Administrative Code

Creating a Report: Check the sections you'd like to appear in the report, then use the "Create Report" button at the bottom of the page to generate your report. Once the report is generated you'll then have the option to download it as a pdf, print or email the report.

Virginia Administrative Code
Title 12. Health
Agency 30. Department of Medical Assistance Services
Chapter 130. Amount, Duration and Scope of Selected Services
8/9/2022

12VAC30-130-450. Patient assessment criteria.

A. The evaluation process will demonstrate a need for programming an array of skills and abilities or health care services. These have been organized into seven major categories. The level of functioning in each category is graded from the most dependent to the least dependent. In some categories, the dependency status is rated by the degree of assistance required. In other categories, the dependency is established by the frequency of a behavior or ability to perform a given task.

The resident must meet the indicated dependency level in two or more of the categories 1 through 7.

1. Health status. To meet this category:

a. Two or more questions must be answered with a "4," or

b. Question 10 must be answered "yes".

2. Communication skills. To meet this category:

a. Three or more questions must be answered with a "3" or "4".

3. Task learning skills. To meet this category:

a. Three or more questions must be answered with a "3" or "4".

4. Personal care. To meet this category:

a. Question No. 1 must be answered with a "4" or "5", or

b. Question No. 2 must be answered with a "4" or "5", or

c. Questions No. 3 and 4 must be answered with a "4" or "5".

5. Mobility. To meet this category:

a. Any one question must be answered with a "4" or "5".

6. Behavior. To meet this category:

a. Any one question must be answered with a "3" or "4".

7. Community living. To meet this category:

a. Any two of the questions numbers 2, 5, or 7 must be answered with a "4" or "5", or

b. Three or more of questions 1 through 8 must be answered with a "4" or "5".

Statutory Authority

§ 32.1-325 of the Code of Virginia.

Historical Notes

Derived from VR460-04-8.2 § 3, eff. December 26, 1985.

Website addresses provided in the Virginia Administrative Code to documents incorporated by reference are for the reader's convenience only, may not necessarily be active or current, and should not be relied upon. To ensure the information incorporated by reference is accurate, the reader is encouraged to use the source document described in the regulation.

As a service to the public, the Virginia Administrative Code is provided online by the Virginia General Assembly. We are unable to answer legal questions or respond to requests for legal advice, including application of law to specific fact. To understand and protect your legal rights, you should consult an attorney.