According to CFR 483.102(b)(3), an individual has an intellectual disability (previously mental retardation) if he or she has:
42 CFR 483.100-138 is largely mute about the timing of Resident Reviews. Recall that the CFR still described an annual Resident Review; it has not been updated to reflect subsequent legislative changes.
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.
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.