Screening Procedures for Long Term Care Services
PASRR Level I Form
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. The level one form must be approved prior to admission to the nursing facility.
North Dakota Onsite Nursing Assessment Form
For use by DDM contracted onsite evaluator. To be completed for all onsite medical necessity referrals.
North Dakota Preadmission/Resident Review Mental Health Evaluation Form
For use by DDM contracted onsite evaluator. To be completed for all MI preadmission and resident review referrals.