Attention A T users. To access the menus on this page please perform the following steps. 1. Please switch auto forms mode to off. 2. Hit enter to expand a main menu option (Health, Benefits, etc). 3. To enter and activate the submenu links, hit the down arrow. You will now be able to tab or arrow up or down through the submenu options to access/activate the submenu links.

Geriatrics and Extended Care

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State Veteran Home 10-10SH

Welcome to the access site for completion and submission of the web-based online 10-10SH form for State Veterans Homes and VA Medical Centers.

Click here or on the image below to access the online 10-10SH form or follow the instructions below to access the PDF.

Logo for 10-10SH modernization program

If you are a State Veterans Home or VA employee, to open this PDF document - Automated 10-10SH Form (Version 3.7.17) - right click the form and "save the link as" onto your computer. Then open the document from your computer (not the browser) with Adobe Reader or Adobe Acrobat. When you have opened it, click on Enable all Features. Next, enter your full name and credentials, e.g., John Smith, MD and either the last 4 digits of your Social Security Number (SSN) or the 4 digits of your Employee Identification Number.

Users can also access the Automated Training PDF for additional guidance - Training Presentation for the Automated 10-10SH Form (Version 3.7.14) 

Please note we will be provisioning all State Veteran Homes and VA medical centers users on the online 10-10SH in the very near future.

For questions please email: VHA12GECStateHomePerDiemInquiries@va.gov