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Revision 22-1; Effective Nov. 28, 2022
This section provides an overview of the PL1 Screening and its role in the PASRR process. The PL1 Screening form may be downloaded from the Texas Medicaid & Healthcare Partnership (TMHP).
2310 Purpose
Revision 22-1; Effective Nov. 28, 2022
The PL1 Screening form is designed to identify people suspected of having an MI, ID, or DD who are seeking admission to a NF. The PL1 screens for possible eligibility for PASRR specialized services and is the first step toward enabling people to be served per their unique needs.
2320 PL1 Screening Form
Revision 22-1; Effective Nov. 28, 2022
The PL1 Screening form contains the following sections:
- Section A:
- Submitter Information (NF and LA only) — Identifies contact information for the person submitting the PL1 into the LTC online portal.
- Referring Entity Information — Contains information about the person who performed the PL1 Screening.
- Section B:
- Personal Information — Contains information about the person who is being screened. This section also contains fields used to update the PL1 due to a death or discharge.
- Section C:
- PASRR Screen — Completed for all people seeking admission to a NF. The PL1 documents the suspicion of an MI, ID or DD based on information available to the RE.
- Local Authority Information — Documents information about the LIDDA, LMHA, or LBHA associated with the PL1 submission.
- Section D:
- Nursing Facility Choices — Documents the person’s or LAR's choice(s) of NFs for admission.
- Section E:
- Alternate Placement Preferences — Documents the person’s or LAR’s alternate placement preferences.
- Alternate Placement Disposition — Documents to which alternate placement program the person was admitted.
Note: See Section 2320.2, Positive PL1 for more instructions about how to complete Section E of the PL1 if positive.
- Section F:
- Admission Category — Documents the NF admission type for the person.
2320.1 PL1 Submission
Revision 22-1; Effective Nov. 28, 2022
Only LIDDA, LMHA, LBHA, or NF can submit the PL1 Screening form in the LTC online portal. Following successful submission, the LTC online portal will issue alerts based on the information in Section C of the completed form.
Note: When the PL1 is positive and the admission type is preadmission, the LIDDA, LMHA, or LBHA must enter the PL1 in the LTC online portal within three business days of receipt from the RE.
2320.2 Positive PL1
Revision 22-1; Effective Nov. 28, 2022
If the RE selects “Yes” to any of the fields in Section C, PASRR Screen, then the PL1’s status is considered positive for suspicion of an MI, ID or DD. A positive PL1 triggers an alert to the LIDDA, LMHA, or LBHA, or both, via the LTC online portal to proceed to the next step of the PASRR process — the PASRR evaluation (PE).
When the LIDDA, LMHA or LBHA receives a PL1 Screening form from the RE, the LIDDA, LHMA or LBHA must:
- Review the PL1 Screening form to confirm the RE has completed the required fields before submitting the PL1 screening form on the LTC Online Portal.
- If Section E fields E0100-E0400, or any other required field of the PL1 screening form, is not completed, the LIDDA, LMHA, or LBHA should contact the RE for the information needed to complete the required fields.
- Enter the information received for Section E fields E0100-E0400, which are enabled and required for the PL1 screening form to be submitted.
The nursing facility is responsible for entering the RE’s initial report in Section E of the PL1 if the admission type is exempted hospital discharge or expedited admission. If the person’s alternate placement preferences change after the PL1 submission, these changes should be documented in the PE, in the initial CLO done at the time of PE, and on the PCSP form.
Note: If the applicable “Section E” tab fields are not completed for a PL1 screening form submission, the PL1 screening form submission will not submit. The Texas Health and Human Services Commission made these system changes to ensure that the person’s alternate placement disposition is documented and available on the LTC Online Portal at the time of discharge.
2320.3 Negative PL1
Revision 22-1; Effective Nov. 28, 2022
If the RE selects “No” to all three fields in Section C, PASRR Screen, then the PL1 status is considered negative for suspicion of an MI, ID or DD. The NF admits a person with a negative PL1 screening and the PASRR process formally ends.
2320.4 Additional PL1 Responsibilities
Revision 22-1; Effective Nov. 28, 2022
LIDDAs, LMHAs and LBHAs are also responsible for inactivating a PL1 screening form when a person is either not admitted to the NF or passes away before being admitted to the NF. This is the only time LIDDAs, LMHAs, and LBHAs are responsible for inactivating a PL1 screening form.
To inactivate a PL1 screening form, the LIDDA, LMHA and LBHA must:
- Complete Section B fields B0650-0655 – Discharge or deceased.
- If field B0650 indicates that the person is deceased, then the Section E tab will not be enabled for data entry and the P1 screening form will submit.
- If field B0650 indicates the person was discharged, fields E0500-E0900 (Alternate Placement Disposition) are enabled and required for the PL1 Screening form to be submitted.
