Understanding and Coding MDS 3.0 Item A1500: "Resident Evaluated by PASRR"

Understanding and Coding MDS 3.0 Item A1500: "Resident Evaluated by PASRR"

Introduction

Purpose:

MDS 3.0 Item A1500, "Resident Evaluated by PASRR," is a crucial element in ensuring that residents in long-term care facilities receive appropriate care tailored to their needs. PASRR (Preadmission Screening and Resident Review) is a federal requirement that mandates screening for individuals with serious mental illness (SMI) or intellectual disabilities (ID) before admission to Medicaid-certified nursing facilities. Proper coding of this item ensures compliance with federal regulations and helps to provide residents with the care and services they need.

What is MDS Item A1500?

Explanation:

MDS Item A1500 captures whether the resident has been evaluated by PASRR and, if so, whether they have been determined to have a serious mental illness, intellectual disability, or a related condition that requires specialized services. PASRR is a two-part process:

1. Level I Screening: Identifies individuals who might have SMI, ID, or related conditions.
2. Level II Evaluation: Conducted if the Level I screening indicates a potential for SMI or ID. This comprehensive evaluation determines whether specialized services are needed.

This item is critical for ensuring that residents receive the necessary mental health services and supports in the appropriate setting.

Guidelines for Coding A1500

Coding Instructions:

1. Identify PASRR Evaluation: Determine if the resident has undergone a PASRR Level I and, if applicable, a Level II evaluation. Check the resident’s admission records or consult with the facility’s admissions coordinator to confirm this information.

2. Response Coding:

   • Code 0 if the resident has not been evaluated by PASRR.
   • Code 1 if the resident has been evaluated by PASRR and determined not to have SMI, ID, or a related condition.
   • Code 2 if the resident has been evaluated by PASRR and determined to have SMI, ID, or a related condition.

3. Documentation: Maintain thorough documentation of the PASRR process, including the date of evaluation, the results, and any recommendations or specialized services provided as a result of the PASRR determination.

Example Scenario:

Ms. Johnson, a resident admitted to a long-term care facility, was screened through the PASRR process and determined to have a serious mental illness. For MDS Item A1500, this would be coded as 2, indicating that she has been evaluated by PASRR and identified as having a condition that requires specialized services.

Best Practices for Accurate Coding

Documentation:

• Ensure that all PASRR evaluations and results are clearly documented in the resident’s record, including any specialized services recommended as a result of the evaluation.

Communication:

• Coordinate with the admissions team, social workers, and mental health professionals to confirm the PASRR status of new admissions and ensure that necessary services are provided and documented.

Training:

• Train staff on the importance of the PASRR process, emphasizing the need for accurate documentation and coding to ensure compliance with federal regulations and the provision of appropriate care.

Conclusion

Summary:

Accurately coding MDS Item A1500 is essential for complying with federal PASRR requirements and ensuring that residents with SMI, ID, or related conditions receive the specialized care they need. Proper documentation and coordination among staff are key to maintaining the integrity of this process.

Click here to see a detailed Step-by-Step on how to complete this item set.

Reference

This information is based on the CMS's Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, Version 1.19.1, October 2024, Page 2-5.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item A1500: "Resident Evaluated by PASRR" was originally based on the CMS's Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, Version 1.19.1, October 2024. Every effort will be made to update it to the most current version. The MDS 3.0 Manual is typically updated every October. If there are no changes to the Item Set, there will be no changes to this guide. This guidance is intended to assist healthcare professionals, particularly new nurses or MDS coordinators, in understanding and applying the correct coding procedures for this specific item within MDS 3.0. The guide is not a substitute for professional judgment or the facility’s policies. It is crucial to stay updated with any changes or updates in the MDS 3.0 manual or relevant CMS regulations. The guide does not cover all potential scenarios and should not be used as a sole resource for MDS 3.0 coding. Additionally, this guide refrains from handling personal patient data and does not provide medical or legal advice. Users are responsible for ensuring compliance with all applicable laws and regulations in their respective practices.