Long Term Care Screening Procedures & Application Process
If you or someone in your family needs nursing facility care or personal care in the home and cannot afford the cost, you may be eligible for to have this service covered by Medicaid. You can apply for Medicaid online or at your local Department of Social Services.
Prescreening is the preauthorization of Medicaid payment for covered Long Term Care services. A nurse from the local Health Department and an adult service worker visit the patient at home to assess the level of care that the patient needs. This information is given to the local Health Department director and a decision is made as to whether or not long term care is necessary and cost efficient. The prescreening process may be completed by a hospital screening committee if the person is in an acute care hospital at the time the placement is needed. Individuals at risk of nursing facility placement have several Home and Community-Based Care Waiver options available to them, in addition to placement in a nursing facility. See Medicaid Options for Care.
Children are eligible to receive services under the EDCD waiver provided they meet the same qualifications as all other individuals. See Screenings for Children.
The nursing facility or personal care provider must be a Medicaid provider. If the individual is in a nursing home, he or she must be in a Medicaid certified bed. (Go to the DMAS Web site for a listing of Medicaid providers).
Steps in the Screening Process
- Request a screening for nursing home, personal care, adult day care, etc. by calling Service Intake at 501-7346.
- A Henrico County DSS social worker will coordinate an appointment time with a nurse from the Health Department. The social worker will contact the family to confirm the appointment time to visit and complete the screening.
- It is helpful to have a family member or caregiver present during the screening visit due to volume of information needed for application.
- After the screening and the visit are completed, the original screening forms will be forwarded to the Henrico County Health Department.
- If approved, you will choose a provider from the “Medicaid approved Providers” list. Contact agencies on the list to determine who can best meet your needs. The provider will then discuss whether or not an aide is available, how many hours they can provide, etc.
- After choosing an agency, contact the Health Department at 501-4648 and have them forward the original screening forms to the nursing home, personal care agency, or adult daycare of their choice.