§ 5503. Hospitalized veterans and estates of incompetent institutionalized veterans

§ 5503. Hospitalized veterans and estates of incompetent institutionalized veterans

(a)

(1)

(A) Where any veteran having neither spouse nor child is being furnished domiciliary care by the Department, no pension in excess of $90 per month shall be paid to or for the veteran for any period after the end of the third full calendar month following the month of admission for such care.

(B) Except as provided in subparagraph (D) of this paragraph, where any veteran having neither spouse nor child is being furnished nursing home care by the Department, no pension in excess of $90 per month shall be paid to or for the veteran for any period after the end of the third full calendar month following the month of admission for such care. Any amount in excess of $90 per month to which the veteran would be entitled but for the application of the preceding sentence shall be deposited in a revolving fund at the Department medical facility which furnished the veteran nursing care, and such amount shall be available for obligation without fiscal year limitation to help defray operating expenses of that facility.

(C) No pension in excess of $90 per month shall be paid to or for a veteran having neither spouse nor child for any period after the month in which such veteran is readmitted for care described in subparagraph (A) or (B) of this paragraph and furnished by the Department if such veteran is readmitted within six months of a period of care in connection with which pension was reduced pursuant to subparagraph (A) or (B) of this paragraph.

(D) In the case of a veteran being furnished nursing home care by the Department and with respect to whom subparagraph (B) of this paragraph requires a reduction in pension, such reduction shall not be made for a period of up to three additional calendar months after the last day of the third month referred to in such subparagraph if the Secretary determines that the primary purpose for the furnishing of such care during such additional period is for the Department to provide such veteran with a prescribed program of rehabilitation services, under chapter 17 of this title, designed to restore such veteran’s ability to function within such veteran’s family and community. If the Secretary determines that it is necessary, after such period, for the veteran to continue such program of rehabilitation services in order to achieve the purposes of such program and that the primary purpose of furnishing nursing home care to the veteran continues to be the provision of such program to the veteran, the reduction in pension required by subparagraph (B) of this paragraph shall not be made for the number of calendar months that the Secretary determines is necessary for the veteran to achieve the purposes of such program.

(2) The provisions of paragraph (1) shall also apply to a veteran being furnished such care who has a spouse but whose pension is payable under section 1521(b) of this title. In such a case, the Secretary may apportion and pay to the spouse, upon an affirmative showing of hardship, all or any part of the amounts in excess of the amount payable to the veteran while being furnished such care which would be payable to the veteran if pension were payable under section 1521(c) of this title.

(b) Notwithstanding any other provision of this section or any other provision of law, no reduction shall be made in the pension of any veteran for any part of the period during which the veteran is furnished hospital treatment, or institutional or domiciliary care, for Hansen’s disease, by the United States or any political subdivision thereof.

(c) Where any veteran in receipt of an aid and attendance allowance described in subsection (r) or (t) of section 1114 of this title is hospitalized at Government expense, such allowance shall be discontinued from the first day of the second calendar month which begins after the date of the veteran’s admission for such hospitalization for so long as such hospitalization continues. Any discontinuance required by administrative regulation, during hospitalization of a veteran by the Department, of increased pension based on need of regular aid and attendance or additional compensation based on need of regular aid and attendance as described in subsection (l) or (m) of section 1114 of this title, shall not be effective earlier than the first day of the second calendar month which begins after the date of the veteran’s admission for hospitalization. In case a veteran affected by this subsection leaves a hospital against medical advice and is thereafter admitted to hospitalization within six months from the date of such departure, such allowance, increased pension, or additional compensation, as the case may be, shall be discontinued from the date of such readmission for so long as such hospitalization continues.

(d)

(1) For the purposes of this subsection—

(A) the term “Medicaid plan” means a State plan for medical assistance referred to in section 1902(a) of the Social Security Act (42 U.S.C. 1396a(a)); and

(B) the term “nursing facility” means a nursing facility described in section 1919 of such Act (42 U.S.C. 1396r), other than a facility that is a State home with respect to which the Secretary makes per diem payments for nursing home care pursuant to section 1741(a) of this title.

(2) If a veteran having neither spouse nor child is covered by a Medicaid plan for services furnished such veteran by a nursing facility, no pension in excess of $90 per month shall be paid to or for the veteran for any period after the month of admission to such nursing facility.

