Chapter 514 - Nursing Facility Services - DHHR - State of West ...
Chapter 514 - Nursing Facility Services - DHHR - State of West ...
Chapter 514 - Nursing Facility Services - DHHR - State of West ...
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evaluator. All Level II evaluators are either licensed psychologists or Board certifiedpsychiatrists.It is the responsibility <strong>of</strong> the facility in which the PAS is completed, to arrange for the Level IIevaluation. This evaluation must be completed, including a report <strong>of</strong> the mental health statusand whether specialized services are needed, within (7 to 9) seven to nine days following thereferral. The Level II must be completed prior to the individual’s admission into a nursingfacility. Upon completion <strong>of</strong> the evaluation, both the referring entity and the PASARR Level IIevaluator must provide the complete mental health evaluation and the original Level I evaluationto the receiving nursing facility. Additionally, the results <strong>of</strong> the evaluation shall be sent toPsychological Consultants and Associates (PC&A) via mail to 202 Glass Drive, Cross Lanes,<strong>West</strong> Virginia 25313 or fax to (304) 776-7247 on the applicable forms.42 CFR 483.106 (ii) states “In cases <strong>of</strong> transfer <strong>of</strong> a resident with MI or IDD from a nursingfacility to a hospital or to another nursing facility , the transferring nursing facility is responsiblefor ensuring that copies <strong>of</strong> the resident’s most recent PASARR and resident assessment reportsaccompany the transferring resident”. This regulation applies to all residents <strong>of</strong> nursing facilities.Repeat Level II evaluations are necessary when there is an acute exacerbation <strong>of</strong> the mentalillness resulting in an inpatient admission to a psychiatric facility/psychiatric unit. Thedischarging facility must complete a new PAS, assuring that #31 on the PAS is completedaccurately, in which a Level II will be triggered.<strong>514</strong>.6.7 Specialized <strong>Services</strong> for I/DDSpecialized services for an individual identified as I/DD are a continuous program for anindividual requiring aggressive, consistent implementation <strong>of</strong> a program <strong>of</strong> specialized andgeneric training, treatment, health and related services developed by an IDT that is directedtowards:The acquisition <strong>of</strong> the behaviors necessary for the individual to function with as muchself-determination and independence as possible; andThe prevention or deceleration <strong>of</strong> regression or loss <strong>of</strong> their current optimal functionalstatus.These services are generally provided in an intermediate care facility for persons with I/DD or arelated condition. If the resident is presently residing in a nursing facility when the Level II iscompleted and specialized services for I/DD is indicated, and the responsible party refuses thisrecommendation, this refusal must be documented in the resident’s record and readdressedwith the responsible party on a continuing quarterly basis or until a Level II recommendsotherwise.<strong>514</strong>.6.8 Specialized <strong>Services</strong> for Mental IllnessSpecialized services for an individual with an acute exacerbation <strong>of</strong> a major mental illness arethe continuous and aggressive implementation <strong>of</strong> an individualized plan <strong>of</strong> cares that:Department <strong>of</strong> Health and Human Resources <strong>Chapter</strong> <strong>514</strong>: <strong>Nursing</strong> <strong>Facility</strong> <strong>Services</strong> Page 32January 1, 2013DISCLAIMER: This manual does not address all the complexities <strong>of</strong> Medicaid policies and procedures,and must be supplemented with all <strong>State</strong> and Federal Laws and Regulations.