Regulatory Review – Veteran Eligibility

July’s regulatory review comes from the State of Iowa Administrative Rules 481-58.12(1)L “Within 30 days of a resident’s admission to a health care facility receiving reimbursement through the medical assistance program under Iowa Code chapter 294A, the facility shall ask the resident or the resident’s personal representative whether the resident is a veteran and shall document the response. If the facility determines that the resident is a potential veteran, the facility shall report the resident’s name along with the names of the resident’s spouse and any dependent children, as well as the name of the contact person for this information, to the Iowa department of veteran's affairs. Where appropriate, the facility may also report such information to the Iowa department of human services.”

All nursing home providers that accept Medicaid funding should be aware of the requirements related to veterans' eligibility. The best practice is to establish a process for questioning the resident or their responsible party while you’re completing admission paperwork with the resident. This should be documented somewhere in the medical record (as a previous administrator we had it included in the social services assessment). If the resident is a veteran, veterans' spouse or widow, the nursing home must enter the information onto the nursing homes webpage on the IDVA website.  

When DIAL is completing a survey, they will ask for a copy of the current resident list from the IDVA website. The surveyors then verify if the resident’s included in their sample were asked about their veteran status and if they indicate that they were a veteran, spouse, or widow, that their name is included on the resident list. While DIAL does not do any additional review of this information, it is important if/when the resident applies for Medicaid benefits. Prior to being approved for Medicaid benefits veteran residents, spouses, and widows will be required to apply for veterans benefits with the Iowa Department of Veteran’s Affairs. Depending on when they served, they may be entitled to benefits, including a financial benefit that may reduce the amount Medicaid is reimbursing the nursing home for care.

If the resident is not a veteran, spouse, or widow, the documentation of the nursing home asking this question is sufficient evidence of compliance with the State rule.