06/26/2019
LeadingAge Ohio, ODM Meet to Discuss PASRR Changes
On Tuesday, July 25, LeadingAge Ohio met with staff from the Ohio Department of Medicaid (ODM) and the Ohio Department of Mental Health and Addiction Services (MHAS) to discuss the overall functioning of Ohio’s Preadmission Screening and Resident Review (PAS/RR) program, including proposed changes to the PAS/RR Rules. Highlights from the meeting included:
- The Departments continue to see confusion on PAS/RR processes, with some providers confusing it with the level of care determination, and others believing it is only required for Medicaid patients. This is largely due to frequent turnover of key positions.
- Over half of PAS/RR documents are still being submitted via fax, which increases the likelihood of errors in documentation. The proposed rule will require electronic submission.
- For patients who had previously resided in a nursing facility, then had a psychiatric inpatient stay before returning to the nursing facility, the nursing facility may readmit the individual prior to the resident review being completed. This is only for those individuals returning after a previous stay, however.
- PAS/RR Rules are being harmonized across the Departments, with the Medicaid rule package being the first.
- ODM is increasingly concerned about lengthy extensions when a nursing facility is working to transition an individual back into the community. ODM has considered limiting the number of extensions available, but many of the long extensions are not due to provider inaction, but rather due to the scarcity of affordable housing options in the community. This is an area that will work with stakeholders to address.
The biggest change embedded in the rules were to the specialized services (SSs), which previously have only been provided on an inpatient basis. ODM shared that specialized services can be any service or support recommended for an individual based on their level II determination, inclusive of services delivered by an individual mental health practitioner, or those provided through a community mental health center. ODM is currently discussing whether a nursing facility could provide these services directly to residents, and whether a billing mechanism could be established.
Any questions or suggestions related to Ohio’s PAS/RR process may be directed to Susan Wallace, Director of Government Relations and Public Affairs at swallace@leadingageohio.org.