(a) Purpose. The Level I screening is performed by qualified staff of a nursing facility or hospital to determine whether an individual seeking admission to or residing in a facility needs further evaluation because of suspected mental illness, an intellectual disability or a related condition.
(b) Applicability. All individuals, regardless of payment source, who apply for admission to a facility on or after January 1, 1989, or who were clients in a facility on January 1, 1989, are subject to the requirements of this Section.
(c) Frequency of screening. - (i) Any individual who was a client in a facility before January 1, 1989, must be screened on or before April 1, 1990.
- (ii) Any individual seeking admission to a facility as a new admission on or after January 1, 1989, must be screened before admission.
- (iii) If the screening does not result in a referral to Level II, the individual need not be screened again unless there is a significant change in the individual's condition that indicates that a Level II screening is advisable.
(d) Screening. All screening shall be performed by a qualified staff member of the facility. A qualified staff member is a member of a nursing facility's or hospital's staff that is qualified, by education, professional status or administrative authority, to discern the possibility or probability of mental illness, intellectual disability, or related condition by reviewing medical records, observation of presenting evidence, or other sources. The screener uses the following criteria: - (i) Mental illness. The screener shall consider whether:
- (A) The individual is diagnosed with a serious mental illness, as defined by 42 C.F.R. § 483.102. This diagnosis shall not include individuals experiencing temporary anxiety or depressive reactions to a terminal or chronic debilitating condition for which specialized services would not be appropriate, but for which mental health services of a lesser intensity than specialized services may be required based on evaluation and recommendation by a physician or a qualified mental health professional;
- (B) The individual has a history of mental illness requiring treatment more intensive than out treatment; or
- (C) There is presenting evidence of a serious mental illness, including possible disturbances in orientation, affect or mood that is not attributable to dementia or other medical diagnosis or treatment.
- (ii) Intellectual Disability. The screener shall consider whether:
- (A) A physician or qualified intellectual disability professional has given the individual a primary or secondary diagnosis of mental retardation or related condition;
- (B) The individual has a history of an intellectual disability or related condition;
- (C) There are cognition or behavior deficits indicating an intellectual disability or related condition; or
- (D) The individual was referred by an agency that serves persons with an intellectual disability or related condition, and the individual was eligible for that agency's services.
(e) Recommendation. Upon completion of the Level I screening, the screener shall make a recommendation as to whether the individual should be referred for a Level II screening: - (i) If the recommendation is that a Level II screening is not necessary, the individual may be admitted to the facility; or
- (ii) If the recommendation is that a Level II screening is necessary, the provisions of Section 7 of this Chapter apply.
(f) Notice. The nursing facility must provide written notice to the individual or client, or his or her legal representative, if the individual is suspected of having mental illness, an intellectual disability or related condition, and is being referred to the SMHA or SIDA for Level II screening. This notice is required for first time Level II identifications only.
(g) Documentation requirements. The facility shall complete documentation in the format specified by the Department.
048-19 Wyo. Code R. § 19-6