Transcript NASVH Summer Conference August 16

2010 Winter Conference
National Association of State Veterans
Home
February 26 - March 4, 2010
Washington, DC
Theresa Hayes
State Home Per Diem Program
Veterans Health Administration
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Per Diem for SVHs from 2002-2009
VA State Home Basic Per Diem Rates
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
NHC/HOSP
$46.49
$51.38
$53.17
$56.24
$57.78
$59.36
$63.40
$67.71
$71.42
$74.42
$77.53
$94.59
DOM
$20.36
$22.03
$23.74
$26.95
$27.19
$27.44
$29.31
$31.30
$33.01
$34.40
$35.84
$38.90
ADHC
N/A
N/A
N/A
N/A
N/A
N/A
$37.91
$40.48
$64.13
$66.82
$69.63
TBA
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Number of State Veterans Nursing Homes,
Domicilaries, and ADHC’s for
FY 2000 – 2009
140
120
111 112 114
100 96
125
119 121
131
102 103
80
60
50
50
51
49
53
53
54
53
52
53
NHC
DOM
ADHC
40
20
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
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Total Number of Authorized Beds
for FY 2009
 Total State Home programs: 137 in 50
states and Puerto Rico
 Total State Veteran Nursing Homes: 131 in
50 states and Puerto Rico (24,302 beds)
 Total State Domiciliary facilities: 53 in 33
states and Puerto Rico (6,086 beds)
 Total State ADHC programs: 1 state (50
slots)
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FY 2009
Annual ADC, Percentage of VA Cost
Average Per Diem Cost & Occupancy Rates
Average Daily Census
Average Percentage of Cost Paid
by VA
 Nursing Home: 19,027
32%
 Domiciliary Care: 2,837
25%
 Hospital Care: 62
(Hospital Closed 3rd QTR)
14%
 Adult Day Health Care: 14
40%




Average Per Diem Cost
Nursing Home: $238.91
Hospital Care: $991.48
Domiciliary Care: $140.52
Adult Day Health Care: $165.22
Occupancy Rates
75% Vet-----85%Total
100%Vet---- 48%Total
93% Vet ---68%Total
32% Vet----73%Total
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38 U.S.C. 1745
(Implementation date May 29, 2009)
Requires VA to begin paying States higher rate for SNF to certain
veterans in State nursing homes with SC disability rated 70% or
higher and those requiring nursing home care for a SC disability.
The new per diem rate is the lesser of the following:
•The applicable or prevailing rate payable in the geographic area
in which the State home is located.
•A rate not to exceed the daily cost of care in the SNF.
The law thus requires VA to use the actual cost of care in State
homes based on a report from the home in determining the higher
per diem, and the home will receive its actual cost if LESS than
the applicable or prevailing rate.
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Effect on Per Diem for Veterans
Without a SC Disability
 Other Veterans on whose behalf VA pays per
diem to State homes (but do not require nursing
home care because of SC disabilities) will still
receive the basic per diem rate from VA. Current
basic per diem rate for NHC is $77.53.
 This rate is adjusted each fiscal year.
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38 U.S. C. 1745
The new law requires VA to furnish medications
needed to treat a SC disability. Aid and Attendance
rules also apply.
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National Estimated Higher Per
Diem Rates
for Nursing Home Care
FY 2007:
FY 2008:
FY 2009:
FY 2010:
$258.64
$268.80
$278.39
$275.53
(Includes Drug Costs)
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The Importance of Form 10-5588 Per Diem
Cost
– The VA Form 10-5588 is a tool for
communicating with the VA the SVH’s cost and
request for federal aid.
– Complete and accurate reporting of per diem
costs is the only way the VA can determine the
per diem amount to pay per 38 U.S.C. 1745.
– Must enter monthly reporting data in Citrix
CORRECTLY and ON TIME.
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VA Form 10-5588 Consists of Several Parts




Gains and Losses
Days of Care
Average Daily Census
Total Per Diem Cost (Daily Cost of Care for the
Month)
 Per Diem Claimed
 Total Amount Claimed
For Hospital, Nursing Home, Domiciliary and Adult
Day Health Care.
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The State home should submit the 10-5588 to VA Medical Center of
Jurisdiction by the end of the 5th workday after the close of each
monthly report period.
VA medical center of jurisdiction staff will review each monthly
10-5588 for accuracy, resolve any discrepancies with the State
home, make payment by electronic fund transfer and file the report.
A report should not be accepted if the report is incomplete,
calculations not accurate, or missing the authorized signature of the
SVH.
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For additional information, please contact:
Theresa Hayes @ (202) 461-6771
[email protected]
or
Brenda Wiggins @ (202) 461-6757
[email protected]
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