priority Group 4, a VA clinician must evaluate and confirm the veteran’s disability status based on specific medical criteria and functional limitations.
Now, let me address the process.
Understanding the Placement Process
Even for Priority Group 4 veterans, placement in a Community Living Center (CLC) or VA-contracted nursing home is not guaranteed. Here's why and how the process works:
- Eligibility Review
- The veteran must undergo a medical evaluation confirming their need for long-term care.
- A financial means test is completed to assess if the veteran qualifies for reduced or waived copays (income must fall below VA thresholds).
- Documentation must be submitted to request placement and initiate services.
- Availability of Beds
- Placement depends on bed availability and prioritization of veterans with service-connected disabilities or urgent short-term care needs.
- Some facilities have long waitlists, especially for veterans with no service connection.
- Cost
- The up to $97/day copay you've heard about is correct for long-term care services for non-service-connected veterans.
- However, copays may be waived or reduced if the veteran’s income and assets fall below certain limits. The financial assessment is crucial.
- Alternatives
- Some families look into State Veterans Homes, which are partially funded by the VA but managed by states and often have different financial rules.
- Exploring Medicaid options, Aid & Attendance benefits, or in-home support can serve as temporary or parallel solutions.
📄 Sample Advocacy Letter to the VA
Here is a sample letter you can adapt and send to your VA contact, such as a VA social worker, primary care provider, or Geriatric and Extended Care (GEC) coordinator:
[Your Name]
[Your Address]
[City, State, ZIP Code]
[Phone Number]
[Email Address]
[Date]
To:
[VA Social Worker/GEC Coordinator Name]
[VA Medical Center Name]
[Address]
Subject: Request for Long-Term Care Placement for Catastrophically Disabled Veteran
Veteran Name: [Full Name]
VA File # or Last 4 of SSN: [####]
Date of Birth: [MM/DD/YYYY]
Dear [Name or “To Whom It May Concern”],
I am writing on behalf of [Veteran’s Name], a Priority Group 4 veteran with a catastrophic non-service-connected disability. [He/She] has been medically evaluated as requiring long-term skilled care, and [his/her] financial resources fall below the VA's means-tested threshold.
We respectfully request assistance with securing placement in a VA Community Living Center or contracted community nursing facility as soon as possible. We are committed to working with the VA to ensure a smooth process and are also open to alternative support resources while awaiting placement.
Please provide an update on the status of this request, including:
- Placement options currently available
- Estimated timelines
- Temporary support resources such as respite care or home health
Thank you for your time and assistance.
Sincerely,
[Your Name]
[Relationship to Veteran]
Tips for Navigating the VA System Successfully
Here are a few practical tips to help caregivers manage the VA’s long-term care placement process more effectively:
- Keep a VA Log Book
- Record dates, times, and names of everyone you speak with at the VA. Include a short summary of each call or meeting.
- This documentation is invaluable when following up or if there’s a breakdown in communication.
- Make and Keep Copies of Everything
- Always keep copies of any forms, medical records, financial documents, or letters you submit.
- The VA has lost or misplaced documents in the past—having duplicates will save time and stress.
- Be Proactive and Polite, But Firm
- Persistence pays off. If you haven’t received a follow-up in 1–2 weeks, call or write again.
- Advocate respectfully, but make it clear that you’re tracking progress and expect a response.
- Engage a Veterans Service Officer (VSO)
- Organizations like the DAV, VFW, or American Legion have trained VSOs who can help navigate the system for free.
- They can escalate requests, help with paperwork, and serve as your ally.
- Ask for the GEC Coordinator
- The Geriatrics and Extended Care team is responsible for long-term care services. You can ask for the GEC social worker or nurse coordinator directly.
If you need help drafting letters, organizing documents, or understanding what to ask in your next call with the VA, I’m here to support you. No caregiver should have to face this system alone. I know, I have done it. As a seasoned nurse,
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