The VA needs to do a better job of tracking the costs of serving the more than 36,000 vets receiving VA nursing home care, aexamination finds.
The review also sheds some light on how state-run veterans homes operate. A significant issue is that admission requirements for the 140 state-owned veterans homes nationwide vary widely by state.
The issue is important because Congress needs better data for budgeting and oversight of the massive operation, the GAO found. In 2012, the VA spent about $6.3 billion on long-term care, including nursing homes and community living centers.
Minnesota has five state-run veterans homes. The home in Minneapolis was recently the subject of a report by the Star Tribune that suggested historic problems at the facility may persist.
Nationally, state-owned vet homes provide care for just over half of the vets receiving VA nursing home care. They also have the largest proportion of vets receiving long-term care of 91 days or more. That's important because the costs of long-term care are high, particularly compared to home and community-based care. The issue is big enough that the VA has proposed starting VA-approved medical foster homes for veterans who would otherwise need nursing home care.
Right now the VA pays for all or at least a portion of the cost of providing nursing home care for eligible veterans in the state-run homes, but has no control over the admission process. In addition, unlike community nursing homes, state vet homes have no restrictions on the number of days the VA must pay for vets described as "discretionary," those who don't have a service-connected disability.
The high cost of using costly VA nursing homes will become increasingly important as the veteran population that uses them changes. Overall, the number of elderly veterans is projected to peak in 2014 and then decline.