The April 10, 2018 FAQ “Are individuals with a traumatic brain injury (TBI) subject to PASRR?” confirms that all individuals applying to a Medicaid-certified nursing facility (NF), regardles
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Need for nursing facility (NF) services is defined by individual states, all of whom establish NF level of care (LOC) criteria.
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.
There are no federal requirements regarding who must request Level I screens, but CFR 42-§483.102 is clear that all individuals who apply to reside in a Medicaid-cer
Pre-Admission General Rule. Under 42 CFR §483.102 (a), the PASRR process applies to all Medicaid-certified nursing facility (NF)
There is no federal requirement that a Level II evaluation be completed prior to the individual returning to the nursing facility (NF).
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 nursing facility (NF).
Per the CFR, at 42 CFR 435.1010, an Institution for Mental Diseases (IMD) is a hospital, nursing facility, or other institution of more than 16 beds that is primar
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.
According to 42 CFR 483.102(b)(3), an individual has an intellectual disability if he or she has:
A Level II evaluation may be halted if the person has a diagnosis solely of dementia, or a diagnosis of dementia in combination with a non-PASRR disability. However, a Level II evaluation should not be halted if a PASRR disability has not yet been ruled out.
According to 42 CFR 483.102(b), a disorder qualifies as a mental illness (MI) for PASRR purposes if it satisfies three major criteria:
The Code of Federal Regulations (CFR) provides no specific guidance related to retention of PASRR records, but it does make clear that retention of PASRR records is a requirement. The basis of the requirement is addressed in two areas cited a
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.
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.
The Code of Federal Regulations (CFR) at §483.130(d) provides examples of categories for which the State mental health or intellectual disability authority may make
The Final Rule was published in November 2016 (80 FR 42168).
42 CFR 483.130(h) provides that the State intellectual disability authority may make categorical determinations that individuals with dementia, whi
A swing bed is a bed that changes (or "swings") between providing hospital services and providing Medicare or Medicaid nursing facility services.