General NF Admission Requirements and Process in Ohio

It is important to start the research and planning process as soon as possible. It seems that it is never too early to review all of your planning options. It may sound silly, but planning for your golden years should probably start when you are in your 20's.

A great planning guide to help you along the way is available at Own Your Own Future

However, if you have waited until the last minute like so many people have, you can still obtain the help that you need. Options such as Home Care, Assisted Living Facilities, etc., are available to provide activities of daily living that you might need. Once it is determined that a Nursing Facility is a probability, it is important to gather as much information soon as possible. Many Nursing Facilities have waiting lists. Important aspects to consider are the rating the facility is given, its proximity to other family, and the type of care that is provided. You can contact the NF Admissions Coordinator to take a tour of the facility. During the tour, you can ask for a list of the deficiencies that the facility may have incurred.

Also, we have provided a couple of nice checklists for you to use when visiting a Nursing Facility. They are available at Checklist 1 and

Checklist 2.

Private Pay Admission

For individuals who are admitted to a NF from the Community (such as their home, apartment, assisted living facility, Hospital Emergency Room, etc.) under private pay or private insurance, certain paperwork is needed by the NF prior to admission. The individual's current Diagnoses, Medications, and Medical Treatment Protocol is needed and should be provided to the NF. The NF will forward this information and a completed PASRR (ODJFS 3622 -3622 to Preadmission Review at the local PASSPORT site for review.

The admissions coordinator at the NF should ask the individual or individual's representative information about a LTCC assessment. This information is available on LTCC worksheet.

However, if the potential NF resident triggers the Ohio PASRR Screen for Mental Illness or Mental Retardation/Developmental Disorder (MR/DD) the paperwork will need to be reviewed by another authority. If the authority approves the placement, the Preadmission Review Worker will then issue the approval to the NF for admission.

Medicaid Admission

For individuals who are admitted from the community to a Medicaid Certified NF under Medicaid payment, the process is different-

1. The person is required to have an assessment in the community prior to NF admission (Unless it is a true emergency). During the visit, the assessor (Nurse or Social Worker from PASSPORT Agency)will complete an ODJFS 3697 form 3697 and a PASRR Screen-PASRR. . Also, if the person is not already on Medicaid, a 7200 (Medicaid application) 7200 will also be completed at the assessment if it has not been completed as yet.

2. After the assessment, the worker will verify the individual's diagnoses and medications with the physician.

3. The 3697 form is faxed or mailed to the physician for signature.

4. Again, if the PASRR screen does not trigger for Mental Illness or MR/DD then further review is not required.

5. If the PASRR does trigger, the paperwork will be forwarded to another authority to review and evaluate the potential NF Admission (This process could potentially add another 2 weeks before a decision is made about the placement).

6. If further review is required and the individual is approved for placement, Preadmission Review will issue the approval for placement at the NF. Remember, the Physician must sign the assessment and at least a Pending Medicaid # is also needed before the final paperwork is faxed to the NF.

Emergency Private Pay Admission

If someone is in the community and an emergency admission is needed to a Medicaid certified NF, the same medical information should be provided to the NF as in the normal private pay admission placement. It is important to plan for such an event.

If a vulnerable person is residing alone or with a fragile spouse in the community, it is a good idea to keep up to date with the individual's and individual spouse's physician regarding current medical information. A good form to keep updated in case of emergency is a 3697. It can be accessed by going to 3697.

The NF will provide the medical information and a completed Ohio PASRR screen PASRR to the local PASSPORT site for their review. .The NF must explain the emergency situation as much as possible (such as loss of caregiver). A LTCC assessment must be considered as well. The LTCC form is available at LTCC Form. As long as the PASRR screen does not trigger for mental illness and/or MR/DD, the Preadmission Review worker will issue the approval for NF placement. If further review is needed, the paperwork will be forwarded to the state authority to obtain an approval for the emergency placement.

Emergency Medicaid Admission

1. The individual's health and safety are at risk and an immediate placement is needed in a Medicaid Certified NF. The reason for emergency needs to be clearly specified.

2. The person helping to initiate the placement can complete an ODJFS 3697 and ODJFS 3622. The physician (MD or DO only)will need to sign and date the certification statement at the bottom of page 1 of the 3697.

3. At least a pending Medicaid # is needed to issue a. If Preadmission Review is able to issue a PAS for admission to the NF, the individual can be admitted to the nursing facility. Within a few days or so, a nurse or social worker from the Preadmission Review site can complete an assessment of the individual at the nursing facility. The paperwork will be forwarded to the physician for a signature.

4. Once signed, and as long as the individual meets Intermediate Level of Care (which is needing assist with at least 2 activities of daily living like bathing, dressing, grooming, taking medications, etc; or requiring 24 hour supervision due to a cognitive impairment, like dementia) Preadmission Review can issue a level of care to the NF for Medicaid payment back to the date of admission. Remember, at least a pending Medicaid # is also needed.

5. If the PASRR screens happens to trigger for mental illness or an MR/DD related issue, the screen and medical information will need to be forwarded to the state authority to determine if an emergency admission is granted for NF admission. If approved, the state authority will issue the determination to Preadmission Review. Preadmission Review will either issue a PAS/LOC if 3697 and Medicaid # are available or PAS only (and then follow the procedure in #4 to complete the level of care).