VA Long-Term Care: Home Care, Adult Day Health, Respite, and Nursing Homes for Veterans

Many families think of VA care as a doctor's appointment at the VA medical center. But VA also runs a large long-term care system through its Office of Geriatrics and Extended Care, covering help at home, day programs, short breaks for family caregivers, and nursing home care. If your loved one is a veteran, these services belong on the list before you sign a private care contract.

The basics: who can get VA long-term care

VA long-term care is part of VA health care, not a separate benefit. In general, a veteran needs:

• Enrollment in VA health care. If your loved one isn't enrolled, start there.
• A clinical need for the service, as determined by the VA care team.
• Availability nearby. Many programs vary by location, and some have waitlists.

For many home and community services, VA also checks that the veteran qualifies for community care. Service-connected disability rating and income can affect both access, especially for nursing homes, and copays.

The first call is usually to the veteran's VA primary care team or a VA social worker. Ask for a geriatric or extended care assessment, and tell them plainly what is happening at home: falls, missed medications, wandering, a caregiver who is exhausted.

Care at home

Homemaker and Home Health Aide care

Trained aides from VA-contracted agencies come to the home to help with bathing, dressing, grooming, toileting, eating, moving around, and errands like grocery shopping. A registered nurse supervises the aides. Visits might be several times a week or occasional, based on assessed need, and can continue as long as the help is needed.

Veteran-Directed Care

Veteran-Directed Care gives the veteran (or a representative) a budget for personal care services and lets them hire their own workers, including a family member or neighbor. A counselor helps build a spending plan. For families who already have a trusted helper, this can be the most flexible option VA offers. It is available to enrolled veterans of any age, but not in every area, so ask your VA social worker.

Home Based Primary Care and skilled home health

Home Based Primary Care brings a VA team, supervised by a VA physician, to veterans with complex health needs for whom clinic visits don't work well. Skilled home health care provides short-term nursing and therapy through community agencies for veterans who are homebound or live far from a VA facility. Home telehealth lets the care team monitor conditions by phone, video, or remote equipment.

Adult day health care and respite

Adult Day Health Care offers a structured day with activities, companionship, help with daily tasks, and sometimes nursing or therapy. Programs run half or full days, usually several days a week, at VA medical centers, State Veterans Homes, or community centers. It also gives family caregivers predictable time to work or rest. See our broader guide to adult day care.

Respite care pays for someone to stay with the veteran at home, for a day program, or for a short stay in a VA Community Living Center or community nursing home while the family caregiver takes a break. VA's copay rules describe respite as available for up to 30 days per calendar year. Nursing home respite should be scheduled in advance. Learn more in our respite care guide.

Nursing home care: three settings

Eligibility for nursing home care is more limited than for home services. Veterans who need care for a service-connected condition, veterans rated 70% or more service-connected, and veterans rated totally disabled based on individual unemployability generally have the strongest eligibility. Other enrolled veterans may be placed based on available resources, and income matters. All programs require that the veteran be medically stable and assessed as needing that level of care.

Also compare with nursing homes in general and with how Medicaid pays for long-term care, since many veterans in non-VA facilities rely on Medicaid.

Medical Foster Homes and other residential options

A Medical Foster Home is a private home where a trained caregiver looks after a few residents around the clock, as an alternative to a nursing home. VA inspects and approves these homes and continues care through Home Based Primary Care, which the veteran must be enrolled in. But VA does not pay the home itself. The veteran pays the caregiver directly, about $1,500 to $3,000 a month according to VA, depending on income and the care needed.

VA also may approve adult family homes and assisted living settings, but it doesn't run or pay for them. That is where VA pension with Aid and Attendance often fills the gap.

What it may cost: VA extended care copays

Some veterans owe nothing, based on disability rating, income, or other factors. Others owe copays after the first 21 days of care in a 12-month period. For 2026, VA lists maximum long-term care copays of:

• Up to $97 a day for inpatient extended care, such as a Community Living Center stay or overnight respite
• Up to $15 a day for outpatient care, such as adult day health care or daytime respite

The actual amount depends on financial information reported on VA Form 10-10EC, the Application for Extended Care Benefits. A VA social worker can help you fill it out.

Next steps

1. Confirm enrollment. Make sure the veteran is enrolled in VA health care.
2. Request an assessment. Ask the primary care team for a geriatric or extended care evaluation and a social work referral.
3. Complete VA Form 10-10EC. This sets any copay for extended care.
4. Line up the paperwork. A health care power of attorney and current medication list will make every step easier.
5. Support the caregiver. Enroll in the VA Caregiver Support Program for training, coaching, and respite.

If you're unsure whether your loved one needs help at home, a day program, or round-the-clock care, our guide to choosing the right level of care can help you sort it out before you talk with VA.

Last reviewed October 19, 2026. General information only, not medical, legal, or financial advice. Benefit rules and amounts change, so confirm with the agency before you decide. See our disclaimer.