If an individual tests positive at Level I for both mental illness (MI) and intellectual disability (ID), how many Level II evaluations must be performed?

All individuals applying to a Medicaid-certified nursing facility must be screened for both MI and ID. According to 42 CFR 483.128(e) if a Level II evaluation is required “The State's PASARR program must use at least the evaluative criteria of § 483.130 (if one or both determinations can easily be made categorically as described in § 483.130) or of §§ 483.132 and 483.134 or § 483.136 (or, in the case of individuals with both MI and IID, §§ 483.132, 483.134 and 483.136 if a more extensive individualized evaluation is required).”

In other words, an individual who tests positive on both screens must undergo two Level II evaluations – one for MI and one for ID.