42 C.F.R. 483, subpart C, 483.100 – 483.138, Minn. Stat. §256B.0911 (LTCC), Minn. Stat. §256B.092 subd. 7, 8 and 8a (Rule 185 case management)

Preadmission screening (PAS)

Preadmission screening (PAS) activities determine a person’s need for nursing facility (NF) level of care for Medical Assistance (MA). Lead agencies and the Senior LinkAge Line work in conjunction to complete the various PAS activities, which includes activities required by the federal Omnibus Budget Reconciliation Act (OBRA), described below.

OBRA

As part of the PAS process, a person must receive at least one OBRA screening before he/she can be admitted to an MA-certified NF. This process ensures people receive care in a setting that best meets their needs, as well as receive specialized services if necessary.

There are two types of OBRA tools:

The OBRA Level I screening and OBRA Level II evaluative report (if applicable) are required regardless of the length of stay or payer of the NF services.

A person must receive an OBRA Level I screening before he/she can be admitted to an MA-certified NF. This process starts with the Senior LinkAge Line online referral form.

The OBRA Level I screening:

For more information, see CBSM – OBRA Level I screening.

Developmental disabilities and related conditions

If the OBRA Level I screening indicates a person has a diagnosis or suspected diagnosis of developmental disabilities or related conditions, he/she also must receive an OBRA Level II evaluative report before he/she can be admitted to an MA-certified NF.

The lead agency uses OBRA Level II Evaluative Report for People with Developmental Disabilities or Related Conditions, DHS-4248 (PDF) to assess if the person:

For more information, see CBSM – OBRA Level II evaluative report.

Mental illnesses

If a person has a mental illness or symptoms of a mental illness, see DHS – Preadmission screening and resident review (PASRR Level II-MI).

There are two types of interfacility transfers, regardless of payer source, that are exempt from PAS requirements:

In these situations, the person does not need a new PAS because he/she received a PAS when he/she was first admitted to an NF.

This exemption applies to all people, with or without a diagnosis of developmental disabilities or related conditions.

Transfers between NFs in Minnesota

A person does not need a new PAS if he/she transfers between any of the following facilities in Minnesota:

The NF must forward previous PAS results when the person transfers.

Transfers from NF to acute hospital to NF

A person does not need a new PAS if he/she both:

The NF must forward previous PAS results when the person transfers.

Exception

If a person 21 years or older enters a psychiatric hospital from an MA-certified NF in Minnesota, he/she must receive a new PAS (including OBRA screenings) before he/she can return to an MA-certified NF. For more information, see DHS – Preadmission screening and resident review (PASRR Level II-MI).

Admission to an out-of-state NF funded by Minnesota MA

When a Minnesota resident seeks admission to an out-of-state NF, the Minnesota hospital or health care professional seeking admission for the person must follow the PAS requirements of the state in which the facility is located.

The out-of-state facility must complete the Senior LinkAge Line online referral form for entry into MMIS to allow for MA payment. The person must meet Minnesota’s NF level of care criteria for MA payment of NF services (see CBSM – Level of care).

The Senior LinkAge Line does not complete PAS activities, and the lead agency does not complete an in-person assessment for a Minnesota resident admitted to an out-of-state NF.

Admission to an out-of-state NF not funded by Minnesota MA

When a Minnesota resident seeks admission to an out-of-state NF not funded by Minnesota MA, the lead agency must follow the policies of the state in which the facility is located.

Admission to a Minnesota NF, swing bed or boarding care facility from another state

When a person either lives in another state or transfers from an out-of-state facility and seeks admission to a Minnesota MA-certified NF, swing bed or boarding care facility, the Senior LinkAge Line completes PAS activities for the person.

The health care professional seeking admission for the person (e.g., North Dakota hospital discharge planner) or the out-of-state NF must complete the Senior LinkAge Line online referral form before admission.

Note

Transfers from an out-of-state NF to a Minnesota NF are not exempt from PAS requirements. Only transfers between Minnesota facilities are exempt. For more information, see the transfers and readmissions section.