Provider Alerts

 

This Provider Alert serves as a reminder that the Preadmission Screening (PAS) is a federal requirement (Code of Federal Regulation (CFR), Title 43, Sections 483.100-138) for all members initially entering a Skilled Nursing Facility (SNF) to determine if they have a possible Serious Mental Illness (SMI)or have an Intellectual Disability/Development Disability/Related Conditions (IDD/DD/RC). The Federal regulation indicates that a Preadmission Screening and Resident Review (PASRR) is required for all members who apply for admission into a Medi-Cal certified SNF regardless of the individual’s insurance type or payment source. This requirement also applies to members who already reside in a Medi-Cal certified SNF.

The PASRR process must be completed within an annual average of 7 to 9 working days once the Level I Screening is submitted by a General Acute Care Hospital (GACH). The Department of Health Care Services (DHCS) is the designated State Mental Health Authority responsible for the SMI PASRR Determination and DDS is the State ID/DD/RC Authority responsible for the ID/DD/RC PASRR Determination.

Additional information regarding this process has been outlined below, but you can also refer to the links below that explains the process in detail and contains the onboarding schedule for all GACH’s in California.

• https://www.dhcs.ca.gov/services/MH/Documents/PASRR-Information-Notice22-002-Preadmission-Compliance.pdf
• https://www.dhcs.ca.gov/services/MH/Documents/PASRR-General-Acute-CareHospital-GACH-PASRR-Onboarding-Schedule-January-to-April-2023.xlsx

PASRR Responsibilities:

• General Acute Care Hospital (GACH):
  • required to perform the Preadmission Screening (PAS) on any member being discharged to a SNF.
•  SNF:
  • required to perform the PAS when a member is being admitted directly from the community.
  • required to initiate Resident Review (RR) by submitting Level 1 Screening only when there is a significant change in the member’s physical or mental condition.

PASRR Program Changes:

• California is required to be in compliance with preadmission standards by July 1, 2023
• GACHs are now required to complete the PASRR process prior to a member’s discharge to a SNF.
• This includes the Level 1 Screening that is submitted by the GACHs through the PASRR Online System.
• SNFs are discouraged from accepting and admitting any members without a completed PASRR.
• Federal law prohibits FFP reimbursement for services provided to members prior to the PASRR completion.
• Beginning May 1, 2023, MCPs will ensure PASRR completion when authorizing SNF services.

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If you have questions or need assistance, please call our Provider Services team at (209) 942-6340. You may also visit https://www.hpsj.com/alerts/ for online access to the documents shared. The most recent information about Health Plan of San Joaquin and our services is always available on our website https://www.hpsj.com/.