The purpose of new Rule 59G-1.040 is to specify Florida Medicaid’s process required for Pre-Admission Screening and Resident Review (PASRR). The PASRR is a federally mandated process to help ensure individuals in need of long-term care services ...

 

AGENCY FOR HEALTH CARE ADMINISTRATION

Medicaid

RULE NO.:RULE TITLE:

59G-1.040Pre-Admission Screening and Resident Review

PURPOSE AND EFFECT: The purpose of new Rule 59G-1.040, F.A.C., is to specify Florida Medicaid’s process required for Pre-Admission Screening and Resident Review (PASRR). The PASRR is a federally mandated process to help ensure individuals in need of long-term care services reside in the most appropriate and least restrictive setting possible, are not inappropriately placed in nursing homes, and receive the services they need in that setting. The PASRR process is required for all applicants to Medicaid-certified nursing facilities, which include children under age 21 years, regardless of payor. The rule also ensures that every applicant receives a PASRR Level II evaluation and determination if indicated in the PASRR Level I. This rule supersedes the PASRR process and forms currently in the Florida Medicaid Nursing Facility Services Coverage and Limitations Handbook, incorporated by reference in Rule 59G-4.200, Florida Administrative Code.

SUMMARY: SUMMARY: This rule is mandated by federal law to ensure that Medicaid-certified nursing facility applicants and residents with mental illness, intellectual disabilities, or related conditions are identified and admitted or allowed to remain in a nursing facility only if there is a verified need for nursing facility services. Additionally, if a need for specialized services is determined, federal guidelines require that such services must be provided.

NOTE: The Agency has determined that the electronic uploading materials incorporated by reference in paragraph 59G-1.040(2)(e) and subparagraph 59G-1.040(2)(k)1. would constitute a violation of federal copyright law. This material is available for public inspection and examination at the Agency for Health Care Administration, 2727 Mahan Drive, Tallahassee, FL 32308. Please contact Margaret Reilly at the contact information provided below for questions.

SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS AND LEGISLATIVE RATIFICATION:

The Agency has determined that this will not have an adverse impact on small business or likely increase directly or indirectly regulatory costs in excess of $200,000 in the aggregate within one year after the implementation of the rule. A SERC has not been prepared by the agency.

The Agency has determined that the proposed rule is not expected to require legislative ratification based on the statement of estimated regulatory costs or if no SERC is required, the information expressly relied upon and described herein: A checklist was prepared by the Agency to determine the need for a SERC. Based on this information at the time of the analysis and pursuant to Section 120.541, F.S., the rule will not require legislative ratification.

Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.

RULEMAKING AUTHORITY: 409.919 FS.

LAW IMPLEMENTED: 409.902, 409.905(8), 409.912, 409.913 FS.

A HEARING WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:

DATE AND TIME: Wednesday, September 18, 2013, 3:00 p.m. – 4:00 p.m.

PLACE: Agency for Health Care Administration, 2727 Mahan Drive, Building 3, Conference Room A, Tallahassee, Florida 32308-5407

Pursuant to the provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this workshop/meeting is asked to advise the agency at least 48 hours before the workshop/meeting by contacting: Margaret Reilly at the Bureau of Medicaid Services, [phone]. If you are hearing or speech impaired, please contact the agency using the Florida Relay Service, 1(800)955-8771 (TDD) or 1(800)955-8770 (Voice).

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Margaret Reilly, Medicaid Services, 2727 Mahan Drive, Mail Stop 20, Tallahassee, Florida 32308-5407, telephone: [phone], e-mail: [e-mail]

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

59G-1.040 Pre-Admission Screening and Resident Review.

(1) Purpose.

(a) The Pre-Admission Screening and Resident Review (PASRR) is a federal requirement mandated by the Nursing Home Reform Act, as amended. It is intended to ensure that Medicaid-certified nursing facility applicants and residents with a diagnosis of or suspicion of serious mental illness or intellectual disabilities, or related conditions, are identified and admitted or allowed to remain in the nursing facility only if there is a verified need for such services.

(b) PASRR is required for all applicants to Medicaid-certified nursing facilities, regardless of payor.

(c) Florida’s PASRR process promotes community-focused, patient-centered care by ensuring psychological, psychiatric, and functional needs are considered along with personal goals and preferences when planning long-term care services. Multiple state agencies and providers work together to ensure the individual’s long-term care needs are met in the most integrated setting appropriate.

