PASRR - II. Definitions

Definitions include sources when applicable, in parentheses.

  1. CFR: Code of Federal Regulations.
  2. Change in Condition: a change in status, either physical or mental, which results in a decline or improvement in the mental health, intellectual disability status, or functional abilities of the resident, and is unexplained by the use of medication, a medication interaction, an acute illness or infection. The Change in Condition (CIC) review has replaced the requirement for an annual resident review.
  3. CIC: change in condition.
  4. CMR: Code of Maine Regulations.
  5. Code of Federal Regulations: the collection of rules and regulations of the Federal government. 42 CFR Ch IV, Subpart C governs the PASRR program. 
  6. Code of Maine Regulations: the collection of rules and regulations of the State of Maine. These include the licensing rules for NFs (10-144 CMR 110 or http://www.maine.gov/sos/cec/rules/10/ch101.htm) and the MaineCare Manual (10-144 CMR 101).
  7. Community NF: a Medicaid-certified nursing facility.
  8. Dementia: a clinical syndrome characterized by a decline in mental function of long duration in an alert individual. Symptoms of dementia include memory loss and the loss or diminution of other cognitive abilities, such as learning ability, judgment, comprehension, attention, and orientation to time, place and to oneself (from "Regulations Governing the Licensing and Functioning of Skilled Nursing Facilities and Nursing Facilities", 10-144 CMR 110, Ch. 23A2).
  9. Department of Health and Human Services: the MaineCare (Medicaid), mental health and intellectual disability authority for the State of Maine, the administrator of the Minimum Data Set (MDS) program and the licensing authority for NFs.
  10. DHHS: the Department of Health and Human Services.
  11. DSM: American Psychiatric Diagnostic and Statistic Manual, current edition.  Required by 42 CFR § 483.102(b)(1)(i) to identify and describe major mental illness. 
  12. Level II Assessment: the evaluation process that confirms the presence of a mental illness, intellectual disability, or other related condition, after which the assessor determines the need for specialized services, and makes recommendations for the provision of specialized services.
  13. Level I Screen: the preliminary screen conducted on all persons seeking admission to a Medicaid certified nursing facility (NF) or skilled nursing facility (SNF), to identify individuals with major mental illness, intellectual disability, or other related conditions.
  14. MaineCare Manual: the regulations governing the MaineCare (Medicaid) program in Maine, 10-144, CMR 101.
  15. Minimum Data Set (MDS): the State approved assessment instrument which is the current core set of screening, clinical and functional status elements forming the foundation for the comprehensive assessment of all residents in nursing facilities (from "Regulations Governing the Licensing and Functioning of Skilled Nursing Facilities and Nursing Facilities", 10-144 CMR 110, Ch 12A).
  16. Mental Health Authority: the Department of Health and Human Services (DHHS), the agency of state government authorized to make determinations of need for admission to a nursing facility, for individuals who have been identified as having a major mental illness.
  17. Mental Illness: a primary or secondary diagnosis of a mental disorder as defined in the American Psychiatric Association's Diagnostic and Statistic Manual of Mental Disorders (current edition), which does not include dementia (from "Regulations Governing the Licensing and Functioning of Skilled Nursing Facilities and Nursing Facilities", 10-144 CMR 110, Ch 1). See section III for more details.
  18. Intellectual Disability: a significantly sub-average general intellectual functioning (IQ score of 70 or below) existing concurrently with deficits in adaptive behavior, and manifested during the developmental period (from "Regulations Governing the Licensing and Functioning of Skilled Nursing Facilities and Nursing Facilities," 10-144 CMR 110, Ch 1; the American Association on Developmental Disability's Manual on Classification in Mental Retardation[1983]). See Section IV for more details.
  19. Intellectual Disability Authority: the Department of Health and Human Services (DHHS), the agency of state government authorized to make determinations of need for admission to a nursing facility, for individuals who have been identified as having an intellectual disability.
  20. Nursing Facility (NF): a facility licensed by DHHS to provide nursing services.
  21. Other Related Condition: a severe, chronic disability that meets all of the following conditions:
    1. It is attributable to
      1. cerebral palsy, or epilepsy; or
      2. any other condition, other than mental illness, found to be closely related to a developmental disability because this condition results in impairment of general intellectual functioning or adaptive behavior similar to that of persons with a developmental disability, and requires treatment or services similar to those required for these persons; and
    2. It is manifested before the person reaches age 22; and
    3. It is likely to continue indefinitely, and
    4. It results in substantial functional limitations (prior to age 22) in three or more of the following areas of major life activity:
      1. self-care,
      2. understanding and use of language,
      3. learning,
      4. mobility,
      5. self-direction,
      6. capacity for independent living.
  22. PASRR: Pre-admission Screening and Resident Review.
  23. Pre-Admission Screening: the procedure that screens each nursing facility applicant in order to ensure that individuals with mental illness, intellectual disabilities, or other related conditions require the level of care furnished by the facility. A part of the PASRR program.
  24. Specialized Nursing Facility: a nursing facility that has a specialized geropsychiatric nursing unit under contract with DHHS, to provide a higher level of care to residents whose severe mental health needs cannot be met by a regular nursing facility.
  25. Specialized Services: services that are provided in addition to the routine care provided by an NF that results in the continuous and aggressive implementation of an individualized plan of care for a mental illness, a continuous active treatment program for an intellectual disability or other related condition. These services are part of the State MaineCare (Medicaid) Plan.