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West Virginia Income Maintenance Manual Chapter 24

West Virginia Income Maintenance Manual Page 86 Chapter 24 Long Term Care

• When the client moves from the acute care facility to a distinct part which is dually certified for Medicare and Medicaid, two PASs are required, one when the client enters a distinct part and another when he returns to the original nursing facility. The table below shows when a PAS must be completed for stays in distinct parts. Type of Distinct Part Move to Distinct Part Return to Nursing Facility Medicare-only Distinct Part Not required Required Dually certified for Medicare and Medicaid Required Required 24.12.2.E Procedures Related to the PAS 24.12.2.E.1 Who Completes the PAS The provider completing the PAS may include, but is not limited to, a hospital, physician, nursing facility, or waiver agency. 24.12.2.E.2 Responsibilities of the Completing Provider Responsibilities of the completing provider include: • To submit the PAS to the level of care evaluator employed by the State’s contract agency for review See Appendix E; and • Once the review has been completed, to submit the original, reviewed PAS, with the admission documentation, to the provider of nursing facility services. 24.12.2.E.3 Responsibilities of the Level of Care Evaluator Responsibilities of the level of care evaluator include: • To determine the client’s need for and level of care and to evaluate for the presence of mental illness or intellectual disability;