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

Example PASRR Level II Evaluation Tools

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. individuals with ID or MI and individuals with ID and MI). All of the tools presented below are considered entirely comprehensive according to the 2013 National Review of State PASRR Policies and Procedures report

Since PASRR Level II processes vary across states, effective Level II evaluation tools will also be different from state to state. Moreover, many of these are copyrighted and considered property of the state or of a vendor that developed the tool on the state's behalf. For these reasons, these documents should be used as examples of effective Level II tools and should not to be copied outright. You can download a PDF version of each tool by clicking on the state name. 

Missouri: ID and MI 

In Missouri, a vendor oversees the completion of Level II evaluations for individuals suspected of having MI and/or ID. A registered nurse or qualified mental health professional assessor completes Level II MI evaluations; a registered nurse completes Level II ID evaluations. The vendor's quality assurance program reviews the Level II evaluation packets to ensure reliability and validity. For example, a random 10% sampling of all Level II evaluations are closely reviewed each quarter. Detailed instructions for how to complete the evaluation tool are also provided to assessors. 

Nevada: ID, MI, and ID/MI

Nevada's Level II evaluations are easy to follow, comprehensive, and strengths-based. For example, to assess ADLs/IADLs for individuals with MI, Nevada's Level II tools prompt the evaluator to mark on a scale of 1-5 the level of assistance necessary to perform a list of activities. Strengths-based questions are important to help individuals feel capable and strong. 

North Carolina: ID

Noteworthy about North Carolina's Level II ID evaluation tool are the comprehensive options for evaluators to indicate recommended services and placement determination considerations for the individual (pp. 6-8). About fifteen services are listed in checkbox form, which may help to structure the evaluator's recommendations. Additionally, comprehensive definitions of indicators for NF care are provided to assist the evaluator in determining appropriate placement for the individual (pp. 7-8). This format promotes inter-rater reliability and helps to ensure that all individuals receiving a PASRR Level II ID evaluation receive the services they need and that these services are received in the most appropriate setting.

Tennessee: ID, MI, and ID/MI

The Tennessee Level II tool was developed and is managed by a contractor. This is the paper version of the contractor’s electronic tool, which enables easy storage and retrieval of PASRR-related data and the ability to monitor quality and outcomes. This technology helps to make PASRR more efficient and helps ensure individuals with MI and/or ID are served appropriately. This is an excerpt of the contractor’s proprietary and copyrighted Level II tool. 

PTAC currently serves as a contractor for CMS.
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