If the applicable “Section E” tab fields are not completed for a PL1 screening form submission or updated for a discharge, the PL1 screening form submission or update will not submit. The Texas Health and Human Services Commission made these system changes to ensure that the person’s alternate placement disposition is documented and available on the LTC Online Portal at the time of discharge.
2330 Admission Types
Revision 22-1; Effective Nov. 28, 2022
There are three types of NF admissions:
- exempted hospital discharge;
- expedited admission; and
- preadmission.
2330.1 Exempted Hospital Discharge
Revision 22-1; Effective Nov. 28, 2022
Exempted hospital discharge occurs when a physician has certified that a person being discharged from an acute care hospital is likely to need less than 30 days of NF services for the condition that the person was hospitalized. An example of this type of admission would be for a person who falls, breaks a hip and goes into the NF for rehabilitation services.
The RE (acute care hospital) provides the NF with a copy of the PL1. The NF enters the PL1 into the LTC online portal upon the person’s admission.
A person in this category with a positive PL1 only requires a PASRR evaluation if their stay in the NF exceeds 30 days. If the person's stay exceeds 30 days, the LTC online portal sends an alert to the LIDDA, LMHA, or LBHA to complete a PE.
2330.2 Expedited Admission
Revision 22-1; Effective Nov. 28, 2022
Expedited admission occurs when a person meets the criteria for any of the following seven categories:
- Convalescent Care
- Terminal Illness
- Severe Physical Illness
- Delirium
- Emergency Protective Services
- Respite
- Coma
The RE provides the NF with a copy of the PL1. The NF enters the PL1 into the LTC online portal upon the person’s admission.
The length of stay or the type of expedited admission determines when the LTC online portal sends an alert to the LIDDA, LMHA, or LBHA to complete a PE for a person. For example, a person admitted who is in a coma will not receive a PE until they regain consciousness.
2330.3 Preadmission
Revision 22-1; Effective Nov. 28, 2022
Preadmission occurs when admitting a person from a place other than an acute care hospital, such as a community setting like home, hospice, group home, psychiatric hospital or jail. If the RE is a family member, LAR, other personal representative selected by the person or an emergency placement source, the RE may request assistance from the LIDDA, LMHA, LBHA, or NF to complete the PL1.
If the PL1 is positive (see Section 2320.2, Positive PL1), the RE provides the LIDDA, LMHA, or LBHA with a copy of the PL1. The person may not be admitted to a NF until the LIDDA, LMHA, or LBHA completes a PE.
If the PL1 is negative (see Section 2320.3, Negative PL1), the RE provides the NF with a copy of the PL1 when the person presents at the NF for admission.
Medical necessity (MN) is the determination that a person requires the level of care provided at a NF. It is important to note that the information entered in the PE for a preadmission is used by TMHP to determine MN for a person whose PE is positive. An MN determination is critical for people who want to admit to a NF or divert from a NF admission and instead go directly into a community setting.
2340 Admission Type on PL1
Revision 22-1; Effective Nov. 28, 2022
A part of completing the PL1 requires the RE to determine the admission type or category based on the answers to Section F of the PL1 Screening form.
| Admission Type: | PL1 Completed By: | PL1 Submitted By: |
|---|---|---|
| Positive Preadmission | RE | LIDDA if positive for ID/DD, LMHA or LBHA if positive for MI |
| Negative Preadmission | RE | NF |
| Expedited Admission | RE | NF |
| Exempted Hospital Discharge | RE | NF |
| Change of Ownership (CHOW) | The old NF contract or vendor number becomes the RE to the new contract number. | The new contract number |
| NF to NF Transfers | The discharging facility becomes the RE to the admitting facility. | The admitting facility |
The LTC online portal determines admission type or category by responses in Section F of the PL1. If the response in F0100 is “0” (meaning No) and the response in F0200 is “0” (meaning not expedited admission), then the admission category is considered “preadmission” by default.
2350 PL1 Submission
Revision 22-1; Effective Nov. 28, 2022
After completing the PL1, the RE has the final responsibility to send the completed paper PL1 Screening form to the appropriate party for submission to the LTC online portal. The chart below summarizes which party the PL1 is sent depending on the admission type in Section F and positive or negative status in Section C of the PL1 Screening form.
| Admission Type: | PL1 Completed By: | PL1 Submitted By: |
|---|---|---|
| Positive Preadmission | RE | LIDDA if positive for ID/DD, LMHA or LBHA if positive for MI |
| Negative Preadmission | RE | NF |
| Expedited Admission | RE | NF |
| Exempted Hospital Discharge | RE | NF |
| Change of Ownership (CHOW) | The old NF contract/vendor number becomes the RE to the new contract number. | The new contract number |
| NF to NF Transfers | The discharging facility becomes the RE to the admitting facility. | The admitting facility |