1. OBRA & PAS Screens

2. OBRA
Omnibus Budget Reconciliation Act of 1987 (OBRA) is a federal regulation mandating that all patients/residents (age 18 and older) entering Medicaid/Medicare funded nursing facilities must receive a comprehensive assessment prior to admission.
The purpose of these assessments is to verify medical necessity for a nursing facility.
During this evaluation, a resident is given a DON score (Determination of Need), the minimum score needed to qualify for SNF services is 29

3. PAS Pre-Admission Screening is necessary for those patients with a:
Developmental Disability
Mental Illness
PAS screens are completed to determine the specific service needs and prevent inappropriate admissions to long-term care facilities
Level 2
Developmental Disability (prior to the age of 22)
Completed by DD PAS Agency
Level 3
Mental Illness (Excludes Dementia, DD, EtOH/Substance Abuse)
Completed by MH PAS Agency

4. Tracking & Collecting
In an effort to simplify the collection of OBRA screens, new protocols have mandated that when an OBRA is completed in the hospital, the screener/agency will provide a copy of the OBRA with the hospital discharge planner. Once the patient is discharged to a SNF, the hospital is responsible for sending a copy of the OBRA along with the patient.
We must be diligent in requesting and tracking all OBRA and PAS screens for all of our residents. Work closely with your local screening agency and be sure to request a post-screen if you are having trouble getting a screen for a particular patient.

5. Social Security Number
Tracking Form
Date of Admit
Patient Name
D.O.B.
Social Security Number
Admitted From
OBRA/PAS Agency
Date Requested
Date Received
11/2/15
John Doe
5/17/44
Kindred – Sycamore
Elder Care Services
11/3/15
11/4/15
Lisa Frank
6/24/30
OSF St. Anthony
VNA
11/6/15
11/8/15
Tom Smith
9/18/51
Home
POST requested from LSSI

6. No Screen = No Medicaid Payment
No OBRA?
If an OBRA screen has not been completed and the state catches this during survey, the building can be penalized and fined.
No Screen = No Medicaid Payment

7. However…
Once you have verified the screen has been completed by an agency, you can admit the Medicaid/Medicaid pending patient
Secure the screen ASAP – you don’t have to have it in hand to admit – if you verified it does exist
It may be at the prior nursing home
You have time to get the DON screen IF –
The payer is anything other than Medicaid
Request the post screen immediately
The agency can take 2 weeks to do the screen

8. Did you know…? OBRA screens are good for 60 days..
OBRA screens can transfer from facility to facility
Respite Care patients do not need an OBRA screen if the stay is 15 days or less.
Hospice does not require OBRA – however if patient improves and comes off hospice a screen will be needed

9. Post Screens When requesting POST screens, if the patient is:
Between the ages of 18 to 59 - the screen must be completed by the Division of Rehabilitation Services (DORS)
Age 60 and older - screens should be completed by your local Department of Aging
There are only three circumstances in which an OBRA screen will be back dated to the day of admission and/or the date a screen is requested:
1. Admission due to loss of caregiver
2. Out of state admission
3. Direct admission from the ER