Colorado User Tools
Colorado PASRR Tools

Adobe Acrobat Icon State's PASRR Training Tools


Adobe Acrobat Icon SEP Decision Tree


Adobe Acrobat Icon NF Transfers and Hospitalizations


Adobe Acrobat Icon Hospital Back up Onsite Nursing Assessment


Adobe Acrobat Icon CMHC Status Change Process


Adobe Acrobat Icon Beer's List (6/2008)
Daily Antipsychotic Oral Dosages for Organic Conditions


Adobe Acrobat Icon GDS List (7/2006)
Geriatric Depression Scale (GDS-SV)


Adobe Acrobat Icon Colorado Swing Bed Guidelines (6/2006)


Adobe Acrobat Icon Colorado Licensed Swing Bed Hospitals (5/2008)


Adobe Acrobat Icon PASRR Med List (9/2006)


Adobe Acrobat IconLevel I Pre-admission Screening and Resident Review (PASRR)
The Level I form is used to identify those individuals intended for evaluation through the PASRR (mental illness, mental retardation/related condition) Level II process. A Level I screen must be completed on all applicants regardless of payment source applying for admission to a Medicaid Certified Nursing Facility. Only submit the Level I form to DDM if any “YES” response is checked.


Adobe Acrobat Icon ULTC 100.2 (9/2009)
The ULTC 100.2 is a client needs assessment tool used to identify the medical necessity for individuals receiving or has applied for Medicaid. The referral agency will complete the first 3 pages of this form prior to submitting to their local Single Entry Point. The Single Entry Point will complete the ULTC 100.2 along with the SEP info sheet and submit to DDM only if it contains a FAILED. Level I.
Geriatric Depression Scale (GDS-SV)


Adobe Acrobat Icon DDD Pre-assessment (11/2004)


Adobe Acrobat Icon CMHC Depression Diversion Form


Adobe Acrobat Icon CMHC Status Change Form


Adobe Acrobat IconDDNF Annual Resident Review (1/2005)


Adobe Acrobat Icon DDNF Annual Resident Review (3/2004)


Adobe Acrobat Icon PASRR LTC Regulations





Additional forms (Colorado Department of Health Care Policy and Financing)
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