1. Networking with NAPP Webinar Tuesday, January 26, 2016 National Association of PASRR Professionals NAPP Host: Brandon Sturgill

2. Re-cap www.pasrr.org 2 PASRR Technical Assistance Center (PTAC) Discussed Quality of Life for Nursing Facility Residents

3. POLL www.pasrr.org 3 Are you a: Medicaid Agency State Authority (MI) State Authority (ID) Local Level/ Provider Other/ (Consultant/ Private)

4. National Perspective www.pasrr.org 4 www.cdc.gov/nchs/hus/contents2014.htm#101

5. Nursing Facility Environment www.pasrr.org 5

6. Percentage of Users of Long-Term Care Services with a Diagnosis of Depression www.pasrr.org 6 Morbidity and Mortality Weekly Report (MMWR)

7. CFR Requirements on QOL § 483.15 Quality of life. www.pasrr.org 7 (a) Dignity. (b) Self-determination and participation. (c) Participation in resident and family groups. (d) Participation in other activities. (e) Accommodation of needs. (f) Activities. (g) Social Services. (h) Environment. A facility must care for its residents in a manner and in an environment that promotes maintenance or enhancement of each resident's quality of life.

8. Objective: Relate Concepts Directly to PASRR www.pasrr.org 8 Can PASRR be utilized as a tool to improve quality of life (QOL) for nursing facility residents? How can PASRR be utilized to improve QOL? Is improving QOL a PASRR function? Who is responsible? How do we know PASRR activities are actually making a difference in QOL?

9. Can PASRR be utilized as a tool to improve quality of life (QOL) for nursing facility residents? www.pasrr.org 9 Yes No Uncertain

10. How can PASRR be utilized to improve QOL?

11. Significant Change in Condition Requirement PL 104-315 www.pasrr.org 11 (a) REQUIREMENT FOR NOTIFICATION OF STATE AUTHORITY.— Section 1919(b)(3)(E) of the Social Security Act (42 U.S.C. 1396r(b)(3)(E)) is amended by adding at the end the following: ‘‘In addition, a nursing facility shall notify the State mental health authority or State mental retardation or developmental disability authority, as applicable, promptly after a significant change in the physical or mental condition of a resident who is mentally ill or mentally retarded.’’ www.congress.gov/104/plaws/publ315/PLAW-104publ315.pdf

12. §483.120 Specialized Services www.pasrr.org 12 Is directed toward diagnosing and reducing the resident's behavioral symptoms that necessitated institutionalization, improving his or her level of independent functioning, and achieving a functioning level that permits reduction in the intensity of mental health services to below the level of specialized services at the earliest possible time.

13. PASRR Monitoring & Quality Assurance www.pasrr.org 13 Quality Control of PASRR Determinations and Summary of Finding Recommendations Monitoring NF’s to Assure Recommendations/Findings are Integrated Into Care Planning

14. Anti-psychotic Drug Use- OIG/HHS Report 2011 www.pasrr.org 14 14% of elderly nursing home residents had Medicare claims for atypical antipsychotic drugs. 83% of Medicare claims for atypical antipsychotic drugs for elderly nursing home residents were associated with off-label conditions 51% of Medicare atypical antipsychotic drug claims for elderly nursing home residents were erroneous, amounting to $116 million. oig.hhs.gov/oei/reports/oei-07-08-00150.pdf

15. Education & Outreach www.pasrr.org 15 ConferencesTargeted TrainingTechnical AssistanceProactive Outreach

16. Relationship with State Survey Agency www.pasrr.org 16 Make an introduction Explain the importance of PASRR Get buy-in Build a relationship Share data Collaborations with the state survey agency

17. www.pasrr.org 17 How do we know PASRR activities are actually making a difference in QOL?

18. Are your PASRR determinations effective? www.pasrr.org 18 Should the states consider a more aggressive approach to ensuring PASRR compliance? What about using MDS to locate target populations (MI & RC versus SMI & ID)? Teaming up with the Medicaid authority and state survey agency? MFP liaison? PASRR recommendations/findings integrated into care planning?

19. Innovation Should Never Stop www.pasrr.org 19 Leverage technology to continuously improve your processes. There is nothing that says you can’t exceed the federal requirements for PASRR.

20. Annual Meeting www.pasrr.org 20 NAPP will hold an Annual Meeting for members only on January 28, 2016, 11:00 AM - 12:30 PM central time. Please mark your calendars and plan to join us! The Annual Meeting will include: Committee Reports from each working NAPP committee Update on the State of the Association NAPP Successes and Challenges Results of new Board of Directors member election for 2016 Other issues to be identified by our members

21. NAPP member? Did not receive the invite? www.pasrr.org 21 nappfrontdesk@pasrr.org

22. Thank you for your participation! www.pasrr.org 22 www.pasrr.org