0815.000.00 Vendor Eligibility

0815.025.05 Preadmission Screening Process

IM-59 June 25, 2015; IM-33 March 29, 2012; IM-117 October 24, 1997

Prior to placement in a MO HealthNet (MHN) certified bed, the potential resident’s attending physician completes the DA-124C. If the physician does not suspect the potential resident of being MR, MI, or DD the nursing facility may admit the resident without further screening. A copy of the DA-124C will be kept in the resident’s record at the nursing facility. If the resident requests MHABD vendor, the facility will submit a copy of the DA-124C with the DA-124A/B to COMRU for a level of care (LOC) certification. COMRU will enter the LOC on the DA 124 Inquiry Report screen (I124).

If the potential resident is suspected of being MR, MI or DD:

  1. The potential resident may not be admitted to the nursing facility unless they meet a valid special admission category. There are 5 special admission categories that would qualify a potential resident suspected of being MR, MI or DD to enter a NF prior to the Level II screening being completed. See form DA-124C for a list of special admission categories.
  2. If the potential resident does not meet a special admission category, the nursing facility, hospital, or attending physician sends the DA-124A/B and C forms to the Department of Health and Senior Services, Division of Senior and Disability Services, Central Office Medical Review Unit (COMRU).
  3. COMRU reviews the DA-124A/B and C forms and certifies if the individual is in need of the level of care (LOC) provided by a nursing facility.
  4. For individuals suspected of being MR, MI or DD, COMRU forwards the DA-124A/B and C forms to the Department of Mental Health (DMH) Division of Behavioral Health for a Level II screening.
  5. The DMH will notify COMRU if the individual may be admitted to the nursing facility.
  6. COMRU notifies the facility and the individual/responsible party of the decision, and enters the information on the DA-124 Inquiry Report screen (I124). When a Level II screening is completed, the FSD designee must receive a copy of the Level II Notification for FSD form (DA-625) prior to authorizing payment or denying vendor benefits.