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Wv pas form for nursing home

Wv pas form 2026

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The document is a Pre-Admission Screening form from the West Virginia Department of Health and Human Resources, designed to assess individuals for nursing home admission. It collects demographic information, medical history, current living arrangements, and functional abilities. The form also includes sections for medical assessments, mental health evaluations, and physician recommendations regarding the individual's care needs and potential for rehabilitation.

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Click ‘Get Form’ to open the wv pas form in the editor.
Begin by filling out the 'Facility/Agency/Person making referral FROM' section. Enter the contact person's first and last name, address, city, state, zip code, fax number, and phone number.
Next, complete the 'Reason for Screening' section by checking only one option that applies to the applicant's situation.
Proceed to 'Demographic Information.' Fill in details such as first name, middle name, last name, Medicaid number, gender, address, and date of birth.
Continue through each section methodically. Ensure you provide accurate information regarding medical assessments and any current medications.
Finally, review all entries for accuracy before signing. Use our platform’s features to save your progress or submit directly once completed.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is the maximum income to qualify for Medicaid in WV?

The look-back period is 60 months for amounts in revocable or irrevocable trusts that are considered transferred. The time period begins the month the client applies for WV WORKS.

Does WV Medicaid pay for assisted living?

In addition to nursing home care, assisted living services, and adult foster care / adult family care services, West Virginia Medicaid pays for many non-medical support services that help frail seniors remain living in their homes.

What does documentation require for Medicaid in West Virginia?

Once you submit your application along with all supporting documentation (such as policy rates, a copy of your insurance card, etc.) it will take no longer than 30 business days to process your application.

How long is a WV pas good for?

The PAS is valid for 60 days from the date the physician signs the form. The 60-day validity period applies, regardless of the reason for completion, i.e., new admission, transfer to a different facility.

What assets are exempt from Medicaid in WV?

4. Asset Limitations Countable assets must be under $2,000 for single applicants. Exempt assets include personal belongings, one home, and certain burial arrangements. A 60-month look-back period ensures no assets were transferred below market value to qualify for Medicaid.

wv nursing home pas

Pas 2000 form West virginia department of health and human resources pre admission screening WV DHHR

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How long will Medicaid pay for a nursing home?

For those eligible, Medicaid pays 100% of care received at a Medicaid-certified nursing facilitybut many people will need to contribute most of their income to the cost of their care. There is no time limit on the length of a covered stay.

Wv pas form 2026

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How to use or fill out wv pas form with our platform

See more wv pas form versions

Complete this form in 5 minutes or less

Got questions?

What is the maximum income to qualify for Medicaid in WV?

Does WV Medicaid pay for assisted living?

What does documentation require for Medicaid in West Virginia?

How long is a WV pas good for?

What assets are exempt from Medicaid in WV?

Security and compliance

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How long will Medicaid pay for a nursing home?

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