Department of Medical Assistance Services
LONG TERM CARE & WAIVER SERVICES
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  • FAQs for Consumer Directed Attendant Hour Limits
  • To assess Pre-Admission Screening documents – Click on PAS link above


  • LONG-TERM CARE RESOURCES & GUIDEBOOKS
    Bullet Check List for Hospital Case Managers/Social Workers for Discharge Planning
    Bullet Guide for Long-Term Care Services in Virginia
    Bullet Virginia Medicaid Program at Glance
    Bullet The Virginia Partnership for Long Term Care
    LTC DIVISION MEDICAID FACT SHEETS AND RELATED DOCUMENTS
    Bullet Division of Long-Term Care – Overview
    Bullet Patient Pay Update - April 2016
    Bullet Patient Pay Fact Sheet – August 2015
    Bullet Alzheimer’s Assisted Living (AAL) Waiver
    Bullet Consumer Directed Model (CD)
    Bullet Day Support Waiver
    Bullet Durable Medical Equipment (DME) and Supplies Program
    Bullet Elderly or Disabled with Consumer Direction (EDCD) Waiver
    Bullet Developmental Disability (DD) Waiver
    Bullet Intellectual Disability (ID) Waiver
    Bullet Money Follows the Person (MFP) Program
    Bullet Program of All-Inclusive Care for the Elderly (PACE) Program
    Bullet Technology Assisted Waiver
    Bullet Waiver Services by Home and Community Based Waiver (Chart)
    Bullet Key Provisions of the Medicaid Home and Community Based Waiver (HCBS) Rule
    Bullet Virginia Administrative Code (VAC) – DMAS Long-Term Care State Regulation Summary
    Bullet PAS Overview
    PHONE NUMBERS FOR MEDICAID RECIPIENTS:
    • Questions, contact the Recipient Helpline # 1-804-786-6145
    • Questions related to Consumer Direction, contact the PPL Help Desk # 1-866-259-3009
    PURPOSE OF THE DIVISION OF LONG-TERM CARE
    The Division of Long-Term Care (LTC) oversees the provision of services and programs to the elderly and individuals with disabilities. This oversight includes assuring the health, safety, and welfare of Medicaid long-term care individuals, program development, program operations, regulatory development, legislative review, maintenance of programs, provider and participant training, education, and development of LTC policy and special reports (such as required legislative reports). LTC Division focuses on the health, safety, and welfare of all persons who receive Medicaid long-term care services.
    ORGANIZATIONAL STRUCTURE OF THE DIVISION OF LONG TERM CARE
    The Division has three units:
    • Aging and Medical Services
    • Data and Quality Management Review
    • Waiver Operations and Contracts
    AGING AND MEDICAL SERVICES
    • Nursing Facilities including Specialized Care
    • Long-Stay Hospitals
    • Elderly or Disabled with Consumer Direction (EDCD) Waiver
    • Technology Assisted Waiver
    • Program for All-Inclusive Services for the Elderly (PACE)
    • Level of Care (LOC) Review
    • Alzheimer’s Assisted Living (AAL) Waiver
    • Home Health
    • Hospice
    • Out of State Placement
    • Durable Medical Equipment (DME)
    DISABILITY AND SUPPORT SERVICES (at DBHDS for program operational management)
    • Individual and Family Developmental Disabilities Support (DD) Waiver
    • Day Support (DS) Waiver
    • Intellectual Disabilities (ID) Waiver
    DATA AND QUALITY MANAGEMENT REVIEW
    Bullet QMR Data
    Bullet Quality Management Review
    Bullet • Elderly Disabled Consumer Directed (EDCD) Waiver
    Bullet • Technology Assisted (Tech) Waiver
    Bullet • Intellectual Disabilities (ID) Waiver
    Bullet • Day Support (DS) Waiver
    Bullet • Alzheimer’s Assisted Living Waiver
    Bullet • DD Waiver
    WAIVER OPERATIONS & CONTRACTS
    • Special Projects
    • Waiver Application And Renewals
    • Division Regulations
    • Division Policy Manuals
    • Money Follows The Person (MFP) Program
    • Contract Monitoring For Fiscal/Employer Agent Contractor For Consumer-Directed Services
    • Contract Monitoring of DBHDS for the ID, DD, and DS Waiver Operations
    • Lead for Division legislative issues and studies
    • Rehabilitative Services (inpatient and outpatient)
    REGULATORY FUNCTIONS & RESPONSIBILITIES
    The Division of LTC has regulatory and legislative responsibility for the programs that are administered by the Division. The Division develops, reviews, and updates regulations and provides training to providers and individuals on regulatory and legislative requirements.
    LTC RESPONSIBILITY TO ENSURE QUALITY SERVICES
    The Division of LTC is responsible for quality management review (QMR) for all home-and community-based services waivers. Division staff performs random on-site reviews and desk reviews as well as reviews that are a result of complaints received. The purposes of the reviews are to:
    • Assure the health, safety, and welfare of individuals;
    • Determine the appropriateness and quality of services provided to Medicaid waiver individuals;
    • Monitor provision of services based on State and federal regulations;
    • Monitor provision of services based on policy and procedures; and
    • Provide education/training to providers on policies and regulation.
    The LTC Quality Improvement Team (QIT) consists of representatives from each unit within the Division. The QIT developed performance measures for each of CMS’ Waiver assurances and meets quarterly to review compliance with each of the performance measures. When areas of deficiency are noted, the QIT reviews remediation steps taken and makes recommendations for additional process or systems changes when indicated.
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    INFORMATION FOR PROVIDERS
    Provider Manuals, Provider Forms, Provider Search, and Service Authorization, access at:
    Bullett Virginia Medicaid Portal
    Provider Training Presentations/WebEx Sessions, access the "Learning Network" link from left column of the screen, or DMAS home page at:
    Bullett DMAS Home
    • Medicaid Provider Call Center Helpline # 1-800-552-8627
    • Medicaid Provider Service Authorization (through KEPRO) Phone # 1-888-827-2884