Overview
VA provides an extensive array of long-term care (LTC) to veterans. VA
provides institutional long term care to veterans through VA Nursing Homes,
Community Nursing Homes, State Veteran Homes, and Domiciliaries. VA also
provides assistance to some veterans through the Community Residential
Care program. Other services offered in both inpatient and outpatient settings
include Hospice, Respite Care, and Geriatric Evaluation and Management
(GEM). Other outpatient LTC services provided by VA include Home Based
Primary Care, Community Home Health Care, Adult Day Health Care, and Homemaker/
Home Health Aide Services.
Eligible veterans can also receive some LTC services through Medicare.
Medicare provides Community Home Health Care, Community Nursing Home, and
Hospice services.
Because of the wide variety of venues for the delivery of LTC services,
there is no single database for all LTC services provided to veterans.
Instead, data are located in various databases. Table 1 summarizes the
types of long-term care services available to veterans, as well as where
data can be found. Table 2 contains a summary of the databases that contain
LTC data, how to access the database, and which LTC services it includes.
It is important to note that in some cases, data integrity may be in question.
For example, not all veterans in a State Veterans Home are found in the
Fee Basis files, nor are all those in Community Nursing Homes found in
the Medical SAS Inpatient: Extended file. Although all HBPC visits should
be recorded in both the Medical SAS Outpatient and HBPC visit files, about
10% are found in only the Medical SAS Outpatient file or the HBPC visit
file. Hospice and respite care are identified through ICD-9 codes, but
often the code is not listed in the patient's record. VIReC is working
to provide researchers with information about the accuracy of LTC data
in these databases.
Table 1: Long Term Care Services
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|
Service |
Type of Service |
Payment Source |
Datasets Including the Service |
VA
Nursing Homes |
Inpatient |
VA |
Medical SAS Inpatient: Extended |
VA Nursing Home Census |
Resident Assessment Instrument - Minimum Data Set (RAI-MDS) |
Patient Assessment Files (PAF) |
Community Nursing Homes |
Inpatient |
VA Contract |
Medical SAS Inpatient: Extended |
Fee Basis |
Community Nursing Home Facilities |
State Homes |
Inpatient |
VA |
Fee Basis |
State |
No data currently available |
Domiciliary |
Inpatient |
VA |
Medical SAS Inpatient: Acute |
Medical SAS Inpatient: Extended |
Respite |
Inpatient |
VA |
Medical SAS Inpatient: Acute |
Medical SAS Inpatient: Extended |
Outpatient |
VA |
Medical SAS Outpatient |
Hospice |
Inpatient |
VA |
Medical SAS Inpatient: Acute |
VA Contract |
Fee Basis |
Outpatient |
VA |
Medical SAS Outpatient |
VA Contract |
Fee Basis |
Home Based Primary
Care (HBPC) |
Outpatient |
VA |
Medical SAS Outpatient |
Home Based Primary Care (HBPC) |
Community Home Health Care |
Outpatient |
VA Contract |
Fee Basis |
Adult
Day Health Care (ADHC) |
Outpatient |
VA |
Medical SAS Outpatient |
VA Contract |
Fee Basis |
Homemaker / Home Health Aide |
Outpatient |
VA Contract |
Fee Basis |
Community
Residential Care |
Residential |
VA / Private Pay |
Residential Home Care - Master |
Outpatient |
VA |
Medical SAS Outpatient |
Geriatric
Evaluation and Management (GEM) Unit |
Inpatient |
VA |
Medical SAS Inpatient: Acute |
Outpatient |
VA |
Medical SAS Outpatient |
Table 2: Long Term Care Datasets
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|
Dataset
|
Notes
|
Types of Care Included
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Medical SAS Inpatient:
Acute
|
Use BEDSECN , DBEDSECT (Bed Sections)
and diagnosis codes to identify LTC services.
|
Domiciliary
|
Respite |
Hospice |
GEM Unit |
Medical SAS Inpatient:
Extended
|
Use BEDSECN , DBEDSECT (Bed Sections), STATYP (Station
Type), and diagnosis codes to identify LTC services.
|
VA Nursing Home
|
Community Nursing Home |
Domiciliary |
Medical SAS
Outpatient
|
Use CL , CLC , CL1-CL15 (Clinic
Stops), and procedure codes to identify LTC services.
