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

All individuals applying to a Medicaid-certified nursing facility (NF) must be screened for both mental illness and intellectual disability. According to 483.128 (e), if a Level II evaluation is required “The State's PASRR 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 mental illness and one for intellectual disability.