The PASRR Technical Assistance Center helps states fulfill the goals of Preadmission Screening and Resident Review

If the answer to MDS 3.0 Question A1500 is "yes," and the individual has undergone a significant change in condition, should the nursing home always contact the SMHA/SIDA?

No. Some significant changes in status may have a dramatic impact on a resident's MI/ID status, while others may have little or no impact. For example, a hip fracture that limits mobility may serious exacerbate a person's behavioral symptoms, especially if the individual does not fully comprehend why their mobility has suddenly changed. By contrast, an individual who develops a pressure ulcer may experience no changes in their MI/ID status.

Note that there are no rules to determine when a significant change in condition should warrant a referral to the mental health or intellectual disability authority. It is ultimately a judgment call, to be made by the individual's care team. If there is any doubt, however, you should place the call and talk to the staff at the relevant authority about what is happening with the individual. Even if the state staff ultimately conclude that a resident review is not necessary, the call will give you an important opportunity to talk to the staff about the kinds of changes that might require a referral.

As with PASRR itself, the aim of Question A1500 is not to generate a series of fixed rules ("if resident undergoes significant change of Type X, contact the mental health authority"). Rather, the goal is to ensure that the needs of residents with MI/ID are being addressed properly, and their care is holistic and person-centered.

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