The VA pays for nursing home care for some veterans, but the "70% service-connected means free" shorthand you may have heard blends two separate federal rules into one. If a hospital has just told you that your father needs a nursing home, the difference between those rules is what decides whether the VA must cover his nursing home care and what the family might owe. VA community living centers, contracted community nursing homes, and State Veterans Homes each work a little differently, and a veteran rated below 70% may still be able to get VA nursing home care.,

In This Guide

VA Community Living Centers, Contracted Homes, and State Veterans Homes

"VA nursing home" can mean three different places, and knowing which one your loved one is headed for tells you a lot about who pays. The U.S. Department of Veterans Affairs says a veteran can get nursing home care in one of three settings: Community Living Centers (VA nursing centers designed to feel like home), Community Nursing Homes (non-VA nursing homes the VA contracts with in many parts of the country), and State Veterans Homes (state-owned and state-managed centers that provide full-time care for veterans and, sometimes, non-veteran spouses and Gold Star parents).

Community Living Center Community Nursing Home State Veterans Home
Who runs it The VA; most are on or close to a VA medical center campus A non-VA nursing home under contract with the VA The state
How the VA pays VA provides the care directly; a copay may apply VA pays for care at a contracted home when the veteran meets VA's criteria VA pays the state a per diem, or pays in full for qualifying service-connected veterans
Who can go Enrolled veterans with a clinical need, when a bed is available Veterans the VA transfers or admits, when they meet VA's criteria Eligible veterans; sometimes spouses and Gold Star parents
How long Most times a short stay after a hospital discharge; rarely for life VA payment limited to six months per transfer, with statutory exceptions See our State Veterans Homes guide

The details behind each row of this comparison of VA nursing home settings come from VA's own pages and the statutes that govern each setting.,, For a nursing home stay, the VA says whether its benefits help pay "depends on your income and the level of your service-connected disability."

Who the VA Must Cover, and Who It May Cover

Federal law sorts veterans into two groups for VA nursing home care, and the two groups are treated differently.

The mandatory group under 38 U.S.C. 1710A

Under 38 U.S.C. 1710A, the VA "shall provide nursing home care which the Secretary determines is needed (1) to any veteran in need of such care for a service-connected disability, and (2) to any veteran who is in need of such care and who has a service-connected disability rated at 70 percent or more." Under 38 U.S.C. 1710A, a 70% service-connected rating is a trigger for mandatory VA nursing home care, not a copay rule. VA's duty under 38 U.S.C. 1710A to provide this nursing home care is not permanent: 38 U.S.C. 1710A(d) ends it on December 11, 2026, unless Congress extends it, so a family planning a long VA nursing home stay should ask the VA what authority covers care after December 11, 2026. The copay exemptions under 38 CFR 17.111(f), described below, are a separate rule from the 38 U.S.C. 1710A nursing home care mandate and are unaffected by the December 11, 2026 end date of the 38 U.S.C. 1710A mandate.

Notice what 38 U.S.C. 1710A still requires even for this mandatory group: the VA has to determine that the veteran needs nursing home care. A 70% service-connected rating alone doesn't place any veteran in a VA nursing home bed.

Everyone else who is enrolled

A veteran outside the 1710A mandatory group isn't shut out. For VA long-term care, the VA says "All of these must be true:" the veteran is signed up for VA health care, "We conclude that you need a specific service to help with your ongoing treatment and personal care", and "The service (or space in the care setting) is available near you." For VA long-term care, the VA may also consider other factors, like service-connected disability status or insurance coverage.

So a father rated 30% still has a real path to VA nursing home care: enrollment in VA health care, a VA finding of need, and an available space. A veteran rated 30% is not in the 38 U.S.C. 1710A mandatory group unless he needs nursing home care for a service-connected condition.

What You'll Pay for VA Nursing Home Care

Cost is the next thing to plan for. Whether your loved one owes a VA copay for nursing home care is decided by 38 CFR 17.111, a separate rule from the 1710A mandate above.

