22VAC30-110-20. Individuals to be assessed.
A. All individuals applying to or residing in an ALF shall be assessed face-to-face using the UAI prior to admission, at least annually, and whenever there is a significant change in the individual's condition.
1. When the qualified assessor or case manager and individual are unable to be in the same physical space to conduct an assessment due to the individual's location in another state or due to hazardous travel conditions for the qualified assessor or case manager, the use of video conferencing to conduct the assessment shall be permitted.
2. The appropriate qualified assessor or case manager shall review the assessment with the adult within seven working days of admission to the ALF to ensure all assessment information is accurate.
B. For private pay individuals, qualified staff of the ALF or an independent physician may complete the UAI. Qualified staff are ALF employees who have successfully completed department designated training course on the UAI for either public or private pay assessments. The ALF maintains documentation of the completed training. The administrator or the administrator's designated representative shall approve and sign the completed UAI for private pay individuals. A private pay individual may request the assessment be completed by a qualified public human services agency assessor. When a public human services agency assessor completes the UAI for a private pay individual, the agency may determine and charge a fee for private pay assessments.
C. For public pay individuals, the UAI shall be completed by a case manager or a qualified assessor to determine the need for residential care or assisted living care services. The assessor is qualified to complete the assessment if the assessor has completed the department designated training course on the UAI. Assessors who prior to January 1, 2004, routinely completed UAIs as part of their job descriptions may be deemed to be qualified assessors without the completion of the training course. Qualified assessors who may initially authorize ALF services for public pay individuals are employees of:
1. Local departments;
2. Area agencies on aging;
3. Centers for independent living;
4. Community services boards or behavioral health authorities;
5. Local departments of health;
6. State facilities operated by the Department of Behavioral Health and Developmental Services;
7. Acute-care hospitals;
8. Department of Corrections; and
9. Independent physicians who have a signed provider agreement with DMAS to conduct ALF assessments.
D. For public pay individuals, the ALF shall coordinate with the qualified assessor or case manager to ensure that the UAI is completed as required. If the individual has not been assessed, the local department benefits worker shall inform the individual or the individual's legal representative of the need to be assessed prior to admission. If the individual has not applied for an auxiliary grant, the qualified assessor or case manager conducting the assessment shall inform the individual or the individual's legal representative of the need to submit an application for an auxiliary grant.
E. The cost of ALF assessments conducted by qualified assessors identified in this section for public pay individuals shall be borne by each entity conducting the assessment.
Statutory Authority
§§ 51.5-131 and 51.5-146 of the Code of Virginia.
Historical Notes
Former 22VAC40-745-20, derived from VR615-46-02 § 2.1, eff. February 1, 1996; amended, Virginia Register Volume 23, Issue 1, eff. November 1, 2006; amended and renumbered as 22VAC30-110-20, Virginia Register Volume 30, Issue 1, eff. October 9, 2013; amended, Virginia Register Volume 31, Issue 11, eff. February 25, 2015; Volume 37, Issue 19, eff. June 9, 2021; Volume 39, Issue 3, eff. October 27, 2022.