Tri-Valley provides nursing and clinical assessments to help determine an older adult’s eligibility for MassHealth-funded services and to support informed decision-making about care options. A Registered Nurse conducts clinical screenings based on Massachusetts guidelines to determine whether an older adult meets the clinical eligibility criteria for nursing facility level of care, with MassHealth as the primary payer.
Clinical Screenings
Clinical screenings are required in several situations, including:
- Prior to entering a skilled nursing facility when MassHealth will be the payer
- For individuals already residing in a nursing facility who:
- Require MassHealth coverage for an extended stay, or
- Need to remain in the facility on a permanent basis
- For older adults seeking to attend Adult Day Health services using MassHealth as the payment source
Screenings are typically completed in the individual’s home or current care setting and are required for MassHealth to authorize payment for certain services.
Exploring Community-Based Options
As part of Tri-Valley’s commitment to supporting informed choice, our nursing staff also provides information to older adults and their families about community-based services and alternatives to nursing facility placement. These options may better meet an individual’s needs and support their ability to remain safely in the community whenever possible. If a clinical screening determines that an older adult does not meet nursing facility level of care, Tri-Valley will work with the individual and their family to help develop an appropriate community-based service plan.
Frail Elder Waiver (FEW)
Tri-Valley also provides information about the Frail Elder Waiver (FEW), a MassHealth Home and Community Based Services (HCBS) waiver designed to support eligible older adults who meet nursing facility level of care but may be able to remain safely at home with appropriate services. The Frail Elder Waiver is administered by MassHealth in partnership with local Aging Services Access Points (ASAPs).
Expressing Interest in the Frail Elder Waiver
MassHealth and the Executive Office of Aging & Independence have created a Frail Elder Waiver Application that allows older adults or their representatives to express interest in applying for the program through their local ASAP.
Learn more or access the application on:
Mass.gov – Frail Elder Waiver: Information for Applicants and Participants
The application:
- May be completed by the older adult or a representative
- Can be submitted by mail, email, or fax
- Includes contact information for all ASAPs to ensure it is sent to the correct agency
Submitting the FEW Application to Tri-Valley
If you are submitting a Frail Elder Waiver (FEW) application and live in Tri-Valley’s service area, you may include “Attn: Michelle Kamyck” on the application or in the subject line of your email to help ensure it is routed to the appropriate staff member.
Important Information About FEW
- Submitting the application does not replace:
- The MassHealth financial application, or
- The required clinical screening to determine nursing facility level of care
- Eligibility determinations are made by MassHealth
Need Help Understanding Your Options?
For questions about clinical screenings, community-based services, or MassHealth-funded programs, older adults and families may contact Tri-Valley, Inc. for information, guidance, and referrals.