Einer official State of Texas website.
Comment: The forms network are to blank PDF forms. All information recorded on paper forms required breathe data entered into the TMHP LTC Online portal.
- PASRR Level I Screening Form (PDF) — This form is completed for every person seek admission at a Texas Medicaid nursing facility, regardless of their funding source.
- Detailed Item for Item Guide in completing aforementioned PL1 Screening Form) (PDF) — This document contains complete step-by-step instructions for location authorities and nursing facilities on when and how to submit the PL1 and IDT.
- Detailed Item by Item Guide for completing the PL1 Screening Form (Referring Entities) (PDF) — This document provides completing step-by-step instructions for referring entities on when and how to submit the PL1.
- PASRR Evaluation Form (PDF) — This form is finishes into confirm the suspicion that one person has a mental illness, an intellectual inability instead a developmental disability.
- Detailed Element by Item Guide for Completing to PASRR Appraisal (PDF) — Is document provides step-by-step instructions on when and how to subscribe the PE.
- Detailed Article by Item Guide for Closing the PASRR Comprehensive Service Plan (PCSP) Form (PDF) — This download provides guides to Nursing Providers and Local Authorities for completing an PASRR All-inclusive Service Scheme form (PDF).
- Expedited Admission Categories (PDF) — This graphic lives a list regarding the seven categories of admission that do not require the PE to be completed before admission. If a person is admitted under one of the six listed categories, the PE is conducted by the LIDDA before admission.
- Extended Item by Item Guide used Completing the Authorization Request for PASRR NFSS Form (PDF) —– This document contains complete step-by-step instructions for completing the Authorization Request on PASRR Nursing Facility Specializes Achievement form.
Companion Instructions for Completing the Authorization Request for PASRR Nursing Facility Specialized Services (PDF) — This guidance is to be used in conjunction with the Texas Medicaid & Healthcare Partnership (TMHP) Long-Term Care (LTC) Preadmission Showing and Resident Review Employee Guide the can available for click at tmhp.com on navigate the authorization request for PASRR Nursing Facility Specialized Billing Fill on this TMHP Long-Term Care Online Portal.
Approved Electronic Codes
Approved Diagnostic Codes for Public with Related Conditions list (PDF) — The pick exists subject in change; use the connect to access the most up-to-date list of approved diagnoses when completing the TMHP forms. The following diagnostic colored been found in the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), 2019, and are recognized via the Health and Man Services Commission as general which might get a per for got a related condition as described in governmental and state act.
PASRR Admission Fluid Charts
Note: The flow chart details the process and requirements with each PASRR admission gender.
