The most common reasons for intervention through PASARR have been medication management and subsequent treatment of residents' behavioral disorders.
PASARR is listed as a continued service under the proposed Medigrant legislation, but what that legislation fails to address is how specialized or rehabilitative services will be handled.
While the company does not have any PASARR contracts, referrals can also arise from the required screenings and evaluations.
States cannot contract with NFs to conduct the required screenings, but a state's PASARR system can use NF-developed resident assessment (RA) data.
In fact, based on individual determinations, the PASARR rules require NFs to provide all psychiatric care below the "specialized services" level necessary to attain or maintain the "highest practicable physical, mental, and psychosocial well-being of each resident.
A state's PASARR evaluation report is expected to identify the mental health services provided by an admitting or retaining NF and the need for specialized services or for services of lesser intensity.
An appeals process is available to individuals who are denied admission to NFs and to NFs who might want to challenge a PASARR decision.
1~ The clear intent of the final PASARR rule is to end such neglect.
Somewhat at odds with this Congressional intent, however, is the interplay between PASARR and the institutions for mental diseases (IMD) rule.
HCFA doesn't see this as a serious problem, because it believes the PASARR process will effectively remove most individuals with serious mental illnesses from NFs to other treatment settings.
The psychiatric disorders specifically targeted by the PASARR
regulations include schizophrenia, paranoia, major affective and schizoaffective disorders, and atypical psychosis as defined in the DSM-III R.