Community Living Centers (VA Nursing Care)

What a Community Living Center stay needs

1. 1Enrolled, and VA finds the care is neededYou are signed up for VA health care, VA concludes you need the service for your ongoing treatment and personal care, and space in the care setting is available near you. VA may also consider other factors, like service-connected disability status or insurance coverage.
2. 2Financial information, unless you are exempt from copaysUnless a copay exemption applies to you, the rule says you give VA Form 10-10EC when you first ask for extended care, and the form says that if you decline to give financial details, VA charges the maximum copay. Veterans exempt from extended care copays include those with a compensable service-connected rating, those whose yearly income is below the basic VA pension rate for a veteran with no dependents, and Medal of Honor recipients; the rule also exempts some kinds of care. If you are not sure whether you need the form, ask your VA medical facility.

Source: VA.gov: nursing homes, assisted living, and home health care (opens in new tab); 38 CFR 17.111(e) (opens in new tab); 38 CFR 17.111(f) (opens in new tab); VA Form 10-10EC (opens in new tab)

What kind of stay is this?

• A short-term stay

  A Community Living Center is a VA nursing center designed to feel like home. VA lists short-term stays in a community living center at the inpatient level of extended care.

  Source: VA.gov: nursing homes, assisted living, and home health care (opens in new tab); VA.gov: current VA health care copay rates (opens in new tab)

• A longer stay

  In a VA nursing home setting you live there full time, with nursing and medical care and help with daily tasks 24 hours a day. VA lists long-term stays in a community living center at the same inpatient level of extended care. For copays, the rule describes nursing home care as care for people who are not acutely ill and do not need hospital care, but who need nursing care and related medical services around the clock.

  1. 1Enrolled, VA finds the care is needed, and financial informationThe same two rules as a short-term stay, above: enrollment with a VA finding that the care is needed, and VA Form 10-10EC unless a copay exemption applies to you.
  2. 2Income and service-connected disabilityVA.gov says help paying for nursing home care depends on your income and the level of your service-connected disability.
  3. 3Assets, after 180 days of careFor the first 180 days of extended care, VA sets the copay from your and your spouse's income and expenses. After that, VA counts assets too, with some protected, so a longer stay can change the copay.

  Source: 38 CFR 17.111(c)(7) (opens in new tab); VA.gov: nursing homes, assisted living, and home health care (opens in new tab); VA.gov: current VA health care copay rates (opens in new tab); 38 CFR 17.111(e) (opens in new tab); 38 CFR 17.111(f) (opens in new tab); 38 CFR 17.111(d)(1) (opens in new tab)

Time limits

Unless a copay exemption applies to you, give VA Form 10-10EC to a VA medical facility when you first ask for extended care, when you ask again after a break in care of more than 30 days, and each year when you update your financial information for VA health care. If you are receiving extended care, report changes that might change your copay by giving your VA medical facility a new VA Form 10-10EC within 10 days of the change.

What to gather, and what it shows VA

Your VA social worker and care team arrange the stay, and forms go to your VA medical facility. BeneVets does not ask for copies of them.

Steps, in order

1. Get free help from a VSO

   A VSO can help you apply for VA health care. Free help: an accredited VSO can file this with you. Find one near you in the BeneVets VSO directory at Find an accredited VSO near you.

   Source: VA.gov: accredited representatives (opens in new tab); VA.gov: how to apply for VA health care (opens in new tab)

2. Enroll in VA health care

   Apply for VA health care with VA Form 10-10EZ, online, by phone, by mail, or in person. If you are already enrolled, skip this step.

   Source: VA Form 10-10EZ (opens in new tab); VA.gov: how to apply for VA health care (opens in new tab)

3. Ask your VA social worker

   Contact your VA social worker to find out how to get long-term care services, nursing home care included. Or call the VA toll-free hotline at 877-222-8387, Monday through Friday, 8:00 a.m. to 8:00 p.m. ET.

   Source: VA.gov: nursing homes, assisted living, and home health care (opens in new tab)

4. Talk through your needs with VA

   Your VA care team decides whether you need the care for your ongoing treatment and personal care, and whether space is available near you.

   Source: VA.gov: nursing homes, assisted living, and home health care (opens in new tab)

5. Give VA the extended care form, unless you are exempt

   If no copay exemption applies to you, give VA Form 10-10EC to your VA medical facility at the times under Time limits. VA uses it to set any copay after the first 21 days. The financial information rule above lists who is exempt, and what happens if you decline to give financial details. If you are not sure whether you need the form, ask your VA medical facility.

   Source: VA Form 10-10EC (opens in new tab); 38 CFR 17.111(e) (opens in new tab); 38 CFR 17.111(f) (opens in new tab)

6. Report changes that affect your copay

   If you are receiving extended care, report changes that might change your copay, such as in marital status, income, assets, expenses, or whether a spouse or dependent lives in the community, on a new VA Form 10-10EC given to your VA medical facility. Time limits gives the deadline.

   Source: 38 CFR 17.111(e) (opens in new tab); VA Form 10-10EC (opens in new tab)

Good to know