Due to the current COVID-19 public health emergency, the Texas Health and Human Services Commission (HHSC) is asking all Nursing Facilities (NFs) to submit PASRR Positive PL1s a little differently than under normal circumstances.
For the duration of the public health emergency, any new PL1 for a PASRR positive resident must be submitted as an Exempted Hospital Discharge admission type.
Why it's important
Because of the public health emergency, local authorities are not able to visit NFs and conduct PASRR Evaluations (PEs) in a timely manner. Submitting a PL1 as Exempted Hospital Discharge (EHD) delays the requirement of a PE for 30 days, and allows TMHP to accept LTCMI forms without a PE on file. Submitting PASRR Positive PL1s as EHD will allow NFs to avoid missing out or delaying Medicaid reimbursement due to LTCMI rejections.
SimpleLTC form update
To help avoid any reimbursement delays and to assist with HHSC compliance, SimpleLTC has temporarily disabled the option to submit a PASRR Positive PL1 as Expedited Admission and will auto-populate the form as Exempted Hospital Discharge.
- “PASRR positive resident” refers to any resident who should have one or more “Yes” answers in section C of the PL1 for Mental Illness (MI), Developmental Disability (DD), or Intellectual Disability (ID)
- This is a temporary waiver that will extend for the duration of the public health emergency
- HHSC will notify NFs when the waiver is lifted and the emergency is over
- Preadmission PL1 forms that would normally be sent by the Referring Entity (RE) to the LA for submission should now be faxed directly to the NF and submitted as EHD
- This change does not affect PASRR Negative PL1 forms, which should be submitted as usual
- Referring entities (REs) should still be requested for a completed PL1 form when a resident admits to the facility
- If local authorities are unable to perform a PE after the extended time period of 30 days, HHSC will instruct them to ignore the alert to complete the PE; TMHP will still be able to accept LTCMIs if the 30 days pass
- Once the public health emergency is over, local authorities will begin working through the backlog of PL1 forms waiting for a PE
- HHSC will be monitoring the submission of PASRR Positive PL1 forms as EHD admissions
- For any NF going through a CHOW, new PL1 forms are still required for all residents; in cases for PASRR Positive residents the PL1 should also be submitted as EHD
As always, contact the SimpleLTC support team with any questions at firstname.lastname@example.org or at 469-916-2803.