VA Nursing Homes vs. Private Nursing Homes: What Veterans Should Know

When a veteran needs nursing home care, the decision about where to receive that care can have a major financial and personal impact. The VA operates its own nursing homes, called Community Living Centers, at approximately 130 VA medical centers nationwide. These facilities provide skilled nursing, rehabilitation, and long-term custodial care at little or no cost to eligible veterans. Private nursing homes, on the other hand, are available to anyone but cost an average of over $10,000 per month. This guide compares VA Community Living Centers with private nursing homes across the factors that matter most: cost, eligibility, quality, availability, and what each option covers.

What VA Community Living Centers Provide

VA Community Living Centers are skilled nursing facilities located within the VA health care system. They provide a range of services that include short-term rehabilitation after a hospitalization, long-term nursing care for veterans who can no longer live independently, hospice and palliative care for veterans at the end of life, respite care to give family caregivers a break, and specialized programs for veterans with dementia or other cognitive conditions.

Each CLC is staffed with registered nurses, licensed practical nurses, certified nursing assistants, physicians, physical therapists, occupational therapists, speech therapists, social workers, dietitians, and recreation therapists. Because CLCs are part of VA medical centers, residents have immediate access to the full range of VA medical services, including specialty care, pharmacy, laboratory, and imaging services. This integrated model is one of the key advantages of VA nursing home care.

CLCs emphasize rehabilitation and helping veterans return to the community whenever possible. Many CLC admissions are for post-hospital rehabilitation, where the goal is to restore function and discharge the veteran to home within weeks. However, CLCs also provide long-term care for veterans who need ongoing custodial nursing services, particularly those with high service-connected disability ratings who are entitled to this level of care.

What Private Nursing Homes Provide

Private nursing homes, also called skilled nursing facilities, are operated by private companies, nonprofit organizations, or government entities outside the VA system. They are open to anyone who needs nursing-level care, regardless of military service. Private nursing homes provide many of the same clinical services as CLCs, including skilled nursing, rehabilitation, and custodial care.

There are far more private nursing homes available than VA CLCs. According to federal data, there are approximately 15,000 Medicare and Medicaid-certified nursing homes in the United States. This means you have much more choice when it comes to location, facility amenities, and care options. Private facilities range from basic Medicaid-funded homes to luxury facilities with private rooms, gourmet dining, and extensive activity programs.

Private nursing homes are funded through a mix of private pay, Medicare, Medicaid, and long-term care insurance. Medicare covers up to 100 days of skilled nursing care per benefit period following a qualifying hospital stay. After Medicare coverage ends, residents must pay out of pocket, use long-term care insurance, or qualify for Medicaid. Many long-stay residents in private nursing homes eventually spend down their assets and transition to Medicaid as a payment source.

Comparing Costs: VA vs. Private Nursing Home Care

Cost is often the deciding factor for veterans and their families when choosing between VA and private nursing home care. The difference in cost between the two options is substantial.

Private nursing homes in 2026 charge an average of $10,965 per month for a semi-private room and $11,294 per month for a private room. These figures translate to approximately $131,580 to $135,528 per year. In high-cost areas, prices can be significantly higher. For a veteran without long-term care insurance or substantial savings, these costs can deplete a lifetime of assets within a year or two.

VA Community Living Center costs depend on your eligibility status. Veterans with a 70 percent or higher service-connected disability rating pay no copay for CLC care. Veterans needing care for a service-connected condition also pay nothing. Other enrolled veterans may pay an extended care copay that is calculated based on income and assets, but even these copays are typically a small fraction of private nursing home rates. For many eligible veterans, CLC care is effectively free.

State veterans homes offer another affordable option. They accept VA per diem payments, Medicaid, and private pay. Costs at state veterans homes are generally lower than private nursing homes and vary by state. They serve as a middle ground between the VA's CLCs and fully private facilities.

Eligibility and Admission Priorities

Private nursing homes accept any resident who can pay for care, whether through personal funds, insurance, Medicare, or Medicaid. There are no military service requirements or disability ratings to consider. If you have the financial means, you can generally be admitted to a private facility with available beds.

VA CLC admission is more restricted and follows a priority system. The VA is legally mandated to provide nursing home care to veterans with a service-connected disability rating of 70 percent or higher and veterans who need nursing home care for a service-connected condition. Beyond these mandatory groups, the VA prioritizes veterans who need post-hospital rehabilitation, veterans receiving end-of-life care, and other enrolled veterans based on clinical need and available resources.

