Referring Entity FAQs

Referring Entity (RE) PASRR Responsibilities General Overview

  • Complete the PL1 Screening Form (PL1) for everyone being recommended for admission into a Medicaid Certified NF.
  • Send negative, Expedited Admission and Exempted Hospital Discharge PL1's to NF with the individual upon hospital discharge.
  • Fax Preadmission positive PL1's to appropriate Local Authority (LA/LMHA).

General hospital questions

I have never heard of the changes in the PASRR process and I need immediate assistance.
From 2009 to the present, DADS, DSHS, and TMHP have worked collaboratively in an inter-agency work group with external stakeholders, including the Texas Hospital Association. The PASRR Program is under the Purview of the Department of Aging of Disability Services (DADS). The Texas Administrative Code at the following website: http://texreg.sos.state.tx.us/public/readtac$ext.ViewTAC?tac_view=4&ti=40&pt=1&ch=17

Texas Department of State Health Services (www.dshs.state.tx.us) has a robust PASRR web page with extensive information and training specifically for hospitals as a Referring Entity with new roles and responsibilities in the PASRR process. DSHS Regulatory Division and the Texas Hospital Association have sent out monthly newsletters and regular email blasts on the changes since the fall of 2012. DSHS is currently presenting weekly webinars to train and educate the hospital community. Please visit the DSHS PASRR website for webinar registration and other useful information at: www.dshs.state.tx.us/MHSA/PASRR.

Who needs the PL1?
Every individual seeking admission into a Medicaid certified nursing facility, regardless of funding source requires the PL1 Screening form to be eligible for admission to the NF.

Do veterans need the PL1?
Yes, Every individual being referred for NF care must have the PL1 form entered into the LTC portal to be eligible for admission to the NF, regardless of funding source.

Who is responsible for completing the PL1?
The PL1 is always to be completed by the RE. The RE is the first entity that recommends or refers the individual for NF placement. In most cases the RE will be the hospital. The RE can also be family, law enforcement, a physician's office, or other community care agency.

Who do I fax the PL1 form to?

  • Expedited Admissions, Exempted Hospital Discharges and negative PL1's are sent directly to the NF with the individual in the transfer packet.
  • If the individual is Preadmission positive (individual is suspected of having MI, ID, or DD and is not Expedited or Exempted) the RE completes a paper copy of the PL1 form and faxes the form to the LA.

Where can I find a copy of the form?
Go to http://www.tmhp.com/Pages/Medicaid/medicaid_forms.aspx , select 'Long Term Care Programs', and click on 'PASRR Level I Screening Form'.

Can the NF come to the hospital to do the PL1?
The NF should not complete the PL1 as this is the responsibility of the RE. The NF completing the PL1 creates a conflict of interest for individual choice in residential placement. NF participation in completion of the PL1 at hospitals is a violation of the PASRR processes and may be subject to non-compliance sanctions.

What do we do if a NF won't take a resident who doesn't need a PL1?
Complete the PL1 as Texas Administrative Code and federal regulations require RE's to comply with this process.

CFR:
http://www.gpo.gov/fdsys/pkg/CFR-2010-title42-vol5/pdf/CFR-2010-title42-vol5-sec483-100.pdf

TAC:
http://texreg.sos.state.tx.us/public/readtac$ext.ViewTAC?tac_view=4&ti=40&pt=1&ch=17

Updated: February 1, 2016