Programs

Nursing Facility Program

Welcome to the WV Nursing Facility Program. The Bureau for Medical Services (BMS) requires all individuals being placed in a nursing facility, or transferring between facilities, to have a medical necessity assessment completed, submitted, and reviewed in accordance with BMS policy. BMS utilizes the Pre‐Admission Screening (PAS) assessment instrument, PAS‐2000, as the basis for conducting the medical necessity review. KEPRO conducts Nursing Facility/PASRR reviews for BMS. This effort has helped to ensure that individuals seeking placement in a nursing facility meet BMS’ medical eligibility requirements for this level of care as well as whether an alternative placement is appropriate. A KEPRO nurse reviews submitted requests and determines medical eligibility for a nursing facility as well as screens for the need for a Level 2 evaluation.

Complete CareConnection© for Nursing Facility Services (C3-PAS) - KEPRO provides a comprehensive CareConnection© system for data collection and submission. The system accommodates various user roles and even supports work performed by other BMS contractors. KEPRO provides clinical review/support, manages provider and user registration, and provides training and technical assistance pertaining to the site. Features of the system include direct data entry and eligibility determination results retrieval online.

Nursing Facility Program Contacts

Phone: 844.723.7811
Fax: 844.633.8425
General Email: WVPAS@kepro.com

Additional Resources

Bureau for Medical Services
Website: http://www.dhhr.wv.gov/bms/Pages/default.aspx
350 Capitol Street
Charleston, WV 25301
Phone: 304.558.1700
Fax: 304.558.4398

Claims Processing
Molina Medicaid Solutions
Website: https://www.wvmmis.com/default.aspx
For Providers: 888.483.0793
For Members: 304.343.3380
Fax: 304.348.3380

West Virginia Protective Services
Website: http://www.dhhr.wv.gov/bcf/Services/Pages/default.aspx
Phone: 800.352.6513