Who owes no copay at all

Under 38 CFR 17.111(f), the veterans and care not subject to VA's extended-care copays include:

Ask the VA to confirm which 38 CFR 17.111(f) copay exemption, if any, applies to your loved one.

The 21 free days, then a daily ceiling

A veteran who isn't exempt pays no VA copay for geriatric or extended care for the first 21 days of care in a 12-month period. Under 38 CFR 17.111, that 12-month period "begins on the date that VA first provided extended care services to the veteran."

Starting on day 22, the VA's 2026 copay table lists up to $97 for each day of inpatient care, which includes stays in a community living center. The 2026 VA inpatient extended-care copay of up to $97 a day is a ceiling, not a bill: under 38 CFR 17.111, a veteran owes the copay only to the extent the veteran and spouse have available resources. Under 38 CFR 17.111(d)(3), the VA extended-care copay for any month "may be less" if the veteran provides information showing it should be reduced or eliminated.

How the VA figures "available resources"

For a veteran who has been receiving extended care for 180 days or less, 38 CFR 17.111 counts only income: the income of the veteran and spouse, minus a veterans allowance of $20 per day, a spousal allowance of $20 per day if the spouse lives in the community, and expenses. From day 181 on, VA's extended-care copay calculation under 38 CFR 17.111 also counts the veteran's and spouse's liquid and fixed assets.

A spouse at home gets extra protection. For 2026, the VA's community spouse resource allowance is $162,660; if the veteran has a spouse still living in the community who isn't also receiving extended care, that allowance reduces the liquid assets VA uses to set the extended-care copay.

The form that sets the amount

The VA bases copays after day 21 on the level of care and the financial information the veteran provides on VA Form 10-10EC, the Application for Extended Care Services. Filling out VA Form 10-10EC can feel invasive, but it's the step that can lower a copay, so it's worth doing carefully.

VA Community Living Centers

A VA Community Living Center (CLC) is a VA nursing home. The VA says veterans may stay in a Community Living Center for a short time or, in rare instances, for the rest of their life, and that CLCs most times serve short stays after a hospital discharge.

Every VA Community Living Center provides nursing home level of care, including help with activities of daily living like bathing and dressing, plus skilled nursing and medical care. The VA lists 24-hour skilled nursing care, restorative care, access to social work services, and geriatric evaluation and management among CLC services. Some VA Community Living Centers also provide mental health recovery care, special care for veterans with dementia, respite care, and palliative and hospice care, but not all CLCs provide all services, so the VA tells families to contact the local VA medical center.

To be admitted to a VA Community Living Center, a veteran must first be enrolled in the VA health system and be medically and psychiatrically stable, and eligibility is based on clinical need and setting availability. A VA copay may be charged for Community Living Center care based on service-connected status and financial information; the VA directs veterans to a VA social worker or case manager to complete the 10-10EC and learn the amount.

Community Nursing Homes the VA Contracts With

Sometimes the right bed isn't in a VA building. A VA Community Nursing Home is a non-VA nursing home that contracts with the VA, and the VA Community Nursing Home program runs in many communities so veterans can get care near their homes and families. Every VA Community Nursing Home provides 24-hour skilled nursing care, occupational and physical therapy, and access to social work services.

The VA says it will only pay for Community Nursing Home care if the veteran meets eligibility criteria involving service-connected status, level of disability, and income. A veteran who doesn't meet the VA's Community Nursing Home criteria will need to use their own resources, which may include Medicare benefits or applying for Medicaid.

What the statute allows

The VA Community Nursing Home program rests on 38 U.S.C. 1720. The VA may transfer a veteran it has been caring for in a VA facility to a non-VA nursing home at VA's expense when it determines the veteran needs a protracted period of nursing home care. 38 U.S.C. 1720 says the VA "may transfer" a veteran, so a community nursing home placement is the VA's call to make.

The VA may also authorize direct admission to a community nursing home, at VA expense, for a veteran who needs nursing home care for a service-connected disability, or for a veteran discharged from a VA hospital who is receiving VA home health services, once a VA physician (or a contract physician where none is available) examines the veteran and determines the need.