Because CLCs have limited beds, not every veteran who requests admission can be accommodated. Waiting lists are common, particularly at CLCs in major metropolitan areas. If a CLC cannot take you, the VA may arrange placement in a community nursing home through its community care program or refer you to a state veterans home. Understanding these priorities and potential wait times is important when planning for nursing home care.

Quality and Staffing Comparisons

Quality of care is a major concern when choosing a nursing home, and both VA and private facilities have strengths and weaknesses. VA CLCs are subject to internal VA quality standards and regular inspections. The VA publishes quality data for its CLCs, including measures related to resident health outcomes, staffing levels, and inspection results. Many CLCs have achieved high marks in resident satisfaction and clinical outcomes.

Private nursing homes are regulated by state health departments and inspected by both state and federal agencies. Medicare publishes star ratings for nursing homes on Medicare.gov, where you can compare facilities based on health inspections, staffing ratios, and quality measures. Quality varies widely among private nursing homes. Some are outstanding, while others have histories of violations and poor care. Researching individual facilities before making a choice is essential.

One advantage of VA CLCs is their integration with the VA medical system. CLC residents have direct access to VA physicians, specialists, pharmacy, and other medical services without needing to coordinate between separate providers. This can lead to better coordination of care and faster response to medical issues. Private nursing homes must coordinate with outside physicians and hospitals, which can sometimes create delays or communication gaps.

Availability and Geographic Considerations

One of the biggest practical challenges with VA Community Living Centers is their limited availability. With approximately 130 CLCs nationwide compared to more than 15,000 private nursing homes, the odds of having a CLC close to your home or family are much lower. Veterans in rural areas may find that the nearest CLC is hours away, which can make it difficult for family members to visit regularly.

Bed availability within CLCs is another issue. Many CLCs have more demand than they can accommodate, leading to waiting lists. The VA addresses this by contracting with community nursing homes and supporting state veterans homes, but these alternatives may not offer the same level of VA integration or the same cost structure.

Private nursing homes are available in virtually every community, giving you much more flexibility in choosing a location close to family and friends. This proximity can be important for quality of life, as regular visits from loved ones are associated with better outcomes for nursing home residents. If staying near family is a top priority, a private nursing home may be the more practical choice, even if it costs more.

Paying for Private Nursing Home Care as a Veteran

If you choose or need to use a private nursing home, there are several ways to pay for it. Understanding your options can help you make the best financial decision for your situation.

Medicare covers up to 100 days of skilled nursing care per benefit period after a qualifying three-day hospital stay. For days 1 through 20, Medicare pays the full cost. For days 21 through 100, you pay a daily coinsurance of $204.50 in 2026. After day 100, Medicare pays nothing. This short-term coverage is useful for rehabilitation but does not cover long-term stays.

Medicaid covers long-term nursing home care for people who meet strict financial requirements. In most states, you must have countable assets of $2,000 or less and meet income limits. Many veterans eventually qualify for Medicaid after spending down their assets on care. Medicaid has a five-year look-back period for asset transfers, so planning well in advance is important.

Long-term care insurance, if you have it, can cover private nursing home costs up to your policy's daily benefit amount and benefit period. The VA's Aid and Attendance pension can supplement your income if you qualify. Personal savings, home equity, and retirement accounts are also commonly used to pay for care. Many families use a combination of these sources to fund nursing home stays.

How to Choose Between VA and Private Nursing Home Care

Choosing between a VA Community Living Center and a private nursing home depends on your individual circumstances. There is no single right answer, and the best choice will depend on your eligibility, financial situation, care needs, location, and personal preferences.

If you have a 70 percent or higher service-connected disability rating, VA CLC care is generally the best option financially. You are guaranteed access to VA nursing home care at no cost. The integration with VA medical services is an added benefit, especially if you have complex health conditions managed by the VA.

If you do not have a high service-connected disability rating, weigh the potential cost savings of VA care against the location and availability limitations. If the nearest CLC is far from your family and has a long waiting list, a private nursing home closer to home may better serve your overall well-being. Consider visiting both types of facilities, talking to current residents and families, and reviewing quality ratings before making your decision.

Regardless of which option you choose, start planning early. VA CLC admission can involve waiting lists, and Medicaid eligibility for private nursing homes requires careful financial planning. Talk to your VA social worker, a veterans service organization, or a financial advisor who specializes in long-term care to explore all your options and create a plan that protects your health and financial security.