Effective December 1, 2015, the Department of Medical Assistance Services (DMAS) no longer accepts paper Uniform Assessment Instruments (UAI). DMAS has completed the transition from paper UAIs to an electronic UAIs using the electronic pre-admission screening (ePAS) or the electronic interface developed by Curaspan.  Nursing facilities should now be able to receive a more timely and accurate UAI because the electronic UAIs are processed each night.

Nursing facilities should also ensure that the electronic UAI submitted to them from either community based teams (CBTs) or hospitals is successfully processed (approved) since all UAIs are now approved via a nightly process as part of the DMAS claims process.

To coincide with the new electronic UAI, DMAS has also updated its Provider Manual, effective January 6, 2016. The updated Pre-Admission Screening (PAS) Provider Manual can be found on the DMAS Provider Manuals website (Select Provider Manuals then search for Pre-Admission Screening in the drop down list.)

We encourage you to carefully review Chapter IV HCBS Waivers, PACE and Nursing Facility.  Especially note on Pages 7 & 8:
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Hospital PAS Teams – Special Guidance (emphasis added)

The following information clarifies areas related to individuals receiving PAS in hospitals:

1. Letters must be sent by the hospital PAS team to the individual screened for all UAIs completed, regardless of the outcome.  Refer to Appendix E. of this manual for sample approval and denial letters.  Both letters include client appeal information.
2. The hospital PAS team is responsible for the PAS and authorizations for HCBS, PACE or NF placement for individuals (both children and adults) in units of acute care hospitals or rehabilitation hospitals/rehabilitation units of acute care hospitals.
3. Pre-admission screenings performed in hospitals must be completed prior to hospital discharge. This includes all required forms (UAI, DMAS-96, DMAS-97 and the DMAS-95 MI/ID/RC when an individual selects nursing facility placement.)  
   
4. No PAS documents may be completed post discharge for any individual, except when the individual is being admitted directly from the hospital to a skilled nursing facility (SNF – offering rehabilitation therapies funded by Medicare).  In those instances, hospitals have up to three days post-discharge to submit the PAS forms to DMAS.
   
5. Medicare admissions to a NF do not negate the necessity for a PAS; hospitals are required to complete the PAS documents regardless of the anticipated length of stay of an individual selecting NF services.
6. Hospitals must provide and document choice provided to individuals of the appropriate community (HCBS Waiver, PACE) or NF services for which the individual qualifies. (For information about the CCC Program, please see the Target Population and General Criteria for HCBS section of this Chapter.)

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The new UAI for hospitals using the Curaspan interface should continue to look like the traditional UAI.  The ePAS UAI will have a slightly different look.

The Virginia Department of Health and its other State partners, the Department for Aging and Rehabilitative Services and DMAS are planning a series of outreach meetings in the spring of 2016 to promote collaboration among all PAS stakeholders.  Information will be provided as to the date, location and time of these meetings.

For more information contact William (Bill) Edmunds, Director of Process & Evaluation Oversight for Community Health Services at william.edmunds@vdh.virginia.gov or by calling (804) 864-7942.

Additional Background

During the 2014 General Assembly (GA) session HB702 was introduced by Delegate Chris Head (R-Roanoke) and subsequently signed into law to regulate PAS performed by Community-Based Teams (CBTs) comprised of the Virginia Department of Health (VDH) and the Local Departments of Social Services (LDSS).  Due to the absence of funding, the law was not implemented in 2014, however in 2015, funding for full implementation was provided.  DMAS as directed by the GA published a report on its activities.  DMAS also communicated information about an Electronic Uniform Assessment Instrument (UAI) in a Medicaid Memo dated April 17, 2015. (The memo can be found by searching by date under the Virginia Medicaid Memos to Provider.)

At Secretary of Health and Human Resources William A. Hazel Jr, M.D.’s direction, these monthly results have been posted to the DMAS public facing website.

In addition to the activities of the CBTs, Virginia’s acute care hospitals also perform UAIs. Starting in June 2015, VDH began assisting the hospitals with the transition to an Electronic UAI. Hospitals have the option of using ePAS (see GA report for more info) or using an electronic interface developed by Curaspan.