We’ve worked with DADS to get answers to your top IDT questions
Beginning July 7, 2015, Texas nursing facilities must begin documenting PASRR Interdisciplinary Team (IDT) meetings for PASRR-positive residents via a new IDT form. We’re happy to announce that SimpleCFS™ supports the new IDT requirements so that customers can easily complete IDT processes without interrupting their workflow.
On July 7, SimpleLTC hosted a free webinar for several hundred Texas providers, which was led by Cathy Belliveau, Senior PASRR Program Specialist with DADS. Webinar participants asked dozens of specific questions, some of which we could not cover on the call due to time limitations.
We've worked with DADS to get answers to all those questions and are posting them here. We'll continue to update this document as we obtain more information.
1) If we have issues with the LA/LMHA not being able to meet upon the NF request and they want to reschedule, what support will the NF receive from DADS to prevent the burden of the NF to reschedule the IDT meeting?
Keep a copy of your contact with the LA/LMHA and document efforts made to schedule their attendance. Contact the DADS PASRR unit at 855.435.7180 if you’re unable to get the LA/LMHA to attend.
2) Will we be allowed to have an IDT meeting at 14 days with the LA/LHMA and then again at Day 21 without a penalty.
The IDT is a required PASRR meeting. The 21-day meeting is your Care Plan meeting. Both meetings are required.
3) Who pays for specialized services? If they are covered by an HMO, they require an authorization. This could take longer than 30 days to obtain as the facility has no control over the HMO process.
PASRR services are carved out of the HMO requirements.
4) We have two residents for whom a specialized wheelchair has been recommended. We are unable to find a DME in our county who can make the wheelchair, as they say they currently do not have a contract with DADS.
The NF arranges for the DME providers. DME providers are not contracted by DADS. If your NF is unable to locate a provider of DMEs in the local area, you will need to reach outside of the area to locate a provider.
5) Have the Local Authorities been educated on their part in the IDT process, so they can assist and encourage the NF to have this meeting?
Yes, the LA/LMHAs have been trained. DADS sent out provider letters and held several webinars regarding this new requirement.
6) Are all PASSRs-positive residents required to have an IDT meeting? How do we know who has specialized services or positive PASSR?
All PASRR-positive individuals who were confirmed positive by a PASRR Evaluation (PE) should have an IDT meeting conducted. All individual records have to contain a copy of both the PL1 and PE. PEs are conducted by the LA/LMHA and entered into the TMHP database.
- SimpleCFS users: To simplify the process of finding which PL1 forms are awaiting IDT form submission, SimpleLTC has created a report entitled, "PL1 Awaiting IDT Submission". You can find it on the Reports page.
- TMHP portal users: Search the MDS 3.0 Comprehensive FSI function. This report can be run to identify anyone in your facility who is PASRR-positive.
7) Do we do the IDT form for PASRR every time we do a quarterly IDT on our NF residents?
The IDT is only the initial meeting. You are required to review Specialized Services at least annually and you should use the IDT form to record any changes to Specialized Services on that form.
8) How does the NF know when the LA has completed the form in order to print?
There is not currently a TMHP portal alert to notify you when the LA/LMHA has certified the IDT. The LA/LMHA has three days to certify the IDT. It’s recommended that you check the IDT status after a week to print the fully initiated IDT. Contact the DADS PASRR unit at 855.435.7180 if the LA/LMHA hasn’t certified the IDT a week after you’ve entered it.
9) How often are IDT meetings required?
Initially, and then a review of Specialized Services at least annually.
10) If a significant change MDS is done on a resident, does the IDT meeting need to be conducted again with LA representative and the form done again, or is this only for new admission PASRR-positive residents?
Only if the significant changes warrant a new PASRR Evaluation by the LA/LMHA and the Specialized Services are modified as a result of the new PE.
11) If the resident requires PT/OT/ST services, does the NF provide the therapist or are they provided by someone else?
The NF provides the therapist. Keep in mind that Medicaid provides additional funding for PASRR positive (PE) individuals who are Medicaid eligible. This funding is in addition to your daily rate payments.
12) If we have a resident who was PASRR-positive before July 7, 2015, are we are not required to do the IDT? Even in conjunction with their quarterly care plan meetings?
The IDT is required from July 7, 2015 forward for anyone who had an IDT on that date or after. Anyone already in your facility should have an update done and information added to the IDT screen at least annually.
13) If we are completing these annually, do we need to complete these with significant changes as well?
See the answer to #10
14) Is family attendance required? Who invites the family?
A Legally Authorized Representative (LAR) is authorized by law to act on behalf of the resident, e.g., parent, guardian, etc. (see §415.303). LARs are required to be invited by the NF as they are for any meeting concerning the care of the individual. Family members are normally invited but are not necessarily required unless they are listed as the LAR.
15) Is the IDT form required to be on the resident's chart
16) What about PASRR-positive patients who come in on Medicare and we click the button at the bottom for not expedited less than 30-day stay? Does this still need to be done by day 14 or when they stay past the 30 days?
The IDT will only be held after the PE has confirmed the individual to be PASRR-positive. If the individual has left on or before the 30th day, the NF should enter the discharge date and the discharge event on the PL1 (sections B0650 and B0655). Once this information has been entered, the alert to conduct a PE that was sent to the LA/LMHA will stop and cancel the requirement to conduct the IDT as well.
The NF should also use sections B0650 and B0655 to enter information if an individual is in the NF for respite and leaves on or before the 14th day.
All PASRR positive individuals* (regardless of funding) should have an IDT meeting. At that meeting, if the individual does not have Medicaid, this should be noted in the comment section. If Medicaid is available for the individual at a later time, the IDT can be held again to go over Specialized Services the individual is now eligible for.
17) If a resident comes in to our facility for short term and has the 30-day exemption, do we still do the IDT or wait to see if they remain in the facility after 30th day?
18) What if the resident is PASRR-positive and the NF has not received any contact from the LA/LMHA?
The PL1 may be positive but the individual is not considered positive unless the LA/LMHA does the PE to confirm the individual meets the requirements for IDD or MI. The LA/LMHA has seven days from the date they receive an alert to conduct the PE. Note that if the individual is in the NF for Exempted Status (30 days or less), the alert to the LA/LMHA will not be sent unless the individual remains in the NF after the 30th day. If the individual is there for Respite, the alert to the LA/LMHA will not be sent unless the individual remains in the NF after 14 days.
See # 16 for the importance of entering the discharge information on the PL1.
If the PE has been completed and it confirmed that the individual is PASRR positive and the NF is unable to reach the LA/LMHA to schedule the IDT, the NF may contact the PASRR unit at 1 855 435-7180.
To locate the LA/LMHA for your area, click here.
19) What if the resident is admitted skilled part A? Do we still follow date requirements for day 14, etc.?
All PASRR positive* individuals (regardless of funding) should have an IDT meeting. At that meeting, if the individual does not have Medicaid, this should be noted in the comment section. If Medicaid is available for the individual at a later time, the IDT can be held again to go over Specialized Services the individual is now eligible for.
* This means PE Confirms positive (not just PL1 is positive)