(2) Definitions.

(a) Adult(s) – Individuals who are age 21 and older.

(b) CARES – The Florida Department of Elder Affairs’ Comprehensive Assessment and Review for Long-Term Care Services program.

(c) Child(ren) – Individuals who are age three through 20.

(d)Early Steps – Florida's early intervention system, administered by the Florida Department of Health, Children’s Medical Services, that offers services to eligible infants and toddlers (birth through age three) with significant delays or a condition likely to result in a developmental delay. Early intervention is provided to support families and caregivers in developing the competence and confidence to help their child learn and develop.

(e) Intellectual Disability (ID) – Individuals are determined to have ID (mild, moderate, severe, or profound) according to the criteria in the American Association on Intellectual Disabilities’ manual entitled, Intellectual Disability: Definition, Classification, and Systems of Supports (11th Ed. 2010), incorporated by reference. ID includes related conditions, i.e., individuals who have a severe, chronic disability that meets all of the following conditions:

1. Is attributable to:

a. Cerebral palsy or epilepsy; or

b. Any other condition, other than mental illness, found to be closely related to ID because this condition results in impairment of general intellectual functioning or adaptive behavior similar to that of persons diagnosed with ID, and requires treatment or services similar to those required for these persons;

2. Is manifested before the person reaches age 22;

3. Is likely to continue indefinitely; and

4. Results in substantial functional limitations in three or more of the following areas of major life activity:

a. Self-care;

b. Understanding and use of language;

c. Learning;

d. Mobility;

e. Self-direction; or

f. Capacity for independent living.

(f) Legal Guardian – The parents for a child under age 18, or a person appointed by the courts to exercise the legal rights of the individual who is being evaluated.

(g) Level I PASRR Screener – The Agency for Health Care Administration (AHCA), or the entity to which AHCA delegates this responsibility, shall perform the Level I PASRR screening for all children. The CARES program or the entity to which CARES delegates this responsibility shall perform the Level I PASRR screening for all adults. AHCA and CARES will collectively be referred to as the Level I PASRR Screener.

(h) New Admission – An individual admitted to a nursing facility for the first time or not admitted as a readmission.

(i) Nursing Facility (NF) – A Medicaid-certified nursing facility.

(j) Readmission. – An individual who is readmitted within 90 days to an NF from a hospital to which the individual was originally transferred by that NF for receiving care.

(k) Serious Mental Illness (SMI) – An individual is considered to have an SMI, if the individual meets the following requirements on diagnosis, level of impairment, and duration of illness:

1. Diagnosis: A major mental disorder under the Diagnostic and Statistical Manual of Mental Disorders (4th Ed. 2000), incorporated by reference, such as a schizophrenic, mood, paranoid, panic, or other severe anxiety disorder; somatoform disorder; personality disorder; other psychotic disorder; or another mental disorder that may lead to a chronic disability, but not a primary diagnosis of dementia, including Alzheimer’s disease or a related disorder, or a nonprimary diagnosis of dementia unless the primary diagnosis is a major mental disorder.

2. Level of Impairment: Functional limitations in major life activities within the past three to six months that would be appropriate for the individual’s developmental stage; an individual typically has at least one of the following characteristics on a continuing or intermittent basis, or is likely to exhibit one of the following characteristics without continued treatment or intervention:

a. Serious difficulty interacting appropriately and communicating effectively with other persons, a possible history of altercations, evictions, firing, fear of strangers, or avoidance of interpersonal relationships and social isolation;

b. Serious difficulty in sustaining focused attention for long enough to permit the completion of tasks commonly found in work settings or in work-like structured activities occurring in school or home settings, manifest difficulties in concentration, inability to complete simple tasks within an established time period, makes frequent errors, or requires assistance in the completion of these tasks; or

c. Serious difficulty in adapting to typical changes in circumstances associated with work, school, family, or social interaction, manifests agitation, exacerbated signs and symptoms associated with the illness, or withdrawal from the situation, or requires intervention by the mental health or judicial system;

3. Recent Treatment: A treatment history indicating the individual has experienced at least one of the following:

a. Psychiatric treatment more intensive than outpatient care more than once in the past two years (for example, partial hospitalization or inpatient hospitalization); or

b. Within the last two years, due to the mental disorder, experienced an episode of significant disruption to the normal living situation, for which supportive services were required to maintain functioning at home, or in a residential treatment environment, or which resulted in intervention by housing or law enforcement officials.

