Get Preadmission Screening And - Fdhc State Fl

The Preadmission Screening and Resident Review (PASRR) Level I Screen is an essential document for individuals seeking admission to a Medicaid-certified nursing facility in Florida. This guide provides clear instructions on how to accurately complete the form online, ensuring all required information is provided to facilitate the screening process.

Follow the steps to fill out the PASRR Level I Screen effectively.

1. Press the ‘Get Form’ button to access the PASRR Level I Screen form and open it in your preferred online editor.
2. Begin by entering the individual’s demographic information at the top of the first page, including their name, date of birth, and insurance details. Ensure all entries are legible.
3. Indicate the individual’s current location by checking the appropriate box (e.g., hospital, home, nursing facility). If applicable, provide the information of a parent, guardian, or legal representative.
4. Input the Medicaid identification number and any other health insurance details if available. In the section titled ‘Requesting Admission to,’ list up to three potential nursing facilities.
5. Navigate to the second page and repeat the individual’s name and date of birth at the top. Fill out Section I, where you will assess and check the boxes regarding any history or suspicion of serious mental illness or intellectual disability.
6. Provide any necessary details regarding social services or medical support received related to mental illness or intellectual disabilities.
7. On Page 3, answer the indicators in Section II to help detail further conditions or diagnoses that may influence the decision-making process.
8. Continue to Page 4, where you will specify if the individual is being admitted provisionally or under a hospital discharge exemption, providing any requisite dates.
9. Complete Section IV by determining if the individual may be admitted to a nursing facility based on the findings from your screening.
10. Finally, if a Level II evaluation is needed, ensure that the form is signed by the screener and distributed to the appropriate offices. You can then save your changes, download or print the completed form for submission.

Begin completing your PASRR Level I Screen online today to ensure timely processing of the admission request.