Department of Medical Assistance Services
SCREENING FOR LONG TERM CARE SERVICES AND SUPPORTS (LTSS)
Long term Care picture

Overview

Medicaid Screenings for Long-Term Services and Supports

In 1982, § 32.1-327.2 (re-codified at § 32.1-330) of the Code of Virginia was revised to require preadmission screening (PAS) for all individuals requesting Medicaid Long-term Services and Supports (LTSS) which includes home and community-based services (HCBS) or institutional long-term care. Medicaid LTSS Screening is the first level of authorization for Medicaid reimbursement for nursing facility level-of-care, Commonwealth Coordinated Care Plus (CCC Plus) waiver, and Program for All-inclusive Care for the Elderly (PACE).

Screening ensures Medicaid-eligible individuals, and those who will become eligible for Medicaid within six months, meet the required level of care criteria. This criteria is based on the degree of support needed to perform activities of daily living (ADL); whether the individual has medical or skilled nursing needs; and is “at risk” for nursing facility admission within 30 days of the screening in the absence of services (42CFR§441.302). Screening is conducted by hospital staff at discharge and by community-based teams including staff from local departments of social services and health.

DMAS has strengthened the screening process by developing an automated screening submission and claims process. In collaboration with the Virginia Department of Health (VDH) and the Department for Aging and Rehabilitative Services (DARS), DMAS developed an electronic preadmission screening system called ePAS that eliminated paper forms associated with the PAS process, including the UAI, and included an electronic claims submission process for Medicaid reimbursement to the screening entities. The system enables DMAS to track the time between a request for a screening and completion of that screening as well as whether an individual chooses a nursing facility or community-based program for services.

Effective September 1, 2016, emergency regulations created the framework for defining and managing the screening process. Development of the final regulatory package is in process with anticipated completion by August 2018.

Screening For LTSS General Information & Resources
Bullett CCC Plus and Electronic Screening Update
Bullett Virginia PASRR Training – December 2015
Bullett User Guide for Tableau – A Tool to manage PAS performance
UAI USER'S MANUAL AND OTHER RELATED MANUALS
Screeners may visit the Virginia Department of Social Services (VDSS) website to access the UAI Users' Manual.