**GAO-09-145**                      Published: Jan 23, 2009. Publicly Released: Jan 23, 2009.                  

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## Highlights

In fiscal year 2007, the Department of Veterans Affairs (VA) spent about $4.1 billion on long-term care for veterans. VA provides--through VA or other providers--institutional care in nursing homes and noninstitutional care in veterans' homes or the community. In response to a statute, VA published in 2007 a long-term care strategic plan through fiscal year 2013. VA includes long-term care spending estimates in its annual budget justifications for Congress. These estimates are based on workload projections--the amount of care to be provided--and cost assumptions. VA has discretion in allocating appropriated funds among its medical services, such as long-term care. GAO examined (1) VA's reporting of planned workload in its 2007 long-term care strategic plan and (2) VA's long-term care spending estimates, including its cost assumptions and workload projections, in VA's fiscal year 2009 budget justification. GAO analyzed budget and planning documents and interviewed VA officials.

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## Topics

Veterans

Budget functionsBudget obligationsBudget outlaysConfidential communicationsCost analysisFunds managementFuture budget projectionsHealth care facilitiesHealth care planningHealth care programsHealth care reformHealth care servicesHealth resources utilizationHome health care servicesLong-term careNursing homesStrategic planningVeteransVeterans hospitalsVeterans' medical careCost awarenessCost estimates