Resources
PASRR regulations at 42 CFR 483.128(m) permit Level II evaluations to be terminated if the Level II evaluator finds that individual has:
“A primary diagnosis of dementia (including Alzheimer’s Disease or a related disorder)” (42 CFR 483.128(m)(2)(i)); or
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.
Richard Sanderson, a PTAC consultant, reviews a variety of tools to detect common mental health and substance use disorders, most of which are in the public domain. Sanderson categorizes the tools according to how long they take to administer, along with their strengths and weaknesses.
Yes, hospitals can perform Level II evaluations -- provided they have the qualified staff. In order to complete these evaluations, hospitals would first have to negotiate payment rates with the relevant state agency.
Presented and attached below are Level II evaluation tools currently used in four states: Missouri, Nevada, North Carolina, and Tennessee. Some tools are specific to one population (e.g. individuals with ID) whereas other tools are used to assess more than one population (e.g.
This report (below) presents the first systematic, empirical effort to document the design of PASRR systems in all States and the District of Columbia.
June 2012 PASRR Webinar
You can download a PDF version of the presentation slides at the bottom of this webpage.
The key to meaningful interstate coordination is to share Level II evaluation facts rather than Level II evaluation conclusions or outcomes.
February 2012 PASRR Webinar
You can download a PDF version of the presentation slides at the bottom of this webpage.
According to CFR 483.102(b)(3), an individual has an intellectual disability (previously mental retardation) if he or she has:
All individuals applying to a Medicaid-certified NF must be screened both for mental illness and for intellectual disability. An individual who tests positive on both screens must undergo a Level II for mental illness and a Level II for intellectual disability.
No. It is illegal for NFs to perform a PAS or RR. The PAS must be performed before an individual is admitted to the NF, and must be conducted by parties unaffiliated with the NF.
The CFR does not specify how quickly Level I's must be completed, and with good reason: There is no baseline against which to establish timing requirements.
A level II Preadmission Screen (PAS) must be completed for all applicants who meet NF level-of-care requirements, and who have been identified as having possible MI and/or ID by the Level I evaluation.
No federal requirement specifically addresses this issue. A Level II evaluation is required when there is a change in a resident’s condition. When a resident is returning from a hospital stay, there may be a clear change in condition.
Level II involves a comprehensive evaluation of ID/MI, and a determination of the need for specialized services.