(3) Notwithstanding any provision of title XIX of the Social Security Act, the amount of the payment paid a nursing facility pursuant to a Medicaid plan for services furnished a veteran may not be reduced by any amount of pension permitted to be paid such veteran under paragraph (2) of this subsection.

(4) A veteran is not liable to the United States for any payment of pension in excess of the amount permitted under this subsection that is paid to or for the veteran by reason of the inability or failure of the Secretary to reduce the veteran’s pension under this subsection unless such inability or failure is the result of a willful concealment by the veteran of information necessary to make a reduction in pension under this subsection.

(5)

(A) The provisions of this subsection shall apply with respect to a surviving spouse having no child in the same manner as they apply to a veteran having neither spouse nor child.

(B) The provisions of this subsection shall apply with respect to a child entitled to pension under section 1542 of this title in the same manner as they apply to a veteran having neither spouse nor child.

(6) The costs of administering this subsection shall be paid for from amounts available to the Department of Veterans Affairs for the payment of compensation and pension.

(7) This subsection expires on November 30, 2031.

(Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1234, § 3203; Pub. L. 86–146, §§ 1(b), 2, Aug. 7, 1959, 73 Stat. 298; Pub. L. 86–211, § 6, Aug. 29, 1959, 73 Stat. 435; Pub. L. 87–544, § 1, July 25, 1962, 76 Stat. 208; Pub. L. 87–556, § 1, July 27, 1962, 76 Stat. 245; Pub. L. 87–645, § 2(b), Sept. 7, 1962, 76 Stat. 441; Pub. L. 88–450, § 5(a), Aug. 19, 1964, 78 Stat. 504; Pub. L. 89–362, §§ 1, 2, Mar. 7, 1966, 80 Stat. 30; Pub. L. 91–24, § 10, June 11, 1969, 83 Stat. 34; Pub. L. 92–328, title I, § 104, June 30, 1972, 86 Stat. 394; Pub. L. 93–177, § 5, Dec. 6, 1973, 87 Stat. 696; Pub. L. 95–588, title III, § 307, Nov. 4, 1978, 92 Stat. 2510; Pub. L. 96–385, title V, § 503(b), Oct. 7, 1980, 94 Stat. 1534; Pub. L. 97–66, title VI, § 602, Oct. 17, 1981, 95 Stat. 1034; Pub. L. 98–160, title VII, § 703(4), Nov. 21, 1983, 97 Stat. 1010; Pub. L. 98–543, title IV, § 402(a), Oct. 24, 1984, 98 Stat. 2749; Pub. L. 99–576, title VII, § 701(77), Oct. 28, 1986, 100 Stat. 3298; Pub. L. 101–237, title I, § 111(a), Dec. 18, 1989, 103 Stat. 2064; Pub. L. 101–508, title VIII, § 8003(a), Nov. 5, 1990, 104 Stat. 1388–342; renumbered § 5503 and amended Pub. L. 102–40, title III, § 304(a), title IV, § 402(b)(1), May 7, 1991, 105 Stat. 209, 238; Pub. L. 102–83, §§ 4(a)(2)(A)(x), (3), (4), (b)(1), (2)(E), 5(c)(1), Aug. 6, 1991, 105 Stat. 403–406; Pub. L. 102–86, title I, § 101(a), Aug. 14, 1991, 105 Stat. 414; Pub. L. 102–568, title VI, § 601(a)–(c), Oct. 29, 1992, 106 Stat. 4341; Pub. L. 103–66, title XII, § 12005, Aug. 10, 1993, 107 Stat. 414; Pub. L. 105–33, title VIII, § 8015, Aug. 5, 1997, 111 Stat. 664; Pub. L. 105–368, title IX, § 904(a), Nov. 11, 1998, 112 Stat. 3361; Pub. L. 106–419, title III, § 304, title IV, § 402(e), Nov. 1, 2000, 114 Stat. 1853, 1863; Pub. L. 107–103, title II, § 204(a), title V, § 504, Dec. 27, 2001, 115 Stat. 990, 995; Pub. L. 111–275, title VI, §§ 601(b)(2), 606, 607, Oct. 13, 2010, 124 Stat. 2884, 2886; Pub. L. 112–56, title II, § 262, Nov. 21, 2011, 125 Stat. 732; Pub. L. 112–260, title II, § 203, Jan. 10, 2013, 126 Stat. 2424; Pub. L. 113–146, title VII, § 703, Aug. 7, 2014, 128 Stat. 1797; Pub. L. 115–46, title IV, § 401, Aug. 12, 2017, 131 Stat. 969; Pub. L. 115–182, title V, § 509, June 6, 2018, 132 Stat. 1480; Pub. L. 116–315, title II, § 2013, Jan. 5, 2021, 134 Stat. 4980; Pub. L. 117–333, § 16, Jan. 5, 2023, 136 Stat. 6135.)

