Preadmission and Conversion Screening
Supportive Living Facilities (SLF)
||June 22, 2011|
Preadmission and Conversion Screening
The purpose of this notice is to ensure SLFs understand the processes relating to preadmission screens (PAS) and conversion screens.
The SLF must contact their PAS agent when a person plans to enter a facility. It is best to request a PAS as early as possible in order to not delay the admission due to scheduling problems with the PAS agent. In a non-emergency situation the PAS agent has ten days from the date of the request to complete the screen. A PAS is valid for 90 days from the date it is performed. A resident transferring from a nursing facility (NF) to a SLF, between SLFs or returning from a temporary absence does not require a PAS.
Documentation that a PAS has been performed and the person found appropriate for an SLF is a completed Form HFS 2536, Interagency Certification of Screening Results (pdf). This form is completed and dated by the agent performing the PAS. Generally, this date must be no later than the date of admission. Exceptions to this requirement are if a person is admitted: on an emergency basis due to loss of a caregiver; from a hospital emergency room/outpatient service; or from out of state. In these cases the SLF should contact the PAS agent as soon as possible. The agent has up to 10 days to perform the post admission screen but payment will begin the date of admission if otherwise eligible. Once the screen is completed the PAS agent must provide the SLF with the completed Form HFS 2536 and the Determination of Need (DON) within 10 days. If a person does not meet one of these requirements and is admitted to a SLF prior to the date recorded on the Form HFS 2536, payment will not begin until the PAS date.
A person must score a minimum of 29 points on the DON portion of the PAS to allow Medicaid payment. DON scores below 29 points indicate the person does not need the level of care provided in a SLF and payment will not be approved.
If the PAS identifies a potential mental illness or developmental disability, a Level II screen must be completed by the Department of Human Services Divisions of Mental Health or Developmental Disabilities. If a Level II screen determines the person has a serious and persistent mental illness or developmental disability the person will be determined to not be appropriate for SLF admission. The completed Form HFS 2536 or OBRA I will indicate if the person is determined appropriate for SLF.
A resident who entered a SLF as private pay and converted to Medicaid while in the SLF must have a screen performed at that point in time. This conversion screen will be performed by Healthcare and Family Services' Bureau of Long Term Care (BLTC) field staff. The SLF should contact their BLTC regional office to schedule a conversion screen when the resident becomes Medicaid-eligible. The date of the conversion screen may be later than the date of conversion but must be requested as soon as the SLF becomes aware the resident is Medicaid-eligible. The conversion screen is documented using Form HFS 2536, the same form used when a PAS is completed.
As with the PAS, a conversion screen requires a minimum of 29 points on the DON portion to allow Medicaid payment. Caution should be used when admitting a private pay person who does not score a minimum of 29 points on the DON due to the potential of not meeting the minimum score at the time of conversion after their assets are depleted. If a resident scores less than 29 points on the DON as part of a conversion screen payment will not be approved by HFS.
Transferring Between Facilities
A NF resident transferring to a SLF does not require a PAS. However, a SLF resident transferring to a NF must have a PAS unless a screen was performed within 90 days of the NF admission.
If a SLF is admitting a person from another facility it should attempt to obtain a copy of the original Form HFS 2536 from the discharging facility. If a copy is not available the SLF may use HFS 3864, Screening Verification Form (pdf), to request through their PAS agent verification that a PAS was completed prior to the previous admission.
Noncompliance with the PAS and conversion screening processes detailed above will result in findings and recovery of payments.
Questions regarding this notice may be directed to the Bureau of Long Term Care at 1-217-782-0545.
Theresa A. Eagleson, Administrator
Division of Medical Programs