TOPIC: QUALITY

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.

The enclosed 2015 report (below) updates the 2014 Review of State Preadmission Screening and Resident Review (PASRR) Policies and Procedures. The report was prepared by the PASRR Technical Assistance Center (PTAC), under contract to CMS. The results of this review presents a snapshot of PASRR programs as of September 2015, 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.

West Virginia will present on their Level I screening tool developed to help eliminate false positives and to more accurately identify those individuals with a serious mental illness and/or an intellectual disability/ developmental delay. For West Virginia, a systems approach meant that all entities involved in the process must be trained extensively and frequently Representatives from West Virginia will discuss WV’s current definition of specialized services as well as anticipated changes. The presenter will also discuss the importance of automation to allow reviews to shorten the timeframes for Level I and Level II reviews.

The enclosed 2014 report (below) updates the 2013 Review of State Preadmission Screening and Resident Review (PASRR) Policies and Procedures. The report was prepared by the PASRR Technical Assistance Center (PTAC), 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.

Quality monitoring has become an important component of many Medicaid programs. The regulations that govern Preadmission Screening and Resident Review (PASRR) do not require quality monitoring. Nonetheless, robust quality monitoring programs would help states to run PASRR programs that are more effective and more person-centered. In this webinar, we will review a set of useful quality measures and introduce an Excel-based tool that states can use to track these measures. The measures we will review are likely to be become mandatory for PASRR in the future. By attending the webinar, state staff and PASRR vendors can get an early start on gathering, reporting, and acting on these data.

Led by Nancy Shanley, the November 12th webinar addressed five PASRR conundrums, or issues that are frequently asked about