TOPIC: LEVEL II EVALUATION &
DETERMINATION
The purpose of a Level II evaluation is to confirm that an individual has a mental illness or intellectual disability. The Level II evaluation also assesses the applicant’s need for nursing facility services and whether the applicant requires specialized services or specialized rehabilitative services. This section contains Level II resources for state PASRR programs.
When does a Level II evaluation need to be conducted?
July 7, 2018
FAQ
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.
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?
July 7, 2018
FAQ
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).
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?
July 1, 2018
FAQ
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).
What is the PASRR definition of intellectual disability?
June 2, 2018
FAQ
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.
Do PASRR Regulations Require a Test of Intellectual Functioning Be Completed as a Part of Level II Evaluations for Individuals with Intellectual Disabilities and Related Conditions?
April 27, 2018
FAQ
There is a common misconception about this. The simple answer is "no" -- a test of intellectual functioning (IQ test) is not required by PASRR regulations.
How does a categorical determination for dementia and intellectual disability affect the PASRR process?
April 10, 2018
FAQ
42 CFR 483.130(h) provides that the State intellectual disability authority may make categorical determinations that individuals with dementia, which exists in combination with an intellectual disability (ID) or a related condition, do not need specialized services.