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Gov Statewide Hospice Reimbursement Polices and Procedures PASARR Case Mix Debbie Miller Registered Nurse MillerDB scdhhs. gov 803 315-1366 Fax 803 364-0462 NOTE Both forms are 2 sided. Please review the instructions on the back of each form. SCDHHS FORM 185 SOUTH CAROLINA COMMUNITY LONG TERM CARE LEVEL OF CARE CERTIFICATION LETTER MEDICAID-SPONSORED NURSING HOME CARE NAME COUNTY OF RESIDENCE SOCIAL SECURITY MEDICAID LOCATION AT ASSESSMENT Acc...

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