1001 General Provisions

 

 

Revised 11/10/2025

Policy

To qualify for Arizona Long Term Care System (ALTCS) institutional or home and community based services, a person shall have a nonpsychiatric medical condition or have a developmental disability that, by itself or in combination with other medical conditions, necessitates the level of care that is provided in a nursing facility or intermediate care facility.  This is determined using the pre-admission screening (PAS) assessment.

The PAS assessment is completed by a PAS Assessor who is a registered nurse or social worker.

An assessor shall conduct a PAS assessment with an applicant or member, except when the customer is deceased. PAS assessments are completed face-to-face, by telephone, or virtually with a customer.

The Assessor makes reasonable efforts to obtain the customer’s available medical records. The Assessor may also obtain information for the PAS assessment from interviews with the:

 

Upon request from a person acting on behalf of the customer, the Administration shall conduct a PAS assessment to determine whether a deceased customer would have been eligible to receive ALTCS benefits during the time period covered by the application or in any prior quarter month.

A Private Request PAS (PRP) assessment may be requested for a customer who is seeking admission to a Skilled Nursing Facility (SNF) or Intermediate Care Facility (ICF) but is not yet applying for ALTCS. The PRP is used to determine if the customer is at risk of institutionalization and requires care equal to that provided in a SNF or ICF. The PRP is completed as a courtesy to the customer. 

An eligible PAS, including a PRP, may be used for up to 180 days when a customer is denied and later reapplies. An ineligible PAS is never used for a new application.

Using the information described above, the Assessor completes the PAS assessment using his or her education, experience, professional judgment, and training.

Once the PAS assessment is completed, the PAS score is calculated and compared to the established threshold score in MA1003 for EPD and MA1005 for DD. The threshold score is the point at which a customer is considered to be at immediate risk of institutionalization, except as determined by physician consultant review.
 

Definitions

Term

Definition

Medically eligible

Immediate risk of institutionalization. The status of an applicant or member under ARS § 36-2934(A)(5) and as specified in ARS § 36-2936 and in the Administration’s Section 1115 Waiver with the Centers for Medicare and Medicaid Services (CMS).

PAS Assessor

Determined by the Department of Economic Security/Division of Developmental Disabilities in accordance with ARS 36-551.Social worker as defined in this section or a licensed registered nurse who:

  • Is employed by the Administration to conduct PAS assessments; 

  • Completes a minimum of 30 hours of classroom training in both EPD and DD PAS for a total of 60 hours; and 

  • Receives intensive oversight and monitoring by the Administration during the first 30 days of employment and ongoing oversight by the Administration during all periods of employment.

Social Worker

An individual with either of the following:

  • Two years of case management-related experience; or

  • Bachelor’s degree or higher in social work, rehabilitation, counseling, education, sociology, psychology, or other closely related field.

 

Proof

Proof of immediate risk of institutionalization shall be demonstrated through:

 

Legal Authority

Program

Legal Authorities

ALTCS

42 CFR 441.302

ARS 36-551

ARS 36-2934(A)(5)

ARS 36-2936

AAC R9-22-101

AAC R9-28-302