VA Nursing Homes and Long-Term Care for Veterans

Veterans who need nursing home care have options beyond Medicaid. The Department of Veterans Affairs provides or pays for nursing home care in three main settings: VA-run Community Living Centers, State Veterans Homes run by the states, and community nursing homes that contract with the VA. Each has different eligibility rules and costs, and many veterans use a combination of VA benefits, Medicare, Medicaid and their own money. This guide explains each option and how it fits with Long-Term Care Medicaid.

Figures change periodically. Double-check current amounts before relying on them.

The three main VA nursing home settings

1. Community Living Centers (CLCs)

Community Living Centers are nursing homes run by the VA, usually on or near a VA medical center campus. They provide skilled nursing, rehabilitation, respite, hospice and long-term care. Some stays are short (for rehabilitation after a hospital stay); others are long-term. Admission is based on clinical need and the availability of beds. CLCs often have waiting lists, and not every area has one nearby.

2. State Veterans Homes

State Veterans Homes are owned and run by the states (or by contractors for the state), with VA approval and oversight. The VA pays the state a daily amount (a per diem) for eligible veterans, and the state sets the rest of the rules, including who may be admitted and what residents pay. Some State Veterans Homes also admit spouses or surviving spouses of veterans, and Gold Star parents, depending on state rules. Many State Veterans Homes are certified for Medicaid and Medicare, and residents may use those programs to pay the part of the cost not covered by the VA per diem.

3. Community nursing homes under VA contract

The VA contracts with private nursing homes in the community to care for eligible veterans close to home. Coverage under a contract may be short-term or long-term, depending on the veteran’s eligibility.

Who qualifies for VA-paid nursing home care

Eligibility for VA nursing home care depends on the veteran’s enrollment in VA health care and on factors such as service-connected disability, income and clinical need. In general:

The VA must provide nursing home care to enrolled veterans who need it and who have a service-connected disability rating of 70 percent or more, who have a rating of 60 percent and are unemployable or rated permanently and totally disabled, or who need nursing home care for a service-connected condition.
Other enrolled veterans may receive VA nursing home care if resources allow, often with a copayment based on income and assets, and often for a limited time, such as a short-term rehabilitation stay.
Clinical need is assessed by the VA care team.

Rules on eligibility and copays are detailed and change periodically. A VA social worker at the local VA medical center can explain which options a particular veteran qualifies for.

What it costs

Veterans with mandatory eligibility (such as a 70 percent service-connected rating) generally receive VA nursing home care at no cost.
Other veterans may owe a daily copay for long-term care, based on a financial assessment of income and assets. The VA’s long-term care copay rules are separate from its outpatient copays.
State Veterans Homes charge residents a daily or monthly rate. The VA per diem lowers the cost, and Medicaid, Medicare, long-term care insurance or the resident’s own money may pay the rest.
Community nursing home contracts are paid by the VA for the time the VA authorizes. After that, the veteran may need Medicare, Medicaid or private payment.

How VA nursing home care fits with Medicaid

State Veterans Homes and Medicaid. Where a State Veterans Home is Medicaid-certified, a veteran who qualifies for Medicaid can usually use Medicaid there. Medicaid’s usual rules apply: the asset limit, the look-back and the patient liability. The VA per diem is paid to the home, not to the veteran.
The $90 pension rule. A veteran (or surviving spouse) with no spouse or dependent child who is in a Medicaid-covered nursing home generally has the VA pension reduced to $90 a month. That $90 is protected and does not count toward the patient liability. See How VA benefits count for Medicaid.
Moving between settings. A veteran in a VA-contracted community nursing home whose VA coverage ends may need to apply for Medicaid to stay. Planning the Medicaid application before VA coverage ends avoids a gap. See Applying for nursing home Medicaid.
Medicare. Medicare Part A may cover a skilled nursing stay after a qualifying hospital stay in a Medicare-certified facility, including many State Veterans Homes and community nursing homes, but not in VA Community Living Centers, which are federal facilities.

Other VA long-term care services

The VA also offers care that helps veterans stay at home:

Home-based primary care, in which a VA team provides care at home.
Homemaker and home health aide services.
Adult day health care.
Respite care, to give family caregivers a break.
Veteran Directed Care, in which the veteran receives a budget to hire their own caregivers, sometimes including family members. See Getting paid by the VA as a family caregiver.
Medical foster homes, in which a veteran lives in a private home with a caregiver who has been approved by the VA. The veteran usually pays the caregiver for room, board and care.
Hospice and palliative care.

Availability varies by VA medical center.

How to apply

Enroll in VA health care, if not already enrolled.
Ask the VA care team or a VA social worker for a long-term care assessment.
Complete the financial assessment the VA uses to set copays, if required.
For a State Veterans Home, apply to the home directly. Each state sets its own admission process and may have a waiting list.
Plan for Medicaid if VA coverage will be limited in time or if a State Veterans Home charges more than the veteran can pay.

Accredited veterans service officers can help at no cost.

Questions to ask

Does the veteran have mandatory eligibility for VA nursing home care?
If not, how long will the VA pay, and what will the copay be?
Is the facility Medicare- and Medicaid-certified?
If the veteran will need Medicaid later, can they stay in the same facility?
Does a State Veterans Home admit the spouse too?
Is there a waiting list?

A worked example

Raymond, an 83-year-old Vietnam-era veteran with a 30 percent service-connected rating for hearing loss, has a stroke and is discharged to a community nursing home under a VA contract for rehabilitation. The VA authorizes a short-term stay. His care team tells the family that long-term VA-paid care is not available because his rating is below 70 percent and the stroke is not service-connected. His family applies for a State Veterans Home, which has a waiting list, and files a Medicaid application during the VA-paid stay. When the VA contract ends, Medicaid approves him for the community nursing home, and he moves to the State Veterans Home when a bed opens, where Medicaid continues to pay his share after the VA per diem.

Comparing the options

Setting	Run by	Typical cost to the veteran	Medicaid?
Community Living Center	VA	None for mandatory eligibility; copay possible otherwise	Not usually used
State Veterans Home	State (with VA per diem)	Daily or monthly charge, reduced by the per diem	Often, if certified
Community nursing home under contract	Private facility	VA pays for the authorized period	Often, after VA coverage ends

Getting experienced help

Veterans often qualify for some VA help but not all, and the gaps are commonly filled by Medicaid. Planning ahead avoids a period of private payment when VA coverage ends. A Certified Medicaid Planner can explain how Medicaid will treat the veteran’s income, VA benefits and assets, and how to protect a spouse at home; a VA-accredited representative or veterans service officer can handle VA claims. As a rough guide, published fees for help with a Medicaid application range from about $500 to $6,000 and full planning from about $2,500 to $15,000 or more.

Frequently asked questions

Can a spouse live in a VA nursing home? VA Community Living Centers serve veterans. Some State Veterans Homes admit spouses or surviving spouses; it depends on the state.

Will the VA pay for a private nursing home near me? It may, under a contract, for eligible veterans and for an authorized period.

Do State Veterans Homes take Medicaid? Many do. Ask whether a specific home is certified.

Does a VA nursing home affect my spouse’s finances? VA copays may consider the spouse’s income. Medicaid’s spousal protections apply if the veteran is on Medicaid. See Spousal impoverishment.

Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.