[Code of Federal Regulations]

[Title 42, Volume 3]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR483.132]



[Page 541-542]

 

                         TITLE 42--PUBLIC HEALTH

 

  CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF 

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 483_REQUIREMENTS FOR STATES AND LONG TERM CARE FACILITIES--Table 

of Contents

 

 Subpart C_Preadmission Screening and Annual Review of Mentally Ill and 

                      Mentally Retarded Individuals

 

Sec. 483.132  Evaluating the need for NF services and NF level of 

care (PASARR/NF).



    (a) Basic rule. For each applicant for admission to a NF and each NF 

resident who has MI or MR, the evaluator must assess whether--

    (1) The individual's total needs are such that his or her needs can 

be met in an appropriate community setting;

    (2) The individual's total needs are such that they can be met only 

on an inpatient basis, which may include the



[[Page 542]]



option of placement in a home and community-based services waiver 

program, but for which the inpatient care would be required;

    (3) If inpatient care is appropriate and desired, the NF is an 

appropriate institutional setting for meeting those needs in accordance 

with Sec. 483.126; or

    (4) If the inpatient care is appropriate and desired but the NF is 

not the appropriate setting for meeting the individual's needs in 

accordance with Sec. 483.126, another setting such as an ICF/MR 

(including small, community-based facilities), an IMD providing services 

to individuals aged 65 or older, or a psychiatric hospital is an 

appropriate institutional setting for meeting those needs.

    (b) Determining appropriate placement. In determining appropriate 

placement, the evaluator must prioritize the physical and mental needs 

of the individual being evaluated, taking into account the severity of 

each condition.

    (c) Data. At a minimum, the data relied on to make a determination 

must include:

    (1) Evaluation of physical status (for example, diagnoses, date of 

onset, medical history, and prognosis);

    (2) Evaluation of mental status (for example, diagnoses, date of 

onset, medical history, likelihood that the individual may be a danger 

to himself/herself or others); and

    (3) Functional assessment (activities of daily living).

    (d) Based on the data compiled in Sec. 483.132 and, as appropriate, 

in Sec. Sec. 483.134 and 483.136, the State mental health or mental 

retardation authority must determine whether an NF level of services is 

needed.