Level II PASRR Information

  (The information in this portion of the website may be of use to Certified Mental Health Center staff and others interested in the determination process of whether there is a diagnosis of mental illness or mental retardation, appropriate care, related laws, requirements, and forms.)

 

AUTHORIZATION:

Preadmission Screening and Resident Reviews (PASRRs) are federally mandated screenings directed by the Medicaid Title XIX Program, EqualityCare. The Mental Health and Substance Abuse Services Division (MHSASD), has final authority for mental illness (MI). Developmental Disabilities Division (DDD) has final authority for mental retardation (MR).

 

PURPOSE:

The purpose is to assure appropriateness of placement and care for any person with MI or MR or any person thought to have MI or MR or who has had a change in their mental status AND who is either already in a nursing facility or who is applying for admission to a nursing facility.

 

PASRR EVALUATIONS:

There are multiple levels involved with PASRR screening. PASRR Level I is performed on all clients entering into a Medicaid certified nursing facility. The link for completing the PASRR Level I is http://wyequalitycare.acs-inc.com/index.html. Level II evaluations are screenings for nursing facility applicants and residents who are thought to have serious MI and/or MR to accurately assess whether an individual needs specialized services and/or nursing facility level of care. Level II screening packets are required to include:

·         PASRR Level I

·         Psychosocial evaluation

·         Psychiatric evaluation, if on file

·         LT101 less than 60 days old

·         Current History and Physical

·         Current medications

·         Progress notes

·         If MR a comprehensive medication history and IQ testing

·         Informed Consent Form

 

Fax the completed packet to APS Healthcare, Attention Sandra Jensen, at 1-866-858-8476 for a Level II PASRR review to be completed. Determination of Appropriateness for nursing facility placement is made by a qualified MH Clinician at APS Healthcare with coordination between MHSASD/DDD and EqualityCare as necessary.

 

TIME SENSITIVE:

Clients who are screened for PASRR II are often in urgent need of structured care. Completion of PASRR screenings, evaluations, determinations and related paperwork, are all time sensitive; please submit all the required documentation listed above on the first submission to avoid delays in determinations.  After screening packet is complete and received by APS a MH Clinician performs a final evaluation. After this evaluation is completed, a qualified clinical staff person at the Division gives final authority and final determination notifications are sent. Simultaneously, APS MH Clinicians establish appropriate placement for the resident based on level of care needed.

 

BILLING:

Billing and payments for evaluations are accomplished directly between the Medicaid contractor (ACS) and each provider of service.  The Division is prohibited from actually billing on behalf of any contractor.

 

FORMS: (PDF's)

Updated PASRR Policy

Updated PASRR Definition of Serious Mental Illness

Updated PASRR Responsibilities, Protocols, and Instruction for Level II

PASRR Level II Evaluation Form for Mental Illness

(NEW) Informed Consent Form

Updated Appeals Process  

CONTACTS:

Clarification on matters related to the Level II portion of PASRR’s may be obtained by calling Sandra Jensen at APS Healthcare at 1-866-880-4080 ext. 8930.

Clarifications related to billing portions of PASRR screenings may be obtained by calling ACS at 1-800-251-1268.

 

Helpful Links:

www.wyequalitycare.acs-inc.com/index.html

www.wyhealthytogether.com