THE OMEGA HOUSE in Houghton. The U.S. Department of Veterans Affairs is no longer picking up the cost of room and board at the house but will continue to cover hospice services. (Ben Garbacz/Daily Mining Gazette photo)

HOUGHTON — The U.S. Department of Veterans Affairs will no longer cover room and board costs at Omega House for veterans in hospice care.

Hospice services will continue to be covered by the VA but after audits were conducted it was discovered VA transactions for room and board were in violation of two U.S. codes.

Whenever veterans were in need of hospice care and Canal View had no vacancies, Omega House would take in the veterans if they had vacancies. The expenses were then covered by the VA.

This had occurred for more than six years until late December, when Omega House Executive Director Michael Lutz received a call from the Oscar G. Johnson Medical Facility in Iron Mountain. The medical facility informed him of the audits and that room and board would not be covered beginning in January.

Although the Iron Mountain hospital informed Lutz of this, the decision to cease the funding did not come from the specific hospital but further up within Veterans Affairs.

When this had transpired, there was much anxiety and worry throughout the community, with Lutz saying that Omega House would typically serve about a dozen veterans a year. He said this has put lots of pressure on families who are looking for care for veterans in need of hospice.

“Now if Canal View is full, these veterans are faced with going to Iron Mountain or Iron River to approved facilities in that area if they have an opening,” Lutz said. “And if they don’t, then these residents or veterans are actually looking at maybe going into Wisconsin.”

Lutz explained that this can become even more distressful for families who cannot afford to travel longer distances but also have less time to spend with their loved one during the end of his or her life.

“It’s possible that these veterans end up dying alone away from family, whereas, if they could be kept in the community that they live in, families can visit and pay their respects. So we feel that’s not the best way to treat our veterans by sending them out of the area,” he said.

Director of the Houghton County Veterans Service Office Joseph Battisfore said his office was informed in mid-January that veterans would no longer receive the coverage. He was also informed of the coding issue and was told the Veterans Health Administration came to understand that they were never authorized to pay for the inpatient hospice room and board.

“I think this may have something to do with the requirements for long-term care facilities, such as for Canal View, because they do obviously more than hospice care,” Battisfore said. “They provide long-term care, and the requirements for them to have a contract with the Veterans Health Administration are much more stringent, and that’s because it’s a different type of level of care.”

Battisfore said the Veterans Health Administration has very stringent requirements for long-term care facilities in order to be contracted with them. He said that facilities can have difficulties rising to the accepted level of care and explained that for a veteran to become eligible for long-term health care such as a nursing home that they have to be rated by the Veterans Benefit Administration at 70% or more for service connected disability.

“So there’s a much larger population that are eligible for that benefit, and that benefit’s type of care is different,” Battisfore explained. “Long-term care is focused on medical interventions and requires a lot more staffing. Canal View does an excellent job at that and also at the hospice, but facilities like Omega are a little quieter, and they’re completely focused on final care and comfort for not only for the veteran, but for providing an environment for the family as well.”

The two codes that were violated — 38 U.S. Code 1720 Transfers for nursing home care, adult day health care; and 38 U.S. Code 1730 Community residential care — both refer to residential care of veterans and acceptable expenses.

The 38 U.S. Code 1720 states the VA can cover room and board essentially only at nursing homes and 38 U.S. Code 1730 infers that the VA cannot pay for residential or very limited custodial and residential services.

These codes prevent Omega House from having room and board covered, but there is hope this can be changed through the government, with both Lutz and Battisfore reaching out to both state Rep. Greg Markkanen, R-Hancock, and U.S. Rep. Jack Bergman, R-Watersmeet.

Lutz and Battisfore said both Markkanen and Bergman were receptive to their pleas and both have made this issue a priority. Lutz and Battisfore both acknowledged the process will likely be lengthy but urged citizens to contact their representatives and request change to the law that will allow hospice facilities like Omega House to have room and board covered.

It is unlikely that Omega House is the only facility affected in this way, and this could actually be a national issue which will gain further attention from the federal government.

The word has spread about this issue, with a veteran inquiring about the situation at a VA meeting going over medical benefits, services and the state of the Iron Mountain VA Medical Center at the Chassell VFW hall in mid-February.

During that meeting, the reasons behind the room and board funds ceasing were revealed to the veterans who attended, with the speakers encouraging them to contact their local representatives to change the codes.

Medical Center Director for the Oscar G. Johnson VA Medical Center John Shealey expressed that he wished the VA could continue to cover the room and board at Omega House, but expenses must be spent in a way that is legally compliant.

“We are committed to taking care of veterans in the best way possible and giving them the most comprehensive care possible,” Shealey said. “We really value our veterans of the Upper Peninsula and northeastern Wisconsin. We have to be careful, because we’ve got to be able to prove care but also have to stay within the combines of the law.”

Omega House will continue to service veterans and their families, but room and board cost will be determined after potential discounts are explored via financial aid forms. Typical daily rates are $310 before discounts.