Virginia Administrative Code › Title 12 - HEALTH › Agency 30 - DEPARTMENT OF MEDICAL ASSISTANCE SERVICES › Chapter 130 - AMOUNT, DURATION AND SCOPE OF SELECTED SERVICES › Part III - Preadmission Screening and Annual Resident Review › Section 12VAC30-130-140 - Definitions

Current through Register Vol. 40, No. 24, July 15, 2024
"Community Services Board (CSB)" means the local
					 governmental agency responsible for local mental health, mental retardation,
					 and substance abuse services. Boards function as service providers, client
					 advocates, and community educators.
"Dementia" means, for the purposes described herein, having
					 a primary diagnosis of dementia, as described in the Diagnostic and Statistical
					 Manual of Mental Disorders, 3rd edition, revised in 1987, or a nonprimary
					 diagnosis of dementia unless the primary diagnosis is a major mental disorder
					 as defined herein.
"Diagnostic and Statistical Manual of Mental Disorders, 3rd
					 edition" means the 1987 publication of the American Psychiatric Association
					 classifying diagnoses of abnormal behavior.
"Interfacility transfer" means when an individual is
					 transferred from one nursing facility (NF) to another nursing facility, with or
					 without an intervening hospital stay. Interfacility transfers are subject to
					 annual resident review rather than preadmission screening. In cases of transfer
					 of a resident with MI or MR or a related condition (MR/RC) from a NF to a
					 hospital or to another NF, the transferring NF is responsible for ensuring that
					 copies of the resident's most recent preadmission screening and annual resident
					 review (PASARR) and resident assessment reports shall accompany the
					 transferring resident.
"Level I identification" means the process performed to
					 identify nursing facility applicants with a condition of mental illness or
					 mental retardation.
"Level II evaluation" means the evaluation process for
					 nursing facility applicants who are identified as having a condition of mental
					 illness or mental retardation as defined herein. The purpose of the Level II
					 evaluation is to recommend placement of and services to nursing facility
					 applicants with statutorily defined mental illness or mental
					 retardation.
"Mental Illness (MI)" means a serious mental illness
					 meeting all of the following requirements:
1. The individual has a major mental disorder
				  diagnosable under the Diagnostic and Statistical Manual of Mental Disorders,
				  3rd edition, revised in 1987 that is a schizophrenic, mood, paranoid, panic, or
				  other severe anxiety disorder; somatoform disorder, personality disorder, other
				  psychotic disorder, or another mental disorder that may lead to a chronic
				  disability. The disorder is not a primary diagnosis of dementia, including
				  Alzheimer's disease or a related disorder, or a non-primary diagnosis of
				  dementia unless the primary diagnosis is a major mental disorder as defined
				  here;
2. The disorder results in
				  functional limitations in major life activities within the past three to six
				  months that would be appropriate for the individual's developmental stage. An
				  individual typically has at least one of the following characteristics on a
				  continuing or intermittent basis:
a.
				  Interpersonal functioning. The individual has serious difficulty interacting
				  appropriately and communicating effectively with other persons, has a possible
				  history of altercations, evictions, firing, fear of strangers, avoidance of
				  interpersonal relationships, and social isolation;
b. Concentration, persistence, and pace. The
				  individual has serious difficulty in sustaining focused attention for a long
				  enough period to permit the completion of tasks commonly found in work settings
				  or in work-like structures, activities occurring in school or home settings,
				  manifests difficulties in concentration, inability to complete simple tasks
				  within an established time period, makes frequent errors, or requires
				  assistance in the completion of these tasks; and
c. Adaptation to change. The individual has
				  serious difficulty in adapting to typical changes in circumstances associated
				  with work, school, family, or social interaction, manifests agitation,
				  exacerbated signs and symptoms associated with the illness, or withdrawal from
				  the situation, or requires intervention by the mental health or judicial
				  system.