Tools and Resources

PASRR: A FOCUS ON PERSON CENTERED RECOMMENDATIONS

PASRR applications (ODM-3622) which require a Level II assessment and determination from OhioMHAS will always offer service recommendations, regardless of the determination outcome. The determination will first identify the placement option that is the most inclusive in which the individual can access needed supports and services. Next, the person-centered recommendations address the services and supports an individual may require, regardless of where the individual resides. For example, a nursing facility resident’s recommended services and supports may assist with discharge planning and community integration.

Ohio Department of Health (ODH) is contracted by the Centers for Medicare & Medicaid Services (CMS) with surveying nursing facilities (NF) in Ohio. During a survey, ODH staff have an opportunity to review PASRR determinations and individual records to ensure NFs are implementing the recommendations in a resident’s care plan and to ensure that PASRR records are complete per Ohio Administrative Code (OAC) requirements, such as when an individual admits to a NF or experiences a significant change in condition. 

FEDERAL REGULATIONS

There are three Federal (F) Regulation tags connected to PASRR requirements which may be cited on ODH surveys. 

• F644 | Coordination of PASRR Assessments: Is the facility incorporating Level II recommendations in the resident's care plan and overall plan of care? 
   
• F645 | PASRR Screening: This regulation addresses the “basics” of the PASRR process. Is this facility identifying residents with Level II conditions? Are they completing a Resident Review prior to the hospital exemption expiring? Are they requesting timely extensions to time limited approvals? Are they actively engaging in discharge planning for those with received a denial letter? 
   
• F646 | Significant Change Notification: Is the facility identifying significant changes in condition and submitting appropriate 3622s following an identified change? 

STAFF SPOTLIGHT

REBECCA GRIMM, PASRR QUALITY MANAGER, ASSISTANT BUREAU CHIEF

Rebecca Grimm joined the PASRR Bureau in 2018 and previously served as the Hearings and Appeals Coordinator prior to her appointment as PASRR Quality Manager in 2021. She obtained her Bachelor of Science in Social Work from Ashland University in 2012 and her Masters of Social Work (Community and Social Justice Concentration) from The Ohio State University in 2013.  

Rebecca, how would you describe your role in PASRR? 
After coming from the Hearing and Appeals role, I oversee the quality improvement process and I work on developing an agenda for best practices as it relates to community outreach and technical assistance for providers and stakeholders.  
 
What has been new for you to learn in your role as Quality Manager?
PASRR has a big learning curve but being familiar already has been a positive. Even in my new role I still find new things to discover, including that quality and clinical reviews go hand in hand. I am focused on internal coordination with staff, partners, and stakeholders and maintaining quality for all the citizens of Ohio.
 
What is something you are most proud of since joining PASRR?
We see ourselves as advocates for all Ohio residents who are involved in PASRR. I want to say that the teamwork in PASRR makes me proud of what we are able to accomplish on a daily basis.

POLICY REMINDER

RECORD RETENTION

According to state regulations, OAC 5160-3-15.1 (L)(4), the nursing facility shall maintain a copy of the Level I screen (ODM-3622), all supporting documentation and results of the Level II determination in the resident's record at the facility.
 
Additionally, if a resident transfers to another nursing facility, the admitting facility is responsible for ensuring PASRR requirements are met and that copies of the most recent Level I screen and, if applicable, Level II determination are in the resident’s record. In some instances, the admitting facility may need to submit a Resident Review in HENS prior to admission when the resident has no PASRR records from the transferring facility.
 

ABOUT MAXIMUS

The Clinical Services Division of Maximus, formerly known as Ascend, assists state partners across the country in the management of complex programs to help ensure that individuals with intellectual, behavioral health and developmental disabilities and complex medical conditions receive the appropriate care and supports they need. The Company has provided PASRR assessment services for over 20 years. Maximus has national experience providing federally compliant PASRR programs in 15 states.

Learn more about Maximus services and capabilities.
 

QUALITY SATISFACTION SURVEY

YOUR FEEDBACK IS APPRECIATED

We appreciate your feedback about your assessment experience with Maximus. We will use your feedback to improve our processes and to ensure excellence in providing our services. This five-minute survey is anonymous, unless you would like to provide your contact information.

To complete the survey, use the camera on your smartphone to scan the QR code:



Or use your computer: https://www.surveymonkey.com/r/MMSCustomersvc

THE ROLE OF SUPPORTIVE DOCUMENTATION IN PASRR

A message from Jeff Ryan, PASRR Clinical Supervisor, Ohio Department of Mental Health & Addiction Services

Supportive documentation that is relevant, accurate, and updated is the “life blood” of the PASRR clinical review.  This information allows the clinical reviewers to better understand the comprehensive needs of the individual who is applying for nursing facility (NF) services. The reviewer uses this information to determine the most comprehensive setting to meet the applicant’s total needs. The reviewer’s determination will also include recommendations to assist in the care planning of the individual, regardless of where that person resides.

