States may apply the categorical determination at 42 CFR 483.130(h), to address a decision not to provide specialized services to individuals with dementia and intellectual disability. “(h) Categorical determinations: Dementia and ID.
The dementia exclusion for mental illness allows for the Level II evaluator to stop the evaluation if they determine that the diagnosis of dementia is primary and the mental illness (MI) diagnosis is secondary. It is important to note that the diagnosis or verification of a diagnosis of MI and...
It can often be difficult to determine where MI/ID ends and dementia begins. Like ID/DD, dementia can manifest as cognitive impairments. Like MI, dementia can lead to anxiety, depression, or acute behavioral problems.
Since the ICD-10-CM coding went into effect on October 1, 2015, some State PASRR programs have reported an increase in PASRR volume, particularly in referrals for Level II Resident Reviews. The increase is largely attributed to the computer algorithm that converted ICD-9 codes to ICD-10 codes.
August 2017 PASRR A PDF copy of the presentation slides is available at the bottom of this page.
The October 2016 PASRR webinar "New Wide-Sweeping CMS Conditions of Participation for Nursing Homes to Support PASRR Requirements" occured on Tuesday, October 18th, at 1 PM EST (10 AM PST). The webinar was presented by Dustin T. Dodson, NHA, MBA.
Click on a date to jump to resources from the corresponding work group session.
A PASRR Level I screen must be completed for all applicants to a Medicaid-certified nursing facility, regardless of payer. A Level I screen must be completed before a resident can be admitted into a nursing facility.