Planners of Nursing Home for Veterans Face Multiple Unknowns

The state of Wyoming cleared the way for studies on the feasibility of a skilled nursing center for veterans, a facility that the state currently lacks.

“Our concern is in the future, what will be the need for skilled nursing?” Col. Steve Kravitsky, director of the Wyoming Veterans Commission (WVC), told Skilled Nursing News. “Even though the veteran population is declining, we percieve the need may go up.”

“May” is the key word; there are many uncertainties about the needs of veterans in the state, which the studies are hoping to clarify. Though the demand for SNF services by Wyoming veterans is expected to decrease, the population most at risk of needing long-term care (LTC) services is likely to increase, according to a needs analysis conducted by Wyoming’s Department of Health (DOH) in 2017.


On March 13, Wyoming Gov. Matt Mead signed a law authorizing $300,000 to conduct Level I and II studies on the need for and feasibility of a SNF for veterans in the state.

The VA has a 65% match program that provides states with a funding mechanism for building skilled nursing centers, but the state has to match 35% of the necessary funds. The proposed SNF would be modeled on the so-called “Green House” concept, which has groups of six to 10 individual rooms arranged around common areas, the DOH analysis indicates.

The VA seems to be moving in the direction of this model, away from the institutional nursing home to foster more of a community, according to Wyoming’s DOH. But one of the issues surrounding the establishment of a brick-and-mortar care center is the state DOH’s long-term strategy to move people into home and community-based settings, mirroring a nationwide trend.


It’s also hard to say whether or not veterans will have more acute health care needs than the general population. The exposure of veterans to Agent Orange in Vietnam is just one of several potential health issues, Kravitsky said.

“You just don’t know what you don’t know at this time,” he said, adding this applies to many different aspects of veterans’ needs in the state. It’s not clear, for instance, how veterans in Wyoming — who number about 48,000 at present — get skilled nursing care if they require it.

The 2017 analysis assumed that veterans are at the same risk of needing LTC services as the general population of Wyoming, and estimated that about 500 veterans in the state currently receive SNF care. But there’s no data on where they receive this care at present.

Though the U.S. Department of Veterans Affairs (VA) provides a per diem rate of roughly $106 per day for eligible veterans at “State Homes,” the fact that Wyoming currently lacks a SNF means that veterans who are eligible to receive this benefit can’t currently do so, Kravitsky explained. For veterans who are “77% or higher disabled,” the VA pays the full cost of skilled nursing or nursing care needs. But without a SNF designed for veterans in the state, this benefit can’t be realized.

As it stands, veterans could be using local nursing homes, paying for it with their own insurance, Kravitsky said. But there’s no way of knowing for sure until the studies are completed.

“For me, personally, it’s about putting benefits in the hands of vets who’ve earned them and giving them the capability to use it in the state,” Kravitsky told SNN. “To me, that’s the central argument, not the fact that the state doesn’t have one.”

Written by Maggie Flynn

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