Lines blur on long-term care for vets, non-vets

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Tim Mullaney
Tim Mullaney

Flags are flown at half-mast only until noon on Memorial Day. I'm guessing this is common knowledge that somehow escaped me until this year. There's some nice symbolism here. First, the flag is flown at half-mast in tribute to fallen soldiers. It's then raised as sign of the continuing life of the nation, and a reminder to honor the fallen by acting honorably.

Certainly, part of acting honorably is seeing to the long-term care needs of surviving veterans, so it's in this spirit that I'm sharing a roundup of some recent news items. Interestingly, it seems the line separating civilian and veteran nursing home care may be blurring. Public-private partnerships are being floated, and the system for determining VA funding for nursing home care might soon resemble the system used for Medicaid.

Minnesota contemplates creative alternatives to VA homes

Minnesota may boast 10,000 lakes, but it has only five veterans homes. Waiting lists have now stretched to nearly 900 people, and funding for a new facility is not imminent.

In response, the state's House of Representatives recently created its first-ever select committee on veterans housing. The nine members are charged with proposing potential solutions — and they're already thinking outside the box.

A “decentralized” approach would make sense, according to Rep. Alice Hausman (DFL-St. Paul). Rather than a few large facilities that force some veterans to move far away from family and friends, the state could create smaller homes around the state, which would be easier to manage. However, federal regulations limiting the number of beds per state, as well as the way funding is determined, could hamper this plan.

Another possibility: partnering with nonprofits, or adding veterans' wings to existing nursing homes. Critics of this idea say veterans do better when they have dedicated facilities, given their specific needs. This is something I heard a few months ago from an expert in the field, Eleanor Krassen Covan, Ph.D.

The committee members may have their work cut out for them, but if they come up with a workable model, it could be emulated by other states. Their report is due by early 2014.

Senators propose ‘look-back' period

Sens. Ron Wyden (D-OR) and Richard Burr (R-NC) recently proposed a three-year “look-back” period over a veteran's assets, to determine eligibility for the Aid and Attendance benefit.

Some veterans essentially hide their assets in annuities and trusts to qualify for the A&A benefit, which covers assisted living expenses. But the problem here is not unscrupulous, wealthy veterans gaming the system, although there might be some of those. The bigger issue is so-called “pension poachers,” who sell aging veterans on these annuity schemes to extract hefty fees. And, once their money is wrapped up in annuities, veterans may be unable to draw on their savings to pay for long-term care. These schemes could even disqualify veterans from Medicaid, the New York Times pointed out.

The Wyden/Burr bill would make qualifying for A&A similar to the process of determining Medicaid eligibility for nursing home care, which involves a 60-day look-back period. The senators argue this will make veterans think twice about annuity plans and discourage pension poachers.

From Navy to nursing home

If the news of poachers and waiting lists got you down, here's a story to lift your spirits.

Imagine two young men from the Brown Park neighborhood of Omaha, NE, drafted into the Navy during World War II. They attend the same boot camp and ship off to different locations. They both move back to Omaha after the war but lose touch for decades, until one of the men moves into a house formerly owned by the other.

Fast forward a few more years, and they're neighbors in a nursing home, being filmed by a local TV crew as they walk the hallway, singing “Anchors Away.” Click here to see for yourself.

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Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Emily Mongan.

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