|
Hospice
|
Home Based Primary Care (HBPC) |
Adult Day Health Care (ADHC) |
GEM Unit |
Home Based Primary Care (HPBC)
|
Location at Austin Information Technology Center (AITC formerly: CFD; formerly: AAC):
RMTPRD.SYS.HBC.MASTER (Master file)
RMTPRD.SYS.HBC.VISITS (Visit file)
|
Home Based Primary Care (HBPC)
|
Fee Basis
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Use FPOV , PATTYPE , PAYCAT , PLSER , HCFATYPE , TRETYPE , LPAYTYP to
identify LTC services.
|
State Home
|
Community Nursing Home |
Hospice |
Community Home Health Care |
Homemaker/Home Health Aide |
Adult Day Health Care (ADHC) |
Community Nursing Home Facilities
|
Location at Austin Information Technology Center (AITC formerly: CFD; formerly: AAC): HCPPRD.CNH.R200.MASTER
This is a facility level file.
|
Community Nursing Home
|
VA Nursing Home Census
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Location at Austin Information Technology Center (AITC formerly: CFD; formerly: AAC): MDPPRD.MDP.SAS.CENSUS.Pmyy (1993-2003)
MDPPRD.MDP.SAS.FYyy.CENSUS (1985-1993)
|
VA Nursing Home
|
Residential Home Care - Master
|
Location at Austin Information Technology Center (AITC formerly: CFD; formerly: AAC): HCPPRD.RHC.R001.MASTER (Current Quarter
only)
This is a facility level file.
|
Community Residential Care
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Resident Assessment Instrument - Minimum Data Set (RAI-MDS)
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See VIReC's RAI-MDS Web page for details.
|
VA Nursing Home
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Patient Assessment Files (PAF)
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Location at Austin Information Technology Center (AITC formerly: CFD; formerly: AAC):
MDPPRD.MDP.SAS.mmmyy.PAF
Data for this database is no longer being collected (Available
for 1986-2000).
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VA Nursing Home
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Documentation
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VA Long Term Care: Programs
and Services is a three-volume guide published in August 1996
Now retained as VIReC historical documents
- Introduction
- Volume
I an overall description of the services and programs, existing databases
and how they may be accessed, issues of data quality and areas in which
the databases are incomplete, and a description of paper records and
local VAMC efforts to compile information on a particular program or
service.
- Volume
II a compendium of database file names, content statements, and value
labels (when available) for all databases identified in Volume I, and
a table comparing the variables available in each database.
- Volume
III a listing of relevant Health Services Research projects on VA LTC services,
including abstracts and bibliographies when available.
- An
Overview Of VA Long-Term Care Database And Information Resources was
published in September 2000 in VIReC Insights as an update
to the guide listed above.
VIReC is currently working to provide a current Research User Guide to
Long Term Care Data for Veterans.
LTC resources in the VA
Overviews of VA LTC
VHA Publications
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|
Directives
Handbooks
Manuals
Letters
Data Briefs
VHA Directives
VHA Handbooks
Back to VHA Publications
M-1, Part I, Chapter 3
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State
Veterans' Homes
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9-30-92
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M-1, Part I, Chapter 4
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Admissions
- Hospital and Domiciliary Care
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1-6-93
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M-1, Part I, Chapter 13
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Releases
from Inpatient Care
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4-8-93
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M-1, Part I, Chapter 18
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Outpatient
Care - Fee
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12-16-93
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M-1, Part I, Chapter 31
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Long-term
Care Patient Assessments
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11-13-91
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M-5, Part II, Chapter 1
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Nursing
Home Care (General)
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7-19-88
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M-5, Part II, Chapter 2
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VA
Nursing Home Care Unit
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7-19-88
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M-5, Part IV
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Domiciliary
Care
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12-6-90
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M-5, Part VIII
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State
Veterans Homes
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11-4-92
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M-5, Part IX
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Adult
Day Health Care
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4-18-94
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MP-6, Part XVI, Chapter 4
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New
PTF Coding Instructions for Patients in VA NHCU and Com. Nursing
Homes
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3-24-92
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MP-6, Part XVI, Chapter 5
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New
PTF Coding Instructions for Patients in VA Domiciliary
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3-24-92
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Data Briefs from Health
Care Financing & Economics (HCFE)
Back to VHA Publications
Help
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For additional support, please contact the VIReC
Help Desk or call VIReC at 708-202-2413.
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