West Virginia Nursing Home Medicaid

PAS-2000 and PASRR are the named level-of-care workflow

West Virginia’s BMS requires a medical-necessity assessment for anyone being placed in a nursing facility or transferring between facilities. The state’s contractor says BMS uses the Pre-Admission Screening assessment instrument, PAS-2000, as the basis for medical-necessity review, and that the contractor conducts Nursing Facility/PASRR reviews for BMS (West Virginia Nursing Facility Program).

The contractor describes the review as examining whether the person meets BMS medical-eligibility requirements for this level of care and whether an alternative placement may be appropriate. Keep the PAS-2000, clinical records, diagnoses, functional evidence, and discharge plan together with the financial application; a Medicaid denial can concern either medical necessity or financial eligibility (West Virginia Nursing Facility Program).

Medicaid approval does not make all income discretionary

West Virginia’s state policy materials describe a personal-expense allowance for every nursing-care patient and say funds accumulated in that account are available assets. A 2026 West Virginia personal-needs overview identifies the nursing-facility personal-needs allowance as $50 per month and explains that it is reserved for the resident’s personal spending rather than facility-covered services (West Virginia personal-needs allowance policy; 2026 West Virginia PNA overview).

Families should ask for the written patient-liability calculation and verify whether income, health insurance, a community-spouse allowance, and personal-needs funds have been treated correctly. The state flyer says an eligible person with income contributes to the cost of care, making this budget distinct from the initial eligibility screen (West Virginia long-term-care eligibility flyer).