The six-month limit and its exceptions

Under 38 U.S.C. 1720(a)(3), VA-paid care in a community nursing home may not run more than six months in the aggregate for any one transfer, except in three cases:

  1. The veteran was transferred from a VA hospital where the hospitalization was primarily for a service-connected disability.
  2. The nursing home care is required for a service-connected disability.
  3. The VA judges that a longer period of nursing home care is warranted.

Under 38 U.S.C. 1720, the same VA payment rules and six-month limit, with its exceptions, apply to a direct admission to a community nursing home. If your family is planning around a community nursing home, ask the VA social worker early how long VA payment is expected to last and what happens next.

State Veterans Homes and the VA Per Diem

State Veterans Homes are run by the states, but the VA helps pay for veterans' care there in two different ways. For more on how the homes themselves work, see our guide to State Veterans Homes.

The basic per diem

For an eligible veteran outside the payment-in-full group described below, the VA pays a State Veterans Home a daily per diem under 38 U.S.C. 1741, and the statute directs that payment to the state. The VA State home per diem is the lesser of one-half of the daily cost of the veteran's care or the basic per diem rate VA sets each fiscal year, and by statute the payments for any veteran can never exceed one-half of the cost of that veteran's care in the State home. So for a veteran outside the payment-in-full group, the VA State home per diem covers at most half of what the State Veterans Home's care costs. The per diem does not cover the rest of the cost of that veteran's care, so before admission, ask the home's business office what the veteran will be charged each month and what ways of paying it the home accepts.

Payment in full for qualifying service-connected veterans

Under 38 U.S.C. 1745, the VA pays State homes for nursing home care provided to a veteran who needs that care for a service-connected disability, or who has a service-connected disability rated at 70 percent or more and needs the care. VA's regulation, 38 CFR 51.41, also includes a veteran rated totally disabled based on individual unemployability who needs nursing home care.

For a veteran who needs nursing home care for a service-connected disability or is rated 70% or more (or, under 38 CFR 51.41, rated totally disabled based on individual unemployability), VA's State home payment "constitutes payment in full to the State home for such care," and the State home may not charge any individual, insurer, or entity other than the VA for the nursing home care the VA paid for under its agreement. For a qualifying veteran's family, that means the State Veterans Home cannot send the family, the veteran, or an insurer a bill for the nursing home care the VA paid for. The 38 U.S.C. 1745(a) payment-in-full rule covers nursing home care specifically.

How to Get a VA Nursing Home Placement

You don't have to figure this out alone, and you don't have to start from scratch. Here is the usual order of steps.

1
Step 1

Enroll in VA health care

Apply with the Application for Health Benefits, VA Form 10-10EZ, online at VA.gov, by phone at 877-222-8387 (Monday through Friday, 8:00 a.m. to 8:00 p.m. ET), by mail, in person at a VA medical center or clinic, or with help from an accredited representative or Veterans Service Organization.

2
Step 2

Know the priority group

After enrollment, the VA assigns the veteran to one of 8 priority groups based on service history, disability rating, income, Medicaid eligibility, and other benefits. Our priority groups guide explains each one.

3
Step 3

Ask for the VA social worker

The VA directs veterans to a VA social worker or case manager to complete the copay form, and says to contact your local VA medical center to find out which services its CLC provides.

4
Step 4

Complete VA Form 10-10EC

with the VA social worker or case manager. The financial information on VA Form 10-10EC is what the VA uses to set any extended-care copay after day 21.

If your loved one is in a non-VA hospital right now, raise the VA with the hospital's discharge planner as early as you can. Enrollment in VA health care, a VA finding of need, and an available bed all have to line up before a VA nursing home placement happens.

How This Differs From Aid and Attendance

These two are easy to mix up: both involve the VA and both can help with a nursing home. But they're different kinds of benefits. Everything above is a health care benefit, meaning the VA provides or pays for the care itself. VA Aid and Attendance is an add-on to the VA Veterans Pension, which VA bases on the gap between the applicant's income and the Maximum Annual Pension Rate, under a different application and different rules than Medicaid. Our guide to how Aid and Attendance pays for a nursing home walks through the pension side.

