Advanced Group Determinations by Category

Advanced Group Determinations by Category A. Advanced group determinations by category permits the nursing facility (NF) to omit the PASRR Level II in certain circumstances that are time-limited or where the need for the NF is clear or the need for specialized services is unlikely provided that the person is not a danger to themselves or others, if their exempting conditions are documented, and the Appropriateness Review Committee (ARC), after reviewing this documentation, determines that a PASRR Level II is not required. B. Examples of categories include, but are not limited to: 1. Terminal illness, 2. Severe physical illnesses including, but not limited to: a) Coma, or b) Ventilator dependent, 3. Provisional admission pending further assessment in cases of delirium where a diagnosis cannot be made until the delirium clears, 4. Emergency protective services with a stay lasting no longer than seven (7) days, or 5. Very brief and finite stays of up to a fixed number of days to provide respite to in-home caregivers to whom the person with MI or ID/DD is expected to return following the brief NF stay. C. If the evaluator believes that the person would benefit from specialized services despite the presence of conditions considered to be in an exempted category, the evaluator must refer the person for a PASRR Level II. D. Findings for an advanced group determination must be documented in the PASRR Level I and must, at a minimum: 1. Identify the name and professional title of the person recommending the determination and the date of the recommendation, 2. Identify the specific condition(s) which qualifies the person for exemption from the PASRR Level II, 3. If applicable, describe the nature of any further assessment(s) needed to determine the most appropriate setting and/or specialized services for the person, 4. Identify, to the extent possible, based on the available information, NF services that may be needed, including any mental health, specialized services and/or specialized rehabilitative services, and 5. Include evidence to support the evaluator’s conclusions.