Subpart C—Preadmission Screen- ing and Annual …

1 Centers for Medicare & Medicaid Services, HHS (iv) The facility's administrator or Incorporation of the 1987 edition of director of nursing. the Diagnostic and Statistical Manual (3) The notice specified in paragraph of Mental Disorders, 3rd edition, was (p)(2) of this section must include the approved by the Director of the Federal identity of each new individual or com- Register in accordance with 5 pany. 552(a) and 1 CFR part 51 that govern (q) Required training of feeding assist- the use of incorporation by reference. 1. ants. A facility must not use any indi- This mental disorder is.

2 Vidual working in the facility as a paid (A) A schizophrenic, mood, paranoid, feeding assistant unless that individual panic or other severe anxiety disorder;. has successfully completed a State-ap- somatoform disorder; personality dis- proved training program for feeding as- order; other psychotic disorder; or an- sistants, as specified in of this other mental disorder that may lead to part. a chronic disability; but (B) Not a primary diagnosis of de- [56 FR 48877, Sept. 26, 1991, as amended at 56 mentia, including Alzheimer's disease FR 48918, Sept. 26, 1991; 57 FR 7136, Feb.]

3 28, or a related disorder, or a non-primary 1992; 57 FR 43925, Sept. 23, 1992; 59 FR 56237, Nov. 10, 1994; 63 FR 26311, May 12, 1998; 68 FR diagnosis of dementia unless the pri- 55539, Sept. 26, 2003; 74 FR 40363, Aug. 11, 2009] mary diagnosis is a major mental dis- order as defined in paragraph (b)(1)(i)(A) of this section. Subpart C preadmission Screen- (ii) Level of impairment. The disorder ing and Annual Review of results in functional limitations in Mentally Ill and Mentally Re- major life activities within the past 3. tarded Individuals to 6 months that would be appropriate for the individual's developmental SOURCE: 57 FR 56506, Nov.

4 30, 1992, unless stage. An individual typically has at otherwise noted. least one of the following characteris- tics on a continuing or intermittent Basis. basis: The requirements of (A) Interpersonal functioning. The in- through governing the State's dividual has serious difficulty inter- responsibility for preadmission screen- acting appropriately and commu- ing and Annual resident review nicating effectively with other persons, (PASARR) of individuals with mental has a possible history of altercations, illness and mental retardation are evictions, firing, fear of strangers, based on section 1919(e)(7) of the Act.

5 Avoidance of interpersonal relation- ships and social isolation;. Applicability and definitions. (B) Concentration, persistence, and pace. The individual has serious dif- (a) This Subpart applies to the ficulty in sustaining focused attention screening or reviewing of all individ- for a long enough period to permit the uals with mental illness or mental re- completion of tasks commonly found tardation who apply to or reside in in work settings or in work-like struc- Medicaid certified NFs regardless of tured activities occurring in school or the source of payment for the NF serv- ices, and regardless of the individual's 1 The Diagnostic and Statistical Manual of or resident's known diagnoses.

6 Mental Disorders is available for inspection (b) Definitions. As used in this sub- at the Centers for Medicare & Medicaid Serv- part ices, room 132, East High Rise Building, 6325. (1) An individual is considered to Security Boulevard, Baltimore, Maryland, or have a serious mental illness (MI) if at the National Archives and Records Ad- the individual meets the following re- ministration (NARA). For information on quirements on diagnosis, level of im- the availability of this material at NARA, pairment and duration of illness: call 202 741 6030, or go to: http://. (i) Diagnosis.

7 The individual has a codeloflfederallregulations/. major mental disorder diagnosable Copies may be obtained under the Diagnostic and Statistical from the American Psychiatric Association, Manual of Mental Disorders, 3rd edi- Division of Publications and Marketing, 1400. tion, revised in 1987. K Street, NW., Washington, DC 20005. 69. VerDate Mar<15>2010 12:01 Nov 17, 2010 Jkt 220183 PO 00000 Frm 00079 Fmt 8010 Sfmt 8010 Q:\42\X42\ ofr150 PsN: PC150.