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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 - Facilities Serving Children Under Age 21

These procedures apply strictly to individuals displaced by flooding and detail required associated screening/evaluations per instructions 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 individuals 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, or by the fifth day following the date Facility A first accepts any patient from the evacuation.

Facility A relocated to another building: For individuals requiring Continued Stay Reviews, 5 additional working days are approved to complete the review.