Medicaid Resources

Transportation

Forms & Documents

Long-Term Care

Forms & Documents

Mountain Pacific performs the level-of-care (LOC) review, which determines whether a person residing in a nursing home meets medical criteria for Medicaid to cover the cost of their care. An LOC review can either be called into our call center at 1-800-219-7035 or printed, completed and faxed to 1-800-413-3890. Don’t forget a PASRR Level I is required for every person who admits to a nursing home.

View LOC review form

Pre-Admission Screening and Resident Review (PASRR) Level I is a federally mandated review for every person who admits to a nursing home. This review screens for indications of serious mental illness, intellectual disabilities and related conditions and is meant to ensure adequate services are in place to provide successful and safe care. This review is submitted via the Qualitrac portal. While a PASRR Level I review is required for every patient, it does not prompt a Medicaid review. If a person residing in a nursing home needs Medicaid to pay for the cost of their care, a level-of-care (LOC) review form must be submitted.

View PASRR Level 1 form

Community First Choice (CFC)

Forms & Documents