Incomplete VA Form By the Assisted Living Facility.

are specific statements an Assisted Living Facility needs to include on VA Form
21-0779. This Form is actually a nursing home affidavit but can be used by an
Assisted Living Facility.

of using the Form, the Facility can write a letter containing all the required

the Facility uses the Form or its own letter, it should confirm that the
Facility is providing a protective environment.  The problem with VA
Form 21-0779 is that there is no space for the details.  Therefore, an
attachment to the Form with the details should be prepared and signed. 

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Handbook – Veteran’s Benefits
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Posted on: 2 Comments

2 Responses

  1. Rita Files says:

    If an assisted living facility uses the form, what is the best way to communication that it’s not a nursing home? Do you suggest the form over the letter?

  2. We are recommending our clients, request the ALF, to submit a letter on their letterhead and only send the 21-0779 if it is requested. A lot of ALF directors are refusing to complete this form, because it is for nursing homes and they do not want to have problems with their state agencies coming back and saying that they are promoting themselves as a skilled facility.
    Hopefully, the VA will produce a new ALF form by January, if not, I may create one similar to the 21-0779.

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