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 undergo at minimum a Level I evaluation, whether they have TBI, some other mental disability, or no mental disability. Whether an individual with TBI should test positive at Level I depends upon when the TBI was acquired.
For a variety of reasons, including the availability of evaluators, it may not always be possible to perform a complete psychiatric evaluation on an individual before they are admitted to a NF.
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.
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.