ANNOUNCEMENT: END OF PUBLIC HEALTH EMERGENCY
IMPACT TO THE PASRR PROGRAM

The 30-day delay of PASRR Level I screenings and Level II evaluations in response to the COVID-19 public health emergency (PHE) will terminate on May 11, 2023. 
 
As such, the Center for Medicare and Medicaid Services expects states to resume full PASRR activities in accordance with state PASRR rules (OAC 5160-3-15, OAC 5160-3-15.1, and OAC 5160-3-15.2) as of May 12, 2023. Therefore, providers must also return to the pre-PHE timeframes for completing PASRR requirements and related level of care requests.
 
To view a copy of the press release, click here. 
 
For additional questions, please submit them to PASRR@medicaid.ohio.gov.

FREQUENTLY ASKED QUESTIONS

Who needs a Pre-admission Screening?
State and federal law require anyone who is seeking admission to a Medicaid-certified nursing facility, regardless of payer source, to have a Pre-Admission Screening (PAS) completed prior to admission.
 
What if an individual does not present with a serious mental illness?
A Level I screen is still required, however, individuals who have no indications of serious mental illness are not subject for further review by the Ohio Department of Mental Health and Addiction Services. The receiving nursing facilities are responsible for ensuring all individuals seeking admission have met PASRR requirements.
 
Is anyone eligible for an exemption from the PASRR process even when short-term stays are needed?
An individual who has been hospitalized for acute inpatient care and requires nursing facility services for the condition for which care was received on a medical/surgical unit at a hospital is eligible for a hospital exemption. The attending physician certifies before admission to the facility that the resident is expected to require fewer than 30 days of nursing facility services. Following admission under the hospital exemption, should a nursing facility stay be expected to exceed 30 days, the nursing facility must complete a Resident Review for an expired hospital exemption.
 
Can a nursing facility admit an individual as long as the Level I screen (ODM-3622) has been submitted and determination is pending?
No. Individuals should not be admitted to a Medicaid-certified nursing facility, and the facility cannot bill Medicaid for services rendered until the PASRR process has been fully completed. This includes completion of the Level I screen and, if applicable, the Level II assessment and determination. The NF has the responsibility to refuse to admit an individual until the PASRR process is completed, or the individual is ruled out from further evaluation, or is approved for NF services, if the individual was referred for further evaluation.

PASRR BOARD REPORTS CORNER

REMINDER: PASSWORDS EXPIRE EVERY 90 DAYS
To enhance security and to keep your user account active in AssessmentPro, please log in on a regular basis and change your password every 90 days. If you have any questions, please contact us at Board.Reports@mha.ohio.gov.
 

ABOUT MAXIMUS

The Clinical Services Division of Maximus, formerly known as Ascend, assists state partners across the country in the management of complex programs to help ensure that individuals with intellectual, behavioral health and developmental disabilities and complex medical conditions receive the appropriate care and supports they need. The Company has provided PASRR assessment services for over 20 years. Maximus has national experience providing federally compliant PASRR programs in 15 states.

Learn more about Maximus services and capabilities.
 

QUALITY SATISFACTION SURVEY

YOUR FEEDBACK IS APPRECIATED

We appreciate your feedback about your assessment experience with Maximus. We will use your feedback to improve our processes and to ensure excellence in providing our services. This five-minute survey is anonymous, unless you would like to provide your contact information.

To complete the survey, use the camera on your smartphone to scan the QR code:



Or use your computer: https://www.surveymonkey.com/r/MMSCustomersvc

OHIO DEPARTMENT OF MEDICAID ANNOUNCES END DATE OF PUBLIC HEALTH EMERGENCY

Impact to the PASRR Program

The 30-day delay of PASRR Level I screenings and Level II evaluations in response to the COVID-19 public health emergency (PHE) will terminate on May 11, 2023.

As such, the Center for Medicare and Medicaid Services expect states to resume full PASRR activities in accordance with state PASRR rules (OAC 5160-3-15, OAC 5160-3-15.1 and OAC 5160-3-15.2) as of May 12, 2023. Therefore, providers must also return to the pre-PHE timeframes for completing PASRR requirements and related level of care requests.

To view a copy of the press release, click here.
For additional questions, please submit them to PASRR@medicaid.ohio.gov.