23 Miss. Code. R. 207-2.7 - Admission Requirements

A. A Pre-Admission Screening and Resident Review (PASRR) Level I must be completed to determine clinical eligibility for persons seeking admission to a Division of Medicaid certified nursing facility (NF) regardless of payment source except for the exclusions listed in Miss. Admin. Code Part 207, Rule 1.2.

1. The PASRR Level I must be submitted to the Division of Medicaid's Envision web portal upon completion. The completed PASRR Level I must be faxed to the Division of Medicaid if the provider is not a Mississippi Medicaid provider.

2. A person must receive a PASRR Level I numerical threshold score of fifty (50) or greater to be clinically eligible for NF placement, or be determined clinically eligible through a secondary review or physician's determination.

3. Persons with mental illness (MI), an intellectual disability/developmental disability (ID/DD) and/or a related condition (RC) determined to require a NF level of care must receive a PASRR Level II to ensure appropriate placement and the provision of necessary specialized rehabilitative services or supplemental services and supports regardless of payment source.

B. The PASRR Level I Section X summary, physician's admission orders for the persons immediate care, applicable communication form, and PASRR Level II, if required, must be submitted e lectronically by the admitting NF to the Medicaid Regional Office of the person's county of residence for determining Medicaid eligibility.

C. Persons seeking admission to a Nursing Facility for the Severely Disabled (NF-SD) must meet the following additional requirements:

1. Have a diagnosis of spinal cord injury, closed head injury, long-term ventilator dependency or another diagnosis similar or closely related to the severity and involvement of care of those diagnoses, and

2. Be assigned one (1) of the following Minimum Data Set (MDS) Resource Utilization Group (RUG)-IV 48 Grouper categories: ES3, ES2, HE2, HE1, HD2, HD1, HC2, HC1, HB2, HB1, LE2, LE1, LD2, LD1, LC2, LC1, LB2, LB1.

Notes

23 Miss. Code. R. 207-2.7

42 U.S.C. §§ 1395i-3, 1396r; 42 C.F.R. §§ 435.1010, 483.100-483.106, 483.112; 483.120; Miss. Code Ann. §§ 43-13-117, 43-13-121; SPA 15-004.

Revised to correspond to SPA 15-004 (eff. 01/01/2015); Amended 7/1/2015 Amended 6/1/2019