PASRR is required for all individuals who apply for admission to a Medicaid-certified NF, regardless of insurance type (Medicaid, Medicare, or private pay). Thus, private pay applicants who test positive at Level I could be found at Level II to need specialized services.
According to 42 CFR 483.102(b), a disorder qualifies as a mental illness for PASRR purposes if satisfies three major criteria:
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.
Nursing facility (NF) is a term of art that refers to long-term care facilities certified by the state survey agency (SSA) to provide services to Medicaid recipients.
Whether PASRR applies depends entirely on the certification of the facility, and not on any fact about the individual who is applying for admission to that facility. If an individual is applying to a Medicaid-certified facility, PASRR must be administered before he or she can be admitted.
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.
Recall that PASRR stands for "Preadmission Screening and Resident Review." By definition, PAS ("Preadmission Screening") must be performed before an individual is admitted to a Medicaid-certified nursing facility.
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.
No. The Balanced Budget act of 1996 eliminated the requirement for annual resident review, specifying that reviews are required instead upon changes in condition.
Level II involves a comprehensive evaluation of ID/MI, and a determination of the need for specialized services.