Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-97 - Nursing homes › Subchapter I - RESIDENT RIGHTS, CARE AND RELATED SERVICES › Preadmission Screening and Resident Review (PASRR) in Medicaid Certified Facilities › Section 388-97-1975 - PASRR requirements after admission of a resident

Current through Register Vol. 24-14, July 15, 2024
Following a resident's admission, the nursing facility
						must:
(1) Review all level I screening
					 forms for accuracy. If at any time the facility finds that the previous level I
					 screening was incomplete, erroneous or is no longer accurate, the facility must
					 immediately complete a new screening using the department's standardized level
					 I form, following the directions provided by the department's PASRR program. If
					 the corrected level I screening identifies a possible serious mental illness or
					 intellectual disability or related condition, the facility must notify DDA
					 and/or the mental health PASRR evaluator so a level II evaluation can be
					 conducted.
(2) Record the evidence
					 of the level I screening and level II determinations (and any subsequent
					 changes) in the resident assessment in accordance with the schedule required
					 under WAC
					 388-97-1000.
(3) Maintain the level I form and the level
					 II evaluation report in the resident's active clinical record.
(4) Immediately complete a level I screening
					 using the department's standardized form if the facility discovers that a
					 resident does not have a level I screening in his or her clinical record,
					 following directions provided by the department's PASRR program. If the level I
					 screening identifies a possible serious mental illness or intellectual
					 disability or related condition, notify the DDA and/or mental health PASRR
					 evaluator so a level II evaluation can be conducted.
(5) Notify the DDA and/or mental health PASRR
					 evaluator when a resident who was admitted on an exempted hospital discharge
					 appears likely to need nursing facility services for more than thirty days, so
					 a level II evaluation can be performed. This notification must occur as soon as
					 the nursing facility anticipates that the resident may require more than 30
					 days of nursing facility services, and no later than the twenty-fifth day after
					 admission unless good cause is documented for later notification.
(6) Notify the DDA and/or mental health PASRR
					 evaluator when a resident who was admitted with an advance categorical
					 determination appears likely to need nursing facility services for longer than
					 the period specified by DDA and/or the mental health PASRR evaluator, so that a
					 full assessment of the individual's need for specialized services can be
					 performed. This notification must occur as soon as the nursing facility
					 anticipates that the resident will require more than the number of days of
					 nursing facility services authorized for the specific advance categorical
					 determination and no later than five days before expiration of the period
					 (three days for protective services) unless good cause is documented for later
					 notification.
(7) Immediately
					 notify the DDA and/or mental health PASRR evaluator for a possible resident
					 review when there has been a significant change in the physical or mental
					 condition, as defined in WAC
					 388-97-1910, of any resident who
					 has been determined to have a serious mental illness or intellectual disability
					 or related condition. Complete a new level I screening for the significant
					 change.
(8) Provide or arrange for
					 the provision of any services recommended by a PASRR level II evaluator that
					 are within the scope of nursing facility services. If the facility believes
					 that the recommended service either cannot or should not be provided, the
					 facility must document the reason(s) for not providing the service and
					 communicate the reason(s) to the level II evaluator.
(9) Immediately complete a new level I
					 screening using the department's standardized form if the facility finds that a
					 resident, not previously determined to have a serious mental illness, develops
					 symptoms of a serious mental illness, and refer the resident to the mental
					 health PASRR evaluator for further evaluation.
(10) Provide services and interventions that
					 complement, reinforce and are consistent with any specialized services
					 recommended by the level II evaluator. The resident's plan of care must specify
					 how the facility will integrate relevant activities to achieve this consistency
					 and the enhancement of the PASRR goals.
(11) Discharge, in accordance with WAC
					 388-97-0120, any resident with a
					 serious mental illness or intellectual disability or related condition who does
					 not meet nursing facility level of care, unless the resident has continuously
					 resided in the facility for at least thirty months and requires specialized
					 services. The nursing facility must cooperate with DDA and/ or mental health
					 PASRR evaluator as it prepares the resident for a safe and orderly
					 discharge.