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.
The so-called “IMD exclusion” bars federal contributions to the cost of medically necessary inpatient care incurred in treating Medicaid beneficiaries ages 21-64 who receive care in institutions that qualify as IMDs.
42 CFR 483.130(o) has this to say about the retention of PASRR records:
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.