Section He-M 1302.12 - Notification and Documentation of Level II Evaluations and Determinations(a) A written report of the findings of the level II evaluation and determination pursuant to He-M 1302.04 or resident review pursuant to He-M 1302.13 shall be prepared by the PASRR office and conveyed to the following: (1) The applicant and, if applicable, his or her legal representative;(2) The discharging hospital, if applicable;(3) The admitting or retaining nursing facility; and(4) The attending physician, if applicable.(b) The written report shall include the following:(1) A listing of the evaluations reviewed, including the evaluators' names and professional titles and dates prepared;(2) The name and title of the reviewer and date of review;(3) An interpretation of the results of the evaluations in terms of the applicant's functional status;(4) A brief summary of the applicant's medical and social history;(5) The positive traits or developmental strengths of the individual;(6) The weaknesses or developmental needs of the individual;(7) A description of the supports identified in He-M 1302.04(a) (2) d. that the individual would need to live in the community;(8) If nursing facility services are recommended, identification of the specific services needed to meet the individual's needs;(9) If specialized services are recommended, what specifically is required to meet the individual's needs;(10) If specialized services are not recommended, identification of any specific DD or mental health services of lesser intensity that the individual requires to meet his or her needs;(11) The basis for the report's conclusions, including the specific reason for the determination rendered and referenced section of the rule;(12) The right of the applicant or legal representative to appeal a nursing facility admission determination;(13) The right of the applicant to have someone, including an attorney paid for by the applicant, represent him or her at the hearing; and(14) The process for appealing the determination, including the names, addresses, and phone numbers of the office of client and legal services of the department and advocacy organizations such as the Disabilities Rights Center, Inc., that the individual or guardian may contact for assistance in appealing the determination.N.H. Admin. Code § He-M 1302.12
#10216, eff 10-29-12 (from He-M 1302.09 )