388-97-1900  <<  388-97-1910 >>   388-97-1915

WAC 388-97-1910

Definitions related with PASRR.

"AAA" means area agency on aging.
"Advance categorical determination" means a determination by a mental health or DDA PASRR evaluator that an individual may be admitted to a nursing facility on a temporary basis. The PASRR evaluator will do an abbreviated evaluation that is sufficient to determine that the individual has an intellectual disability or related condition and that the individual meets nursing facility level of care, but does not need specialized services at that time. The potential reasons are:
(1) Protective services stay of not more than seven days;
(2) Respite in a nursing facility for not more than thirty days; and
(3) Delirium (full level II evaluation required when condition improves).
"DDA" means the developmental disabilities administration within the department.
"Exempted hospital discharge" means the process by which an individual who meets the criteria may be admitted to a nursing facility without a PASRR level II evaluation, even though he or she may have a serious mental illness or an intellectual disability or related condition.
"HCS" means home and community services within the department.
"Intellectual disability or related condition" means a condition as defined in 42 C.F.R. §483.102(b)(3) and 42 C.F.R. §435.1010 or successor laws.
"Preadmission screening and resident review process" or "PASRR process" means the process required by federal law to determine if placement in a nursing facility is appropriate for an individual who has a serious mental illness, an intellectual disability or related condition, or both, and if so, to determine whether specialized services are necessary. The PASRR process includes the following steps:
(1) A "PASRR level I" screening is conducted by a referring provider, such as a hospital or physician, or by designated HCS, AAA or DDA staff, to identify whether an individual may have a mental illness, an intellectual disability or related condition, or both. Under the limited circumstances described in this chapter, a nursing facility may conduct the screening. The standardized form and guidelines developed by the department's PASRR program must be used to conduct the Level 1 screening.
(2) A "PASRR level II" evaluation is conducted by the DDA or mental health PASRR evaluator, or both, as appropriate. This evaluation is performed with individuals who, based upon the PASRR level I screening, are suspected of having a mental illness, an intellectual disability or related condition, or both. The level II evaluator determines:
(a) Whether the individual has a serious mental illness and/or an intellectual disability or related condition;
(b) If so, whether nursing facility placement is appropriate; and
(c) If so, whether the individual requires specialized services while residing at the nursing facility.
"Resident review" means a PASRR level II evaluation of a resident with serious mental illness and/or intellectual disability or related condition after that resident has experienced a significant change in physical or mental condition, as defined in this section.
"Serious mental illness" means a condition as defined in 42 C.F.R. §483.102 (b)(1) or successor laws.
"Significant change in physical or mental condition" for PASRR purpose means a deterioration or improvement in the physical or mental condition of a resident with serious mental illness or intellectual disability or related condition such that:
(1) The resident may reasonably require new, different, or fewer specialized services than the resident had been receiving; or
(2) Community placement is a reasonable consideration for the resident.
"Specialized services" are services provided or arranged for by the department as described in 42 C.F.R. §483.120 or successor laws, which are additional to services the nursing facility is required to provide. The PASRR level II evaluation identifies the specialized services needed by the resident.
[Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. § 483.100-138. WSR 15-18-026, § 388-97-1910, filed 8/25/15, effective 9/25/15.]
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