Instruction manual for completing PASRR Level II Assessments

1 2013 Bock Associates Instruction manual FOR completing PASRR Level II Assessments [Created by Bock Associates for use in the State of Alabama.] TABLE OF CONTENTS Introduction .. 1 Chapter 1: Overview .. 3 Training Program .. 3 Historical Development of PASRR .. 4 Introduction to Bock Associates .. 6 Bock Associates Personnel .. 6 Stephen LoBello, PhD.. 6 Georgia Kaufman, RN .. 6 Debbie Britton, RN .. 7 Mary Mettel .. 7 Melissa Morris .. 7 Chapter 2: Basics .. 9 Timeframe for completing Assessments .. 9 Scheduling and Confirming Appointments.

2 9 Interview with the Individual .. 10 Assessment Types .. 10 General Instructions for completing Assessments .. 11 Photocopying .. 11 Halted Assessments .. 12 Aborted Assessments .. 12 Chapter 3: completing the PASRR Assessment .. 13 Identification .. 13 Social History .. 14 Hospital or Community Programs .. 14 Functional Assessment .. 14 Review of Medical Systems .. 15 Medical Criteria .. 16 Social Status and Developmental Needs .. 16 Behavioral Health .. 16 MI/ID Behavioral Assessment .. 17 Summary of Psychological and Adaptive Testing .. 17 IQ Tests.

3 18 Results of Psychiatric Testing .. 18 Evaulator s Recommendations .. 18 Evaluator s Certification .. 19 Chapter 4: Glossary .. 21 Bock Associates | Introduction 1 I NTRODUCTION The development of the Comprehensive ProFiler, attendant forms and collateral manuals has taken over fifteen years of research and development by many of the national leaders in geriatric medicine, nursing, social work, psychology and psychiatry. The validity and reliability of the instruments is based on conducting over 100,000 Assessments including such culturally diverse populations as Asian, African-Americans, Hispanic, Native-Americans, and numerous non-English speaking groups.

4 The field tested clinical protocols have been reviewed in three state CMS PASRR Implementation Reviews and found to meet all federal requirements. Our commitment to clinical superiority dictates that we use these protocols and attendant forms over checklists that may minimally meet federal criteria. We do so because we believe that our role is not only to determine nursing home eligibility, but also to contribute to individualized care planning, and thereby quality care. The assessment protocols are designed to accomplish the following four objectives: 1.

5 Provide information that will confirm or reject the presence of mental illness (MH), intellectual disability (ID), developmental disability (DD), or dual diagnosis (DU); 2. Validate the absence or presence of a qualifying exemption; 3. Determine an individual's current functional Level and medical conditions to support a Level of care determination; and 4. Determine an individual's current developmental strengths and weaknesses as the basis for a determination of the need for mental health/intellectual disability rehabilitation or specialized services.

6 The Comprehensive ProFiler instrument is the primary means for the assessor to collect descriptive medical, demographic and psychosocial data, interview results, assessor observations and historical information required by federal regulations. Assessments are subjected to a quality assurance program and are reviewed by a psychiatrist (MH/DUAL) or psychologist (ID/DD/DUAL) for a clinical interpretation before being submitted to the state for a final service determination. Bock Associates is committed to providing the Alabama OBRA Screening Office (OBRA) with a clinically sound, comprehensive approach that is in full compliance with all federal and state statutory and regulatory requirements and that meets the service needs of individuals who are mentally ill and/or /intellectually disabled/developmentally disabled in the State of Alabama.

7 Therefore, the following are four, primary points that you must remember as an assessor: 1. All information must be ACCURATE and LEGIBLE. 2. Based on hospital/nursing facility records, observations, and reports from the individual's family, guardian/legal representative and/or hospital/nursing facility staff, you are recording information that will be reviewed and interpreted by a clinician who has never met the individual and that will be used to determine the individual's need for nursing facility Level of care and for mental health/intellectual disability rehabilitation or specialized services.

8 Please review the assessment and make sure your documentation allows the clinician to see a complete and accurate picture of the client you saw. 3. An individual has the right to file a written appeal for reconsideration of a decision that he/she believes is not in her/his best interest. Appeals are conducted through administrative hearings that are not adversarial or punitive in nature and that seek to result in consensus. 2 Introduction | Bock Associates 4. We must maintain the highest Level of courtesy, professionalism and quality when interacting with individuals who are applying to reside or are residing in nursing facilities, their families and hospital/nursing facility staff.

9 Please present yourself in a manner that positively represents your profession, and do not bring your children, spouse, parents, or friends to the assessment site. Completion of Assessments is to be done in person with the individual who is applying for nursing facility placement. Due to the structure of the evaluation, and federal guidelines, a telephone interview with the individual does not constitute a completed evaluation. Bock Associates | Chapter 1: Overview 3 C HAPTER 1 : OVERVIEW TRAINING PROGRAM Each of the assessment tasks that are required under the Center for Medicare and Medicaid Services (CMS's) final rule for PASRR are within the traditional scope of practice in nursing, psychiatry, psychology and social work.

10 However, based on extensive experience in conducting statewide PASRR programs and on the results of CMS Implementation Reviews, Bock Associates understands that a comprehensive training program must be implemented to ensure that the demands of the PASRR program will be met. Bock Associates has developed a two-tiered comprehensive, project specific, eight hour training program that has proven to be effective in each of its state PASRR projects. The first tier of the training program includes Instruction by project personnel in a mandatory orientation workshop.