Instructions for Completion of PASRR Level I Screen
This document provides detailed instructions for completing the PASRR Level I Screen. It includes guidelines for demographic information and clinical assessments. Designed for healthcare professionals, this form is essential for evaluating eligibility for nursing facility care.
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How do I fill this out?
To fill out the PASRR Level I Screen, start by providing the demographic information of the individual. Next, answer the mental illness screening questions based on the individual's history. Finally, ensure that all sections are completed accurately before submission.
How to fill out the Instructions for Completion of PASRR Level I Screen?
1
Gather necessary demographic information such as name and social security number.
2
Complete the mental illness and intellectual disability screening sections.
3
Check the outcomes of each screening section.
4
Sign and date the form as the screening professional.
5
Submit the completed form to the appropriate authorities.
Who needs the Instructions for Completion of PASRR Level I Screen?
1
Healthcare providers needing to assess patient eligibility for NF admission.
2
Social workers assisting individuals with developmental disabilities.
3
Psychiatrists evaluating mental health conditions prior to care placement.
4
Family members seeking necessary information for their loved ones.
5
Agencies involved in developmental disabilities services coordinating care.
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What are the important dates for this form in 2024 and 2025?
Important dates for PASRR Level I Screen submissions include the annual updates which take effect starting January 1st each year. Please check the official announcements for specific deadlines. For 2024, ensure submissions are completed by December 31, 2024, to remain compliant.
What is the purpose of this form?
The purpose of the PASRR Level I Screen is to evaluate individuals for nursing facility (NF) admissions and ensure proper resource allocation for those with mental health and developmental disabilities. It serves as a crucial tool in determining eligibility for specialized services. Proper completion and submission of this form facilitate a smoother transition for individuals requiring care.
Tell me about this form and its components and fields line-by-line.
- 1. Name of Applicant: Legal name including first name and last name.
- 2. Social Security Number: Full social security number of the applicant.
- 3. Current Location Address: Address of the individual at the time of assessment.
- 4. County of Current Location: County where the individual is located.
- 5. Date of Birth: Applicant's birthdate.
- 6. Current Location Setting: Setting where the assessment is taking place (e.g., home, hospital).
- 7. Clinical Assessment/Authorization Status: Status of clinical assessment authorization.
- 8. Mental Illness Diagnosis: Information regarding any major mental illness diagnosis.
- 9. Intellectual Disability Status: Indication if there is a diagnosis or history of intellectual disability.
- 10. Agency Referral: Information regarding any agency referral related to ID/DD/RC.
What happens if I fail to submit this form?
Failing to submit the PASRR Level I Screen can lead to delays in the individual's admission to nursing facilities. It may also result in missed opportunities for necessary evaluations and support services. Therefore, careful completion and timely submission are essential.
- Admission Delays: Without the form, the processing of nursing facility admission may be stalled.
- Missed Proper Evaluation: Incomplete or unsubmitted forms can hinder essential evaluations to determine care needs.
- Service Access Issues: Failure to submit may prevent access to necessary health services and resources.
How do I know when to use this form?
- 1. Nursing Facility Admissions: Use this form to assess eligibility for nursing home care.
- 2. Mental Health Assessments: Complete the form for evaluations of mental health conditions.
- 3. Developmental Disability Services: Use it when coordinating care for individuals with developmental disabilities.
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What happens if I don't fill out the form correctly?
Incomplete or incorrect forms may delay the processing of the individual's application for nursing facility care.
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