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PENNSYLVANIA DEPARTMENT OF HUMAN SERVICESOFFICE OF LONG-TERM LIVING

OBRAPreadmission Screening

Resident Review Identification Form

(Level I Tool)

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Objectives of the Webinar

Overview of the Federal (CMS) Requirements for PASRR

What is required for NFs regarding PASRR NF eligibility PASRR Level I Tool Process Program Office Criteria Role of the Program Offices Important Websites Who to call for help

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PASRR Background Is a requirement under Medicaid, pursuant to

OBRA 1987 (Omnibus Budget Reconciliation Act) and 42 CFR §483.100-483.138

Applies to all individuals seeking admission to a Medicaid certified nursing facility (NF) regardless of payment source and ensures that individuals are placed in the least restrictive setting possible.

Is part of the licensure for a Medicaid participating NF

Provisions were addressed in PA Bulletin, Volume 18, Number 52 on December 24, 1988.

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Background cont.

Requires that a NF does not admit any new resident with Mental Illness (MI), an Intellectual Disability (ID) or Related Condition (ORC) unless the individual is determined through a PASRR evaluation to be appropriate for NF services (CFR §483.106(a))

Failure to timely complete (prior to admission) the PASRR process will result in forfeiture of Medicaid Reimbursement to the NF during the period of non-compliance in accordance with Federal PASRR Regulations (CFR §483.122(b))

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Prior to Admission to a NF the following must be done: Preadmission Screening Identification

(PASRR-ID) Level I tool Preadmission Screening Evaluation

(PASRR-ID) Level II tool (if needed) Program Office Letter of Determination

received if Level II was needed.

Preadmission Screening

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PASRR-ID: Section I – Demo, Diagnosis, & Communication

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PASRR-ID: Section II – NCD/Dementia

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PASRR-ID: Section III - Serious Mental Illness

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PASRR-ID: Section III-B 1

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PASRR-ID: Section III-B 2

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PASRR-ID: Section III-C-Level of Impairment

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PASRR-ID: Mental Health Note

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PASRR-ID: Intellectual Disability – Section IV

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PASRR-ID: Section IV-D, E, F

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PASRR-ID: Intellectual Disability Note

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PASRR-ID: Section V - Other Related Conditions

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PASRR-ID: Other Related Condition Note

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PASRR-ID: Section VI - Home & Community Services

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PASRR-ID: Section VII -Exceptional Admission

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PASRR-ID: VII-B, C, D

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PASRR-ID: Change in Exceptional Status

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PASRR-ID: Section VIII – Screening Outcome

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PASRR-ID: Section IX– Individual Completing Form

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If the Criteria on the PASRR-ID (Level I) form indicates a need for a PASRR Level II form to be completed, it must be completed prior to admission to a long-term care nursing facility.

The entity completing the PASRR-EV (Level II) must forward the evaluation and required information to the appropriate Program Office.

What happens if the Program Office criteria is met?

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• The Area Agency on Aging (AAA) in the County you are in does the Level II Assessments (Call the AAA to start this process)

• The following information is needed by the AAA in order to do the assessment:– MA 51– PASRR Level I form– Comprehensive Medical History that includes a physical exam and

diagnoses– Comprehensive Medication history (most current and immediate past)– Comprehensive Psychosocial and Psychiatric evaluations– Last 3 days of Physician progress notes and orders– Last 3 days of nurses notes– Current medication record– PT/OT/ST recent notes– CT/Neurological consults

Process for the Level II Assessment

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The Program Office will review the information (listed on the prior slide) to determine if the individual:o Meets the criteria for the Program Officeo Eligibility for Long Term Services and Supports o Needs Specialized Services

End result is a Program Office Letter of Determination

Role of the Program Office

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Order MA Forms:http://www.dhs.pa.gov/dhsassets/maforms/index.htm

OBRA Information Website:http://www.dhs.pa.gov/provider/longtermcarecasemixinformation/obratrainingInformation/index.htm

Long Term Care Nursing Facility Providers website:http://www.dhs.pa.gov/provider/longtermcarecasemixinformation/index.htm

Important Websites

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PASRR Clarifications, Questions and Answers Document

PASRR FORMS

• The Website to download and/or order the PASRR Level I (MA 376) Assessment form and the PASRR Level II (MA 376.2) Assessment forms can be found at:http://www.dhs.pa.gov/dhsassets/maforms/index.htm

PASRR BULLETINS

• MA376

• MA376.2

PASRR TRAINING

• Handouts for Webinar Training (11/2015)

HELPFUL INFORMATION

• Field Operations Offices and Phone numbers

• Program Office and Contacts

OBRA Information Website

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Ruth Anne Barnard, B.S.N., R.N. MDS/OBRA Coordinator for Field Operations◦ rbarnard@pa.gov◦ 717-214-3736

Randy NolenDivision Director of Field Operations◦ rnolen@pa.gov◦ 717-772-2543

Program Offices – see list found on the OBRA Website (see previous slide)

Field Operations Supervisors – see list found on the OBRA Website (see previous slide)

Questions?

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