I recently received a call from someone who said they were contracted by the state to conduct a "virtual" PASRR assessment of my loved one who was moved into a new nursing home. I ask because I have been raising concerns about neglect, that their phones ring unanswered for hours at at time, missing clothes, weight loss, UTIs, insufficient staffing, etc. I am wondering if they are planning to use this as a reason to come back and say "we can no longer provide for your loved one's needs". In the midst of Covid, this would be horrendous. The NH has not responded to my question about why the request for a second assessment. Does anyone know anything about PASRR assessments?
Pre admission screening and records review.
in order To go into a NH and have Medicaid pay for it, the individual has to meet whatever criteria set by the state or insurance to show they are “at need” for skilled nursing care. It’s pretty standard stuff. Really any insurer will have something like this..... like to ensure that they have solid documentation that they need the level of care the insurance is getting billed for. I’m not sure if PASRR is federal acronym or one used by selectively by some states.
What was the backstory on how your mom entered the NH?
Like was she hospitalized (MediCARE) and then discharged for rehab (MediCARE) at a NH; her rehab ended and now she transitioned from rehab patient to LTC resident? & applied for Medicaid to pay for the NH?
OR
Did she move from living independently or with family to the NH without a hospital stay?
If this is private pay, usually they are all ok on residents as long as they are current on their private pay bill.
Please realize these are VERY VERY different ways to go into a NH.
the hospital stay & rehab path will have a nice fat medical chart for the records review and ime for these it’s a pretty perfunctory lookie-Lou in her hospital & rehab charts, RXs, so totally ace the “needs assessment”.
BUT
If it’s a move into a NH from living independently or in AL, likely will not have detailed documentation to show “need” for skilled nursing care. What seems to happen (this for my mom who was in IL then into a NH totally bypassing AL phase) is that the fat hospital medical chart is not there. So preCovid, a assessment duo (RN & SW) would visit them in the NH (like within first week of admission) to do an on-site in person assessment. If there are issues, it’s for the “medically needy” aspect of Medicaid. & as such it will be the NH who takes the lead on this as their medical care is under the MD medical director and DON at the NH; but the resident or their Dpoa needs to sign off for or maybe send a request for old medical records & lab reports to be sent to the NH. For my mom, it was that meds were left off and a comorbity was overlooked. NH called me, I filed an Medicaid medical appeal & got a hearing date but NH got all the info needed and put it in moms chart & scanned a copy up to the state. State approved her & so hearing date dismissed.
If your mom is getting a second assessment, there’s imo something amiss in her being “at need” for the level of care this NH can provide. I’d suggest that you contact SW at the NH to ask what the issues are.
It’s not totally unusual for a facility to be unable to do the level of care needed. It’s not nefariousness necessarily. It can be something straightforward.... like too too obese for staff to care for; or could be super detailed health care thats beyond standard skilled nursing care, like 25/7 vent care which tends to need a specialized acute care place.
what’s her care needs?