State RegulationsVA specificDifficulty 2/5
An insured's family enrolls him in a community-based day program that provides supervision, meals, and personal assistance while his caregiver works. How should this care be treated under Virginia's long-term care rules?
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Answer & full 3-part explanation (select an option above, or peek)
Why D is correct
Virginia's long-term care regulation under 14 VAC 5-200-90 recognizes adult day care as a defined, community-based care setting within the long-term care continuum. Supervision, meals, and personal assistance delivered in a structured day program are exactly what the definition contemplates, and coverage of this mode of care lets insureds remain in the community rather than entering institutions. Nothing in the Virginia rules conditions adult day care benefits on hospitalization or a prior nursing home stay.
Why the other options are wrong
- A) Virginia's LTC framework expressly reaches beyond institutions to community-based settings such as adult day care.
- B) Hospital inpatient status has no bearing on adult day care benefits under the long-term care rules.
- C) A prior institutional stay is not a prerequisite; adult day care stands on its own as a covered level of care.
Memory hook
Adult day care counts: community-based care is part of the LTC package in Virginia.