2017 PASRR RFB Appendix B - PASRR Decision Tree.doc
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- Solicitation number
- S-0627 DCTS-17
- Issued by
- Wisconsin
About this file
This file is an appendix to a Request for Bid issued by the Wisconsin Department of Health Services for Preadmission Screening and Resident Review (PASRR) Level II Screens. The document provides a decision tree diagram that outlines the PASRR screening process required by federal regulations for evaluating prospective and current nursing home residents in Wisconsin. The Level I screening process, conducted by nursing home or hospital discharge staff, determines whether an individual may have a serious mental illness or developmental disability. If Level I screening indicates potential disability, the case proceeds to Level II screening by the PASRR contractor, unless the admission qualifies as short-term under one of three permitted exemptions. The decision tree guides contractors through determining whether individuals have serious mental illness or intellectual/developmental disabilities and whether they have severe medical conditions or cognitive impairment that would substantially affect their ability to benefit from specialized services.
The Level II screening process results in one of three documentation types depending on clinical findings: a Full Level II Screen when specialized services may be needed, an Abbreviated Level II Screen when no specialized services are required, or a Partial Level II Screen when severe medical conditions or severe cognitive loss preclude assessment. Throughout the process, contractors must determine the appropriateness of nursing facility placement and identify any need for specialized services or psychiatric rehabilitative services. The contractor has until the end of any applicable short-term exemption plus ten days to complete the Level II Screen assessment.
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Preadmission Screening and Resident Review (PASRR) Level II Screens
Appendix B
PASRR DECISION TREE
LEVEL I PROCESS
No
Yes
LEVEL II PROCESS
A Level I Screen is completed by nursing home staff or hospital discharge staff. Does the Level I indicate that the person might have a major mental illness or a developmental disability?
No further screening is needed. The person may be admitted.
Will the admission be short-term (within limits permitted under one of the three (3) PASRR short-term exemptions)?
The person can be admitted. Send a copy of the Level I Screen to the PASRR contractor.
The nursing facility should arrange for a safe and orderly discharge.
Does the person need to stay longer than the time permitted for the applicable short-term exemption?
The nursing facility must refer the person to the PASRR contractor before the end of the short-term exemption. The contractor has until the end of the short-term exemption + ten (10) days to complete the Level II Screen.
Does the person have a “serious mental illness” or an “intellectual/developmental disability” as defined by the Federal regulations?
The PASRR contractor collects data to determine if the person has a severe medical condition (including dementia). Does the person have a severe medical condition or a severe cognitive loss that substantially impairs the person’s ability to participate in or benefit from specialized services or specialized psychiatric rehabilitative services?
The contractor completes documentation for a Partial Level II Screen. The PASRR process is done.
The contractor needs to complete a Full Level II Screen. The contractor may use existing data that appears to be accurate and appears to reflect current functioning, however, all data elements are to be addressed. The contractor must determine if nursing facility placement is appropriate and if the person needs specialized services or specialized psychiatric rehabilitative services to address his/her disability needs. The PASRR process is done.
The contractor completes documentation for an Abbreviated Level II Screen. The person does not need specialized services. The contractor needs to determine if a nursing facility placement is appropriate. The PASRR process is done.
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RFB No. S-0627 DCTS-17
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