TOPIC: RESIDENT REVIEW

A Resident Review is triggered whenever an individual undergoes a significant change in status and that change has a material impact on their functioning as it relates to their mental illness or intellectual disability. The notion of “significant change” is defined in the manual governing the Minimum Data Set (MDS). Readmissions to the nursing facility and inter-facility transfers are also subject to a Resident Review. This section contains resources related to Resident Review for state PASRR programs.

How quickly must resident reviews be completed?

FAQ

Originally, Resident Reviews—Level II post-admission evaluations—had to be conducted annually; hence, the original name of the program was Preadmission Screening and Annual Resident Review, or PASARR, which is the title that is still in the rule.

Is a Resident Review required when an individual is transferred from one facility to another?

FAQ

"According to 42 CFR §483.106(b)(4) of the Code of Federal Regulations (CFR), when an individual is transferred from one nursing facility (NF) to another NF, with or without an intervening hospital stay, the individual is not considered a “new admission” and does not need preadmission screening. 42 CFR 483.106(b)(4)(ii) clarifies that the transferring NF must ensure that all copies of the resident’s PASRR paperwork (including any Level II information) must be transferred with the individual.

What is considered a "significant change in condition?"

FAQ

The Centers for Medicare & Medicaid Services (CMS) Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, version 1.5, provides guidance to nursing facilities (NF) on when a significant change requires referral for a PASRR Resident Review evaluation if a mental illness, intellectual disability, or related condition is present or is suspected to be present.

When are Resident Reviews required?

FAQ

In order to be eligible for federal financial participation (FFP), Specialized Services must be included in the State Plan. They are considered “specialized add-on services” that can be provided under the nursing facility benefit authorized the Section 1905(a) of the Social Security Act.

PASRR: The Dementia Exclusion for Serious Mental Illness (2017)

Webinar

This webinar aims to clarify the relationship between PASRR Level II evaluations and dementia and mental illness. Current concerns about practices related to dementia and mental illness will be reviewed and the responsibilities of Level I screeners and Level II evaluators will be addressed. Areas of confusion related to dementia and mental illness will be identified and training resources will be recommended.

PTAC currently serves as a contractor for the Centers for Medicare & Medicaid Services 

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