Get Pasrr-id Level 1 Form 1-1-16

Filling out the PASRR-ID Level 1 Form 1-1-16 online is an essential step for nursing facility applicants. This guide provides a clear and supportive approach to help you navigate each section of the form with confidence.

Follow the steps to complete the form online.

1. Press the 'Get Form' button to obtain the form and open it for editing.
2. Fill in the demographics section. Provide the date the form is completed, the applicant's or resident's social security number, and their full name (last, first).
3. In the communication section, indicate whether the applicant requires assistance with communication by selecting 'Yes' or 'No.' If 'Yes,' provide details.
4. Proceed to Section II, regarding neurocognitive disorders. Answer the questions related to the diagnosis of NCD, and provide corroborative testing information if applicable.
5. Move to Section III to answer questions about serious mental illness. Provide diagnosis details, recent treatments, and any significant life disruptions experienced by the individual.
6. In Section IV, assess for intellectual disabilities. State if there is evidence of an ID diagnosis and provide relevant history.
7. Complete Section V concerning other related conditions. Specify any diagnoses that occurred prior to age 22 and check any substantial functional limitations.
8. Fill out Section VI regarding home and community services, answering whether the individual or family has been informed about available services.
9. Section VII addresses exceptional admission criteria. Indicate if the individual qualifies and check the appropriate boxes for exemption.
10. Conclude with Section VIII, indicating the screening outcome and whether further evaluation is necessary.
11. Finally, in Section IX, the individual completing the form must print their name, date, and signature, and include the facility name and telephone number.
12. After filling out the form, save your changes before downloading, printing, or sharing the completed document.

Complete your documents online to ensure timely submission and compliance.