The Short Answer

The VA provides long-term care for eligible veterans through two main channels: VA-owned nursing homes (Community Living Centers) and State Veterans Homes — which are state-operated facilities that receive VA per diem funding to keep costs low for veterans. If you have a service-connected disability rated 70% or higher, or you're rated 100% or receiving TDIU, you may qualify for priority placement and reduced or no-cost care. Veterans rated 60% service-connected qualify for nursing home care for their service-connected conditions. State Veterans Homes exist in all 50 states and Puerto Rico, offering nursing home care, assisted living, and adult day health services at rates significantly below private facilities.

Why This Matters for Disabled Veterans

Private nursing home care costs a median of over $9,000 per month for a semi-private room. Assisted living averages over $4,500 per month. For a disabled veteran on a fixed income — even with VA disability compensation — these costs can wipe out savings within months.

VA long-term care programs exist to prevent exactly that outcome. Veterans with significant service-connected disabilities can receive nursing home care at little or no cost. State Veterans Homes, which serve the majority of veterans in long-term care, charge on a sliding scale based on income — and for 100% rated veterans, the cost can be zero. These are not welfare programs. You earned this benefit through your service.

Yet many veterans don't know these programs exist, assume they won't qualify, or discover them only after a health crisis forces an emergency placement — when waitlists are longest and options are few. Planning ahead matters.

Types of VA Long-Term Care Facilities

VA Community Living Centers (CLCs)

Community Living Centers are VA-owned and VA-operated nursing homes located on or near VA medical center campuses. They provide:

• Skilled nursing care — 24-hour nursing, rehabilitation, and medical management
• Long-term custodial care — ongoing assistance with activities of daily living for veterans who can no longer live independently
• Short-term rehabilitation — post-surgery or post-illness rehab to help veterans return home
• Specialized dementia and psychiatric care — secure units for veterans with Alzheimer's, PTSD-related behavioral issues, or severe mental illness
• Hospice and palliative care — end-of-life comfort care
• Respite care — short stays to give home caregivers a break

CLCs are staffed by VA employees, including VA physicians, nurses, social workers, and therapists. Medical care is fully integrated with your VA health record. There are approximately 130 CLCs across the country, but not every VA medical center has one.

State Veterans Homes (SVHs)

State Veterans Homes are the backbone of veteran long-term care in the United States. They are owned and operated by state governments (often through a state department of veterans affairs), but they receive significant VA funding in the form of per diem payments and construction grants. This VA support keeps veteran costs far below private facility rates.

SVHs typically offer three levels of care:

Nursing Home Care (State Veterans Nursing Homes)

Skilled nursing and custodial care for veterans who need 24-hour supervision and medical support. This is the most common SVH service. Many facilities are dedicated nursing homes; others combine nursing home and assisted living on a single campus.

Assisted Living / Domiciliary Care

For veterans who need help with daily activities (bathing, dressing, medication management) but don't require 24-hour skilled nursing. Not every state offers assisted living through its veterans home program — availability varies widely by state.

Adult Day Health Care

Daytime supervised care for veterans who live at home or with family but need structured health monitoring, social interaction, and therapeutic activities during the day. This is the least intensive SVH service and serves as an alternative to full-time residential care.

There are over 150 State Veterans Homes nationwide, with at least one in every state and Puerto Rico. Most states have multiple facilities. Some states — like Texas, California, Florida, and Virginia — have extensive SVH networks with a dozen or more Homes.

Contract Community Nursing Homes

In areas where no VA CLC or State Veterans Home is available (or when those facilities have waitlists), the VA can place veterans in contract community nursing homes — private nursing homes that have agreements with the VA. The VA pays for the care and monitors quality, but the facility is privately owned. This option ensures veterans can access long-term care even in regions without dedicated veteran facilities.

Eligibility for VA Long-Term Care

Eligibility depends on the type of facility and the type of care you need. The rules are different for VA Community Living Centers and State Veterans Homes.

VA Community Living Center Eligibility

You must meet all of the following:

• Enrolled in VA health care. If you're not already enrolled, you need to apply using VA Form 10-10EZ.
• Medically need nursing home level of care. A VA physician or clinical team must determine that you require 24-hour nursing supervision, skilled nursing, or rehabilitation that can't be provided at home.
• Have a service-connected disability rated 60% or higher, OR you're rated 100% (including TDIU), OR you're receiving a VA pension, OR your service-connected condition is the reason you need nursing home care.

Priority groups: The VA gives placement priority to:

1. Veterans with service-connected disabilities rated 70% or higher
2. Veterans rated 100% (including TDIU)
3. Veterans needing care for a service-connected condition
4. Veterans receiving VA pension
5. Other enrolled veterans (based on availability)

State Veterans Home Eligibility

Eligibility for State Veterans Homes has both VA and state components:

• VA requirements: You must be a veteran discharged under conditions other than dishonorable, and you must meet the VA's clinical need standard (nursing home level of care for nursing homes; assisted living level for domiciliary/assisted living).
• State requirements: Each state sets its own additional eligibility rules. Most states require:

• Residency in that state (typically 1 year, though some require less)
• Proof of military service (DD-214 or equivalent)
• Income and asset information for fee determination

Key difference from CLCs: State Veterans Homes are not restricted to veterans with high disability ratings. Any honorably discharged veteran who meets the state's residency and clinical criteria can apply — VA disability rating is not a gatekeeper for admission. However, your disability rating does affect your cost (see the Cost section below).

