TOPIC: LAWS & RULES

This webinar focuses on the results of a recent study conducted by the US Department of Health and Human Services Office for Civil Rights (OCR) and identify training opportunities for nursing facilities for proper facilitation of Section Q of the Minimum Data Set.

For a state to have its Medicaid plan approved by the Centers for Medicare and Medicaid Services (CMS), it must maintain a Preadmission Screening and Resident Review (PASRR) program that complies with the relevant federal laws and regulations. Everyone who applies for admission to a nursing facility (NF) must be “screened” for evidence of serious mental illness (MI) and/or intellectual disabilities (ID), developmental disabilities (DD), or related conditions.

When individuals apply for admission to a nursing home and are screened by PASRR, they cross a boundary of sorts from one kind of provider setting into another kind of provider setting – typically, from the hospital where they have been admitted to the world of PASRR screeners and evaluators, and finally (for many, if not all), to the world of the nursing home.

The final Home and Community-Based Services regulations set forth new requirements for several Medicaid authorities under which states may provide home and community-based long-term services and supports. The regulations enhance the quality of HCBS and provide additional protections to individuals that receive services under these Medicaid authorities.

The enclosed report updates the 2012 Review of State Preadmission Screening and Resident Review (PASRR) Policies and Procedures, which was a first-of-its kind national survey of PASRR programs. The report was prepared by the PASRR Technical Assistance Center (PTAC), a partnership between Truven Health Analytics and Mission Analytics Group, under contract to CMS. The results of this review presents a snapshot of PASRR programs as of August 2014, with a primary focus on the comprehensiveness of Level I tools and an analysis of Minimum Data Set (MDS) data. The survey does not capture any aspects of program implementation or performance.

Developed in response to recent state inquiries, the September 10th webinar, "A Look at PASRR Related Appeals," provided useful information for improving PASRR appeals. Speakers Dr. Janet Spinelli and Mr. Sam Fante outlined background components of appeal hearings and the necessary steps in the appeal process. The webinar also introduced important considerations during the hearings process, examples of successful appeal procedures and useful tips for a more effective agency testimony.