On Dec. 31, 2015, the Texas Department of Aging and Disability Services (DADS) issued an information letter for nursing facilities regarding new procedures for managing Pre-Admission Screening and Resident Review (PASRR) Level 1 (PL1) screening forms.

The details of Information Letter No. 15-84 are shown below and can also found on the DADS website. If you have questions, please email Cathy Belliveau, DADS PASRR Senior Program Specialist.

PL1 Screening Forms Received from a Referring Entity

When a PL1 screening form is received from a referring entity, the nursing facility should review Section C, PASRR Screen (Screener), of the form before the form is entered into the portal.

Section C states the following:

• Mental Illness: Is there evidence or an indicator that this is an individual that has a mental illness?
• Intellectual Disability: Is there evidence or an indicator that this is an individual that has an Intellectual Disability?
• Developmental Disability: Is there evidence or an indicator that this is an individual that has a Developmental Disability (Related Condition) other than an Intellectual Disability (e.g. Autism, Cerebral Palsy, Spina Bifida)?

If any question is answered “no” and the facility has information from medical records or information from family members that would make the answers to Section C “yes,” the facility should contact the referring entity and request a revised PL1. The NF should explain the reasons for the requested change to Section C. The NF should not request to change the answers from “yes” to “no”. A positive PL1 should not be changed to a negative PL1.

If the NF is unable to get a revised PL1 from the referring entity, the NF should complete Form 1013, Request to Change a Negative PASRR Level 1 (PL1), and provide information regarding the number of requests for a revised PL1, the name and contact information of the referring entity and the name and identifying information of the individual who needs the revised PL1 on the form, or if necessary, attach a separate piece of paper with the information. The NF should fax completed forms to the Texas Department on Aging and Disability Services (DADS) at (512) 438-2180.

DADS will review all requests to modify a negative PL1 if the referring entity does not send a corrected PL1 to the NF as requested. DADS will provide approval or denial of the request on Form 1013, Request to Change a Negative PASRR Level 1 (PL1), and return the form to the NF. All correspondence should be kept in the individual’s medical record.

Review PASRR Eligibility Annually

In addition to the resident review generated by a Minimum Data Set (MDS) for a resident with a mental illness (MI), an intellectual disability (ID), or a developmental disability (DD) who experienced a significant change in status, the NF should review the PL1 forms annually to verify the forms on file accurately reflect a resident’s PASRR status. Section C of the PL1 should be reviewed for individuals with a negative PL1.

If the NF, after reviewing the PL1, determines a negative status should be changed to a positive status, the NF submits DADS Form 1013, Request to Change a Negative PASRR Level 1 (PL1), to request authorization to submit a new PL1. Completed forms should be faxed to DADS at (512) 438-2180.

DADS will review all requests to modify a negative PL1. DADS will provide approval or denial of the request on Form 1013, Request to Change a Negative PASRR Level 1 (PL1), and return the form to the NF. All correspondence should be kept in the individual’s medical record.

Change of Ownership (CHOW)

If the NF undergoes a change of ownership (CHOW) and is issued a new provider contract number, the NF must submit new PL1s for all active PL1s within 90 days of receiving the new contract number.

In the event of a CHOW with a new contract number, the NF is the referring entity and creates new PL1s. The NF may use all records available including previously submitted PASRR evaluations (PEs) to complete the new PL1s. Individuals identified as PASRR positive by a PE should not be identified as negative on the new PL1. For previous positive PL1s with a corresponding negative PE, please email Cathy Belliveau, PASRR Senior Program Specialist, for further instructions.

The NF should not copy the PL1 from the old contract number to the new PL1 under the new contract number.

Nursing Facility to Nursing Facility Transfers

When an individual leaves one NF to reside in another NF, the sending NF is the referring entity to the receiving NF and completes a new PL1. The PL1 hard copy should be sent to the receiving NF with the individual at the time of admission. The sending NF should not copy the current PL1 to send to the receiving NF.

A NF must not admit an individual without a PL1. The NF should make sure it has a new PL1 at the time of admission. This includes ensuring the new PL1 has the new admission date and the correct admission type.