(l) Significant Change – A major decline or improvement in the resident's status. A major decline in a resident’s status involves changes that require intervention to correct the decline through staff involvement and/or through implementation of standard disease-related clinical interventions that: (i) are anticipated to effect more than one area of the resident's health status; (ii) requires interdisciplinary review or revision of the care plan; or, both (i) and (ii). A major improvement in a resident’s status involves changes in a resident’s circumstances that: (i) are anticipated to effect more than one area of the resident's health status; (ii) requires interdisciplinary review or revision of the care plan; or, both (i) and (ii).

(m) Specialized Services – Services that are not covered in the NF per diem and are required for appropriate placement in the NF setting for individuals with ID or SMI whose needs are such that continuous supervision, treatment, and training by qualified mental health or intellectual disability personnel is necessary. Specialized services are specified by the state and, combined with the services provided by the NF, result in continuous and aggressive implementation of an individualized plan of care. Specialized services for ID are directed toward the acquisition of the behaviors necessary for the individual to function with as much self-determination and independence as possible and toward the prevention or deceleration of regression or loss of current optimal functional status, to include behavior analysis services and training services. Specialized services for SMI are utilized to address episodes of mental illness and are rendered at levels required to avert or eliminate the need for acute inpatient psychiatric care.

(3) The Level I PASRR Screener or, for children under age three, the Early Steps program, must be notified whenever an individual is referred to an NF for admission.

(4) Level I PASRR.

(a) A Level I PASRR screening determines whether an individual referred for admission into an NF has or is suspected of having an SMI or an ID diagnosis or related conditions.

(b) A Level I PASRR must be completed for all individuals who are new admissions to an NF regardless of the source of payment.

(c) Individuals not requiring a Level I PASRR prior to admission to an NF, referred to as provisional admissions, are as follows:

1. In cases of delirium, a Level I PASRR must be completed within seven days after the delirium clears;

2. For emergency admissions requiring protective services, a Level I PASRR must be completed within seven days of admission;

3. An individual admitted to an NF for a caregiver’s respite, unless the stay exceeds 30 days; however, a Level I PASRR must be completed in advance of the expiration of the 30 days, if the stay is expected to exceed the time limit;

4. An individual who is admitted to an NF under the 30-day hospital discharge exception, pursuant to Title 42, Code of Federal Regulations, section 483.106(b)(2); however, if the individual’s stay exceeds the 30 days, a Level I PASRR must be completed no later than the 40th day; or

5. A child admitted to an NF under age three; however, a Level I PASRR must be completed within seven days of the child’s third birthday, if the child is still residing in the NF.

(d) The Level I PASRR must be completed by the Level I PASRR Screener prior to an individual’s admission to an NF subject to the exceptions in subparagraphs (4)(c)1.-5.

(e) Within two days after the Level I PASRR is completed, if the individual has or is suspected of having a diagnosis of SMI and/or ID, the Level I PASRR Screener must send the individual and his or her legal guardian written notice stating that the individual has or is suspected of having SMI and/or ID and is being referred for a more in-depth Level II PASRR evaluation. Within the same two days, the Level I PASRR Screener must also send all of the following documentation to the Agency for Persons with Disabilities (APD) for individuals suspected of having ID, or to the Department of Children and Families (DCF) for individuals suspected of having SMI:

1. Level I PASRR;

2. Documented informed consent;

3. Medical certification for NF/home and community-based services;

4. Other medical documentation including relevant case notes or records of treatment/medication administration record;

5. Psychiatric or psychological evaluation, if available;

6. An assessment conducted by the Department of Elder Affairs (DOEA), if appropriate;

7. An assessment conducted by the Children’s Multidisciplinary Assessment Team (CMAT), if appropriate; and

8. An assessment conducted by the Early Steps program, if appropriate.

(f) The Level I PASRR Screener is responsible for documenting on a Level I PASRR screening whether the individual is seeking a provisional admission into an NF and the type of provisional admission. They are also responsible for documenting and tracking the appropriate time limits for when a Level I PASRR must be completed for these provisional admissions and making certain that the individual is referred for a Level II PASRR prior to the expiration of the time period.

(5) Level II PASRR, in General.

(a) The Level II PASRR is an in-depth evaluation of the individual and a determination of the need for NF services. If an NF is the most integrated setting appropriate to meet the individual’s long-term care needs, the Level II PASRR must also evaluate what specialized services, if any, are needed for the individual.

