top of page

FAQs

Since its inception, all 50 states, including the District of Columbia, have requested some form of technical assistance from PTAC.  As a result of questions posed by the states, PTAC has developed a library of FAQs to use as a resource for states to find a quick snapshot of information regarding common PASRR topics.  Click on Read More below to access the FAQ, as well as additional information related to the topic.

July 7, 2018

When does a Level II evaluation need to be conducted?

Pre-Admission General Rule. Under 42 CFR §483.102 (a), the PASRR process applies to all Medicaid-certified nursing facility (NF) applicants, regardless of the source of payment for the NF services, and regardless of the individual's or resident's known diagnoses. Therefore, a Level II evaluation must be completed for all such applicants who meet NF level of care requirements, and who have been identified as having suspected mental illness (MI) and/or intellectual disability (ID) by the Level I preadmission screening process.

July 7, 2018

If a nursing facility resident with MI/ID is admitted to a hospital for a short time and then wishes to return to the facility, must a Level II evaluation be completed prior to their return to the facility?

There is no federal requirement that a Level II evaluation be completed prior to the individual returning to the nursing facility (NF). A Level II evaluation is required when there is a significant change in a resident’s condition. When a resident is returning from a hospital stay, there may be a clear change in condition. In instances where the significant change is evident, the individual would be subject to a Resident Review upon their return to the nursing facility, per 42 CFR §483.106(b)(3).

July 7, 2018

When does a Level I screen need to be conducted?

According to CFR 42-§483.102, a PASRR Level I screen must be completed for all applicants to a Medicaid-certified nursing facility, regardless of payer. A Level I screen must be completed before a resident can be admitted into a nursing facility. If a current nursing facility resident experiences a significant change in his or her mental or physical condition, the individual is subject to a Resident Review evaluation.

July 1, 2018

If a nursing facility resident with mental illness or intellectual disability is admitted to a hospital for a short time and then wishes to return to the facility, must a Level II evaluation be completed prior to her return to the facility?

There is no federal requirement that a Level II evaluation be completed prior to the individual returning to the nursing facility (NF). A Level II evaluation is required when there is a significant change in a resident’s condition. When a resident is returning from a hospital stay, there may be a clear change in condition. In instances where the significant change is evident, the individual would be subject to a Resident Review upon their return to the nursing facility, per CFR §483.106(b)(3).

July 1, 2018

Why does the PTAC site make reference to "mental retardation”?

The PASRR Final Rule (57 FR 56450) was published in 1992, at which time the term "mental retardation" was still widely used. In the time since the PASRR Final Rule was published, the term "intellectual disability" has come to replace "mental retardation" in most state laws.

June 2, 2018

What is the PASRR definition of intellectual disability?

Identifying related conditions may involve some discretion on the part of a clinician or evaluator. However, although related conditions are treated by PASRR as a subset of intellectual disability, note the definition of related condition does not require that an individual have an intellectual disability so long as other related conditions criteria are met.

June 2, 2018

What are the components of a Cost Allocation Plan (CAP)?

A Cost Allocation Plan (CAP) is a narrative description of the procedures that a state will use in identifying, measuring, and allocating costs that it incurs in supporting programs it administers or supervises. In the case of PASRR, the State Medicaid Agency (SMA) is responsible for developing a CAP as part of the requirements for claiming the enhanced 75% match for PASRR-related activities. These requirements are outlined in further detail in § 45 CFR 95 Subpart E. Additional guidance may be given by the Centers for Medicare & Medicaid Services (CMS) Regional Office or contact the PASRR Technical Assistance Center.

April 27, 2018

How does PASRR help individuals transition from a Nursing Facility to a community setting?

Although Nursing Facilities (NFs) are primarily responsible for helping individuals transition to the community, PASRR can play a vital role in helping NFs develop individualized plans of care that support successful transition. The “common ground” of NFs and State PASRR programs is the well-being of the individual.

April 27, 2018

What is the PASRR Definition of Mental Illness?

According to 42 CFR 483.102(b), a disorder qualifies as a mental illness (MI) for PASRR purposes if it satisfies three major criteria

bottom of page