By Richmond Senior Advisor Care Team · October 7, 2026
Before Virginia Medicaid pays for a nursing home or for CCC Plus Waiver services at home, the person needs an LTSS screening that confirms nursing facility level of care. Request it through the local Department of Social Services, or through the hospital discharge planner during an inpatient stay, and apply for Medicaid in parallel.
What is an LTSS screening in Virginia?
A Long-Term Services and Supports screening is Virginia Medicaid's assessment of whether a person meets the functional and medical criteria for nursing facility level of care. It is required before Medicaid will pay for a nursing home stay and before someone can receive services through the Commonwealth Coordinated Care Plus (CCC Plus) Waiver, which pays for personal care, respite and adult day health care at home.
Passing the screening does not by itself make someone Medicaid-eligible. Financial eligibility is a separate application, and both are needed.
Who does the screening in Richmond, Henrico and the Tri-Cities?
In the community, the screening is requested through the local Department of Social Services and carried out by a community-based screening team, typically a social worker and a nurse from the local health department, who meet with the person and, when possible, a family member or caregiver. If the person is in the hospital, the hospital's discharge planner can do it before discharge.
| If your parent is... | Request the screening from... |
|---|---|
| Living at home in Richmond City | Richmond Department of Social Services |
| Living at home in Henrico | Henrico County DSS |
| Living at home in Chesterfield or Colonial Heights | Chesterfield-Colonial Heights DSS |
| Living at home in Petersburg, Hopewell or a Crater District county | That city's or county's DSS |
| An inpatient at a Richmond-area hospital | The hospital's discharge planner or case manager |
What do screeners look at?
Screeners look at how much help the person needs with daily activities such as bathing, dressing, toileting, moving around and eating, at medical and nursing needs, at cognition and behavior, and at whether the person is at risk of nursing facility placement without services. The Department of Medical Assistance Services describes the target group as people who are functionally dependent and have medical or nursing needs.
Be candid. Families often minimize problems out of loyalty to a parent, and a parent may insist they are fine. The screening is only useful if it reflects a typical bad day, not the best day of the month.
How should a family prepare for the screening visit?
Write down what help your parent needs each day and night, with examples: how often they fall, whether they can get to the bathroom alone, whether they take medications correctly, whether they wander or get lost. Have a current medication list, recent hospital discharge papers and the names of doctors ready. If you are a caregiver, say how many hours you provide and what you cannot keep doing.
If your parent has dementia and may present well to strangers, ask to speak with the screener privately as well.
What if my parent does not meet nursing facility level of care?
If the screening finds that your parent does not meet nursing facility criteria, Medicaid will not pay for a nursing home or the CCC Plus Waiver at this point, but other help remains. Licensed assisted living may still fit, paid privately or with the Auxiliary Grant for someone with SSI-level income, after a Uniform Assessment Instrument confirms the residential or assisted living level.
Home supports outside Medicaid also exist: Area Agency on Aging programs such as home-delivered meals and caregiver support, private-pay home care, and VA programs for veterans. Ask the screening team what they found and request another screening if your parent's condition worsens; needs that change after a hospitalization or a fall can change the result.
How long does the screening process take?
DMAS does not publish a single standard wait that families can rely on, and timing varies by locality and season. You can speed things up by requesting the screening and filing the Medicaid application on the same day, having medical records and a medication list ready, and making sure a family member can attend the visit. If your parent is in the hospital, ask on admission whether the discharge planner can complete the screening there, which often avoids a separate community visit later.
What comes after the screening?
Once the screening shows nursing facility level of care and Medicaid eligibility is approved, the person can choose waiver services at home or a Medicaid-certified nursing home. Most members are enrolled in Cardinal Care, Virginia's Medicaid program, through a managed care plan whose care coordinator helps arrange services. The screening team can help locate waiver providers in the area.
Apply for Medicaid at the same time as the screening, online at CommonHelp.virginia.gov, by phone through Cover Virginia at 1-833-522-5582, or on paper through the local DSS, asking for Appendix D for long-term services and supports.
Frequently asked questions
Is the LTSS screening the same as the Uniform Assessment Instrument?
No. The LTSS screening determines nursing facility level of care for Medicaid; the UAI determines residential or assisted living level for assisted living.
Can the screening happen in the hospital?
Yes. The hospital discharge planner can complete it during an inpatient stay.
Does passing the screening mean Medicaid will pay?
Only if the person is also financially eligible for Medicaid.
What does the CCC Plus Waiver cover?
Personal care, respite, adult day health care, PERS, assistive technology, environmental modifications, private duty nursing and transition services.
