Effective July 15, 2010, Ascend Management Innovations (DDM Ascend), in conjunction with the North Dakota Department of Health and Human Services (NDDHS), will begin using a revised screening form for North Dakota Level of Care (LOC) services. The North Dakota Nursing Facility Level of Care criteria have not changed. LOC screening is required for all ND Medicaid recipients receiving or applying for Medicaid funded Nursing Facility, Swing Bed, and waiver/other services, in addition to all individuals receiving a PASRR Level II evaluation.

Based on feedback Ascend received from providers, the LOC form has been changed to request more details for each criterion and to include specific instructions clarifying the information needed. The new form is designed to collect comprehensive information about the individual's medical needs and increase the efficiency of the LOC process. Additionally, the submission process has been tailored to meet the needs of the type of program for which it is submitted.

The new version of the LOC form can be found for download at www.PASRR.com under the ldblquote Print a Copy of the Formrdblquote icon. Instructions for completing the form as well as training videos are available on the website. Please take the time to review these materials.

The new version of the LOC screen can be submitted on-line at www.PASRR.com or via our toll-free fax at 877-431-9568. The older LOC form will not be accepted after August 31, 2010. All screens submitted on the old form will be returned to the referral source for completion on the new form at that time. Additionally, new LOC screens that are not completed in entirety will be returned to the referral source for completion.

If you have any questions or concerns, feel free to contact Connie Tanner, Operations Manager, at 877-431-1388 ext 3213 or via email at ctanner@ascendami.com.

Ascend has created two training videos in conjunction with ND DHS to explain Level of Care Criteria application. One video is directed at NF/Swingbed providers, and the other is directed at HCBS/Waiver providers. You can find links to the new videos in the Educational Information section below.

The videos are named:
Level of Care Criteria for Long Term Care Services: Explanation & Intent (HCBS/Waivers)
Level of Care Criteria for Long Term Care Services: Explanation & Intent (NF/Swingbed)

When you click the links, a new window will open and the videos will begin playing automatically.

North Dakota Emergency Screening Procedures

Date: 5/3/10

Tennessee is experiencing widespread flooding which has led the Governor to declare the State a disaster area. Ascend's offices have been temporarily evacuated. The following provides emergency screening procedures for NF/SB Level I, Level of Care, and Level II evaluations as well reviews for children under age 21.

Nursing Facilities and Swing Beds
1) Level I screens/Level II evaluations: www.pasrr.com remains operational. Continue to submit screens on-line. If a Level I screen is not approved through pasrr.com, the admitting NF must:
a. Ensure that the individual meets Medicaid LOC criteria.
b. Ensure that the individual does not present as a danger to himself or others and the behavioral health needs of the individual can be met.
c. Complete Level I and, if the individual is a Medicaid recipient, LOC screening procedures with DDM Ascend within 2 business days of DDM Ascend's resumption of operations. Medicaid will be retroactive to the date of admission. Please check www.pasrr.com for updates about Ascend operations.
" The individual will be authorized for up to 7 days as an emergency admission. It will be imperative that tracking information be submitted to alert Ascend of the admission location of the screened individual so that a follow up evaluation/screen can be conducted.

2) NF/SB Level of Care Screens: www.pasrr.com remains operational. Continue to submit screens on-line and these will be processed as soon as we resume operations. If the individual is a NF/SB applicant or a NF resident transferring outside of the 90 day screening period, the receiving facility must ensure that the individual meets Medicaid LOC criteria. DDM Ascend will complete LOC screening outcomes within 2 business days of DDM Ascend's resumption of operations. Medicaid will be retroactive to the date of admission. Please check www.pasrr.com for updates about Ascend operations.


Facilities Serving Children Under age 21
1) Acute Facilities: www.pasrr.com remains operational. Continue to submit screens on-line and they will be reviewed as soon as Ascend resumes operations. Acute facilities may use the emergency admission procedures and must:
a. Ensure that the individual meets acute admission criteria.
b. Complete the Certification of Need Process
c. Contact DDM Ascend within 2 business days of DDM Ascend's resumption of operations. Medicaid will be retroactive to the date of admission. Please check www.pasrr.com for updates about Ascend operations.
" The individual is authorized for up to 7 days as an emergency admission.

2) PRTF Facilities: www.pasrr.com remains operational. Continue to submit screens on-line and they will be reviewed as soon as Ascend resumes operations. PRTFs must:
a. Ensure that the individual meets PRTF admission criteria.
b. Contact DDM Ascend within 2 business days of DDM Ascend's resumption of operations. Medicaid will be retroactive to the date of admission. Please check www.pasrr.com for updates about Ascend operations.
" The individual is authorized for up to 7 days.

While it is our expectation that business operations will resume Tuesday, May 4, the decision to resume operations will be determined by the National Guard. Please continue to check www.pasrr.com for updates. We sincerely apologize for the disruption in operations and will resume services as soon as authorization is provided by State officials.

Effective 3/15/10 - Protocol for Flood Evacuees - Long Term Care Facilities

These procedures apply strictly to individuals displaced by flooding and detail required associated screening/evaluations from the Division of Medical Assistance, Barb Fischer.

New Admissions
For individuals admitted from community settings, the CON/Admission screening must be completed by day 10 by the receiving facility, with Ascend.

Transfer of indiviudals going from facility A to facility B and back to facility A:
Continued Stay Review requirements are waived for 30 days for individuals displaced by flooding. If an individual has a valid CON and is approved for treatment prior to flood evacuation and is moving form one acute facility to another (or one PRTF to another), a CSR is not required for 30 days after the individual's return to the original facility. If the individual is stll present in the original facility at day 31, screening requirements apply and days will not be covered by Medicaid, unless the individual has been reveiwed by Ascend.

Transfer of indiviudals going from facility A to facility B and who remain at facility B:
If an individual has a valid CON /admission screening and is approved for teatment prior to flood evaucation and is moving from one acute facility to another (or one PRTF to another), an admission screen is required immediately upon identification that the individual will not be returning to the original facility.

Level of Care screen types have changed.

• Per instruction from ND DHS, the TBI screen type is no longer available. Individuals previously screened under TBI should now be screened under HCBS.
  
• Tech Dependent has been added as a screen type for individuals receiving Technology Dependent Waiver Services.
  

The Tracking Form has been moved. You can now print a copy by clicking the purple printer labeled Print a Copy of a Form and then selecting Tracking Form.

Attention ND Users:

Good news! If you are entering a Level of Care (LOC) form for individuals who need Personal Care (PC) and Home and Community Based Services (HCBS), you can choose the type HCBS/PC and the system will only require you to enter the form once. You no longer are required to complete a separate LOC form for Personal Care (PC) and one for Home and Community Based Services (HCBS). Remember to choose type HCBS/PC when the individual is applying for BOTH services.

If you have any questions, please feel free to contact Ascend by clicking here or calling 877-431-1388 ext 3330.