Vol. 36 Iss. 7 - November 25, 2019

Chapter 60
Final Regulation

REGISTRAR'S NOTICE: The following regulatory action is exempt from Article 2 of the Administrative Process Act in accordance with § 2.2-4006 A 4 c of the Code of Virginia, which excludes regulations that are necessary to meet the requirements of federal law or regulation provided such regulations do not differ materially from those required by federal law or regulation.

Title of Regulation: 12VAC30-60. Standards Established and Methods Used to Assure High Quality Care (amending 12VAC30-60-306).

Statutory Authority: § 32.1-325 of the Code of Virginia; 42 USC § 1396 et seq.

Effective Date: December 25, 2019.

Agency Contact: Emily McClellan, Regulatory Supervisor, Policy Division, Department of Medical Assistance Services, 600 East Broad Street, Suite 1300, Richmond, VA 23219, telephone (804) 371-4300, FAX (804) 786-1680, or email

Background: Federal law requires that individuals seeking nursing facility placement be screened prior to admission in order to determine if the nursing facility placement is medically appropriate. For a hospital discharging a Medicaid member to a nursing facility, Virginia regulations currently permit up to three days after a Medicaid member's discharge for the hospital to submit the required nursing facility screening forms via the electronic screening portal. This three-day period creates potential lag between the Medicaid member's hospital discharge and admission to a nursing facility.


The amendment removes the option for a hospital to take three days to complete the required screening of a Medicaid member prior to a member's admission to a nursing facility so that the nursing facility can directly admit Medicaid members and fully comply with federal screening requirements.

12VAC30-60-306. Submission of screenings.

A. The screening entity shall complete and submit the following forms to DMAS electronically via ePAS:

1. DMAS-95 - MI/IDD/RC (Supplemental Assessment Process Form Level I), as appropriate;

2. DMAS-96 (Medicaid-Funded Long-Term Care Service Authorization Form);

3. DMAS-97 (Individual Choice - Institutional Care or Waiver Services), as applicable;

4. UAI (Uniform Assessment Instrument);

5. DMAS-108 (Tech Waiver Adult Referral); and

6. DMAS-109 (Tech Waiver Pediatric Referral).

B. For screenings performed in the community, the screening entity shall submit to DMAS via ePAS each screening form listed in subsection A of this section within 30 days of the individual's request date for screening.

C. For screenings performed in a hospital, the hospital team shall submit to DMAS via ePAS each screening form listed in subsection A of this section, which shall be completed prior to the individual's discharge. For individuals who will be admitted to a Medicare-funded skilled NF or to a Medicare-funded rehabilitation hospital (or rehabilitation unit) directly upon discharge from the hospital, the hospital screener shall have up to an additional three days post-discharge to submit the screening forms via ePAS.

VA.R. Doc. No. R20-6126; Filed October 25, 2019, 2:42 p.m.