PASRR LEVEL II Program: A BRIEF OVERVIEW

1. PASRR LEVEL II Program: A BRIEF OVERVIEW Dave Caloiaro, MSW, LISW Chief of Administrative Programs, Planning and Quality Nevada Division of Public and Behavioral Health

2. PASRR LEVEL II PROGRAM Purpose : To ensure that nursing facility applicants and residents with mental illness and or intellectual disabilities are: • Identified • Admitted to or remain in a nursing facility only if they can be appropriately serviced in the nursing facility; and • Provided with needed MI/ID services, including specialized services

3. PASRR LEVEL II Program • PASRR Level II consists of a Comprehensive Evaluation and two determinations: 1) Need for Specialized Services and 2) Need for Nursing Facility Services. • PASRR Level II addresses persons with mental illness and persons with intellectual disabilities. • Pre-Admission Screening (PAS): Identified in Level I with suspected MI or ID • Resident Review (RR): Nursing Facility Resident with suspected new MI/ID or changed status

4. PASRR LEVEL II PROGRAM Two types of PASRR Determinations: • Categorical • Individual

5. PASRR LEVEL II (Categorical Determinations) • Convalescent Care from an acute physical illness • Terminal Illness • Severe physical illness including but not limited to coma, ventilator dependence, Parkinson’s Disease and COPD, which result in a level of impairment so severe the individual cannot be excepted to benefit from specialized services • Delirium, until an accurate assessment can be made • Emergency situations requiring protective services with placement in a nursing facility not to exceed seven (7) days

6. PASRR LEVEL II (Individual Determinations) For those not meeting a categorical PASRR Determination, the Individual Evaluation must confirm if the person: • Is appropriate for nursing facility care and if not, recommend other placement options • Has a mental illness and/or intellectual disability • Requires Specialized Services

7. PASRR LEVEL II: SPECIALIZED SERVICES The State must provide or arrange for the provision of specialized services, to all NF residents with MI or ID whose needs are such that continuous supervision, treatment and training by qualified mental health or intellectual disabilities personnel is necessary.

8. PASRR LEVEL II: SPECIALIZED SERVICES (continued) Specialized Services must be: • Addressed in the Resident’s Care Plan • Supervised by an interdisciplinary team that includes a physician and qualified mental health and/or Intellectual disability professionals • Provides specific therapies and/or treatment; and • Directed and reducing the persons symptoms and improvement level of functioning

9. PASRR LEVEL II EVALUATION REPORTS AND PLACEMENT OPTIONS The PASRR Evaluation and determination Report must include (but not be limited to): • Providing a summary of medical and social history • Confirming if nursing facility services are appropriate • Identifying what PASRR Specialized Services are recommended • If Specialized Services are not recommended, identifying what services of a lesser intensity are required

10. Three States Presentations on PASRR Level II Indiana – Willard Mays Rhode Island - Janet Spinelli Nevada - Dave Caloiaro