Pa. Code tit. 55, pt. III, ch. 1181, subch. D, APPEALS OF ADVERSE DETERMINATIONS, app P

Current through Register Vol. 54, No. 50, December 14, 2024
Appendix P - INITIAL RESIDENT REVIEWS REQUIRED BY OBRA-87 LEGISLATION

(a) Several counties were involved as LAMP sites, and OBRA screenings began on January 1, 1989. Therefore, nursing facilities shall complete the PA-PASARR-ID forms and, if necessary, the Facility Report Form for individuals who were admitted prior to January 1, 1989.

(1) The January 1, 1989 date applies to the following counties:

Allegheny

Schuylkill

Erie

Westmoreland

Luzerne

Wyoming

Philadelphia

York

Allegheny

Schuylkill

Erie

Westmoreland

Luzerne

Wyoming

Philadelphia

York

(2) Nursing facilities in the remaining 59 counties of this Commonwealth shall complete the PA-PASARR-ID form and the Facility Report Form (if necessary) for individuals who were admitted prior to March 1, 1989.

(b) When completing the PA-PASARR-ID form, the exemption for severe medical conditions, (question 1E), may be used for an individual in the target group, only if the person's medical condition is so severe that the person is too sick to benefit from a plan of active treatment for mental illness, mental retardation or other related condition in the foreseeable future.

(c) A person whose PA-PASARR-ID form indicates that further assessment is needed, shall be identified by name, MA ID number (if applicable), and conditions to be assessed on the Facility Report Form. Instructions are available on the reverse side of the form.

(1) When completing the Facility Report Form, if more space is needed for additional names, copies should be made by the nursing facility. If a nursing facility has no individuals identified as needing further evaluation, this form still shall be completed and marked in the appropriate box as having no identified individuals. The completed form shall be returned January 8, 1990 to the following address:

Department of Public Welfare

Office of Medical Assistance Programs

Division of Long Term Care

Client Services

Post Office Box 2675

Harrisburg, Pennsylvania 17105

or

FAX: (717) 731-7060

(2) This review does not include individuals who have been discharged from the nursing facility or who are deceased.

(3) Reviews of individuals identified as needing further evaluation to determine the need for active treatment will be done by the Inspection of Care teams. If possible, these reviews will be performed concurrent with the nursing facility's annual Inspection of Care review. If the Inspection of Care review has already occurred, and the next review is not due until after April 1, 1990, a member of the Inspection of Care team will come to the nursing home to review recipients identified as needing further evaluation.

(d) Failure to submit the required information in a timely manner may result in loss of MA funding for MA patients in the facility.

Pa. Code tit. 55, pt. III, ch. 1181, subch. D, APPEALS OF ADVERSE DETERMINATIONS, app P

The provisions of this Appendix P adopted December 22, 1989, effective 12/23/1989, 19 Pa.B. 5433.