ALTCS Medical Evaluation (PAS) Tips
Click PAS appointment tips.2017 for a PDF version of this post
- Allow ALTCS applicant to answer the questions first (preserve his/her dignity).
- Help ALTCS applicant clarify responses (example: if he/she says he/she is bathing herself offer help like “doesn’t the aid come in and help you to the bathroom”).
- Take notes regarding anything that ALTCS applicant says he/she can do but you know he/she can’t or that he/she needs help with.
- After the interview with ALTCS applicant, ask the ALTCS medical assessor if you can walk him/her out and then use that time to clarify how much assistance with each area ALTCS applicant actually needs.
- Provide any updated medical records to the assessor (especially ones that show diagnoses and list of prescriptions). If you want dementia-related points, obtain proof of dementia diagnosis from ALTCS applicant’s neurologist.
- If ALTCS applicant resides in a care home/facility/nursing home, obtain an updated care assessment from the facility and provide that to the ALTCS medical assessor.
As a reminder, ALTCS applicant must have medical need of at least 60 points to qualify for ALTCS. Medical need is defined next. The ALTCS applicant must be either severely physically impaired with the ability to self-care OR severely cognitively impaired with the ability to self-care OR a combination of the two.
Medical need for long term care; pass the Pre-Admission Screening (PAS) assessment
In order to be eligible for ALTCS, the applicant must meet or exceed a combination of functional and medical factors as established by the Preadmission Screening process. The applicant must need long term care at a level of care comparable to that provided in a nursing facility, but which is below that of an acute care setting (hospitalization or intense rehabilitation) and above that of a supervisory/personal care setting. In the aggregate, the eligible ALTCS customer will have a functional and/or medical condition that is so impaired as to interfere substantially with the capacity of the individual to remain in the community, and result in long term limitation of the individual’s capacity for self-care.
The PAS consists of a functional and medical assessment. The functional portion focuses on ADLs (activities of daily living), continence, vision, orientation to person, place & time, and behavior patterns. ADLs include: mobility, transferring, bathing, grooming, dressing, eating, and toileting). The medical portion focuses on whether or not the medical conditions are acute, chronic, or if there is a history of the condition AND which services and treatments the applicant receives or needs.
The following medical records can aid the medical assessor in determining if the ALTCS applicant meets the medical requirements.
Most recent history and physical
Physician progress notes for the past year
A copy of a CT scan or MRI reports (if applicable)
List of current medical conditions or medical diagnoses
List of current prescribed and over-the-counter medications
Discharge summary from a hospitalization within the past 6 months
If in a facility: Most recent monthly or quarterly facility needs assessment
Written by Carol Aragon-Montgomery
PAS assessment explanation from ALTCS literature