Potential Changes for Veterans in Minnesota
The Minnesota Veterans Home has long been a great option for veterans to receive long-term care in Minnesota. There are five locations in Minnesota where veterans may receive care (Fergus Falls, Hastings, Luverne, Minneapolis, and Silver Bay) and three new locations under construction which will potentially open in the winter of 2023 (Bemidji, Montevideo, and Preston). Eligibility to receive care at the Veterans Homes is much less stringent than the rules for qualifying for means-tested government benefit programs, such as Medical Assistance (Medicaid). On October 18, 2021, proposed changes were published by the Minnesota Department of Veteran Affairs which will affect eligibility for veterans.
One of the proposed changes is a requirement that to apply for admission, the applicant must rent, own, maintain or occupy a residence in Minnesota for the 90 days preceding application for benefits. The requirement also provides that the applicant may not rent, own, maintain or occupy a home in another state. This requirement adds an unnecessary 90-day wait to admission to the Veterans Home that does not currently exist. At homes such as the Minneapolis Veterans Home, which currently has a wait list of 12-48 months for applicants, this creates an unreasonable delay in placement. For veterans who reside out of state for part of the year, they may not have the ability to predict when they will need long-term care services. This would prevent them from receiving care at the Minnesota Veterans home and effectively penalize them for having property outside of Minnesota by causing them to have to privately pay for their needed care for 90 days before they could be admitted to a Veterans Home.
Life estates have had a complicated history in the Medical Assistance context in Minnesota. A life estate is a real estate arrangement where interests in time are divided. The life tenant in a life estate holds the right to use, occupy and possess the property subject to the life estate for their lifetime. The remaining interest holder of the property holds the right to inherit the property on the death of the life tenant. The proposed rules attempt to carry Medical Assistance treatment of life estates into the Veterans Home eligibility criteria. The new rules proposed to value life estates for proportion of ownership based upon the tables used by the Department of Human Services Minnesota Health Care Programs Eligibility Policy Manual. For every other context except qualifying for Medical Assistance or Supplemental Security Income, life estates are valued according to the IRS’s actuarial tables. By adopting the valuation used under Medical Assistance, the life estate has an artificially high valuation.
Non-Saleable Property Eliminated
Currently, property that the applicant did not have the ability to sell was labeled as unsaleable and was considered unavailable for eligibility purposes for the Veterans Home. The proposed rules now require that real property not sold within six months of admission must continually be listed for sale until the property is sold. There is no process for when a property would be considered unsaleable – it is now left solely in the discretion of the financial staff to make a determination on whether property owned by two or more people could be liquidated to cash by the applicant. This ignores complex property ownership situations, such as joint tenants of cabin or farm property with multiple other owners, or life estates, where there is not a market for these properties. It creates an undue burden for the applicant in listing the property for sale where no sale is possible.
Spousal Income Allowance
For married couples, the spouse who is not seeking admission may have some of the income of the resident spouse allocated to them on a monthly basis if their own income is insufficient to meet their basic needs. Qualification for this allocation is not tied to the assets of the spouse, but solely based on their income. The proposed rules seek to apply the asset limits set under the Veterans Administration pension program with Aid and Attendance. This would require that the spouse in need of the applicant’s income to support their basic needs have a net worth of less than $130,773 (as of 2021). This is significantly more restrictive than the current rules provide. The Aid and Attendance pension benefit is typically insufficient to pay for care at a skilled nursing facility, which is the level of care provided by the Veterans Homes, so borrowing from the rules applicable to this benefit for eligibility seems illogical.
Discharge of Resident
The proposed rules also expand the grounds for involuntary discharge of a resident, or eviction. Grounds are expanded for willful or deliberate disregard for the facility’s regulatory requirements or policies, and willful or deliberate disregard for state or federal laws, rules and regulations. These grounds are very broad and are not connected to existing grounds for discharge under Minnesota nursing home law. There is additional no requirement for a medical assessment or the safety of other residents. There is no allowance for residents with diminished capacity or cognitive impairment and their ability to understand the rules. This lacks adequate protections for residents in the discharge grounds, leaving too much to the interpretation of the Minnesota Department of Veterans Affairs.
The proposed rules may be found here.
These rules have not been finalized yet. If they are finalized in their current form, they will greatly affect Minnesota’s veterans’ ability to receive care at the Veterans Home. If you, or your family will be affected by this ruling, you are encouraged to submit comments to the Office of Administrative Hearings Rulemaking eComments website, and also to request a hearing on these proposed rules.
The public has until 4:30 p.m. on Tuesday November 23, 2021, to submit written requests for a hearing to the Office of Administrative Hearings. Requests can be submitted on the eComments website, or in person, via United States mail, or by facsimile addressed to ALJ Jessica Palmer-Denig at the Office of Administrative Hearings, 600 North Robert Street, P.O. Box 64620, Saint Paul, MN 55164-0620 or at 651-539-0310 (fax). If sufficient requests for public hearing are received, it will be held on Tuesday, December 7, 2021, at 9:30 a.m. via Microsoft Teams.