At the Alexander Nininger Jr. State Veterans Nursing Home in west Pembroke Pines, most everything has an order and purpose to it. The lobby that greets friends and family is largely unadorned, save for a poster on a coffee table advertising the upcoming Veterans Day and a binder devoted to the home’s namesake, a 23-year-old Army second lieutenant who was the first Medal of Honor recipient of World War II.
Past the lobby, a calendar displays the scheduled events residents can choose to take part in, everything from Tai-Chi to pet therapy and a book club. Donated military uniforms from the local historical society line the wall as residents watch movies in black and white. Memorabilia sits in display cases — leather-bound journals, a pair of aviator goggles and a Congressional Gold Medal. The residents started offering them as donations about two years ago.
“It grants you some immortality,” said Larry Militello, a decade into his tenure as the nursing home’s administrator, looking down at the dozens of keepsakes. “You may be gone tomorrow, but this will still be here.”
The nursing home on Pines Boulevard and University, one of six in the state exclusively for veterans, houses 120 people — about 116 men and four women. Currently, about eight or nine people are on the wait list.
The nursing home is marking Veterans Day, this weekend, with several parties and events.
Girl Scouts and Boy Scouts will come by to entertain. This year’s Veterans Day carries special meaning, marking 100 years since the armistice that ended World War I. The holiday was originally known as Armistice Day.
Florida, the nation’s third most populous state, is home to the third-highest population of veterans, about 1.5 million. The numbers have fallen slightly in recent years as the Greatest Generation — those who fought World War II — have faded away. Today, those who fought in Vietnam make up about a third of Florida’s veterans. As they age, their medical costs rise.
Adjusted for inflation, spending on Florida veterans’ medical care nearly doubled over the past decade, growing from $2.9 billion to $5.7 billion, according to the U.S. Department of Veterans Affairs.
The needs are many, with drug abuse and depression serious issues. Florida’s veterans’ suicide rate, 34 per every 100,000 veterans, was slightly above the national average for veterans of 30 in 2016. But that’s twice the rate of the population overall.
A 2014 report shows that the portion of spending on mental health treatment at VA facilities rose from about 9 percent of the pie in 2007 to just above 11 percent in 2013.
Half of Florida’s veterans are 65 years or older. Because the population is graying, the state started an initiative four or five years ago to add more veterans nursing homes, said Steve Murray, a spokesman for Florida’s Department of Veterans’ Affairs, which operates and finances the homes. Each of the six existing homes can take 120 residents. The one veterans assisted living center in Lake City can care for 150 residents.
Two new nursing homes are being built, Murray said. The one in Orlando — slated to open in late 2019 — will add 114 beds. The home in Port St. Lucie — scheduled to open in early 2020 — will add 120 beds.
In order to enter a state veterans nursing home, veterans need to be a Florida resident, have received an honorable discharge and have a letter of certification from a VA doctor that he or she qualifies. The amount a person must pay depends on his or her circumstances, Murray said.
Building more veterans nursing homes is costly, Murray said. Each requires about $50 million for construction, plus 165 staffers to provide medical care, laundry services, food preparation and activity planning. Because of that, it makes sense economically to partner with existing, privately run facilities.
Florida has doubled down on its effort to help expand the number of adult day care options for veterans. The U.S. Department of Veterans Affairs provides a per diem to facilities that offer these services.
Murray said many veterans prefer to stay in their own homes as they age, and adult day care gives loved ones caring for a veteran a reprieve, enabling them to go to work.
“No state will have enough veteran nursing homes,” he said. “No state has the resources.”
At the Miami VA, there’s been a steady effort to add more local adult day care services to the VA’s network, said spokesman Shane Suzuki. The Miami VA sees mostly Vietnam, Korean War and World War II veterans, although that will change with the passage of time. In the past year, of the 57,000 patients served by the Miami VA, about 6,000 were deployed in Iraq or Afghanistan.
Suzuki said Veterans Affairs is noticing a demographic shift as more female veterans come in for services. Because of that, the Miami VA is opening an expanded women’s health center in mid-2019 at the main hospital near the Jackson Memorial complex. That will centralize women’s services in one area instead of having them spread throughout the hospital.
The Miami VA is also working on expanding its South Dade clinic from 7,000 square feet to 30,000 square feet. The VA is currently looking for space for that expansion as more veterans are moving to the area.
Militello said the state doesn’t spare resources when taking care of its veterans. Having come from operating private-sector nursing homes, he said he’s never had a problem getting funding for items his residents need.
Though he himself didn’t serve in the armed forces, he’s gained a greater appreciation for what it means for someone to have served his or her country.
“We owe them a great debt,” Militello said. “ We call them the Greatest Generation — they were the gutsiest generation.”