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 388-97-1910 - Definitions related with PASRR "AAA"

Current through Register Vol. 24-14, July 15, 2024
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 CFR § 483.102(b)(3)
						and 42 CFR § 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 CFR § 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 CFR § 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.