Pennsylvania Code
Title 55 - HUMAN SERVICES
Part III - MEDICAL ASSISTANCE MANUAL
Chapter 1181 - NURSING FACILITY CARE
Subchapter D - NURSING HOME REFORM-STATEMENT OF POLICY
APPEALS OF ADVERSE DETERMINATIONS
Section 1181.562 - Adverse determinations
Universal Citation: 55 PA Code ยง 1181.562
Current through Register Vol. 54, No. 44, November 2, 2024
(a) OBRA-87 requires an appeal process for an individual adversely affected by determinations made in the preadmission screening process effective January 1, 1989. An adverse determination is one which denies or conditions the individual admission to the nursing facility. The preadmission screening process involves the following kinds of adverse determinations:
(1) Classification as an individual who is
subject to the preadmission screening process administered by the Department of
Aging under OBRA-87-not including the existing LAMP site review
process-including the issue of whether the individual is mentally ill, mentally
retarded or has a related condition (Form PA-PASARR-ID Appeals).
(2) Classification as an individual who may
not be admitted to a nursing facility (Form PA-PASARR-YN Appeals).
(b) The determination that an individual requires nursing facility services is not an adverse determination which is appealable under OBRA-87 or Department regulations.
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