TriWest Contracting Eligibility
Eligibility is based upon an Evaluation (Document provide by VA Portland Health Care System)
Eligibility is based upon an Evaluation for the following:
1. Medical need for skilled nursing care, which must include a component of physical, occupational or speech therapy.
2. Service connection (SC) of a single category rating of 60% with individual unemployability OR 70%-100% SC, OR need for skilled care for a SC condition.
Placement under a Triwest community care contract, means you will have an extended set of placement options in the Community outside the Traditional VA Community Nursing Home Program. An updated list of locations can be provided after your contracting eligibility has been evaluated and you have been determined eligible. This provision allows for only 100 days of skilled rehab care per calendar year.
Veteran / Family Responsibility in Accepting Triwest
If at any point in your placement at a facility under TriWest and your need for physical, occupation or speech therapy comes to an end, where a d/c home or to lower level of care is not possible, it is highly suggested you request a transfer to a VA-contracted community nursing home, if your current location is not also a VA CNH facility.
The VA cannot guarantee you bed availability at a VA CNH facility for long term care. We can make sure you have the most updated list of available options for referral should you need to transition to a new facility. This may result in your need to apply for Medicaid or pay privately.