Questions re Assist. Liv facilities qualifying for Aid and Attend, income ?s

Discussion in 'General Discussion' started by bunchito, Mar 29, 2007.

  1. bunchito

    bunchito Newbie

    I am new memebr and am so glad I found this site.
    I was originally given info. by one org. that the cost of an assisted living facility would be a justifiable exp. for the aid and attendance benefit. My mother is a widow and my late father was a WW2 war hero My mom was not at all safe at home(various medical issues and needs full time care. The assisted living fac. that she entered on 12/4/06 is great! They provide full-tme supervision, administer her meds, help with bathing, personal care etc. When I started to do the paper work for the VA benefit, one vet svc. ctr. rep. said that unless she is in a nursing home whe is not eligible for the full A & A benefit. he said that that the VA would try to break down the cost of the ALF and have them separete what part of the $2000 is used strictly for medical services. My sister and I are now terrified because she is not able to live on her own but her soc. sec. check is not sufficient to pay the AlF bill of $2000. per month which inlcudes all services! Also, she has $10,000 left in an IRA which my sister and I were planning on using to help pay her ALF expenses until she gets approved and receives her first A & A benefit check. The vet ctr. svc. rep said that once we activate her IRA by withdrawing money that money will have to be added to her monthly income although he did say that maybe it will be a wash since the money will be used for the ALF. Today, i spoke with the Exec. Dir. of an ALF Org who said that the Vet Ctr. Rep is misinformed. She said that there are many, many people who receive the full A& A benefit who reside in ALF's . The facility that my mother is in is an "Age in Place "facility and they have a separate wing for Alzheimers residents as well as a Senior Living Residence for people who are more independent than my mother who is in the ALF Program.

    I apologize for this very long post and would appreciate any advice or suggestions that would help me to get my mom's application approved.

    Many Blessings,

  2. VAAnswers

    VAAnswers Newbie

    The VA has stated in its operational manual that the full cost of Assisted Living Facilities is deductible. A&A is NOT a benefit just reserved for people in nursing homes. The manual states that if a person is deemed Housebound or eligible for A&A "allow all reasonable fees paid to the facility, so long as the facility provides some medical or nursing services for the disabled person. The services do NOT have to be provided by a licensed health professional."

    'All reasonable fees' include such tasks as cooking, cleaning, and tending to the individual's daily needs.

    All that having been said, we have seen veterans services officers who don't even realize that this is the rule. Be very cautious and be sure to ask questions of whomever is preparing your mother's claim (Form #21-534). If anyone tells you that you must split out the Assisted Living costs, refer them to the VA Operating Manual -- M21-1, Part IV, Change 178, 16-VI-5.
  3. veteranadvocate

    veteranadvocate Full Member

    I think what they are refering to is for individuals who are in 'retirement homes' and not 'assisted care facility'. If veteran/widows are in a 'retirement home' then they will have to break down the expenses.
  4. Dru

    Dru Newbie

    May I please have more clarification of the above? My mom, a surviving spouse, with about $1300 per month in income (part of which she gives to a disabled daughter), needs to be moved to an assisted living facility, as her doctor said she needs daily supervision. The assisted living facility will cost about $2800 per month. We - her kids do not have the money to pay this. If we sell her house it would pay for less than 2 years at the facility, plus she has a $15K CD which is her total savings. Is the total cost for the assisted living facility monthly charge deducted from her countable income? When you say "all reasonable fees such as cooking, cleaning, etc. - the services of the assisted living facility are not itemized like that. She also receives physical therapy three times a week, but this is paid for by TriCare.
  5. veteranadvocate

    veteranadvocate Full Member

    With your Mother being in an 'assisted living facility', her entire monthly expenses should be counted toward reducing or deductable from her countable income. You do not need to break down or itemize the cost of the assisted care facility. 'All reasonable fees' means things that are ordinally associated expenses for care. Example: The VA would not allow movie rentals or magizine subcriptions to be included.

    You mentioned something about a disabled daughter. Did the daughter become disable before reaching her 18th birthday? If so, your mother could count her as a dependent and receive additional monthly monetary benefits and can also use some of the disabled daughter's medical expenses. There's even a possiblity that the disabled child could qualify for benefits.

    Hope this addresses some of your questions.
  6. Dru

    Dru Newbie

    Yes, this is helpful. And I appreciate it. The disabled daughter is 56 years old and didn't become disabled until about 10 years ago. Unfortunately, she was a housewife and mother, therefore did not accumulate any quarters toward Social Security or Social Security disability. She and her husband are barely making it on a small income, but not quite small enough to qualify them for any aid.
  7. ForJohn

    ForJohn Newbie

    Hello, I'm new and have been reading the existing posts. This information is great, but I'm still a little confused about the "threshold". My Dad has been in independent living for about 7 years and now needs to move up to assisted living. He has been holding off because he is afraid of using up all his money and the facility he is in will make him leave when his funds are gone. He earns about $26,000 per year from ss, pension and interest. His annual income goes down every year. He earns over the $18,234 threshold for a single person, but his assisted living cost alone will be over $36000 per year. In determining if he meets the threshold, does the VA subtract the $36,000 assisted living fee from his $26,000 annual income to determine if he meets the income threshold? (Of course that would leave him at -$10,000 and that's before insurance premiums, prescription expenses and doctor visits.) Unless that is the case, am I correct in assuming we should not apply for A&A for him?
    #2 daughter
  8. veteranadvocate

    veteranadvocate Full Member

    The VA will use the cost of the Assisted Living expenses to reduce his countable income. If his income is around $18,000 and his Assisted Living expenses is around $36,000 then his countable income is reduced to zero. The other thing that the VA will look at is net worth. They are starting to take a closer look at this area. They consider his age and net worth in determining if his net worth is excessive.

    Hope this is of some help to you.
  9. Rachel

    Rachel Newbie

    Re: Independent Living

    How is it looked at if my family member resides in an independent community in which they do light housekeeping and prepare meals. There are no other services provided other than the one's listed.
  10. ourmomida

    ourmomida Newbie

    Questions re Assist. Liv facilities qualifying for Aid and Attend, income

    I am also a new member and am so glad I found this site. I hope I can get some clarification about the VA Aid and Attendence Benefit. My mother-in-law is the widow of a WWII vet (he served for 6 years). She has limited income (~ $1,800 per month between SS benefits and Federal pension). She has very little in assets, under the stated limit. She will be entering an Assisted Living Residence in NYC in a few days. Her assests will be exhausted in a short time and we are looking for any additional benefits she might be eligible for. She is moderately independant, but she does need help and supervision with her meds and cognitive skills and socialization (much of which family and friends will help with). She can no longer cook/prepare meals, shop, manage money, clean, do laundry, or take care of basic household chores/needs. It seems that she may be eligible for the Aid and Assistence Benefit, but I am not sure if she is eligible and how to go about filing for the benefit (i.e.: what forms to fill out and documentation needed) and if there is some group or agency that can help us without charging a fee.
    Thank you for your help!
  11. veteranadvocate

    veteranadvocate Full Member



    They have a very good step-by-step section that includes what forms are needed and how to complete them. They are also available to answer any questions, at no charge. I know of many individuals who worked with this organization and were very pleased.

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