Are veterans homes part of VA? The difference between state and federal care

Oct 24, 2025 4 min read •

senior care Healthy Aging Veterans Benefits

While it's a widespread belief, state veterans homes are not directly managed or operated by the U.S. Department of Veterans Affairs (VA). This is a crucial distinction for veterans and their families seeking long-term care options, as it impacts management, eligibility, and the application process.

Quick Summary

State Veterans Homes are managed by state governments, not the federal VA, though the VA provides funding and oversight to ensure quality standards. This partnership allows for subsidized care, creating a distinct option for veterans' long-term care needs that is separate from VA-run facilities.

Key Points

State-Managed, Not VA-Managed: State Veterans Homes are owned and operated by state governments, separate from federal VA facilities.
VA Provides Oversight and Funding: The VA certifies state homes and provides per diem payments for eligible veterans, but does not handle daily management.
Eligibility Varies by State: Admission criteria, including residency and acceptance of spouses, are set by each individual state.
Range of Care Services: State homes offer nursing home, domiciliary (assisted living), and adult day care options.
Affordable, Subsidized Care: Due to state and federal subsidies, costs are often significantly lower than private facilities.
Separate from VA Community Living Centers: VA also operates its own long-term care facilities, which have different admission criteria and processes.

State vs. Federal: Understanding the Core Difference

State Veterans Homes and VA-managed facilities, such as Community Living Centers, are distinct entities. The most fundamental difference lies in their management and ownership. State Veterans Homes are owned and operated by state governments, while VA facilities are run by the federal Department of Veterans Affairs. This decentralized system allows each state to establish its own specific admission criteria, residency requirements, and services offered.

The VA's Role in State Veterans Homes

Despite not managing state homes directly, the federal VA plays a significant role through a partnership program. This involvement includes several key areas:

Certification and Oversight: To receive federal funding, a state veterans home must be formally recognized and certified by the VA. The VA then conducts annual surveys to ensure these facilities continue to meet its established standards of care.
Financial Assistance: The VA provides financial support to states for the care of eligible veterans. This assistance comes in the form of a "per diem" payment, which helps states cover a portion of the daily operating costs. The amount of this payment can vary depending on the veteran's disability rating.
Construction Grants: To help states build, acquire, or renovate state veterans homes, the VA offers construction grants, covering up to 65% of the total cost.

Eligibility for Admission

Eligibility for a State Veterans Home differs from VA Community Living Centers because each state sets its own rules. While general veteran status is required, additional criteria often apply. These can include:

State residency requirements, which vary significantly.
Specific types of care needed, such as skilled nursing or domiciliary (assisted living) care.
In many cases, spouses, surviving spouses, and Gold Star parents are also eligible for admission on a space-available basis, which is not typical for federal VA facilities.

Services and Application Process

State Veterans Homes provide a range of services designed for the aging veteran population. These can include:

Nursing Home Care: 24/7 skilled nursing and long-term care services.
Domiciliary Care: A form of assisted living for ambulatory veterans who need some support but not intensive nursing care.
Adult Day Health Care: Services for veterans who live at home but need medical and social support during the day.

Applying for admission typically involves the following steps:

Contact the specific state veterans home directly to understand its unique eligibility and application requirements.
Complete a detailed application form, often involving the submission of military discharge papers (DD-214) and medical records.
Undergo a review process by the state home's admissions committee.
Await placement, which may involve a waiting list, particularly for high-demand services like dementia care units.

Comparison: State Veterans Homes vs. VA Facilities

To clarify the differences, here is a comparison table outlining key aspects of each care option.


Feature	State Veterans Homes	Federal VA Community Living Centers
Management	Owned and operated by individual state governments.	Managed and operated by the federal VA.
Funding	Subsidized by both state and federal (VA per diem) funds.	Fully funded by the Department of Veterans Affairs.
Eligibility	Varies by state; may include spouses, surviving spouses, and Gold Star parents.	Generally restricted to veterans enrolled in VA health care who meet specific clinical needs.
Cost	Typically more affordable than private care; costs vary by state and veteran's income/disability rating.	Often little to no out-of-pocket cost for the veteran, depending on circumstances.
Application	Handled directly by the state veterans home; waiting lists can occur.	Managed through the VA health care system; may have different availability procedures.

Financial Considerations and Benefits

One of the main advantages of State Veterans Homes is the potential for significant cost savings. The combination of state subsidies and VA per diem payments makes care much more affordable than comparable private sector facilities. For veterans with a 70% or higher service-connected disability, the cost may even be fully covered by the federal per diem. Additionally, these homes foster a sense of camaraderie, and staff often receive specialized training for the unique needs of the veteran population.

Conclusion

While a state veterans home is not a direct part of the VA, it is a key component of the broader veterans' care network, thanks to the collaborative partnership between state and federal agencies. Veterans and their families must understand this distinction to navigate the different eligibility requirements, application procedures, and costs associated with state versus federal facilities. Researching the specific criteria for your state is the best first step in securing high-quality, long-term care for a veteran.

For more information on state veterans homes and the VA's role, visit the official VA Geriatrics and Extended Care page on State Veterans Homes.

Frequently Asked Questions

A State Veterans Home is owned and operated by a state government, whereas a VA hospital is managed by the federal Department of Veterans Affairs. State homes typically provide long-term care like skilled nursing or assisted living, while VA hospitals focus on acute medical care.

Cost varies by state and a veteran's income and disability status. While the VA provides a per diem payment, you will likely have some out-of-pocket cost. However, for veterans with a 70% or higher service-connected disability, the VA subsidy may cover the full cost.

Yes, many state veterans homes admit spouses and surviving spouses on a space-available basis. Eligibility and admission criteria for non-veterans are set by each state, so it's important to check with the specific facility.

The application process is managed by the state, not the federal VA. You must contact the specific state veterans home you are interested in to obtain their application forms and follow their unique admission procedures.

Domiciliary care, often similar to assisted living, is for ambulatory veterans who are disabled by age or illness but do not need intensive skilled nursing care. It is a lower level of inpatient care focused on rehabilitation and supported independence.

Yes, many State Veterans Homes have waiting lists, especially for specific types of care like memory care for Alzheimer's patients. The length of the wait can depend on the home's demand and available beds.

To receive federal funding, state veterans homes must meet VA standards and undergo annual inspections. The VA formally certifies these facilities and surveys them yearly to ensure compliance with federal regulations.

Yes, a veteran can typically continue to use their VA healthcare benefits. However, coordination between the state home's services and any VA-provided care should be discussed during the admission process.

References

Medical Disclaimer

This content is for informational purposes only and should not replace professional medical advice. Always consult a qualified healthcare provider regarding personal health decisions.