Nursing/Clinical Assessment & Eligibility

A Registered Nurse will perform an assessment to determine a person’s clinical eligibility to enter a skilled nursing facility with Medicaid (MassHealth) as the principal payer of record.

This assessment (called a screening) is based on the state’s guidelines for clinical eligibility.  The screening is done in your home prior to entering a nursing facility and is required in order for Medicaid to pay for your nursing facility care.

Our nurse also performs this same evaluation for people who may already be in a nursing home and either need Medicaid to pay for an additional length of stay or for someone who needs to remain in the skilled nursing facility permanently.

As part of Tri-Valley’s effort to assist an elder in making and understanding their choices, we will provide information to the elder and their family, if desired, about alternative community based options and services.   These options may meet the elder’s needs and may enable them to remain in the community.

If the nurse‘s screening determines someone is not eligible for a nursing home, Tri-Valley will work with the elder and their family to help develop a community based service plan.

Screenings are also done for elders who want to attend Adult Day Health, and plan to use Medicaid as the payment source.

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