What Does VA Long-Term Care Cost?

Cost depends on which facility type you use and your eligibility category.

VA Community Living Centers

State Veterans Homes

State Veterans Homes charge based on a means test — your income and assets determine your monthly rate. The VA pays a per diem (currently approximately $116 per day per veteran for nursing home care) directly to the facility, which substantially reduces what you owe. Here's how the tiers typically work:

• Veterans rated 100% service-connected or TDIU: The VA per diem covers the full cost. You pay nothing for nursing home care.
• Veterans rated 70% or higher service-connected: You may pay a reduced rate. Many states set the veteran share at 0% to 5% of operating cost after the VA per diem.
• Veterans with a service-connected disability (any rating): The VA per diem reduces your bill, but you pay a share based on income. Typical out-of-pocket ranges from $1,000 to $3,000 per month for nursing home care — compared to $9,000+ at a private facility.
• Veterans with no service-connected rating: You still benefit from the VA per diem, but your monthly cost will be higher — often 40% to 70% of the private rate, depending on the state.

Important: Exact costs vary by state, facility, and your financial picture. Contact the specific State Veterans Home for their current fee schedule. Most SVHs have a financial counselor who walks you through the numbers before you commit.

Can Medicaid Cover the Gap?

Yes — and this is common. If your income and assets are low enough, Medicaid can pay the portion of your State Veterans Home cost that you can't afford. Many SVHs are Medicaid-certified. The facility's social worker can help you apply. Medicaid eligibility rules vary by state, and there are look-back periods for asset transfers, so plan ahead if possible.

Using Medicaid at a State Veterans Home does not reduce the quality of your care. You receive the same services as private-pay residents. The facility simply draws payment from both the VA per diem and Medicaid instead of from you directly.

How to Apply for VA Long-Term Care

Applying to a VA Community Living Center

1. Talk to your VA primary care team. A CLC placement starts with a clinical referral. Your VA doctor, social worker, or Patient Aligned Care Team (PACT) can initiate the process if they determine you need nursing home level of care.
2. Complete the assessment. The VA will evaluate your medical needs, functional status, and care requirements using a comprehensive assessment.
3. Financial screening. If you're not in a no-copay category, the VA will determine your Extended Care Copay obligation based on your income and assets. Submit VA Form 10-10EC (Application for Extended Care Services).
4. Wait for placement. CLCs have limited beds and waitlists vary by location. Priority groups (70%+ rated, 100%, TDIU) get placed first. Wait times can range from a few days to several months.

Applying to a State Veterans Home

1. Find facilities in your state. Use the VA Facility Locator and filter for "State Veterans Home" or contact your state department of veterans affairs for a complete list.
2. Contact the admissions office directly. Each State Veterans Home manages its own admissions. Call the facility and ask to speak with the admissions coordinator or social worker.
3. Submit the application. You'll need:
   • DD-214 (or equivalent proof of service)
   • VA disability rating letter (if you have one)
   • Financial information (income, assets, insurance)
   • Medical records and a physician's assessment documenting your care needs
4. Tour the facility. Always visit before committing. Evaluate cleanliness, staff interaction, activity programs, dining quality, and room setup. Ask about staff-to-resident ratios and any specialty units (dementia, behavioral health).
5. Get on the waitlist if needed. Popular facilities have waitlists. Priority is typically given to 100% rated veterans, then 70%+, then others. Ask the admissions coordinator about current wait times — they vary from weeks to months.

Can Spouses Live in State Veterans Homes?

Yes, in many states. Approximately 30 states allow veterans' spouses and surviving spouses to reside in State Veterans Homes, usually in the assisted living or domiciliary level of care. The VA per diem does not cover spouses — so the spouse's cost is higher than the veteran's, typically closer to the facility's actual operating cost minus any state subsidy. Still, this is often less expensive than a private assisted living facility.

Spouse eligibility rules vary by state. Some states limit spouse admission to specific facilities, while others open all their SVHs to spouses. Contact the facility directly to ask.

Alternatives: Home and Community-Based Care

If you're not ready for residential care — or if your goal is to stay home as long as possible — the VA offers several home and community-based long-term care services:

VA Homemaker and Home Health Aide Care

A trained aide comes to your home to help with bathing, dressing, meal preparation, light housekeeping, and medication reminders. This is available to veterans enrolled in VA health care who need help with activities of daily living. There is no copay if you have a service-connected disability rated 50% or higher.

VA Skilled Home Care

For veterans who need skilled nursing services at home — wound care, IV therapy, catheter care, or injections — the VA provides visiting nurses and therapists. This is a step above homemaker care and requires a physician's order.

