0815.000.00 Vendor Eligibility

0815.025.10 Verification of Preadmission Screening

IM-33 March 29, 2012; IM-117 October 24, 1997

If a MO HealthNet for the Aged, Blind or Disabled (MHABD) applicant or participant enters the facility on or after January 1, 1989, verify that the preadmission screening was completed and the date it was completed. Verification may be obtained by viewing the DA-124 Inquiry Report screen (I124). Print and file a copy of the report in the case record.

For individuals who must have a Level II screening, the date the DMH reaches a decision on proper placement is the date the preadmission screening is considered complete. If a Level II screening is indicated on the DA-124 Inquiry Report Screen, (Codes MI or MR), the FSD must receive a copy of the Level II Notification for FSD form (DA-625) prior to authorizing payment or denying vendor benefits.

If an individual transfers from a non-certified bed to a MHN certified bed whether or not the transfer is made within the same facility or a different one, the nursing facility must complete the Level I screening process. If a Level II evaluation is needed, this must be performed prior to transfer.

An individual transferred from an out-of-state nursing facility to a facility in Missouri must be screened under Missouri’s process prior to approval for MHABD vendor benefits. Therefore, a Level I and Level II screening, where applicable, must be performed before vendor benefits are authorized.

Do not delay authorizing approvals or changes to vendor benefits for verification of preadmission screening when no new DA-124C form is required. There is no need for a new DA-124C form when:

  • an individual is placed in a bed that is not MHN certified

NOTE: The Eligibility Specialist should explore MHABD Spenddown/Non-spenddown or Supplemental Nursing Care (SNC) as appropriate

  • a participant transfers from a MHN certified bed in one facility to a MHN certified bed in another facility
  • a participant is discharged from a MHN certified bed to a hospital and returns to a MHN certified bed, whether in the same or in a different skilled nursing or intermediate care facility
  • a participant is discharged from a MHN certified bed or hospital to home or other non-vendor living arrangement but returns to a MHN certified bed in the same or a different nursing facility within 60 days. If the period of time the individual is at home or in a non-vendor living arrangement is more than 60 days, another Level I screening (DA-124C) must be performed.