PASRR

            ABSTRACT: DOH issues Dear Administrator letter on PASRR and significant change in status.

DOH has issued guidance to remind nursing homes that residents who have been previously identified through the PASRR (Preadmission Screen Resident Review) process as having mental illness or mental retardation and have experienced a significant change in status require a new Level II PASRR evaluation. In addition, the DOH letter introduces a new PASRR NYS Level II Adult Mental Health Evaluation Report.

The guidelines for identifying a significant change in status can be found in the Minimum Data Set (MDS) 3.0 User’s Manual Section 2.6. The PASRR definition for a significant change in status is the same as the MDS 3.0 definition which states, “A significant change is a decline or improvement in a resident’s status that:

• Will not normally resolve itself without intervention by staff or by implementing standard disease-related clinical interventions; is not ‘self-limiting’ (for declines only);

• Impacts more than one area of the resident’s health status; and

• Requires interdisciplinary review and/or revision of the health care plan.”

DOH emphasizes that the Level II evaluation must be made as soon as the significant change is identified and a facility should not wait until the significant change in status is complete.  Communication between the hospital and the nursing home should take place to ensure that the PASRR referral is timely.

In addition, effective September 1, 2011, Level II Adult Mental Health evaluations will result in the issuance of a PASRR NYS Level II Adult Mental Health Evaluation Report. The report provides the PASRR evaluator’s placement and mental health services recommendation. The receiving entity must review this information and incorporate it into the resident’s overall plan of care, including discharge planning. Medicaid funding will not be available when required Level II PASRR evaluations have not been conducted or when the individual has been admitted to the RHCF despite a Level II placement recommendation determining the individual is not appropriate for RHCF placement.

DOH will continue to review the compliance with PASRR requirements to determine if Level II recommendations and referrals are timely, appropriate and consistent with federal requirements.

The DAL, IPRO and DDSO contact information, and the PASRR Evaluation Report is attached .

Members with questions or comments should contact Elliott Frost at 518-867-8832, or via e-mail at efrost@nyahsa.org.