Home-Based Primary Care (HBPC)

HBPC is the VA's most comprehensive home care program. A full primary care team (physician, nurse, social worker, therapist, psychiatrist, pharmacist) manages your care at home. HBPC is designed for veterans with complex, chronic conditions who have difficulty traveling to VA appointments. It's available at many VA medical centers.

Veteran-Directed Care

Similar to the Medicaid Self-Directed Care model, this program lets you hire, train, and supervise your own personal care aide — including family members in some cases. You control the budget and the care plan. Not available at all VA facilities.

Community Residential Care

The VA places you in an approved community residential home (typically a small group home) where you receive room, board, supervision, and personal care. The VA monitors the home and provides clinical oversight. This is less intensive than nursing home care and suits veterans who need supervision but not 24-hour skilled nursing.

Respite Care

Temporary care — either in your home or at a VA facility — to give your family caregiver a break. Available for up to 30 days per year. Every veteran enrolled in VA health care who needs caregiver support is eligible.

Comparing Your Options: CLC vs. State Veterans Home vs. Private Facility

Aid and Attendance and Long-Term Care

If you receive a VA pension (not disability compensation), you may also qualify for the Aid and Attendance (A&A) enhanced pension, which adds a monthly benefit above the basic pension rate if you require the aid of another person for daily activities, are bedridden, or live in a nursing home. A&A can help cover the cost of care in a State Veterans Home or private facility.

For veterans who receive VA disability compensation (not a pension), Aid and Attendance is not available as a separate payment — you're already receiving compensation at a rate that typically exceeds the pension with A&A. However, compensation-rated veterans can still access VA long-term care facilities at reduced or no cost based on their rating percentage.

If you're unsure whether you're receiving compensation or pension, check your award letter. The VA clearly labels which benefit you're getting.

Common Mistakes Veterans Make

• Waiting until a crisis to explore options. Long-term care waitlists can be months long. Start researching facilities and getting on waitlists before you urgently need placement.
• Assuming you make too much money to qualify. State Veterans Homes use a means test, but the VA per diem subsidy applies regardless of income. Even veterans with moderate income pay far less than private rates.
• Not knowing about State Veterans Homes. Many veterans think the VA only provides care at VA medical centers. State Veterans Homes serve the majority of veterans in long-term care and are often closer to home than a CLC.
• Dismissing Medicaid. If you can't afford the SVH cost even with the VA per diem, Medicaid can close the gap. There's no shame in using a benefit you're entitled to — and it doesn't change your care quality.
• Overlooking home-based options. If your goal is to stay home, the VA's homemaker, home health aide, and HBPC programs can provide substantial support. Don't assume your only options are "manage alone" or "go to a nursing home."
• Not checking multiple facilities. State Veterans Homes vary in quality, amenities, and specialty programs. Tour at least two or three before deciding. Ask about staffing ratios, activities, and inspection history.
• Forgetting the spouse option. If you and your spouse both need care, explore State Veterans Homes that accept spouses in assisted living. Being in the same facility (or on the same campus) matters enormously for quality of life.

Planning Ahead: Steps to Take Now

1. Confirm your VA enrollment. If you're not enrolled in VA health care, apply now. Enrollment is a prerequisite for all VA long-term care programs.
2. Identify nearby facilities. Use the VA Facility Locator to find CLCs and State Veterans Homes near you. Contact your state VA for a full SVH list.
3. Get on a waitlist proactively. You can get on a State Veterans Home waitlist before you need immediate placement. Waitlist positions are often based on need urgency, but having your application on file speeds the process when the time comes.
4. Tour facilities. Visit the homes you're considering. Talk to residents and staff. Ask about activities, medical support, and meal quality.
5. Understand your cost. Ask each facility's admissions office for a personalized cost estimate based on your income, assets, and disability rating.
6. Explore home-based care first. If you're currently independent but starting to struggle, ask your VA primary care team about homemaker services, HBPC, or Veteran-Directed Care. These can delay or prevent the need for residential care.
7. Organize your documents. Keep your DD-214, VA rating letters, financial records, and medical power of attorney in an accessible place. When you need long-term care, you'll need these documents quickly.

Key Resources

• VA Facility Locator — find CLCs and State Veterans Homes near you
• VA Geriatrics and Extended Care — official VA long-term care information
• VA Long-Term Care Services Overview
• VA Health Benefits Hotline: 1-877-222-VETS (8387), Monday–Friday, 8am–8pm ET
• Veterans Crisis Line: 988, then press 1 (available 24/7)
• Your State Department of Veterans Affairs — for a complete list of State Veterans Homes in your state and state-specific eligibility rules

Bottom Line

If you're a disabled veteran — especially rated 70% or higher — VA long-term care can save you and your family tens of thousands of dollars per year compared to private nursing homes. State Veterans Homes exist in every state, offer veteran-centered care at dramatically reduced prices, and in many cases cost nothing for 100% rated veterans. But you need to plan ahead, understand your eligibility, and get on waitlists before a health crisis forces an emergency decision. Contact your local VA or State Veterans Home today — even if you don't need care yet. Knowing your options is the first step to making the right one.