HISTORY AND BACKGROUND OF THE PASRR PROGRAM
The United States Congress created the Pre-Admission Screening and Resident Review (PASRR) program under the Omnibus Budget Reconciliation Act (OBRA) of 1987, primarily out of concern that, as a result of the deinstitutionalization movement, many people with “Serious Mental Illness” (SMI) or “Developmental/Intellectual Disabilities” were being inappropriately placed in nursing facilities (NF), where they would not receive the care or specialized services they needed.
Section 42 of the Code of Federal Regulations (42 CFR) specifically requires the state Medicaid agency to include a PASRR program in their state plan and to develop a written agreement with the state mental health authority and state developmental/intellectual disabilities authority, both of which in Nevada are under the Division of Mental Health and Developmental Services (MHDS), detailing the operation of the PASRR program.
In Nevada, MHDS teams with the state Medicaid and the Nevada PASRR Quality Improvement Organization (QIO-like vendor), to assure the proper administration and monitoring, in collaboration with federal regulations and requirements, of the Nevada PASRR program.
MHDS PASRR RESPONSIBILITIES AND SERVICES
MHDS Administrative Central Office
- Administrative oversight of the federally mandated PASRR responsibilities of the state’s mental health and developmental/intellectual services authorities.
- Conducts bi-annual Nevada PASRR Program Compliance Reviews of the 1) PASRR QIO-like vendor, 2) PASRR clients requiring specialized services who reside in nursing facilities, and 3) MHDS’ statewide regional PASRR coordinators.
- Chairs the quarterly Nevada statewide PASRR committee team meetings. The statewide PASRR committee consists of representatives from MHDS, Medicaid and the PASRR QIO-like vendor.
- Provides supervision and guidance to the statewide MHDS regional PASRR coordinators.
MHDS Statewide Regional PASRR Coordinators
There are six statewide MHDS PASRR coordinators in three regions of the state – north, south and rural – representing one mental health coordinator and one developmental/intellectual disabilities coordinator in each region.
The MHDS Regional PASRR Coordinator duties include, but are not limited to:
- Performs quarterly onsite reviews of the PASRR II-B client at the nursing facility (out-of-state performs medical record reviews).
- Works with the nursing facilities to assure the nursing facilities are “providing or arranging for the provision of specialized services needed by the resident.”
- Whenever possible, serves as a member on the client’s multi-discipline Treatment/Care Plan team.
- Assists acute care hospital discharge planners with finding alternatives to nursing facility placement, if indicated.
- Represents their respective regions and attends meetings with respect to the MHDS Statewide PASRR Committee/Team.
PASRR II-B Specialized Services
For Persons with Mental Illness (based on PASRR Evaluation Findings and Recommendations), may include any one or more of the following
· Psychotropic Medications
· Psychiatrist Follow-up Services
· Psychiatric Evaluation
· Psychological Testing
· Transitioning Services, to assist in moving to a less restrictive environment
· Monitoring and Advocacy
For Persons with Developmental/Intellectual Disabilities
- Day Services
- Psychological Services
- Psychological Evaluation
- School Referral and Services
- Transitioning Services, to assist in moving to a less restrictive environment
- Monitoring and Advocacy
If you have questions or require additional information please contact MHDS’ PASRR Program Manager:
Dave Caloiaro, MSW, LISW
Nevada Division of Mental Health and Developmental Services