(b) All Level II PASRR evaluations are individualized.

(c) A Level II PASRR is required if the Level I PASRR indicated a diagnosis or suspicion of SMI and/or ID, and it must be completed under the following circumstances and within the following timeframes:

1.Within 40 days of admission, if the individual was admitted to the NF under the hospital discharge exemption and is later found to require more than the allowed 30-day stay;

2. If a child under age three is admitted to the NF, then a Level II PASRR must be completed within seven days of the child’s third birthday;

3. If the individual does not enter the NF within 30 days of the Level II PASRR evaluation, a new Level II PASRR must be completed prior to admission to the NF;

4. If an individual is transferred to the hospital from the NF and is admitted to the hospital for more than 90 consecutive days, a new PASRR Level II must be completed prior to the individual’s return to the NF;

5. If there is a significant change in the resident’s mental or physical condition, the nursing facility must notify the Level I PASRR Screener in accordance with 42 USC 1396r, and a new Level II PASRR must be completed; or

6. If an individual is admitted to an NF for a caregiver’s respite, a Level II PASRR must be completed in advance of the expiration of 30 days, if the stay is expected to exceed the 30-day time limit.

(d) The following entities must complete the Level II PASRR, regardless of payor:

1. DCF for those individuals diagnosed or suspected of having a diagnosis of SMI;

2. APD for those individuals diagnosed or suspected of having a diagnosis of ID; and

3. When a Level I PASRR results in a suspicion of both SMI and ID, DCF and APD will coordinate to complete the Level II PASRR.

(e) The Level II PASRR evaluation must assess the appropriate placement to meet the individual’s needs.

1. In determining appropriate placement, the evaluator must prioritize the individual’s physical and mental needs, taking into account the severity of each condition. The determination of whether an NF is appropriate must include:

a. Evaluation of physical status (for example, diagnoses, date of onset, medical history, and prognosis);

b. Evaluation of mental status (for example, diagnoses, date of onset, medical history, likelihood that the individual may be a danger to self or others); and

c. Functional assessment (ability to perform activities of daily living).

(f) The Level II PASRR must be completed prior to admission to an NF, and it must be issued in the form of a written determination summary report which:

1. Confirms or rules out SMI or ID;

2. Identifies the name and professional title of each person who performed the evaluation(s) and the date on which each portion of the evaluation was administered;

3. Summarizes the medical and social history, including the positive traits, developmental strengths and weaknesses, or developmental or mental health needs of the individual;

4. Identifies whether NF services and specialized services are needed, and identifies any specific SMI or ID services that are required to treat individual needs;

5. If specialized services are not recommended, identifies any specific SMI or ID services that are of a lesser intensity than specialized services;

6. Identifies placement options that are available to the individual, including whether the individual’s needs could be met in a community setting and what services would be needed for the individual to live in such a setting;

7. Documents that the individual and legal guardian, if appropriate, have been educated about all placement options, including information about the benefits of integrated settings, and have addressed any concerns or objections raised by the individual or legal guardian;

8. Documents that a pre-admission counseling packet was reviewed and provided to the individual or legal guardian, if appropriate, including a signed receipt of the packet; however, in the event the individual or legal guardian refuses to sign off on the packet, the Level II PASRR evaluator will document their refusal;

9. Includes the basis for the summary report's conclusions;

10. Notifies the individual and legal guardian of the right to appeal the determination; and

11. Interprets and explains the summary report to the individual and legal guardian.

12. If the Level II PASRR rules out SMI or ID, the screener does not have to complete the items indicated in subparagraphs (5)(f)4.-8.

(g) The completed Level II PASRR evaluation must be sent to:

1. The PASRR Level I Screener;

2. The evaluated individual or, if appropriate, legal guardian;

3. The admitting or retaining NF, if applicable;

4. The evaluated individual’s attending physician; and

5. The discharging hospital, if applicable.

(h) PASRR Level II evaluations must involve:

1. The individual being evaluated, and the legal guardian, if the individual is under age 18, or a legal guardian has been appointed by the courts; and

2. The individual’s family; if the individual or the legal guardian agrees to family participation.

(6) Level II PASRR for Individuals for Whom a Level I PASRR Indicated a Suspicion of SMI.

(a) DCF must ensure completion of the Level II PASRR evaluations for individuals age three years and older whose Level I PASRR indicated a suspicion of SMI.

