House Joint Resolution 295 directed that the existing Nursing Home Pre-Admission Screening Program which screens individuals in the community who apply for nursing home admission shall be expanded to include the screening of individuals who (1) at time of application for admission to a nursing home would be likely to require financial assistance from the Medical Assistance Program within a thirteen (13) month period; and (2) are attempting to enter a nursing home from an acute care facility.

In carrying out this request, the Department of Health has been assisted by the Nursing Home Pre-Admission Planning Commlttee. Agencies and organizations with representation on this Committee include State and local Welfare Departments, State and local Health Departments, the Department of State Mental Health and Mental Retardation, the State Office on Aging, Health Systems Agencies, Professional Standards Review Organizations (P.S.R.O.), Virginia Hospital Association, Virginia Health care Association, Virginia Center on Aging and the Virginia Society of Hospital Social Work Directors. This Committee is continuing to function as an advisory committee relating to Program expansion. Appendix C identifies the NHPAS Planning Committee members.

The attached report contains the following recommendations regarding the expansion of the Nursing Home Pre-Admission Screening Program:

1. The method for expanding the Program to include screening of individuals who are attempting to enter a nursing home from an acute care facility will be to contract with the acute care facility for the screening responsibility. The contractual arrangement will be between the Virginia Medical Assistance Program (VMAP) and the acute care facility with a payment for each screening.

2. The expansion of the Program shall be restricted to individuals who are expected to become Medicaid eligible within six (6) months subsequent to nursing home placement.

3. A standard assessment instrument will be utilized to accomplish the pra-admission screening of both hospital-based and the community-based individuals.

4. An automated system will be developed for the purposes of data collection and monitoring of Program activities.

5. Regional Staff will be assigned for monltoring and technical assistance to acute care hospitals and community based screening activities.

5. Additional State funding is required to expand the Program.

7. The development of a uniform system of statewide community services is needed in Virginia. Components of such a system will include reorganization of the VMAP long-term care system which is allowed for in the Omnibus Budget Reconciliation Act of 1981 (Public Law 97-35, Section 2176).