Editorial Notes

References in Text

The Social Security Act, referred to in subsec. (d)(3), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Title XIX of the Act is classified generally to subchapter XIX (§ 1396 et seq.) of chapter 7 of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see section 1305 of Title 42 and Tables.

Amendments

2023—Subsec. (d)(7). Pub. L. 117–333 substituted “November 30, 2031” for “October 30, 2028”.

2021—Subsec. (d)(7). Pub. L. 116–315 substituted “October 30, 2028” for “September 30, 2028”.

2018—Subsec. (d)(7). Pub. L. 115–182 substituted “September 30, 2028” for “September 30, 2027”.

2017—Subsec. (d)(7). Pub. L. 115–46 substituted “September 30, 2027” for “September 30, 2024”.

2014—Subsec. (d)(7). Pub. L. 113–146 substituted “September 30, 2024” for “November 30, 2016”.

2013—Subsec. (d)(7). Pub. L. 112–260 substituted “November 30, 2016” for “September 30, 2016”.

2011—Subsec. (d)(7). Pub. L. 112–56 substituted “September 30, 2016” for “May 31, 2015”.

2010—Subsec. (c). Pub. L. 111–275, § 601(b)(2), substituted “in subsection (r) or (t) of section 1114” for “in section 1114(r)”.

Subsec. (d)(5). Pub. L. 111–275, § 606, designated existing provisions as subpar. (A) and added subpar. (B).

Subsec. (d)(7). Pub. L. 111–275, § 607, substituted “May 31, 2015” for “September 30, 2011”.

2001—Subsecs. (b), (c). Pub. L. 107–103, § 204(a), redesignated subsecs. (d) and (e) as (b) and (c), respectively, and struck out former subsecs. (b) and (c), which read as follows:

“(b)(1)(A) In any case in which a veteran having neither spouse nor child is being furnished hospital treatment or institutional or domiciliary care without charge or otherwise by the United States, or any political subdivision thereof, is rated by the Secretary in accordance with regulations as being incompetent, and the veteran’s estate (excluding the value of the veteran’s home unless there is no reasonable likelihood that the veteran will again reside in such home), from any source equals or exceeds the amount equal to five times the section 1114(j) rate, further payments of pension, compensation, or emergency officers’ retirement pay shall not be made until the estate is reduced to one-half that amount.

“(B) The amount which would be payable but for this paragraph shall be paid to the veteran in a lump sum; however, no payment of a lump sum herein authorized shall be made to the veteran until after the expiration of six months following a finding of competency and in the event of the veterans’ death before payment of such lump sum no part thereof shall be payable.

“(C) The Secretary may waive the discontinuance under this paragraph of payments to a veteran with respect to not more than 60 days of care of the veteran during any calendar year if the Secretary determines that the waiver is necessary in order to avoid a hardship for the veteran. Any such waiver shall be made pursuant to regulations which the Secretary shall prescribe.

“(D) For purposes of this paragraph, the term ‘section 1114(j) rate’ means the monthly rate of compensation in effect under section 1114(j) of this title for a veteran with a service-connected disability rated as total.

“(2) Where any benefit is discontinued by reason of paragraph (1) of this subsection the Secretary may nevertheless apportion and pay to the dependent parents of the veteran on the basis of need all or any part of the benefit which would otherwise be payable to or for such incompetent veteran. Paragraph (1) of this subsection shall not prevent the payment, out of any remaining amounts discontinued under that paragraph, on account of any veteran of so much of the veteran’s pension, compensation, or retirement pay as equals the amount charged to the veteran for the veteran’s current care and maintenance in the institution in which treatment or care is furnished the veteran, but not more than the amount determined by the Secretary to be the proper charge as fixed by any applicable statute or valid administrative regulation.

“(3) All or any part of the pension, compensation, or retirement pay payable on account of any incompetent veteran who is being furnished hospital treatment, institutional or domiciliary care may, in the discretion of the Secretary, be paid to the chief officer of the institution wherein the veteran is being furnished such treatment or care, to be properly accounted for by such chief officer and to be used for the benefit of the veteran.