Current through Register Vol. 54, No. 50, December 14, 2024
Section 1181.562 - Adverse determinations(a) OBRA-87 requires an appeal process for an individual adversely affected by determinations made in the preadmission screening process effective January 1, 1989. An adverse determination is one which denies or conditions the individual admission to the nursing facility. The preadmission screening process involves the following kinds of adverse determinations: (1) Classification as an individual who is subject to the preadmission screening process administered by the Department of Aging under OBRA-87-not including the existing LAMP site review process-including the issue of whether the individual is mentally ill, mentally retarded or has a related condition (Form PA-PASARR-ID Appeals).(2) Classification as an individual who may not be admitted to a nursing facility (Form PA-PASARR-YN Appeals).(b) The determination that an individual requires nursing facility services is not an adverse determination which is appealable under OBRA-87 or Department regulations.