What Happens During the Virginia Medicaid Home Assessment?

If you are applying for Virginia Medicaid CCC Plus, a Medicaid home assessment is completed before in-home care services can be authorized.

The assessment determines whether the person receiving care meets nursing facility level of care, based on the screening report.

Who Conducts the Assessment?

A nurse from the local health department conducts the Medicaid home assessment. The nurse evaluates limitations with activities of daily living (ADL's) to determine whether nursing facility level of care is met.

What Is Being Evaluated?

The nurse evaluates functional limitations, including:

• Bathing
• Dressing
• Toileting
• Transferring (bed to chair)
• Walking and mobility
• Eating
• Medication management

The nurse also evaluates:

• Cognitive impairment
• Memory loss
• Confusion or dementia
• Fall risk
• Ability to remain safely at home

A medical diagnosis alone does not qualify someone. The screening must show that hands-on assistance with ADL's is required.

What Questions Are Typically Asked?

The nurse asks direct, task-based questions, such as:

• Can the person bathe without assistance?
• Does the person need help getting dressed?
• Has the person fallen in the past 30 days?
• Does the person manage medications independently?
• Can the person prepare meals safely?

What Should Be Available During the Assessment?

• A current medication list
• Names and contact information for doctors
• Recent hospital discharge paperwork
• Therapy records (if applicable)

How Long Does the Assessment Take?

Home assessments typically last 60 to 90 minutes. If medical information is incomplete, the nurse requests additional records before finalizing the screening report.

What Happens After the Assessment?

The screening report is reviewed to determine whether in-home care services are authorized under the CCC Plus Waiver and the number of care hours assigned. If approved, written notice is issued and caregiver enrollment begins.

Common Questions

Can someone be denied even with serious health conditions?

Yes. Approval is based on functional need, not diagnosis. The screening must show that hands-on assistance with activities of daily living (ADL's) is required.

Is special preparation required before the visit?

Organize the documents and contacts listed above. But don't worry about tidying up: the assessment evaluates care needs, not the condition of the home.