(b) Level II PASRR evaluations for individuals with a suspected SMI diagnosis must:

1. Confirm or rule out the presence of SMI. A qualified mental health professional must confirm or reject the suspicion of SMI indicated in the Level I PASRR by performing a comprehensive history and a physical examination of the person, including:

a. Complete medical history;

b. Review of all body systems;

c. Specific evaluation of the person’s neurological system in the areas of motor functioning, sensory functioning, gait, deep tendon reflexes, cranial nerves, and abnormal reflexes;

d. Additional evaluations conducted by appropriate specialists, where abnormal findings are the basis for an NF placement;

e. Comprehensive drug history including current or immediate past use of medications that could mask symptoms or mimic SMI;

f. Psychosocial evaluation of the person, including current living arrangements and medical and support systems; and

g. Comprehensive psychiatric evaluation including a complete psychiatric history, evaluation of SMI functioning, memory functioning, and orientation, description of current attitudes and overt behaviors, affect, suicidal or homicidal ideation, paranoia, and degree of reality testing (presence and content of delusions) and hallucinations.

2. Include a functional assessment of the individual’s ability to engage in activities of daily living and the level of support that would be needed to assist the individual to perform these activities while living in the community. The assessment must determine whether this level of support can be provided to the individual in an alternative community setting or whether the level of support needed is such that an NF placement is required. The functional assessment must address the self-monitoring of health status, self-administering and scheduling of medical treatment, including medication compliance, or both, and self-monitoring of nutritional status, handling money, dressing appropriately, and grooming; and

3. Determine the need for specialized services. Specialized services for an SMI diagnosis are:

a. Those services not already covered in the NF per diem;

b. Services that are utilized to address an episode of mental illness and that are rendered in an NF at levels required to avert or eliminate the need for inpatient psychiatric care;

c. Developed and supervised by a qualified mental health professional and include one or all of the following:

i. Psychiatric consultation and evaluation;

ii. Psychotropic medication management;

iii. Psychological evaluation; and/or

iv. Psychotherapy

(7) Level II PASRR Evaluations for Individuals for Whom a Level I PASRR Indicated a Suspicion of ID.

(a) APD must ensure completion of the Level II PASRR evaluations for individuals age three and older whose Level I PASRR indicated a suspicion of ID.

(b)Level II PASRR evaluations for individuals with a suspected ID diagnosis must:

1. Confirm or rule out the suspicion of ID; a licensed psychologist must be utilized to identify the intellectual functioning measurement of individuals with ID;

2. Confirm the need for NF placement; and

3. Determine the need for specialized services by assessing:

a. The individual's medical problems;

b. The level of impact these problems have on the individual's independent functioning;

c. All current medications used by the individual and the current response of the individual to any prescribed medications in the following drug groups:

i. Hypnotics;

ii. Antipsychotics (neuroleptics);

iii. Mood stabilizers and antidepressants;

iv. Antianxiety-sedative agents; and

v. Anti-Parkinson agents.

d. Self-monitoring of health status;

e. Self-administering and scheduling of medical treatments;

f. Self-monitoring of nutritional status;

g. Self-help development, such as toileting, dressing, grooming, and eating;

h. Sensorimotor development, such as ambulation, positioning, transfer skills, gross motor dexterity, visual motor perception, fine motor dexterity, eye-hand coordination, and extent to which prosthetic, orthotic, corrective, or mechanical supportive devices can improve the individual's functional capacity;

i. Speech and language (communication) development, such as expressive language (verbal and nonverbal), receptive language (verbal and nonverbal), extent to which nonoral communication systems can improve the individual's function capacity, auditory functioning, and extent to which amplification devices (for example, hearing aid) or a program of amplification can improve the individual's functional capacity;

j. Social development, such as interpersonal skills, recreation-leisure skills, and relationships with others;

k. Academic/educational development, including functional learning skills;

l. Independent living development, such as meal preparation, budgeting and personal finances, survival skills, mobility skills (orientation to the neighborhood, town, city), laundry, housekeeping, shopping, bed making, care of clothing, and orientation skills (for individuals with visual impairments);

m. Vocational development, including present vocational skills;

n. Affective development, such as ability to express emotions, making judgments, and making independent decisions; and

o. The presence of identifiable maladaptive or inappropriate behaviors of the individual based on systematic observation (including, but not limited to, the frequency and intensity of identified maladaptive or inappropriate behaviors).