One pension rule is worth knowing here. When a veteran with no spouse or child, or a surviving spouse with no child, is covered by Medicaid for care in a nursing facility, federal law at 38 U.S.C. 5503(d) limits the VA pension to $90 a month. The statute's definition of "nursing facility" leaves out "a facility that is a State home with respect to which the Secretary makes per diem payments for nursing home care pursuant to section 1741(a)," so the $90-a-month VA pension cap is not applied to a veteran in a State Veterans Home the VA pays per diem to. Federal law and VA's regulation name different months for when the $90 VA pension cap starts, so confirm the effective date with the VA before counting on a number. The $90 VA pension also replaces, rather than adds to, VA disability compensation or DIC.

Medicare is its own separate question. Medicare says, "Generally, Medicare and the U.S. Department of Veterans Affairs (VA) can’t pay for the same items or services," so each time a veteran gets care, the veteran chooses whether Medicare or the VA pays. Our VA and Medicare guide explains how the two fit together.

Frequently Asked Questions

Is VA nursing home care free for veterans who are 70 percent service connected?

A veteran rated 70% or more who needs nursing home care is in the group 38 U.S.C. 1710A requires the VA to provide that care to, and because a 70% rating is a compensable service-connected rating, the veteran is also exempt from VA extended-care copays under 38 CFR 17.111(f). The VA still has to determine that nursing home care is needed, and the 38 U.S.C. 1710A nursing home care mandate is set by 38 U.S.C. 1710A(d) to end on December 11, 2026, unless Congress extends it. The 38 CFR 17.111(f) copay exemption is a separate rule from the 38 U.S.C. 1710A nursing home care mandate and is unaffected by the December 11, 2026 end date of the 38 U.S.C. 1710A mandate.

Can a veteran's spouse live in a State Veterans Home?

Sometimes, and it depends on the home: the VA says State Veterans Homes care for non-veteran spouses and Gold Star parents only "sometimes." The VA's State home per diem is paid for eligible veterans' care, so ask the home's admissions office whether it admits spouses and how a spouse's own care would be paid for.

What if my father's service-connected rating comes through after he moves into a State Veterans Home?

VA's regulation, 38 CFR 51.41, lets a State Veterans Home request payment under its State home care agreement back to the retroactive effective date of the rating or February 2, 2013, whichever is later, if the new rating brings the veteran into the payment-in-full group. Tell the home's business office as soon as the decision arrives.

Does the VA bill Medicare for a VA nursing home stay?

No. The VA says it doesn't bill Medicare or Medicaid for VA care, though it may bill Medicare supplemental health insurance for covered services.

Learn More

VA BenefitsVA Benefits for Seniors: The Complete GuideA complete guide to VA benefits for senior care: long-term care, Aid and Attendance, pensions, DIC, and home grants for older veterans and surviving spouses. VA BenefitsHow VA Aid and Attendance Pays for a Nursing HomeHow VA Aid and Attendance helps pay for nursing home care: the 2026 amounts, the medical-expense rule, the $90 Medicaid pension cap, and how to apply. VA BenefitsState Veterans HomesState veterans homes are state-run, VA-certified care homes. See who gets in, how VA per diem and the 70% rating rule shape the cost, and find your state. VA BenefitsVA Health Care Priority GroupsHow VA health care enrollment and priority groups work for older veterans: who can enroll, the 8 priority groups, copays, how to apply, and long-term care. FinancialHow to Pay for Nursing Home CareHow to pay for nursing home care in 2026: what it costs and how Medicaid, Medicare, VA benefits, long-term care insurance, and private pay each fit in. MedicaidMedicaid Nursing Home Coverage by StateMedicaid pays for nursing-home care in every state, but the income cap, level-of-care test, and rules vary. The federal floor, what changes, and your state.

Find personalized help getting the VA to cover nursing home care for your veteran at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

Still have questions?

Brevy answers from this guide and every other guide here, and can check what you qualify for.

BC

Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.