(c) Specialized services for individuals with ID are:

1. Those services not already covered in the NF per diem;

2. Behavior analysis services, pursuant to Rule 65G-4.009, Florida Administrative Code;

3. Training services, to include:

a. Services intended to support the participation of recipients in daily, meaningful, valued routines of the community, which for older children and adults may include work-like settings that do not meet the definition of supported employment; and

b. Training in the activities of daily living, self-advocacy, and adaptive and social skills that are age and culturally appropriate; the service expectation is to achieve the goals defined by each individual or, if appropriate, the individual’s legal guardian; the training, activities, and routine established by the adult day training program must be meaningful to the individual and provide an appropriate level of variation and interest; this training is provided in accordance with a formal implementation plan, developed under the direction of the individual or, if appropriate, the individual’s legal guardian.

(8) NF Residents No Longer Requiring NF Services, but Requiring Specialized Services.

(a) Any NF resident with SMI or ID who no longer requires the level of services provided by an NF but does require specialized services and who has continuously resided in an NF for at least 30 consecutive months before the date of determination, may choose to continue to reside in the facility or to receive covered services in an alternative appropriate institutional or noninstitutional setting. In consultation with the resident or, if appropriate, the resident’s legal guardian, APD or DCF, as appropriate, must:

1. Inform the resident of the institutional and noninstitutional alternatives available for the resident;

2. Offer the resident the choice of remaining in the facility or receiving covered services in an alternative, appropriate institutional or noninstitutional setting;

3. Clarify the effect on eligibility for services if the resident chooses to leave the facility (including its effect on readmission to the facility); and

4. Provide for (or arrange for the provision of) such specialized services for the resident’s SMI or ID.

(b) Unless the individual or legal guardian, if appropriate, refuses placement outside the NF, any NF resident with SMI or ID who does not require the level of services provided by an NF but does require specialized services, and who has resided in an NF for less than 30 consecutive months before the date of determination, must be discharged to an appropriate setting where the individual will receive the needed specialized services. In consultation with the resident and, if appropriate the resident’s legal guardian, APD or DCF (as appropriate) must:

1. Arrange for the safe and orderly discharge of the resident from the facility;

2. Prepare and orient the resident for such discharge; and

3. Provide for (or arrange for the provision of) such specialized services for the resident’s SMI or ID.

(9) NF Resident Not Requiring NF Services or Specialized Services.

(a) Unless the individual or legal guardian, if appropriate, refuses placement outside the NF, any NF resident with SMI or ID who does not require the level of services provided by an NF and does not require specialized services, regardless of length of stay, must be discharged. APD or DCF (as appropriate) must:

1. Arrange for the safe and orderly discharge of the resident from the facility; and

2. Prepare and orient the individual for such discharge.

(10) Appeals.

(a) PASRR determinations that are contrary to the wishes of the individual or legal guardian are appealable through the administrative fair hearing process.

(b) The individual or legal guardian will receive notice of all PASRR determinations along with notice of the administrative fair hearing process and rights.

(11) Records.

(a) Nursing facilities are required to maintain copies of all PASRR screenings, evaluations, and re-evaluations in the resident’s file, even after the resident has been discharged or has been transferred to another facility.

(b) The Level I PASRR Screener must retain all documentation from the Level I and Level II PASRR screening process for repository.

(12) Oversight.

(a) AHCA, APD, DCF, and DOEA must enter into memoranda of understanding outlining each respective agency’s role in the PASRR process.

(b) The Level I PASRR Screener must perform a quality assurance review of Level II PASRR screenings to determine compliance with the requirements outlined in this rule, federal regulations, state law, and the executed memorandum of understanding. If deficiencies are found, the Level I PASRR Screener will notify the agency performing the Level II PASRR of the deficiencies. Within five business days of receipt of the notice, the agency will correct all deficiencies and submit an amended Level II PASRR.

(13)(a) Annual Reporting to the Secretary of the United States Department of Health and Human Services.

(b) Florida Medicaid must report annually to the Secretary of Health and Human Services the number and disposition of residents not requiring NF services, but requiring specialized services; and residents not requiring NF services and not requiring specialized services.

Rulemaking Authority 409.919 FS. Law Implemented 409.902, 409.905(8), 409.912, 409.913 FS. History–New____________.

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Margaret Reilly

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Elizabeth Dudek

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: August 26, 2013

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: February 11, 2013